The Female Brain (21 page)

Often when I see a couple who are not communicating well, the problem is that the man’s brain circuits push him frequently and quickly to an angry, aggressive reaction, and the woman feels frightened and shuts down. Ancient wiring is telling her it’s dangerous, but she anticipates that if she flees she’ll be losing her provider and may have to fend for herself. If a couple remains locked in this Stone Age conflict, there is no chance for resolution. Helping my patients understand that the emotion circuits for anger and safety are different in the male and female brains is often quite helpful.

A
NXIETY AND
D
EPRESSION

Sarah came into the office one day shaking. She and Nick had been fighting over the woman he was flirting with in his office. Sarah was convinced Nick had flirted right in front of her that weekend at a dinner party. Whenever he cut off the discussion and left the room, a videotape seemed to lock Sarah’s mind into watching the divorce, the division of assets, and the assignment of child custody; saying goodbye to his family; and leaving town. She was having a hard time focusing; she was on alert for the next fight and was becoming sure that their marriage was collapsing.

It wasn’t true. Nick was making a big effort, but the arguing was leaving Sarah’s brain in acute neurochemical distress. All her brain circuits were on red alert. Nick seemed unperturbed, playing his regular Wednesday night game of hoops. He didn’t seem awkward around her at home, yet she was losing sleep, crying all day, and becoming increasingly hopeless. According to Sarah’s reality, the world was coming to an end, but Nick seemed to be showing complete indifference.

Why was Sarah feeling unsafe and afraid while Nick was not? Males and females have different emotional circuitry for safety and fear reinforced by our particular experiences in life. The feeling of safety is built into the brain’s wiring, and scans show that girls’ and women’s brains activate more than men’s in anticipation of fear or pain. According to research at Columbia, the brain learns about what is dangerous when its fear pathways are activated and about what is safe when its pleasure-reward circuits fire. Females find it harder than do males to suppress their fear in response to anticipation of danger or pain. This is why Sarah was freaking out at home alone.

Anxiety is a state that occurs when stress or fear triggers the amygdala, causing the brain to rally all its conscious attention to the threat at hand. Anxiety is four times more common in women. A woman’s highly responsive stress trigger allows her to become anxious much more quickly than does a man. Although this may not seem like an adaptive trait, it actually allows her brain to focus on the danger at hand and respond quickly to protect her children.

Unfortunately, this intense sensitivity in adult women, as in teenage girls, means that they are nearly twice as likely as men to suffer from depression and anxiety, especially through their reproductive years. This troubling phenomenon exists across cultures, from Europe, North America, and Asia to the Middle East. While psychologists have emphasized cultural and social explanations for this “depression gender gap,” more and more neuroscientists are finding that sensitivity to fear, stress, genes, estrogen, progesterone, and innate brain biology play important roles. Many gene variations and brain circuits that are affected by estrogen and serotonin are thought to increase women’s risk of depression. The CREB-1 gene, which is different in some women diagnosed with depression, has a little switch that is turned on by estrogen. Scientists speculate that this may be one of several mechanisms by which women’s vulnerability to depression turns on at puberty with the surges of progesterone and estrogen. Estrogen’s effects may also explain why three times more women than men suffer from the “winter blues,” or seasonal affective disorder. Researchers know that estrogen affects the body’s circadian rhythm, the sleep and wake cycle stimulated by daylight and darkness, triggering these “wintertime blues” in genetically vulnerable women.

Every year scientists are locating more gene variations related to depression that run in certain families. Another gene, called the serotonin transporter gene—or 5-HTT—also seems to trigger depression in females who inherit a particular version of it. Scientists speculate that this gene variation may contribute to making depression more common in women, because its switch is triggered by threats and severe stress. This may have been the situation in Sarah’s case—she came from a family with a history of depression only in the female members. As I know from the many women who come to my clinic, it is often the severe stress caused by the loss of a relationship that pushes genetically vulnerable women over the edge into a clinical depression. Other hormonal events—pregnancy, postpartum depression, premenstrual syndrome, perimenopause—can also disrupt the female brain’s emotional balance, and during a rough period a woman may need chemical or hormonal rebalancing.

K
NOW THE
D
IFFERENCE

As both men and women grow into middle and older ages, gain more life experience, and feel more secure, they often become more comfortable expressing a fuller range of emotions, including those—for men especially—they have long suppressed. But there’s no getting around the fact that women have different emotional perceptions, realities, responses, and memories than do men, and these differences—based on brain circuitry and function—are at the heart of many interesting misunderstandings. Evan and Jane came to see each other’s realities. When she broke down crying out of the blue, he tried to figure out if he was being unresponsive in some way. When she was tired and didn’t want to have sex, he fought his instincts and took her at her word. When he became irritable and possessive, she realized she hadn’t been sexually attentive enough. And just as they had come to understand each other, it was all about to change. There was still one major shift to come in the female reality.

SEVEN

The Mature Female Brain

S
YLVIA WOKE UP
one day and decided, this is it. I’m done. I want a divorce. It had become clear to her that her husband, Robert, was unavailable and ungiving. She was tired of listening to his tirades and fed up with his demands. But what really pushed her over the edge was when she found herself in the hospital for a week for an intestinal blockage and he visited her only twice. Both times he came to ask questions about running the house.

