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Is depression in men different than in women?
Every year, depression afflicts more that 11 million
Americans, but men account for only 1 in 10 diagnosed cases. Because of this,
depression was once considered a "woman’s disease," linked to
hormones and premenstrual syndrome. The lingering stereotype of depression being
a female condition may prevent some men from recognizing its symptoms and
seeking appropriate treatment.
In reality, depression affects both sexes, disrupting
relationships and interfering with work and daily activities. The symptoms of
depression are similar for both men and women, but they tend to be expressed
differently. The most common symptoms of depression include low self-esteem;
suicidal thoughts; loss of interest in usually pleasurable activities; fatigue;
changes in appetite; sleep disturbances; apathy; and sexual problems, including
reduced sex drive.
There are several reasons why the symptoms of depression in
men are not commonly recognized:
- Men tend to deny having problems because they are
supposed to "be strong."
- American culture suggests that expressing emotion is
largely a feminine trait. As a result, men who are depressed are more likely
to talk about the physical symptoms of their depression, such as feeling
tired, rather than those related to emotions.
- Depression can affect sexual desire and performance. Men
often are unwilling to admit to problems with their sexuality—mistakenly
feeling that the problems are related to their manhood, when in fact they are
caused by a medical problem such as depression.
- The observable symptoms of male depression are not as
well understood as those in women. Men are less likely to show
"typical" signs of depression, such as crying, sadness, loss of
interest in previously enjoyable activities, or verbally expressing thoughts
of suicide. Instead, men are more likely to keep their feelings hidden, but
may become more irritable and aggressive.
For these reasons, many men—as well as doctors and other
health care professionals—fail to recognize the problem as depression. Some
mental health care professionals suggest that if the symptoms of depression were
expanded to include anger, blame, lashing out, and abuse of alcohol, more men
might be diagnosed with depression and treated appropriately.
Depression in men can have devastating consequences. The
Centers for Disease Control and Prevention report that men in the U.S. are about
four times more likely than women to commit suicide. A staggering 80 percent of all
people who commit suicide in the U.S. are men. Although more women attempt
suicide, more men are successful at actually ending their lives. This may be due
to the fact that men tend to use more lethal methods of committing suicide; for
example, using a gun rather than taking an overdose.
Why is depression different in men?
Understanding how men in our society are brought up to behave
is particularly important in identifying and treating their depression.
Depression in men often can be traced to cultural expectations. Men are supposed
to be successful. They should restrain their emotions. They must be in control.
These cultural expectations can mask some of the true symptoms of depression,
forcing men to express aggression and anger (viewed as more acceptable
"tough guy" behavior) instead.
In addition, men generally have a harder time dealing with the
stigma of depression. They tend to deal with their symptoms with a macho
attitude or by drinking alcohol. This attitude still pervades many
male-dominated institutions, such as the military and athletics, where men are
taught that "toughness" means putting up with physical pain and
admitting to emotional distress is taboo. Rather than seek help, which means admitting to what they perceive as a weakness, men are more likely to deal
with their depression by drinking heavily or committing suicide.
Special consideration -- bereavement
Men also tend to deal with the loss of a loved one differently
than women. This also may be related to the belief that men must be strong in
the face of adversity, and that showing emotion is a sign of weakness. Men tend
to assume full responsibility for their bereavement and suppress their grief.
Studies show that this suppression can increase the time it takes to grieve, and
lead to complications such as escalating anger, aggressiveness, and substance
abuse. Physical symptoms may include increased cholesterol levels, ulcers, high
blood pressure and pain.
Because they feel unable to openly express their feelings,
many men deal with grief by taking on more activities—such as working overtime
or going on business trips—to occupy their time. They may become involved in
risk-taking behavior, such as dangerous sports or compulsive sexual activity.
Some addictive behaviors, such as alcohol or other drug abuse, can escalate as
the result of suppressed grief.
Can depression in men be treated?
More than 80 percent of people with depression—both men and women—can
be treated successfully with antidepressant medication, psychotherapy or a
combination of both.
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