How To Identify and Treat Depression in Men

In college, I knew a fellow student who was under some typical student-related stress: finishing coursework, applying for a business internship, dealing with family dynamics, etc. Over the semester, he became more and more irritable and moody, and his social circle dwindled as he snapped at friends and lost interest in hanging out outside the home. Although some people tried to help him cope with stress, he did not begin to feel better until his family physician prescribed an anti-depressant.

None of his friends realized it, but he was depressed.

Depression is a devastating and all-too-common mental illness, affecting roughly 10% of the population and twice as many women as men. However, this does not mean that men do not experience depression; much like my friend, male depression may be misunderstood or go undiagnosed. Some men may feel ashamed at their "weakness;" they may view depression as a "female" disorder and so be uncomfortable seeking treatment. Others are misguided by stereotypes of depression (e.g., you have to be sad and crying all the time), so they are not aware of their problem.

Although there are no clinically-proven differences between men's and women's depressive symptoms, certain symptoms are seen as more characteristic of male depression because of the associated stigma:

  1. Irritability instead of crying. Sadness and crying are frequently associated with depression, but men may not display these symptoms due to fear of being labeled "weak" or "unmanly." So, it may be difficult to understand that their angry mood is the result of depression and not a sign of another disorder. Be on the lookout for irritability and sudden, inexplicable anger as signs of male depression.
  2. Unable to think clearly. The inability to make decisions or concentrate on work or other tasks is a sign of depression. They may also be worrying non-stop or constantly blaming themselves for when things go wrong (for example, something as small as forgetting to buy a grocery item at the store).
  3. Withdrawing from the world. A normally outgoing friend turns inward and loses interest in activities that were previously enjoyable. Withdrawing from seeing friends and making plans with others is another sign. Feeling sluggish, experiencing insomnia, and/or lacking an appetite for food and/or sex are other possible symptoms. Sometimes, men will engage in more risk-taking or aggressive behaviors as an outlet for their depressed mood.

Knowing the signs of male depression is important, but it is also important to know that each individual will have different depressive symptoms: No two cases are alike. However, if you suspect that you are depressed based on this information, a visit with a professional is essential. Your physician, psychologist or other mental health professional may recommend one or both of the following treatment options:

  • Medications. Advertisements for anti-depressant medications are everywhere: on TV, in magazines and on billboards. The most commonly prescribed drugs are the selective serotonin reuptake inhibitors or SSRIs (e.g., Prozac, Paxil, and Zoloft). Other types of anti-depressants are tricyclics (e.g., Tofranil, Anafranil) and monoamine oxidase (MAO) inhibitors (e.g., Nardil and Parnate).

    Each individual will respond differently to different medications, so it is important to understand the possible side effects of your particular drug. Sometimes, it may take a "trial-and-error" approach until you find the drug that works for you.

  • Psychotherapy. Although anti-depressants are effective at reducing the symptoms in the short term, psychological therapy can help address your illness in the long term. Cognitive-behavioral therapy, which works on changing negative thought patterns and associated behaviors, is well-known to be effective in helping depressed patients learn new ways of thinking and coping. Check into the details of your health care plan to see how many sessions are covered (typically, plans will cover the first 3 - 5 sessions).

Again, it is important to remember that each individual will experience depression -- and respond to treatment -- in different ways. Sometimes, it takes several courses of drug therapy along with psychological intervention to recover. Depression in men may go unnoticed because of stereotypes, but it is real and treatable. Seeking help as soon as possible will have you or your friend enjoying life again in a short time. Best wishes for your mental health.


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