Sexual harassment is, sadly, a major topic of conversation these days. A rogue’s gallery of well-known and influential men, including Roger Ailes, Bill O’Reilly, Bill Cosby, President Donald Trump and others have been accused of or implicated in the harassment of women. Harvey Weinstein, the disgraced movie mogul, is the latest and, it appears, allegedly one of the worst examples. What hasn’t been talked about often enough, though, is how sexual harassment puts victims at risk for depression.
Natassia Malthe, an actress and former model, is one of Weinstein’s alleged victims, and she claims she suffered depression and anxiety as a result of the incident. Recent research reveals that she is far from alone. Workplace sexual harassment is potentially more damaging than other forms of such abuse.
According to a study involving 7,603 employees from across 1,041 organizations in Denmark, employees who were sexually harassed by supervisors, colleagues or subordinates in the workplace may develop more severe symptoms of depression than employees who experience harassment by clients or customers. The research was published in September in the open access journal BMC Public Health.
[Read: How Do I Know If I Have Depression?]
The researchers scored depression using the Major Depression Inventory, a self-report questionnaire that is used to diagnose depression and estimate symptom severity. The study found that employees who were sexually harassed by a colleague, supervisor or subordinate scored significantly higher than employees who were harassed by clients or customers. In addition, those harassed by colleagues, supervisors or subordinates had a significantly higher risk of clinical depression.
Ida Elisabeth Huitfeldt Madsen, the corresponding author, said in a statement: “We were surprised to see the differences between the effects of harassment by clients or customers compared to harassment by other employees. This is not something that has been shown before.”
Self-Blame Can Spiral Into Depression
This study adds to other research, which is “very consistent that sexual harassment leads to a number of negative and at times profound psychological conditions, including depression,” says Carol Landau, clinical professor of psychiatry and human behavior and medicine at the Warren Alpert Medical School at Brown University. According to Equal Rights Advocates, a national civil rights organization that’s “dedicated to protecting and expanding economic and educational access and opportunities for women and girls,” 90 to 95 percent of sexually harassed women suffer from some form of stress reaction — not only anxiety or depression, but also headaches, sleep disorders, weight loss or gain, nausea, lowered self-esteem and sexual dysfunction. Landau adds alcohol abuse to that harrowing list.
Indeed, sexual harassment may be at least partly behind the reason that women are more likely than men to experience depression. “When the American Psychological Association held a summit on women and depression, one factor affecting women that might explain the gender difference of 2 to 1 in diagnosis of depression was sexual harassment,” says Landau, who was a founding board member of the Office of Women in Medicine and Science at Brown, which provides training, support and mentoring for women at the university, and has published articles on women’s health and curricula for LGBT and vulnerable populations.
[See: Am I Just Sad — or Actually Depressed?]
What is the mechanism for this? “My belief is that sexual harassment — anything from invalidation to microaggressions to threats and coercion — has a negative effect on feelings of self-confidence and self-efficacy,” Landau says. “In a situation where a woman feels powerless or ambivalent about reporting the incidents, she will then internalize shame, and this leads to sadness, withdrawal and isolation. Anxiety at work is likely to follow. If she is not able to reach out to others for social support or to engage in psychotherapy, this can easily spiral into internalized self-blame and ultimately symptoms of depression.” Sexual assault, she adds, is even more damaging. “It is a traumatic and criminal event. We have seen too many examples of this in women in the military,” she says.
And despite the wave of reports coming to the surface in recent months, sexual harassment is probably underreported. “The most important thing to say about the prevalence of workplace sexual harassment it is that any estimate is undoubtedly too low,” Landau says. “We have seen with the Harvey Weinstein case that most women are afraid or ambivalent about reporting workplace sexual harassment due to fear of retribution. We do know that the Harvey Weinstein case, as egregious as it is, is merely one example of a destructive phenomenon.”
It’s a phenomenon that can occur anywhere — even in Landau’s field, the social sciences. She cites a 2016 study in JAMA in which one out of three female clinical researchers reported sexual harassment. The behaviors ranged from “generalized sexist remarks, to inappropriate sexual advances, subtle bribery to engage in sexual behavior, threats to engage in sexual behavior and coercive advances,” the study noted. “And among the women who reported harassment, 40 percent of them reported the more severe episodes and said that the harassment had a negative effect on their self-confidence and had harmed their careers,” Landau says.
[Read: How Depression and Anxiety Go Hand-in-Hand.]
Social Support Is Key
Equal Rights Advocates reports that victims of sexual harassment lose $4.4 million dollars in wages and 973,000 hours in unpaid leave each year in the U.S. While this represents women, Landau points out that sexual harassment is not limited to women. “Many studies of adolescents find that boys can be victims of sexual harassment as well, and certainly members of the LGBTQ community are victims. People of color are likely to feel even more isolated and disempowered,” she says.
The best way to prevent the spiral toward depression, she says, is by seeking support. “Like any other condition associated with shame — alcohol or other substance abuse, child sexual abuse — social support or connecting with other people with the same condition is most important,” Landau says. For example, she suggests reaching out to another woman at work might be a first step if a woman is not comfortable going to the police or the company’s human resources department. Such support can reduce feelings of shame and guilt, record patterns of the perpetrator’s behavior to assist other potential victims and lead to improved coping skills and strategies, she says.
Landau believes that the strong reaction to the Weinstein case is due to the fact that “he is a symptom of a seemingly accepted cultural decay that could create a climate of fear and potential hopelessness. I think it’s always important to look at any psychological condition through the lens of society and culture. Many of the women I see in therapy, many of whom are depressed and have histories of sexual harassment and assault, have been experiencing high generalized levels of anxiety disillusionment and despair given the attitudes and behaviors of the Trump Administration. It is not surprising that most American women, especially those who have been vulnerable, are feeling an overall sense of sadness and anger.”
The answer to this sadness and anger, she says, is what we are seeing now: “It is undoubtedly connecting with other women and allies to obtain support and to effect change.”
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What’s the Connection Between Sexual Harassment by Colleagues and Risks of Depression? originally appeared on usnews.com