At least this is how Sylvia, an attractive woman with brown hair, bright blue eyes, and a spring in her step, explained it to me during a therapy session. Since her early twenties, she felt she had spent most of her time taking care of needy, self-absorbed people. She had fixed their problems, pulling them out of alcoholism or abusive situations, and in return they had sucked her emotionally dry. At age fifty-four, she was still very attractive and felt full of energy. What astounded her more than anything was that she felt as though a haze had lifted recently, and she could see in a way she hadn’t been able to before. The tugs she used to feel at her heartstrings to rescue and care for others had all but vanished. She was ready to take some risks and start walking in the direction of her dreams. “What is it about my life that isn’t working?” she asked. “I want more out of my life than this!” For years she had cooked and cleaned and raised three children as a stay-at-home mother. Though she had yearned to work, Robert had made it impossible by denying her household help. For twenty-eight years she had chauffeured, nurtured and loved their children, made sure homework was done, dinner was eaten, and the house didn’t fall apart. Now, out of nowhere, she found herself asking, Why?

Sylvia’s story has become an all too familiar rite of passage: the menopausal woman chucking everything, and everyone, and starting over, especially now that 150,000 American women per month are entering this phase of life. It’s a process that seems baffling to the premenopausal woman and has shocked more than a few husbands. A menopausal woman becomes less worried about pleasing others and now wants to please herself. This change has been looked at as a moment of psychological development, but it is also likely triggered by a new biological reality based in the female brain as it makes its last big hormonal change of life.

If we took our MRI scanner into Sylvia’s brain, we’d see a landscape quite different from that of a few years before. A constancy in the flow of impulses through her brain circuits has replaced the surges and plunges of estrogen and progesterone caused by the menstrual cycle. Her brain is now a more certain and steady machine. We do not see the hair-trigger circuits in the amygdala that rapidly altered her reality right before her period, sometimes pushing her to see bleakness that wasn’t there or to hear an insult that wasn’t intended. We would see that the brain circuits between the amygdala (the emotional processor), and the prefrontal cortex (the emotion assessment and judgment area) are fully functional and consistent. They are no longer easily overamped at certain times of the month. The amygdala still lights up more than a man’s when Sylvia sees a threatening face or hears about a tragedy, but tears don’t flood her so quickly anymore.

Fifty-one and a half years is the average age of menopause, the moment twelve months after a woman’s last period; twelve months after the ovaries have stopped producing the hormones that have boosted her communication circuits, emotion circuits, the drive to tend and care, and the urge to avoid conflict at all costs. The circuits are still there, but the fuel for running the highly responsive Maserati engine for tracking the emotions of others has begun to run dry, and this scarcity causes a major shift in how a woman perceives her reality. With her estrogen down, her oxytocin is down, too. She’s less interested in the nuances of emotions; she’s less concerned about keeping the peace; and she’s getting less of a dopamine rush from the things she did before, even talking with her friends. She’s not getting the calming oxytocin reward of tending and caring for her little children, so she’s less inclined to be as attentive to others’ personal needs. This can happen precipitously, and the problem is, Sylvia’s family can’t see from the outside how her internal rules are being rewritten.

Until menopause, Sylvia’s brain, like most women’s, has been programmed by the delicate interplay of hormones, physical touch, emotions, and brain circuits to care for, fix, and otherwise help those around her. Societally, she has always been reinforced for pleasing others. The urge to connect, the highly tuned desire and ability to read emotions could sometimes compel her to help even in hopeless cases. She explained to me the times she had chased her friend Marian around town making sure Marian didn’t drive when she was out on a bender; Sylvia spent most of her forties trying to please a demanding father, who had become senile after the death of her mother; and she stayed with Robert convinced that if she kept the peace just a little longer, everyone would remain in the family unit and they’d all be okay. Their marriage had never been a strong one. She had always been worried, Sylvia said, when the kids were young, that if Robert and she split something disastrous would happen to the children.

But now that the kids were grown and out of the house, the circuits that had provided the foundation for these impulses were no longer being fueled. Sylvia was changing her mind. She now wanted to help people on a grander scale—outside the family. As one modern role model to middle-age women, Oprah Winfrey, poetically put it after turning fifty,

I marvel that at this age I still feel myself expanding, reaching out and beyond the boundaries of self to become more enlightened. In my twenties, I thought there was some magical adult age I’d reach (thirty-five, maybe) and my “adultness” would be complete. Funny how that number kept changing over the years, how even at forty, labeled by society as middle-aged, I still felt I wasn’t the adult I knew I could be. Now that my life experiences have transcended every dream or expectation I ever imagined, I know for sure that we have to keep transforming ourselves to become who we ought to be.

Once her estrogen level dropped, oxytocin—the connecting and tending hormone—also dropped. Instead of off-the-charts spikes, Sylvia’s emotional, tending, and nursing impulses were dialed down to a dull, steady roar. There’s a new reality brewing in Sylvia’s brain, and it’s a take-no-prisoners view.

This has become the twenty-first-century reality of ancient female brain wiring. This changed reality in Sylvia’s brain is the foundation of her newly found balance. The brain’s circuits don’t change all that much in the mature female brain, but the high-test fuel—estrogen—that ignited them and pumped up the neurochemicals and oxytocin in the past has eased off. This biological truth is a powerful stimulus for the road ahead. One of the great mysteries to women at this age—and to the men around them—is how the changes in their hormones affect their thoughts, feelings, and the functioning of their brains.