DEPRESSION: Why it’s Different for Men?

Women in our culture know they are distressed and they reach out for help. But, men express depression differently. According to statistic, approximately 25% of all women suffer from depression and about 15% of men – but some researchers question the latter number. Men are less likely than women to seek mental- health treatment in general. The tendency to tough it out rather than ask for help is just one of several reasons why experts believe the oft-quoted statistic are artificially low. Men express emotional pain differently from women, so their symptoms are not always recognized and their depression goes undetected. Fortunately, however, when the condition is recognized, there are many ways it can be successfully treated.

A man couldn't sleep and had no desire for sex. He vaguely worried about his loss of libido, but decided that the source of his problems was chronic sleeplessness. His lack of emotion was such that even when his marriage ended, he barely seemed to care, his career also ceased to matter to him.

The problem was not a sleep disorder. While the outward signs – insomnia, apathy, loss of libido- didn’t match the tearful, unhappy state that’s often associated with the disorder, his problem was depression, and it lasted for about five years before a doctor finally diagnosed and then successfully treated it with anti-depressants.

Most people assume sadness always accompanies depression. But that’s not necessarily true for men. With men you may see more of the angry and irritable depression that than the typical sad depression that we are used to seeing in women. While depressed women tend to cling to sources of comfort and turn their anger against themselves, depressed men often do the opposite. They may isolate themselves from family and friends and act aggressively.

What causes male depression in the first place? Neurotransmitters, including serotonin, norepinephrine and dopamine, which relay signals from one brain cell to the next, play key roles. If, because of a genetic abnormality or other cause, neurotransmitter stores are affected, we may suffer depression or any of a number of other psychological problems. In some cases of mild depression the causes may be testosterone deficiency which can bring on classic symptoms such as fatigue, lack of initiative and sexual difficulties. As with depressed women, a man’s negative life experience – job loss, rejection in love, can devastate the mood and affect neurotransmitter flow. You take a perfectly normal person but put him under stress. Alcohol can boost mood temporarily, which may be why some people with depression drink. But heavy drinking itself may produce or worsen symptoms of depression. While alcohol can cause obvious changes in mood and behavior, the effect of nicotine and some other drugs may be less conspicuous.

Leaving depression untreated can be fatal. There is a 20% risk of suicide with untreated depression. Men are more likely than women to choose a lethal method – like shooting themselves, if they are thinking about suicide. Depression can shorten men’s live in other ways as well. In depression, the duration and intensity of the mood is much greater than a passing episode of feeling down. Depression is likely if either of the above is accompanied by four or more of the ff:

·         Excessive sleepiness or insomnia

·         Appetite changes

·         Fatigue, lethargy or apathy

·         Feelings of excessive or inappropriate guilt, of worthlessness and of hopelessness

·         Forgetfulness, indecisiveness or lack of concentration

·         Thoughts of or attempts at, committing suicide

Call your local hospital or mental health organization if you need a referral to a licensed mental health professional. And if someone you care about starts talking about death or suicide, get him to an emergency room.

In major depression, doctors will usually prescribe anti-depressants as well, Prozac, Zoloft, and Paxil, to name a few which work by keeping more of the mood modulating neurotransmitter circulating within the brain. Another anti-depressant, bupropion (Wellbutrin SR), is also marketed under the name Zyban for people who want to stop smoking. It seems to dampen nicotine cravings and moderate nicotine-withdrawal symptoms. For men whose depression is traced to testosterone deficiency, doctors can prescribe testosterone – replacement therapy via injections or skin patches similar to the ones used to replace estrogen in women. Testosterone can stimulate the growth of a previously undetected prostate cancer and therefore should be administered of an actual deficiency.

The important thing to remember is that depression is not a sign of weakness and it’s not just a women’s problem. It’s an illness, just like heart disease, diabetes and flu. And like other illnesses, it can be treated. No one has to tough it out alone.