Men and Depression

Depression is a serious but treatable medical condition - a brain disease - that can strike anyone, including men. In America alone, over 6 million men have depression each year.

Whether you're a company executive, a construction worker, a writer, a police officer, or a student, whether you are rich or poor, surrounded by loved ones or alone, you are not immune to depression. Some factors, however, such as family history, undue stress, the loss of a loved one or other serious illnesses can make you more vulnerable.

If left untreated, depression can lead to personal, family and financial difficulties, and, in some cases, end in suicide. With appropriate diagnosis and treatment, however, most people recover. The darkness disappears, hope for the future returns, energy and desire come back, and interest in life becomes stronger than ever.

Men and Depression

Researchers estimate that at least six million men in the United States suffer from a depressive disorder every year. Research and clinical evidence reveal that while both women and men can develop the standard symptoms of depression, they often experience depression differently and may have different ways of coping with the symptoms. Men may be more willing to acknowledge fatigue, irritability, loss of interest in work or hobbies, and sleep disturbances rather than feelings of sadness, worthlessness, and excessive guilt. Some researchers question whether the standard definition of depression and the diagnostic tests based upon it adequately capture the condition as it occurs in men.

Men are more likely than women to report alcohol and drug abuse or dependence in their lifetime;. however, there is debate among researchers as to whether substance use is a "symptom" of underlying depression in men, or a co-occurring condition that more commonly develops in men. Nevertheless, substance use can mask depression, making it harder to recognize depression as a separate illness that needs treatment.

Instead of acknowledging their feelings, asking for help, or seeking appropriate treatment, men may turn to alcohol or drugs when they are depressed, or become frustrated, discouraged, angry, irritable and, sometimes, violently abusive. Some men deal with depression by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends; other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm's way.

Four times as many men as women die by suicide in the United States , even though women make more suicide attempts during their lives. In addition to the fact that the methods men use to attempt suicide are generally more lethal than those methods used by women, there may be other issues that protect women against suicide death. In light of research indicating that suicide is often associated with depression, the alarming suicide rate among men may reflect the fact that men are less likely to seek treatment for depression. Many men with depression do not obtain adequate diagnosis and treatment, which may be life saving.

More research is needed to understand all aspects of depression in men, including how men respond to stress and feelings associated with depression, how to make them more comfortable acknowledging these feelings and getting the help they need, and how to train physicians to better recognize and treat depression in men. Family members, friends, and employee assistance professionals in the workplace also can play important roles in recognizing depressive symptoms in men and helping them get treatment.

Depression in Elderly Men

Men must cope with several kinds of stress as they age. If they have been the primary wage earners for their families and have identified heavily with their jobs, they may feel stress upon retirement-loss of an important role, loss of self-esteem-that can lead to depression. Similarly, the loss of friends and family and the onset of other health problems can trigger depression. Nevertheless, most elderly people feel satisfied with their lives, and it is not "normal" for older adults to feel depressed. Depression is an illness that can be effectively treated, thereby decreasing unnecessary suffering, improving the chances for recovery from other illnesses, and prolonging productive life.

However, health care professionals may miss depressive symptoms in older patients, who are often reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or extremely prolonged grief after a loss, and who may complain primarily of physical symptoms. Also, it may be difficult to discern a co-occurring depressive disorder in patients who present with other illnesses, such as heart disease, stroke, or cancer, which in themselves may cause depressive symptoms, or which may be treated with medications that have side effects resembling depression. If a depressive illness is diagnosed, treatment with appropriate medication and/or brief psychotherapy can help older adults manage both diseases, thus enhancing survival and quality of life.

The importance of identifying and treating depression in older adults is stressed by the statistics on suicide among the elderly. There is a common perception that suicide rates are highest among the young; however, it is the elderly, particularly older white males that have the highest rates. Over 70 percent of older suicide victims have been to their primary care physician within the month of their death, many with a depressive illness that was not detected. This has led to research efforts to determine how to best improve physicians' abilities to detect and treat depression in older adults.

Approximately 80 percent of older adults with depression improve when they receive treatment with antidepressant medication, psychotherapy, or a combination of both. In addition, research has shown that a combination of psychotherapy and antidepressant medication is highly effective for reducing recurrences of depression among older adults. Psychotherapy alone has been shown to prolong periods of good health free from depression, and is particularly useful for older patients who cannot or will not take medication. Improved recognition and treatment of depression in late life will make those years more enjoyable and fulfilling for the depressed elderly person, the family, and caregivers.

Depression in Boys and Adolescent Males