Overwhelmingly depression has been seen as a woman's problem, and the rate of depression among women is usually estimated as twice that of men. However recent research has shown that men are actually just as likely to be depressed, if not more so. The difference is that depression symptoms in men and women differ and male depression tends occur at a different stage of life.
According to Australian government statistics, and to a number of US researchers, depression typically affects men in their 40s and 50s, whereas the peak time for depression to show up in women is in their teens and twenties. In men depression--and it's neurobiological identical twin, anxiety--typically occurs at a time of significant, and largely unrecognized hormonal changes similar to a woman's menopause.
For example, during this "male menopause" men's ability to father children is greatly reduced (though, unlike women's ability to conceive, it never actually ends). Male hormonal change can lead to failure to maintain an erection, lethargy, mood swings and increased irritability.
Diagnosing Depression in Men
Depression in men often goes unrecognized--by themselves, colleagues, family and even physicians. Yet some researchers estimate the depression rate among middle-aged men approaches 40%--considerably higher than the rate among women (25%)! Statistically it takes 10 years and three health professionals to properly diagnose depression in men. Often depression is not recognized until men are in their 60s or even 70s.
Why is depression in men so often undiagnosed and undetected?
The symptoms of depression in men are different from the "blue mood" which typifies it in women.
Men typically resist seeking help and male friends and colleagues don't ask in depth questions.
Men don't equate sexual problems with depression.
Nonetheless male depression can have devastating affects on the sufferer, as well as his family and colleagues. Depression can lead to a substantial drop in productivity and work performance (over 30% according to NIMH figures), divorce (the divorce rate of men in midlife is much higher than at other times and depression has been shown to be the main root cause of divorce) and even suicide (the suicide rate for men in their 40s and 50s is three times the US national average--and 80% of all suicides are men!).
Gender Differences in Depression
Men tend to act out their mood disorder while women typically turn it inward. Depression symptoms in men and women can be radically different, leading to lack of understanding and correct diagnosis. Based on the latest research findings here are some of the prime differences between male and female depression (of course not everyone will have the same symptoms, and almost certainly not all of them, this is just a rough guide):
Symptoms in men
Symptoms in women
Blames others
Tendency to self-blame
Anger, irritability, ego inflation
Feels sad, apathetic, worthless
Feels suspicious, guarded
Feels anxious, frightened
Creates conflict
Avoids conflict
Restlessness and agitation
Slows down, nervousness
Compulsiveness
Procrastination
Sleeps too little
Sleeps to much
Becomes controlling
Difficulty maintaining boundaries
Shame (eg. sex performance)
Guilt
Fear of failure
Problems with success
Becomes over status-conscious
Assumes low status
Self-medicates through alcohol
Self-medicates through food
Over use of internet/TV/email
Withdrawal
Helping Men Overcome Depression
Because of the denial surrounding male depression it can be more difficult to treat. Researchers have found that conventional antidepressants can often make the problem worse (for example the lack of libido which often characterizes male depression can be made much worse by SSRIs such as Prozac and this can spiral the patient into even worse depression).
We have found that the best approaches to helping men with depressive symptoms are:
Recognizing the problem. Getting him to admit his depression and seek help is the important first step.
Regular exercise. Researchers at Duke University have shown that 20 minutes brisk walking a day is better than antidepressants.
A healthy diet. Depressed men tend to have unhealthy eating habits.
Clear communication. The way we communicate largely dictates the way we feel. It's important to insist that the depression sufferer is clear in his communication with you, particularly as he may use imprecise or unclear communication to control his relationships.
Social supports. Depressed men often destroy their social support network, as they can severely damage teams at work. Helping them recreate these is very important. Many depressed men have never had an adequate social support network.
Dr Bob Murray is a widely published psychologist and expert on emotional health and optimal relationships. Together with his wife and long-term collaborator Alicia Fortinberry, he is founder of the highly successful Uplift Program, and author of Raising an Optimistic Child (McGraw-Hill, 2006) and Creating Optimism (McGraw-Hill, 2004).
Disclaimer: The diagnosis and treatment of medical or psychiatric disorders requires trained professionals. The information provided in this article is for educational purposes only. It should NOT be used as a substitute for seeking professional help.
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Disclaimer: The information presented on this website is based on the research, clinical experience and opinions of Dr Bob Murray and Alicia Fortinberry. It is designed to support, not replace a relationship with a qualified healthcare professional.