“I’ve lost all of my joy,” laments a new middle-aged female patient. She sits across from me in my psychiatry office and shares her story of how she lived her best life, but now, she was miserable. She initially could not explain what drove her deep despair. After some gentle questioning, she determined that her recent cross-country move fractured her lifelong friendships and cut her deeply-held social ties to her former community. It became clear that the lack of social connection was the strongest driver for her current depression. In my experience, this is a common story.
Research shows that a lack of social connection leads to or exacerbates several mental health issues including depression, anxiety, stress disorders, and substance use to name a few. Even cardiovascular disease, cancer, and autoimmune conditions are worsened by social isolation. A lack of, or a perceived lack of, friendship and social support harms women’s health exponentially more than men's.
While males and females both benefit from human connection, women need relationships for livelihood. Many memes and jokes make light of this phenomenon with an unspoken message: it’s all in our heads. In fact, it is. From the structure and anatomy of a female brain to neurochemistry and hormonal responses, a woman’s brain is literally created to be in connection with others.
Structurally, a woman’s brain, though smaller than a man’s brain, has a greater volume in the prefrontal cortex, orbitofrontal cortex, superior temporal cortex, lateral parietal cortex, and insula. While these names are a foreign language to many, their significance is profound. The prefrontal cortex is responsible for modulating social behavior and personality expression, among other things. The orbitofrontal cortex plays a key role in emotion and reward decoding. One prominent role of the superior temporal cortex and the lateral parietal cortex is social cognition. The insula has a core role in supporting subjective feeling states. These pronounced areas of the female brain are directly involved in social connection.
When looking at neurochemistry, women’s brains appear to have different connections and neurotransmitter responses from men's. The brains of women lean toward right-to-left hemisphere connections, whereas men’s brains gravitate toward front-to-back connections. Right-to-left hemisphere connections lead to higher intuition, emotional perceptions and overall higher social intelligence scores. Women and men process neurochemicals differently. Specifically, the “feel-good-neurotransmitters” serotonin and oxytocin process differently in women. Social connections naturally increase these beneficial chemicals.
Along with neurocircuitry, women’s hormones influence their brain’s drive for social connections. Estrogen and progesterone are the main female hormones that influence connectedness. Estrogen helps to augment serotonin receptors in the brain, which leads to feelings of well-being and also a desire for more social connections. Progesterone, on the other hand, directly increases when feeling emotionally close to a friend. Friendships drive a hormonal response felt in a woman’s brain.
Female friendships fuel the structural connections of a woman’s neuroanatomy, helping to drive peak brain function. Spending time with girlfriends also stimulates interconnections of intrinsically feminine neurocircuits. Lastly, social connections drive hormones that lead to well-being, calmness, and contentment. To that end, social connection is more than a funny meme or well-scripted movie. Social intimacy is a biological need for women. When feeling low, seek others. Friendship wins.
Social intimacy is a biological need for women. When feeling low, seek others. Friendship wins.