10 Things You Should Know About Male Depression

What looks and feels like depression to a woman may not to a man, which is why so many men in America are misdiagnosed or missed altogether. However, considering that the rates of completed suicide of men are three to four times that of women, we need to educate ourselves about male depression and its unique symptoms. The following are 10 things you should know about male depression, compiled from Johns Hopkins Depression and Anxiety Bulletin and other sources.

1. Depression affects about 6 million American men and 12 million American women each year. But these numbers don’t tell the story of men, and older men, in particular.

2. Suicide in men peaks in the 20s and again in the 60s and 70s.

3. Many men experience “depression without sadness,” which makes it more challenging for primary care physicians to make the diagnosis of depression. Some of the symptoms of this kind of depression include severe anxiety, physical discomfort, sleep disorders, and diminished energy and self-confidence as some of its primary symptoms.

4. Men—more commonly than women—are likely to feel angry, irritable, and frustrated rather than sad when depressed.

5. Men tend to cope with depression differently than women. Instead of withdrawing from the world, men may act recklessly or develop a compulsive interest in work or a new hobby. Instead of crying, men may engage in violent behavior.

6. Men are more likely to abuse drugs and alcohol when in the midst of a depression, perhaps to find relief from the pain of depressive feelings. This can make it difficult to determine whether a problem is specifically alcohol-or-drug-related or whether it is primarily depression.

7. Men often report physical symptoms more often than women, such as headaches, joint pain, backaches, dizziness, chest pain, and digestive problems. However, they are often unaware that these symptom are linked to depression.

8. There may be genetic differences between depression in men and women. Five years ago, researchers from the University of Pittsburg identified 19 chromosomal regions linked to one form of major depression, but only three of them were significantly linked in both men and women. The other 16 were only linked in one sex.

9. A worrying recent trend is the increasing rate of suicide among younger men, a trend not seen among young women. The majority of these men have no asked for help before their deaths.

10. The higher suicide rate among men is a worldwide phenomenon. A few exceptions to the general rule exist, for example, among elderly women in Hungary and in some Asian countries. The reasons why men are more likely to kill themselves are complex, but risk factors include unemployment, social isolation, chronic illness, and certain occupations that have access to the means of suicide.


"While the symptoms used to diagnose depression are the same regardless of gender, often the chief complaint can be different among men and women," says Ian A. Cook, MD, the Miller Family professor of psychiatry at the University of California–Los Angeles


Signs of Depression in Men 

1. Men are more likely to report fatigue than women, or what is known as psychomotor retardation, or a slowing down of physical movements, speech, and thought processes. 

2. Health problems such as constipation or diarrhea, as well as headaches and back pain, are common in people who are depressed. But men often don't realize that chronic pain and digestive disorders go hand in hand with depression

3. Instead of seeming down, men who are depressed often show signs of irritability. Men will report feeling irritable because they are having negative thoughts constantly. 

4. Psychomotor retardation can slow down a man's ability to process information, thereby impairing concentration on work or other tasks. Depression fills one with negative thoughts, almost like an intrusion. You're slowed down and constantly thinking about negative things in your world. As a result it makes it very difficult to focus on anything.

5. Some men manifest depression by being hostile, angry, or aggressive. A man who realizes something is wrong may need to compensate by demonstrating that he is still strong or capable. Anger and hostility are different than irritability. "Anger tends to be a stronger emotion," "Irritability is a crankiness." Men can also become hostile when they have withdrawn as a result of their depression and feel under pressure by friends or family to rejoin society.

6. Men might be more likely to report symptoms of depression as stress. It's not that they have more stress; it's that it's more socially acceptable to report it.

7. Substance abuse frequently accompanies depression. Research has shown that alcoholics are almost twice as likely to suffer from major depression as people without a drinking problem. It can happen for both men and women, but using drugs or alcohol to mask uncomfortable feelings is a strategy many men will employ instead of seeking health care. There's a cultural bias of, 'I should be able to fix this myself and so I'll use what chemicals I have available to me to do that.

8. Depression is a common reason for loss of desire and erectile dysfunction (ED).

9. "I can't count the number of people who have said, 'I had money in the bank but the phone got shut off because I couldn't bring myself to [pay the bill] or decide what to do and when.' It gets overwhelming,". Some people naturally have a hard time making decisions, so an inability to make choices is usually worrisome only if it's a new behavior. "It's an information-processing issue," and depression slows down your ability to decide.

10. Women are more likely to attempt suicide, but men are more than four times as likely to die if they do attempt suicide. One reason is that men tend to choose more lethal methods. They more often use firearms and kill themselves the first time they try. Older men are at highest risk for suicide, and doctors may miss depression symptoms in this group. In fact, more than 70% of older suicide victims saw their primary care physician within the month of their death. 

Depression is not a normal part of aging in men or women.