Male Depression: Taking a closer look

At a cursory glance it may appear that women are more prone to depression than men. Women utilize psychotherapy and are diagnosed with depression more frequently (Nolen-Hoeksema,1998). However, research suggests that in reality the prevalence of depression between genders is not vastly different (Martin, Neighbors & Griffith, 2013). In fact, depression appears to be more damaging for men. For example, men are four times more likely to commit suicide than women (Moscicki, 1995).

Why are men diagnosed less with depression? The answer may be that men differ in how they exhibit depressive symptoms. Below are signs of depression in men and management tips.

4 Signs of Depression in Men and Management Tips:

1. Anger/Irritability: Studies indicate that men may be more prone to express anger and irritability when depressed and less inclined to express negative self-feelings/depression (Martin, Neighbors & Griffith, 2013). This is likely due to gender socialization. For men, expressing sadness is not typically consistent with masculinity. Men’s lack of overt expression of negative self-feelings/depression may also perpetuate a limited capacity to label and be aware of depression. These factors may lead to men being under diagnosed with depression.

   In contrast to depression, the expression of anger is considered more consistent with social expectations regarding masculinity. Men typically may be more comfortable expressing anger. Additionally, anger may serve as an attempt to mask and compensate for feelings of weakness. Being aggressive or angry gives one a temporary feeling of power. Unfortunately, anger pushes other people away and can lead to further isolation.

   Men would benefit from verbalizing underlying sadness underneath aggressive outbursts/irritability. Identifying underlying feelings is the first step in separating and letting go of them. Therapy can be very beneficial in fostering this process.

 


2. Reckless Behavior and Substance Abuse: Engaging in substance use, sexual acting out or risky behavior may be an attempt to avoid or mask depression. Men may be prone to manage depression by masking it with mind-altering substances or risky behavior to escape from despair (Martin, Neighbors & Griffith, 2013). Monitoring increases in substance use associated with life events or reckless behavior can be helpful in identifying depression, triggering emotions and thoughts. Additionally, similar to aggression, men may engage in sexual promiscuity to obtain a sense of power and compensate for weakness.

 


3. Somatic Complaints: It is important to note that overall research does not suggest somatization occurs more in men (Wool and Barsky, 1994). However, minimizing and emotionally suppressing feelings can lead to somatization. Consequently, somatization is something to be aware of with men when presenting with other depressive signs. Men may experience physical complaints such as headaches, gastrointestinal issues or stomach issues when depressed. Paying attention to triggers or life events preceding or paralleling the presence of physical symptoms can help provide insight regarding underlying emotional states. A therapist can be very beneficial during this process. Learning progressive muscle relaxation techniques and mindfulness can also help to manage physical symptoms.

 


4. Psychotherapy: In psychotherapy men may be less direct about communicating feelings of depression due to shame. For men where this applies reframing expressing sadness/depression as act of courage rather than a weakness can be helpful. Additionally, men may be prone to terminating therapy prematurely just when initially feeling better consistent with a tendency to minimize emotional pain. It is important to complete a course of therapy to prevent relapse. Gaining a rich understanding of the dynamics of one’s depression is important.

References
Martin, L, A., & Neighbors,W,H., Griffith, D,M. (2013). The Experience of Symptoms of Depression in Men vs Women. Analysis of the National Comorbidity Survey Replication. JAMA Psychiatry, 70(10):1100-1106.

Moscicki, E. (1995) Epidemiology of suicidal behavior. Suicide and life threatening behavior, 25:22–35.

Nolen-Hoeksema, S. (1998) Gender differences in coping with depression across the lifespan. Depression, 3:81–90.

Wool, C., & Barsky, A,J. ( 1994) Do Women Somatize More Than Men?: Gender Differences in Somatization. Psychosomatics, 35 (5) 445-452.