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Men and Depression

Reviewed Apr 19, 2013

Summary

  • Depression is often the reason for suicide among men.
  • Men avoid talking about their feelings.

Depression can affect anyone, male or female, young or old, but in different groups of people it does not look the same. It has been known for a long time that more women than men go through depression. In recent years people have studied how it affects men. Depression is important to spot in men because 4 out of 5 suicides happen in men and depression is often the reason for killing oneself. Even when depressed people don’t end their lives, they miss much of the joy.

Depression in men has special causes, a different look, some bad problems, and its own treatment differences. Here are facts about each of the ways in which depression in men is not the same.

Depression in men can have special causes

Men have often relied on work not only for earnings but also for good self-esteem. Women more often have a strong support group of family and friends. Men who run into problems at work, or become unable to work because of an injury or illness, can take it very hard. Men often find it very hard to stop work at retirement age for the same reason. They may have failed to make friendships that could help them. They may have focused on work and not developed other hobbies and interests that would be fun to do during retirement. Depression related to work and self-esteem can be seen in women too.

Depression in men has its own “look”

Women who are depressed often cry and talk about the sadness, low energy and loss of fun. A depressed man may not want anyone to see him as weak or out of control. His depression takes a different form. He may show a bad temper or even anger instead of sadness. He might have trouble working. He might blame a physical problem such as arthritis for pain that is more than you would expect with that disease. He might get into alcohol or drugs, or unsafe behavior. Men are less likely to ask for help. Their depression might not be recognized for this reason—even by their doctor.

Depression in men can have very bad outcomes
 
Men who are depressed take their own lives at a very high rate. Women who make suicide attempts more often take pills, but men more often shoot themselves. This more dangerous method is one of the reasons why men die from suicide 4 times as often as women, even though more women try to take their own lives.

Depression in men might need different treatments

Men sometimes avoid getting in touch with their feelings and do not choose talk therapy for that reason. Other things that help ease depression, such as exercising regularly, getting the right amount of sleep, reducing stress, and keeping in touch with others may be better places to start treating a man with a more mild case. For more severe depression, the same antidepressants help both men and women.

Talk therapy that is focused on the here and now and involves learning new problem-solving skills, like cognitive-behavioral therapy, can be helpful. Research shows that people in therapy can improve their ability to solve their problems and resolve their depression.

Men sometimes get depressed because of low levels of the male hormone testosterone. Low levels are more common among men who are getting older. When testosterone gel or shots are used to bring the level up to normal, depression sometimes gets better in people who had low levels.

In all these ways, depression in men has special qualities. Some of these qualities can lead to misdiagnosis and also the wrong healing process if depression is not recognized for what it is.

By James M. Ellison, M.D., M.P.H.
Source: "Men and Depression", available at http://www.nimh.nih.gov/health/publications/men-and-depression/index.shtml
Reviewed by Mark Fuller, M.D., Vice President and Regional Medical Director, Value Behavioral Health of Pennsylvania

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