Men and Depression

Depression can strike anyone regardless of age, ethnic background, socioeconomic status, or gender; however, large-scale research studies have found that depression is about twice as common in women as in men. In the United States, researchers estimate that in any given one-year period, depressive illnesses affect 12 percent of women (more than 12 million women) and nearly seven percent of men (more than six million men). But important questions remain to be answered about the causes underlying this gender difference. For example, is depression truly less common among men, or are men just less likely than women to recognize, acknowledge, and seek help for depression?

In focus groups conducted by the National Institute of Mental Health (NIMH) to assess depression awareness, men described their own symptoms of depression without realizing that they were depressed. Notably, many were unaware that "physical" symptoms, such as headaches, digestive disorders, and chronic pain, can be associated with depression. In addition, they expressed concern about seeing a mental health professional or going to a mental health clinic, thinking that people would find out and that this might have a negative impact on their job security, promotion potential, or health insurance benefits. They feared that being labeled with a diagnosis of mental illness would cost them the respect of their family and friends, or their standing in the community.

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.

For additional information, please visit the Depression Center.

This information has been provided with the kind permission of the National Institute of Mental Health (www.nimh.gov).


Last Editorial Review: 7/7/2004



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