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Depression (major depression)

Male depression: Understanding the issues

 

Male depression: Understanding the issues

Male depression is a serious medical condition, but many men try to ignore it or refuse treatment. See what's behind this so that you can move toward healthy changes.

Are you irritable, isolated and withdrawn? Do you find yourself working all the time, drinking too much alcohol, using illicit drugs or seeking thrills from risky activities?

If so, perhaps you're being chased by what Winston Churchill called his "black dog" — male depression. Churchill attempted to ward off his black dog of male depression with compulsive overwork and excessive drinking. For male depression, the coping strategies — unhealthy ones — may be reckless driving, risky sex or shutting yourself off from the world.

But none of these can keep male depression at bay for long. Even worse: When you have male depression, you're also at an increased risk of suicide.

The issues behind male depression

Depression affects about 6 million men and 12 million women in America each year, according to the National Institute of Mental Health. But the big difference in these numbers may not tell the whole story.

While it may seem as if men are less affected by depression, that assumption may not be entirely true. Researchers are trying to understand how and why male depression may be different from female depression, and any implications for treatment. Although the issues remain open to debate and uncertainty, they include the possibilities that:

Male depression may often go undiagnosed
Men and women may experience different depression symptoms
Men with depression are more likely to die by suicide than are women with depression
Men may need an emphasis on learning healthy coping skills

Male depression may go undiagnosed

Male depression may not be as widely recognized as female depression, and therefore men with depression may go undiagnosed. These reasons may include:

Reluctance to discuss depression symptoms. As a man, you may not be open to talking about your symptoms, especially emotions and feelings, with family or friends, let alone with a health care professional. This means you may not get properly diagnosed or treated for male depression.
Seeing mental illness as a threat to your masculinity. Like some other men, you may have learned to place an emphasis on independence, competitiveness, emotional stoicism and self-control. You may think it's "unmanly" to express feelings and emotions associated with depression and instead try to suppress them.
Masking depression symptoms. Depression symptoms in men may be less readily apparent. For instance, you may mask depression symptoms by alcohol or substance abuse. Also, you may focus on physical symptoms of depression, rather than emotional or behavioral problems. And your depression symptoms may not match typical depression symptoms. All of these can make it more difficult to detect male depression and may even lead to a misdiagnosis.
Resisting mental health treatment. Even if you are diagnosed with male depression, you may refuse treatment. You may worry about stigma damaging your career or about losing the respect of family and friends.

Male depression symptoms

Whether it's because of hormones, brain chemicals or coping methods, some evidence suggests that you may experience depression differently from how a woman does.

Signs and symptoms more likely to occur with male depression include:

Violent or abusive behavior
Inappropriate rage
Escapist behavior, such as overinvolvement in work or sports
Risky behavior, such as reckless driving
Sexual liaisons
Alcohol or substance abuse
More frequent thoughts of suicide

Having these kinds of symptoms can make it more difficult to link them to depression, making diagnosis and treatment harder.

Male depression and suicide

Although women attempt suicide more often than men do, men are more likely to complete suicide. Older white men are at the greatest risk of suicide.

Men may be more likely to complete suicide because:

They use methods that are more likely to be lethal, such as guns
They act faster on suicidal thoughts
They show fewer warning signs, such as talk of suicide

When you have suicidal thoughts
If you have thoughts of suicide, get help as soon as possible. If you're considering suicide right now and have the means available, talk to someone now. The best choice is to call 911 or your local emergency services number. If you simply don't want to do that, for whatever reason, you have other choices for reaching out to someone:

Contact a family member or friend
Contact a doctor, mental health provider or other health care professional
Contact a minister, spiritual leader or someone in your faith community
Go to your local hospital emergency room
Call a crisis center or hot line

Male depression and coping skills

Like other men, you may feel that your depression symptoms aren't severe. You may believe that you should be able to just get over them or tough them out. You may try to deny depression symptoms, ignore them or blunt them by drinking too much alcohol, taking illicit drugs or working longer hours.

But these kinds of attempts at coping with male depression will likely just leave you chronically unhappy and miserable, and possibly at risk of losing your life.

It takes effort to practice healthy coping skills rather than automatically turning to alcohol, speeding or frequent sex. Treatment with a doctor or mental health provider can help you learn healthy coping skills. These may include:

Goals. Set realistic goals and prioritize tasks.
Support. Seek out emotional support from a partner or family or friends. In general, men tend to disregard the value of emotional support in coping with male depression.
Activities. Engage in activities you enjoy, such as exercise, movies, ball games or fishing.
Decisions. Delay making important decisions, such as changing jobs, until your depression symptoms improve.

Many effective treatments are available for depression. So don't try to tough out male depression on your own. The consequences may be devastating.

References

  1. Men and depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/men-and-depression/complete-publication.shtml .Accessed Oct. 17, 2008.
  2. Scheibe S, et al. Are there gender differences in major depression and its response to antidepressants? Journal of Affective Disorders. 2003;75(3):223-235.
    Addis ME. Gender and depression in men. Clinical Psychology: Science and Practice. 2008;15(3):153-168.

  3. Kelly MM, et al. Sex differences in the use of coping strategies: Predictors of anxiety and depressive symptoms. Depression and anxiety. 2008;25(10):839-846.

  4. Smith DJ, et al. Differences in depressive symptom profile between males and females. Journal of Affective Disorders. 2008;108(3):279-284.

  5. Marcus SM, et al. Sex differences in depression symptoms in treatment-seeking adults: Confirmatory analyses from the Sequenced Treatment Alternatives to Relieve Depression study. Comprehensive Psychiatry. 2008;49(3):238-246.

  6. Oliffe JL, et al. Men, depression and masculinities: A review and recommendations. Journal of Men's Health. 2008;5(3):194-202.

 

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