Depression in Men

Causes, effects and treatments for depression in men ...

depression in men

A woman often expresses her depression with weepy, sad tears, distressed body language and sullen facial expressions, but seldom do depressed men mimic these same melancholic behaviors.

The reasons for this difference has to do with gender-specific norms established by social, cultural, and ethnic influences. These norms include ideals of men as tough and stoic, always in control, always the ones who hold it together even in the toughest situations. Especially in Western society, it’s not socially acceptable for men to comfort each other, cry, or build networks of friends for sharing sorrows or disappointments.

In addition, social and cultural norms in the U.S. add to the image of the male as the main provider of food and shelter, and depending on the family, to be highly successful and competitive in their careers.

Men who openly display emotions are seen as weak, and sometimes effeminate. So men hide distressful emotions, or mask them by developing unhealthy behaviors. This leads many to not recognize that they are depressed, preventing them from seeking help that would dramatically improve their lives.

Diagnosing depression in men

To diagnose depression in both men and women, therapists and doctors use a diagnostic manual called the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition). This manual lists the symptoms commonly associated with clinical depression, and these symptoms have been reproduced countless times in newspaper, journal, Internet, and other media articles. (see article on Types of Depression.) Most individuals have heard of at least some of these symptoms, including fatigue, social isolation, weight gain or loss, or disturbances in sleep.

Yet these symptoms as outlined in the DSM-IV aren’t gender specific, which according to the journal article “Gender-Sensitive Recommendations for Assessment and Treatment of Depression in Men,” is problematic. Men, the article states, display signs or symptoms of depression differently from women.

This article integrates the empirical findings from a number of research studies conducted by psychological researchers on men and depression. Published in “Professional Psychology: Research and Practice,” the authors focus on masculine-specific norms of depression, arguing that therapists and doctors must consider these norms alongside those listed in the DSM-IV.

Authors Sam V. Cohen, PhD, of the University of Iowa, and Fredric E. Rabinowitz, PhD, of the University of the Redlands, outline the following masculine-specific depressive norms or symptoms:

Increased anger and conflict in interpersonal conflicts. Men will exhibit depressive symptoms in the form of anger, taking out their distress on those with whom they have personal relationships. This behavior might include social withdrawal from these relationships, or even violence. A common reaction to these interpersonal problems is blaming others for their problems. Antisocial and narcissistic traits – excessively selfish or egocentric behaviors - are also possible signs of underlying depression.

Work-related problems

Depressed men also exhibit their anger and distress in work-related or professional relationships, often causing career or employment problems. They also worry excessively about their job performance and the possibility of getting fired or losing their jobs. Additionally, many depressed men perseverate on job-related cultural expectations and a perceived lack of accomplishment.

Increased use of alcohol or drugs. Many men simply turn to alcohol or other mood altering drugs to self-medicate, or escape from their distress. When a man shows up for therapy with a substance abuse problem, often the underlying depression goes unexplored.

Cochran and Rabinowitz maintain that most men will probably experience some of the same depressive symptoms as listed in the DSM-IV, such as sleep disturbances, agitation, suicidal ideation, and decreased interest in hobbies and enjoyable activities. But, they maintain, assessing individuals using the DSM-IV is only the initial step in a process that must include an assessment based on interrelationship issues, work-related problems, and substance abuse. If these male-centered symptoms are not included, therapists and doctors can overlook this debilitating disorder.

Take, for example, a male employee who is referred to counseling for anger management issues. If this individual does not outwardly report or exhibit any of the diagnostic manual’s signs of depression, then the depression, which is the main factor causing the anger issues, will not be addressed.

Or consider an example of someone who has a drinking problem. This man might also show the common DSM-IV list of depressive symptoms, or other male-centered issues, but oftentimes treating the substance abuse takes precedence over determining the underlying issues. A depression diagnosis is again passed over or minimized.

The website Mayoclinic.com also states that many men go undiagnosed when it comes to depression. The website adds driving too fast, getting overly absorbed in work or hobbies, and infidelity or unhealthy sexual behaviors, as also male-centered depressive symptoms. It calls these behaviors a form of “escapism.”

The Mayo Clinic website advises men not to think that depression is a sign of weakness, or a loss of control. Men don’t have to be tough and try to persevere through overwhelming feelings and thoughts. In fact, severe depression is a medical condition that individuals can’t conquer by themselves.

Unfortunately, many in the healthcare community believe that these misguided beliefs are what prevent many from seeking treatment, and ultimately leads to suicide attempts. While more women attempt suicide, more attempted male suicides are fatal. According to the National Institute of Mental Health, four times as many men die by suicide than women.

Theories and national data suggest that the reason for this high suicide rate is related to firearms. More men who attempt suicide use lethal means, such as guns, when they attempt to take their lives. Women, on the other hand, use methods such as poisoning or hanging, methods that often result in failed attempts.

Studies also show that women are much more likely to form close friendships with other women, or social networks, giving them the support they need to counter suicidal thoughts and ideas. And women are less likely to attach a stigma to getting therapy.

Data from the U.S. Centers for Disease Control and Prevention show that the mood disorders of depression and bipolar disorder are the two most common disorders associated with acts of suicide, followed by substance abuse disorders. And 50% of all suicides are committed with a firearm.

This fact alone has some researchers recommending that primary care doctors ask their male patients if they have access to or own firearms.

If you have a desire to help others, especially men, identify and treat depression, you should consider a career as a mental health counselor. In most cases, at least a master’s degree is required to work as a counselor. Advanced degrees such as a PhD provide therapists with more opportunities and a wider range of specialties.

For more information, contact schools offering degrees in mental health counseling.