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by
richard cox
It is a devastating illness that threatens the
jobs, marriages and lives of 6 million American men. Millions more may
suffer in silence, though, because the illness is also a master of
disguise that often eludes detection.
It’s male depression, and the good news is that people can learn to
recognize and get help for it. Doing so can even save a life.
We all think we know the public face of depression: sadness, crying,
feelings of worthlessness or hopelessness, changes in appetite, energy or
sleep patterns. That is how depression often looks in women.
While men and women do share many of the same physical and emotional
symptoms of depression, men usually don’t talk about their feelings
because of cultural expectations.
“Men are less likely to show sadness, especially in social situations,”
says Dr. John W. Burt, a Fort Collins psychologist.
Instead, depression in men often appears as anger or irritability. In the
home, that may mean more fights and arguments.
“I was constantly irritable and annoyed, and we had lots of fights. I just
never seemed to have any fun or enjoy anything,” says Jim, a 55-year-old
Fort Collins resident who struggled with depression. |
Irritability and inability to concentrate can make things difficult on the
job, as well. For some men, though, the workplace can become a refuge as
they try to deal with depression by pouring themselves into their jobs.
A man who is depressed may lose interest in hobbies or activities –
including sex – that once were enjoyable. He also may be driven to risky,
thrill-seeking behavior as temporary relief.
While depression can be damaging to work and family relationships, for men
it also can be damaging to the body, even leading to early death.
Depressed men are twice as likely as men without depression to die of any
cause. Depression is also considered a risk factor for heart disease (and
vice versa).
Depression sometimes prompts men to visit their healthcare provider, but
they are likely to focus on symptoms of depression that are physical in
nature like fatigue, headache, chronic pain or digestive problems, says
Dr. Richard Oddy, a psychiatrist with the Health District.
Perhaps the most sobering difference between men and women who have
depression: men are four times more likely to die by suicide. |
Signs of depression in men
Not everyone who is depressed
experiences every symptom. Some may experience many, others only a
few. In addition to a persistent sad or empty mood, feelings of
worthlessness or hopeless and difficulty sleeping, men also may show
these symptoms of depression:
- Anger, irritability or frustration
- Violent behavior
- Losing weight without trying
- Taking risks, such as reckless driving and extramarital sex
- Loss of concentration
- Isolation from family and friends
- Avoiding pleasurable activities
- Fatigue
- Loss of interest in work, hobbies and sex
- Alcohol or substance abuse
- Thoughts of suicide
- Persistent physical symptoms, such as headaches, digestive
disorders, and chronic pain that do not respond to routine treatment
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In Larimer County, one in six men has been diagnosed with depression at
some point in time, but because men are less likely to recognize and seek
help for their symptoms, male depression may be even more common than the
statistics suggest, Oddy says.
Many men still mistakenly view depression as a weakness despite the fact depression
is a physical illness much like heart disease or diabetes, in this case
resulting from changes within the brain and the chemicals that regulate
thoughts and emotion. As with many other physical illnesses, effective
treatments for depression are available, and people can successfully
manage their condition.
“The three big risk factors are age, family history and gender,” Oddy
says, with women being more prone to depression. “There is an increase in
the rate of depression as people age, but particularly in men.” A family
history of depression increases the risk more.
Stressful life events like a divorce or separation, being widowed or
unemployed, or having financial difficulties or a serious illness can
trigger an episode of depression, he says.
More often than not, it is a spouse or loved one who first suggests
getting help.
“It’s been proven to me that sometimes an outside observer has better
insight into the situation than you might, particularly if you’re
depressed and not thinking clearly,” says Jim, who got treatment at the
suggestion of his wife. “If it hadn’t been for her, I probably would never
have sought help.”
“These men don’t feel sad,” Oddy says. “They just know that they can’t
concentrate. They’ve become indecisive, irritable and haven’t wanted to go
out. They don’t associate that with depression, and even later when they
are better, they still find it hard to believe it was depression.”
If depression is suspected, Oddy says it is important to get a medical
evaluation to rule out any underlying causes of depression such as
diabetes or thyroid disorder and to accurately diagnose the type of
depression.
Counselors at Connections, a mental health and substance abuse resource
center operated by the Health District and the Larimer Center for Mental
Health, can help men find a mental healthcare provider who meets their
needs. Services are confidential and staff can even do a short phone or
in-person depression screening that can suggest what type of help might be
needed.
Because substance abuse, especially drinking too much, is common in men
who are depressed, it is also essential to identify and treat that at the
same time the depression is treated.
Treatment for depression can consist of anti-depressant medication,
counseling or both. Oddy and Burt both note that many men are reluctant to
go for counseling, although some husbands may agree to couples counseling.
Medication alone may suffice in mild cases, but research has shown that a
combination of medication and individual counseling, particularly
something called cognitive behavioral therapy (CBT), often offers the best
results, especially in cases of moderate to severe depression.
“If someone is focusing on negatives, they’re more likely to be
depressed,” says psychologist Burt. CBT teaches people to recognize
negative, distorted thoughts such as, “Bad things always happen to me,”
and replace them with more positive thought patterns.
In addition to treatment, it is also important that men with depression
have the support of friends, family and coworkers, and that they make time
to take care of themselves by exercising, eating well and managing their
stress.
It’s been a couple of years since Jim first got treated for depression, an
event he likens to a fog lifting or a light coming on. “I could see the
sunny side of life again and had a lot more tolerance for day-to-day
things that happen.”
“Depression is a medical condition just like any other condition,” he
says. “You owe it to yourself to do something about it.” |
