Depression in Men

1 in 8 men will experience depression at some point in their life. It is often said that men do not get appropriate diagnosis and treatment for mental health issues because they do not present to their doctor for such issues. While this may be true in some cases, a recent study from the University of Adelaide showed that men with depressive symptoms do in fact engage with their GP, and those with more significant depressive symptoms engage more frequently than men with low-average symptoms. This suggests that, while men are apparently presenting with significant depression, how they are presenting is somehow not being readily identified as depression. The problem of linking the symptoms of depression in men, to identifying their depression, could be for a number of reasons. However, some important (and overlapping) factors are likely to be at play here:

1.    Men’s experiences of depression seem to be different from women’s.

2.    Men’s depression may be characterised by externalising or physical symptoms, such as substance abuse, anger, or risk-taking.

3.    Men are less likely to recognise and identify their depression. Men are more likely to notice and mention their physical symptoms (e.g. tiredness, headaches, weight loss/gain) or behavioural changes (e.g. anger).

4.    Men may communicate differently. They may be reluctant to talk about their symptoms, be unlikely to volunteer information, and downplay the signs and symptoms of depression. However, when they do communicate about their experience, it may be to describe feelings or irritability or anger, rather than saying they feel sad or emotional.

Given these unique characteristics, it is perhaps even more important that there is more general awareness of what depression might look like in men. A good starting point, however, is what depression typically looks like. Someone who is significantly depressed is likely to have symptoms such as:

·       Feelings of sadness, hopelessness or emptiness

·       Extreme tiredness

·       Difficulty sleeping, or sleeping too much

·       Loss of pleasure from activities that were usually enjoyed

Significantly depressed mood is also experienced for most of the day on most days, and the loss of interest or pleasure will encompass nearly all activities, for a period of at least 2 weeks.

In addition to these symptoms, men might experience other signs and behaviours of depression that may not be typically identified as reflecting underlying depression. These additional signs are often characterised by externalising behaviour, due to unhealthy coping strategies that are most typically used by men, and include:

·       Behaviour that is distracting or escapist, such working all the time, or spending a lot of time on sports or video games. Such behaviours can indicate an attempt to avoid difficult feelings and/or relationships.

·       Physical symptoms, such as headaches, stomach problems or chronic pain.

·       Misuse of alcohol or drugs.

·       Irritability, anger, or aggression. This could include violent or abusive (including controlling) behaviour.

·       Withdrawal and isolation from others. 

·       Loss of interest in work, family, sex, going out, sport or other interests.

·       Risk-taking behaviour.

While men, like women, may develop depression for a range of reasons, there are specific factors that might elevate their risk of depression. These include:

·       Problems with physical health, relationships or work

·       Changed living circumstances, such as might be caused by a separation or divorce

·       Pregnancy and/or the arrival of a baby

·       Being, or feeling, socially isolated

·       Using alcohol and/or drugs

Why is all of this important?

By knowing what the risk factors are for men developing depression, and being aware of the specific signs and behaviours that may reflect underlying depression in men, it is more likely that men and those around them will accurately identify mental health concerns, and appropriate treatment may be accessed. 

While many men may find it difficult to ask for help when experiencing symptoms of depression, accessing treatment is important. Ignoring, suppressing or managing depression with unhealthy coping behaviours, generally leads to the symptoms getting worse and the man, and those around him, suffering greatly. It can be devastating in all areas of a man’s life, including his health, career, and relationships. 

It is also notable that men are more likely to complete suicide when significantly depressed, although women attempt suicide more often. This is because men are more likely to use a more lethal method, may act more impulsively, and generally do not alert others to the risk (for example by talking about their suicidal thoughts).

Being aware of the risk factors, signs and behaviours of significant depression in men, having the courage and strength to ask for help, or encouraging and supporting a man you care about to do so, is important and can lead to significant change and improvements in wellbeing. There are many effective treatments available for depression, including medication and psychotherapy. If you or someone close to you thinks you may be depressed, a good starting point is to talk to your GP.