Depression and Men’s Health

Other posts in this series: anxiety, stress, and PTSD

The Men’s Health and Resource Center warns, “Depression is under-diagnosed in men.” And that, “Men are over four times more likely than women to commit suicide.” The center also lists four main categories of concern:

The Center explains, “As you age, you may also start to feel stressed or depressed due to the loss of a loved one, health problems or financial difficulties. Stress may cause you to lose energy, fail to eat enough or isolate yourself. …most men don’t realize that some of the physical symptoms we may experience —things like chronic pain and digestive problems — could actually be caused by a mental health issue such as depression, anxiety or stress.”

“Mental health and your outlook on life can also change without any obvious cause. Sometimes lots of little things build up and the combination can be extremely harmful.”

What is Depression?

As a definition, let’s start with what it is not; most folks tend to use “depressed” to mean they are feeling down in the dumps. While having the “blues” for a few days is probably something most of us feel, it is not depression and it is not something that you just “snap out of.”

Like other medical conditions, for example, diabetes, heart disease or cancer, depression requires treatment. However as Dr. Terry Schrader, of Harvard Health Publishing warns, “Men are less likely to recognize the symptoms initially and less likely to seek treatment. And if the depression is severe and left untreated, they are actually more likely to commit suicide.”^[1]

Symptoms of Depression

The Mayo Clinic offers this list in understanding male depression, which they say “many men try to ignore it or refuse treatment. Learn the signs and symptoms — and what to do:”^[2]

Shared Symptoms Between Men and Women	Male Behaviors that could be signs of depression— but not recognized as such
Feel sad, hopeless or empty Feel extremely tired Have difficulty sleeping Sleeping too much Not get pleasure from activities usually enjoyed	Escapist behavior, such as spending a lot of time at work or on sports Physical symptoms, such as headaches, digestive problems and pain Problems with alcohol or drug use Controlling, violent or abusive behavior Irritability or inappropriate anger Risky behavior, such as reckless driving^[3]

In a discussion between Dr. Schrader and Dr. Michael Miller at Harvard Medical School in July 2016, Dr. Miller listed these symptoms common to both men and women: “Loss of sleep, low energy, difficulty feeling motivated, feeling sad, feeling blue.” Then he explained that men “tend not to talk about those symptoms so much and they’re more likely to appear irritable, cranky, demoralized, and not lead with sadness.”

Dr. Schrader suggested instead, men “might have angry outbursts, they might be losing their temper, but they’re toughing it out. They’re not recognizing that something is wrong.”

“That’s exactly right,” Miller said.” Men tend to want to be seen as strong. They tend to not want to talk to people about their feelings about their problems. Women are much more comfortable doing that and they’re more likely as a result to get help.”

Knowing that “men are particularly vulnerable to ignoring the symptoms, not recognizing them.” Schrader asked, “Why is that?”

Dr. Miller explained that we are not sure, but suggested it may be cultural for men to tough it out or there may be a biological difference. For example, “testosterone may lead men to be more irritable than sad …this is something we’ve seen for centuries. Fortunately, our culture has changed a little bit, so there’s more encouragement to get help. It’s better than 50 years ago, probably my parents’ and grandparents’ generation, but it’s still tough for men to [want to] get help.”

Male depression and coping skills

Treatment, including psychotherapy, with a mental health professional can help you learn healthy coping skills. These may include:
Goals. Set realistic goals and prioritize tasks.
Support. Seek out emotional support from a partner or family or friends. Learn strategies for making social connections so that you can get involved in social activities.
Coping. Learn ways to manage stress, such as meditation and mindfulness, and develop problem-solving skills.
Decisions. Delay making important decisions, such as changing jobs, until your depression symptoms improve.
Activities. Engage in activities you typically enjoy, such as ball games, fishing or a hobby.
Health. Try to stick to a regular schedule and make healthy lifestyle choices, including healthy eating and regular physical activity, to help promote better mental health.

Many effective treatments are available for depression. So don’t try to tough out male depression on your own — the consequences could be devastating.^[5]
—Mayo Clinic

Treatment of Depression

The Mayo Clinic warns, that while it may be hard for men to ask for help, “without treatment, depression is unlikely to go away, and it may get worse.” Untreated this makes you and those close to you miserable. “It can cause problems in every aspect of your life,” they continued, “including your health, career, relationships and personal safety.”

However, the Clinic, promises, “Depression, even if it’s severe, usually improves with medications or psychological counseling (psychotherapy) or both.”^[4]

Dr. Miller suggested starting with your primary care physician and to check out your employee assistance program. “They may have somebody who you could talk to.

He also recommended talking to friends. “A man may be surprised how many of his friends, his male friends, have had these problems and are getting help. They may have ideas about who to see.”

“Also, if you are in a religious community and you trust your rabbi or your priest, a minister, that this is somebody you could also ask.”

He continued by making clear “the main treatments for depression are psychotherapy and medication.” And that while there “are some other things you can do,” he suggested visiting with a mental health professional. “Just going and talking to somebody and getting outside your head can be very helpful even once or twice. Having somebody sympathetic, encouraging somebody who can give you a perspective on your problems and maybe some advice about how to manage your feelings better and medication.

“There are many men who take medicines and you might not know about it, but even a lowish dose of an antidepressant can help take the edge off of that demoralized burden feeling and help somebody manage their life better.

“Things like exercise and diet are also helpful. These kinds of lifestyle things that tend to be good for your heart are also good for your brain and good for your mood,” he concluded.