Male Depression

Male depression: Don't ignore the symptoms

Male depression is a serious medical condition. Many men try to tough it out on their own, but depression symptoms can make them chronically miserable. Effective treatment helps.

http://www.mayoclinic.com/health/depression/MH00103_D

Are you irritable, isolated and withdrawn? Do you find yourself working all the time, drinking too much alcohol, using street 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 with compulsive overwork and large amounts of brandy. For male depression, the coping strategy 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: Men with depression are at an increased risk of suicide.

Male depression often undiagnosed

Each year, depression affects about 6 million American men and 12 million American women. But these numbers may not tell the whole story. Because men may be reluctant to discuss male depression with a health care professional, many men with depression may go undiagnosed, and consequently untreated.

Some men learn to overvalue independence and self-control during childhood. They're taught that it's "unmanly" to express common feelings and emotions often associated with depression, such as sadness, uncertainty or a sense of hopelessness. They tend to see illness — especially mental illness — as a threat to their masculinity. So men may deny or hide their problems until a partner's insistence or a catastrophic event, such as job loss or arrest, forces them to seek treatment.

When they visit their health care professional, men are more likely to focus on physical complaints — headaches, digestive problems or chronic pain, for example — than on emotional issues. As a result, the connection between such symptoms and male depression may be overlooked. And even if they're diagnosed with depression, men may resist mental health treatment. They may worry about stigma damaging their careers or about losing the respect of family and friends.

Symptoms of male depression

In both men and women, common signs and symptoms of depression include feeling down in the dumps, sleeping poorly, and feeling sad, guilty and worthless. Men with depression, however, have bouts of crying less often than do women with depression.

Other symptoms of male depression often include:

• Anger and frustration
• Violent behavior
• Losing weight without trying
• Taking risks, such as reckless driving and extramarital sex
• Loss of concentration
• Isolation from family and friends
• Avoiding pleasurable activities
• Fatigue
• Loss of interest in work, hobbies and sex
• Alcohol or substance abuse
• Misuse of prescription medication
• Thoughts of suicide

In addition, men often aren't aware that physical symptoms, such as headaches, digestive disorders and chronic pain, can be symptoms of male depression.

Job stress a common trigger of male depression

Whether in men or in women, the precise cause of depression isn't known. Researchers believe depression is the result of a combination of genetics, your thought processes and your social environment. Everyone, for instance, is susceptible to depression in the wake of a major life stress, such as the end of an important relationship, the death of a loved one, moving or financial problems.

Some research suggests that for men, job-related stress may also play an important role in male depression. Some job characteristics that may be associated with male depression include:

• Lack of control over your responsibilities
• Unreasonable demands for performance
• Conflicts with supervisors or co-workers
• Lack of job security
• Night-shift work
• Excessive overtime
• More time than you'd like spent away from home
• Wages that don't reflect the level of responsibility

When male depression goes untreated

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 them, ignore them or blunt them by drinking too much alcohol or working longer hours. But left untreated, male depression symptoms can disrupt your life in many ways and leave you chronically unhappy and miserable.

Depression can also affect your health. For instance, it can keep your stress response continually activated, a state that can damage many organs, including the heart. Depression may even shorten your life. In a given year, men with depression are more than twice as likely as men without depression to die of any cause. Women with depression also have an increased risk of dying, compared with women without depression, but the difference is not as great as it is in men. Although the reasons for this difference are unclear, men with depression may be more likely to engage in self-destructive behavior — from excessive drinking to reckless driving to suicide — that may contribute to it.

Depression also increases your risk of divorce and your children's risk of developing depression themselves. At work, male depression makes you less productive, limits your earning potential and increases your risk of losing your job.

Suicide and male depression

Although women are twice as likely to have depression, men are four times as likely to suffer its worst consequence: suicide. Starting in adolescence, men are far more likely than women to take their own lives. Older men, particularly white men over age 85, have the highest suicide rate. Although women attempt suicide more often than men do, men are more likely to complete suicide.

Men are more likely to use more lethal means in suicide attempts, such as guns, which partly accounts for their higher rate of suicide. But other factors also are involved. One such factor may be their tendency to move from suicidal thoughts to suicidal actions faster than women. Men take an average of just 12 months to go from contemplating suicide to attempting suicide. In contrast, it takes women about 42 months. During this time, men are less likely than women to show warning signs, such as talk of suicide. Because this window of opportunity is so short, family and mental health professionals may have little chance to recognize a man's depression and intervene.

Treatment and self-care for male depression

If you or someone close to you is considering suicide, seek help immediately from your doctor, the nearest hospital emergency room or emergency services (911).

If you suspect you have depression, schedule a physical examination with your family doctor or primary health care professional. Conditions such as a viral infection, thyroid disorder and low testosterone levels can produce symptoms similar to male depression. If your doctor rules out such conditions as a cause of your symptoms, the next step may be a depression screening. Treatment for male depression may include antidepressant medications, psychotherapy or both.

Self-care strategies also may help. These include:

• Setting realistic goals and prioritizing tasks
• Spending time with supportive family and friends
• Engaging in activities you enjoy, such as exercise, movies, ball games or fishing
• Delaying important decisions, such as changing jobs or getting married or divorced, until your depression symptoms improve