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- Main article: Clinical depression
Although men are less likely to suffer from depression than women, 6 million men in the United States are affected by the illness. Men are less likely to admit to depression, and doctors are less likely to suspect it. Depression can also affect the physical health in men differently from women. A new study shows that, although depression is associated with an increased risk of coronary heart disease in both men and women, only men suffer a high death rate.2
Men's depression is often masked by alcohol or drugs, or by the socially acceptable habit of working excessively long hours. Depression typically shows up in men not as feeling hopeless and helpless, but as being irritable, angry, and discouraged; hence, depression may be difficult to recognize as such in men. Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. Encouragement and support from concerned family members can make a difference. In the workplace, employee assistance professionals or worksite mental health programs can be of assistance in helping men understand and accept depression as a real illness that needs treatment.
Reluctance to seek help
In focus groups conducted by the National Institute of Mental Health (NIMH) to assess depression awareness, men described their own symptoms of depression without realizing that they were depressed. Notably, many were unaware that “physical” symptoms, such as headaches, digestive disorders, and chronic pain, can be associated with depression. In addition, men were concerned that seeing a mental health professional or going to a mental health clinic would have a negative impact at work if their employer or colleagues found out. They feared that being labeled with a diagnosis of mental illness would cost them the respect of their family and friends, or their standing in the community.
Instead of acknowledging their feelings, asking for help, or seeking appropriate treatment, men may turn to alcohol or drugs when they are depressed, or become frustrated, discouraged, angry, irritable, and, sometimes, violently abusive. Some men deal with depression by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends. Other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm’s way.
“When I was feeling depressed I was very reckless with my life. I didn’t care about how I drove. I didn’t care about walking across the street carefully. I didn’t care about dangerous parts of the city. I wouldn’t be affected by any kinds of warnings on travel or places to go. I didn’t care. I didn’t care whether I lived or died and so I was going to do whatever I wanted whenever I wanted. And when you take those kinds of chances, you have a greater likelihood of dying.”-Bill Maruyama, Lawyer
There is a significantly higher risk of suicide in young men compared to women of the same age. The rate of suicide in men is four times that of women, though more women attempt it. In fact, after age 70, the rate of men's suicide rises, reaching a peak after age 85.
More than four times as many men as women die by suicide in the United States, even though women make more suicide attempts during their lives. In addition to the fact that men attempt suicide using methods that are generally more lethal than those used by women, there may be other factors that protect women against suicide death. In light of research indicating that suicide is often associated with depression, the alarming suicide rate among men may reflect the fact that men are less likely to seek treatment for depression. Many men with depression do not obtain adequate diagnosis and treatment that may be life saving.
More research is needed to understand all aspects of depression in men, including how men respond to stress and feelings associated with depression, how to make men more comfortable acknowledging these feelings and getting the help they need, and how to train physicians to better recognize and treat depression in men. Family members, friends, and employee assistance professionals in the workplace also can play important roles in recognizing depressive symptoms in men and helping them get treatment.
It is increasingly understood thet the pressures of masculinity contribute to many of these issues.
References & Bibliography
- Cochran, S.V. and Rabinowitz, F.E.. (1999). Men and Depression: Clinical and Empirical Perspectives. Academic Press.
- Lynch, J.L. and Kilmartin, Christopher T. (1999). The Pain Behind the Mask: Overcoming Masculine Depression. Binghamton, NY: Haworth.
- Real, T. (1997). I Don’t Want To Talk About It: Overcoming the Secret Legacy of Male Depression. Scribner.
- Blehar MD, Oren DA. Gender differences in depression. Medscape Women’s Health, 1997; 2(2):3. Revised from: Women’s increased vulnerability to mood disorders: integrating psychobiology and epidemiology. Depression, 1995; 3:3-12.
- Brownhill,S., Wilhelm,K., Barclay,L., and Gordon Parker,G. (2002). Detecting Depression in Men: A Matter of Guesswork. International Journal of Men’s Health. 1(2), May.
- Klerman GL, Weissman M. Increasing rates of depression. Journal of the American Medical Association, 1989; 261: 2229-35.
- Clayton AH, Warnock JK, Kornstein SG, Pinkerton R, Sheldon Keller, McGaravey EL.A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. Journal of Clinical Psychiatry, 2004; 65(1): 62-67.
- Möller-Leimkühler, Anne Maria. (2002). Barriers to help-seeking by men: A review of sociocultural and clinical literature with particular reference to depression. Journal of Affective Disorders, Volume 71, Issues 1-3, September, pp. 1-9.
- Nurnberg HG, Hensley PL, Gelenberg AJ, Fava M, Lauriello J, Paine S. Treatment of antidepressant associated sexual dysfunction with sildenafil: a randomized controlled trial. Journal of the American Medical Association, 2003; 289(1): 56-64.
- Pollack W. Mourning, melancholia, and masculinity: recognizing and treating depression in men. In: Pollack W, Levant R, eds. New Psychotherapy for Men. New York: Wiley, 1998; 147-66.
- Google Scholar
- Frawley, Margaret. (1998). Suicide and Depression in Males of Various Ages: A Rural Perspective. Paper to National Forum on Men and Family Relationships, Canberra, 9-11 June.
- Nicholas, J., and Howard,J.(1998). Better Dead Than Gay? Depression, Suicide Ideation and Attempt Among a Sample of Gay and Straight-Identified Males Aged 18 to 24. Youth Studies Australia, v.17 n.4, pp.28-33.