A recent report from researchers at the UCL Institute of Education and the University of Liverpool analysed information on more than 10,000 children born in 2000-01 who are taking part in the Millennium Cohort Study. It incorporated questions from 14-year olds on their ‘depressive symptoms’.

Almost a quarter (24%) of girls and 9% per cent of boys said they suffered from depression.

These findings raise important questions about the differences between boys and girls in terms of their mental health. Are such anomalies down to biology or society? And how early is the dividing line between the sexes drawn?

We sought the views of one of our experienced counsellors, Joanna Jamieson.

Jo has been an online counsellor for Kooth for over 13 years and has supported thousands of boys and girls since the service launched in 2004.

What do you think accounts for the difference in the state of boys’ and girls’ mental health in this country?
I think that the consensus is that boys don’t talk about their emotions in the same way. Generally, they don’t discuss their problems as openly. Boys may have been brought up to believe they must be emotionally tougher or that it’s not a ‘boy thing’ to cry.

A male gender role may be to be assertive, individualistic, independent and even aggressive in line with traditional roles, to provide and protect for their families in adulthood. There are many single parent families, however, where there is a lack of a positive male role model and there may be confusion about identity for boys in particular.

Are the differences solely down to social pressure – the way we expect boys and girls to behave?
No, I don’t think that’s the whole story. There are biological differences in that females are wired to be more relationally oriented and nurturing. Their ‘attachment’ to their baby is important in survival, so I am sure that there are biological factors too. There are many external influences: family, parents, teachers and peers.

Girls tend to have more emotional language or tend to externalise their emotions and are able to access their emotions more easily. They feel it’s okay to cry and will be more open in sharing their feelings with each other. I am speaking generally though. There are expectations from society, of course, and boys and girls will develop a kind of blueprint for their own sex which then may guide them into the activities and environments that they choose.

They can find that they feel unhappy not being able to be their authentic self and may feel a huge dissonance in what society expects of them.

As an online counsellor, can you always tell if a young person on the site is male or female?
This would be in their case notes, which are visible to us. But strangely it can sometimes be intuitive if I haven’t registered that information immediately on the site. I get a sense quite quickly. It’s hard to explain why, but maybe it’s in the presentation.

If I hadn’t checked on gender, I may experience that young person as being more practical, with less use of emotional language. There can be a more cognitive use of words. Fewer emojis. There could also be a minimising or downplaying of emotions, so for example a boy might say ‘I shouldn’t be feeling this’ or ‘this is stupid’

It’s very difficult to categorise though, as all our young people are uniquely themselves and it’s important that we experience them in this way.
Chronological and emotional developmental age is also a huge factor in how young people present. Part of our robust assessment is gathering all of this information in the opening of our ‘chats’ with the young person.

Are there gender differences in terms of presenting issues?
Issues are similar on the whole. If children or young people are struggling with bullying, for example, there may be differences in how it’s expressed. Boys tend to be more physical and may be aggressive, whereas there may be more name-calling among girls. Again, this is a generalisation.

There seems to be more self-harming amongst girls. But we can’t be sure that we are getting an accurate account of boys self-harming too as they may not feel able to admit it. I talk to many girls about worries around relationships: friends and boyfriends. Possibly not quite as many boys will feel inclined to talk about friendships in the same way, but will discuss emotionally intimate relationships and insecurities.

There are many fears around sexuality for boys too. They may worry about how to disclose this and the impact that this will have on family and friends. Anxiety, depression and loneliness are always common to both genders. Dating abuse tends to more prevalent in teenage girls – but again, perhaps the find this easier to share with us, than boys do. This is also true of physical and sexual abuse, in my experience.

More girls than boys come on to Kooth – why do you feel that is?
I think girls, on the whole, feel more able to talk about emotional problems, about how they’re feeling. Again, it’s that they are generally able to externalise their emotions, particularly in teenage years and both boys and girls have learned their gender role consistent behaviour.
Some of the boys that I talk to will tell me that they feel isolated from their peers; they don’t feel that they fit into the traditional view of their gender role. This might be because they don’t play football, or like sport. Their friendships may be mostly online, through computer gaming, which is a very lonely existence. It’s really important that we give boys the language to express their sadness, fear and vulnerability. This could be done through teaching emotional literacy to young children and encouraging boys to express their feelings at home and at school.

Do you find you react differently, as a counsellor, to boys and girls?
That’s an interesting question and I would hope not, but when we have a new young male coming on the site, it feels even more important to make him comfortable, welcome and for him to know that we are there for him. Of course we do this with all our young people but there is the knowledge that for some boys, this is a difficult and challenging thing to do. I know it must’ve taken a lot of courage to come on to the site, so I might feel that it’s even more important for them to have a good experience of counselling. Again, this is a very general statement which applies to both genders.

The UCL study found that 1 in 4 girls reported being depressed. Is that reflected in your experience as a counsellor?
Many of our young people present with anxiety, which can lead to depression. The word ‘depressed’ is used to explain to another person just how sad you might be feeling. This might cover feeling a bit down for a few days, because of issues with friends, home, school etc. It may also mean not being able to function due to deteriorating mental health issues.

It can be hard for a young person to articulate or to diagnose their feelings. But they are trying to tell us just how sad, bad, angry or hurt they are feeling. Whatever label they use for that, they just need to be heard. We need to be more aware of helping children and young people to feel comfortable talking about their feelings, and more importantly to be accessible to listen to them and give them time. It is not the label of depression that is important but what our young people are trying to tell us.