Are lower rates of alcoholism in Jewish men linked to higher rates of depression?
While a recent study said they may be, some experts disagreed.
“It’s really backwards thinking,” said Judith Weinstein Klein, a Berkeley psychologist. “Usually people who are alcoholic are very depressed.”
The study — presented last month at the annual meeting of the American Psychiatric Association in Miami — showed that within a one-year period, 13 percent of Jewish men surveyed suffered from major depression compared with 5.4 percent of non-Jewish men.
Citing a 2.8 percent rate of alcoholism among Jewish men compared to about 14 percent for non-Jewish men, the study hypothesized an inverse link between the two factors.
However, Dr. Itzak Levav, a Brown University psychiatrist and co-author of the study, stressed the link is only speculative. “We have interesting hunches,” he said, “but we don’t wish to commit ourselves to more than that.”
Klein and others question whether any connection truly exists between booze and depression, the extent to which alcohol may mask depression — and even whether Jews drink less than others.
In their clinical experience, they have found a biochemical predisposition to depression among Jews. They also have identified a range of cultural factors that may cause depression in Jewish men.
Jewish men, they said, tend to be high achievers. Many choose professions that involve the potentially weighty task of aiding people in crisis. And, as Jews, they belong to a faith that urges regular acknowledgment of personal and collective pain.
“Jewish men definitely have a complex relationship with their inner life,” Klein said. “They are much more likely to describe [depressive] feelings, feelings of dissatisfaction, feelings of self-doubt.”
Levav and his Brown colleague Dr. Robert Kohn drew their results from the Epidemiological Catchment Program, a major study of American mental health conducted in the 1980s by the American Institute of Mental Health.
To arrive at their conclusions, the two Providence, R.I., psychiatrists analyzed surveys of 4,583 adult white males, 431 of whom were Jewish, in Los Angeles and New Haven, Conn.
In analyzing the study, Levav and Kohn — whose findings have yet to be published in a scientific journal — did not cite factors other than alcohol as possible causes of depression in Jewish men.
Measuring depression by such standard symptoms as despondency and disrupted patterns of sleep, appetite and sexual desire, the researchers found that Jewish men and women display roughly the same rates of the disorder.
In the general population, other studies have shown, women are twice as likely to be depressed as men.
But it may be the characteristics Jewish men and women share — among them tendencies for perfectionism and self-exploration — that equalize their rates of depression, therapists have said.
“Another factor that is unavoidable is we [Jews] have never felt secure anywhere,” said Rabbi Abraham Twerski of Pittsburgh, a psychiatrist and author of numerous books on self-esteem, addiction and family dynamics. “Even in the United States, we are constantly reminded of anti-Semitism, which is flourishing.”
But even with all the experiences Jewish men and women share, experts have said that factors unique to Jewish males may be linked specifically to their depression.
Many Jewish men, said Klein, are raised by doting caretakers who instill their young boys with an inflated sense of self. Later, when those men “have the fall that we all experience, it is sometimes felt as excruciating.”
The soul-searching mid-life period can be a particularly vulnerable time for the achievement-oriented Jewish male, Klein added. “When we get to that time of life where we’re looking at what we’ve accomplished, Jewish men are very prone to feeling they haven’t done enough.”
Meanwhile, it may be that levels of Jewish observance have some bearing on depression among Jewish men.
The surveys from which Levav and Kohn culled their data found the New Haven Jews to be more observant than the Los Angeles Jews, a factor measured by affiliation with more traditional branches of Judaism. Consistent with the paper’s findings, the New Haven Jews showed higher rates of depression and lower rates of alcoholism.
Experts, however, said there could be other reasons for the correlation.
Though Judaism encourages people to use all means available to maintain optimum health, Twerski, who is an Orthodox rabbi, has seen a resistance to psychiatry and psychology among some observant Jews.
The resistance, he explained, stems from the classic psychoanalytic indictment of religion found in such Sigmund Freud works as Future of an Illusion and Religion and Its Discontents. As a result, some traditional Jews regard psychotherapy as a threat to religion.
“It’s more than skepticism,” Twerski said. “There’s a distrust, almost a paranoia.”
Even for those Jews who do seek therapy, Judaism by its very nature demands an exploration of life’s deepest and most perplexing questions.
“To take Judaism seriously means that one focuses on the imperfection of the world, and of life, in a regular fashion,” said Joel Crohn, a psychologist with practices in Kensington and San Rafael.
For example, Crohn cited such somber days as Yom Kippur, Tisha B’Av and Yom HaShoah. “These are times Jews look within themselves for the ugliness of the world and try to correct it,” he said.
Though many Jewish holidays call for joyous celebration, even some of those viewed as “happy holidays” have a serious genesis, Crohn pointed out.
Purim, for instance, “has to do with victory over enemies, with not being slaughtered,” despite it being celebratory.
Crohn, who estimates that 25 percent of his patients are Jewish, said he sees them grappling with worldly issues in a way few others do.
“They struggle with their connection to history and eternity and feel torn between the lure of individualism in American society and the demands of belonging to the group.”
Ultimately, while such struggles can be confounding, they can also work to the good of the individual — and society, Crohn said. “You carry a certain amount of pain, then you translate that to working to make the world better — and make yourself better.”