Depression in Men

Why should I care about depression in men?

From childhood, men are taught to be in control of their feelings. And until recently, it looked like they were. That’s because until recently, men were diagnosed with depression only about one-tenth as often as women. But new research suggests that what they're really good at is hiding their feelings. Depression in men may always have been far more common than we knew.

Depression touches every race, income level, and age. Identifying depression in men can sometimes be difficult.

Here are some basic facts about depression you should know. You are at risk for depression if you

  • Have had a prior episode of depression
  • Have family members with depression
  • Are at a low-income level

Depression is also more common if you have illnesses, such as

Treating depression cansometimes improve these conditions.

Depression is a serious but treatable medical condition -- a brain disease -- that can strike anyone. In America, more than 6 million men have depression each year. If left untreated, it can result in personal, family, and financial problems. The most serious consequence of depression in men is suicide. Men are four times more likely than women to commit suicide.

What is depression?

Clinical depression is much more than just feeling down. It is a serious disruption of a person’s regular way of thinking, feeling, and acting.

In general, symptoms of depression include

  • Loss of energy
  • Problems sleeping and concentrating
  • Sadness and loss of interest in pleasurable activities
  • Thoughts about death or suicide

These symptoms of depression can last for weeks or months at a time.

Because women are diagnosed with depression 10 times more often than men, these symptoms of depression are really "their" common symptoms. It is common for men to have them also, but the signs of depression in men may be different. Instead of appearing sad, men often can become irritable or aggressive, drink too much, or act recklessly.

Men often don't recognize or admit they're depressed, and they are less likely than women to seek help for depression. Also, because the signs of depression in men can look different than they do in women, doctors may not diagnosis it as often. For these reasons, depression in men may often go unidentified and untreated.

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There are several recognized forms of depression:

  • Major depression . With major depression, depressive symptoms interfere with the ability to work, eat, sleep, and enjoy life. Symptoms are serious and last for weeks or months.
  • Psychotic depression. Psychosis refers to an inability to differentiate reality from non reality. In psychotic depression, someone may experience unshakable beliefs that he is worthless and deserves punishment, or that he has sinned or committed a crime, or that his problems are so hopeless he feels doomed. His imagination might also play tricks on him, such as hearing a voice telling him he is worthless or that he should kill himself. Suicide risk is especially high in this form of depression.
  • Persistent depressive disorder. A depressive episode can last for two years or longer in a minority of individuals. When that happens it is called persistent depressive disorder, which can involve either a longstanding depressed mood plus low-grade depressive symptoms that are fewer than the number seen in major depression (a condition also called dysthymia) or a longstanding full syndrome of major depression (also called chronic major depression).
  • Bipolar disorder . With bipolar disorder, episodes of depression alternate with mania, an excessively "high" mood with excessive energy and sleeplessness and the potential for serious problems.

After years of research, no one yet understands what really causes depression. Chemicals that nerves use to "talk" to each other in the brain are thought to function improperly. Consequently, certain areas of the brain that regulate mood and thinking can be less active or function improperly during periods of depression. Research in these areas is ongoing.

How can I prevent depression?

There is no known medicine, supplement, or herb that prevents a first episode of depression.

After one episode of depression, most people will experience recurrences. But you can prevent or reduce these relapses by:

  • Taking antidepressant medicines consistently as prescribed: Taking medicine for six months to a year after an initial bout of depression prevents depression from coming back.
  • Learning and practicing cognitive therapy techniques: Done properly, these techniques may work as well as antidepressant medicines for some forms of depression to help prevent recurrences.
  • Getting regular exercise and sleep
  • Avoiding alcohol and drug use, which can cause or worsen depression and make medication treatments for depression work less effectively

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What are the treatments for depression?

There are effective treatments for depression. In fact, more than 80% of men respond to treatment for depression. Your primary care doctor or a psychiatrist can create a treatment plan for you. That plan for treating depression may include:

  • Antidepressants . The medicines most often used for depression treatment today are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). These antidepressants are thought to strengthen the connections between nerve cells within brain circuits that regulate mood.
  • Talk therapy. Many kinds of psychotherapy or talk therapy are effective in treating depression. Cognitive therapy, also called cognitive-behavioral therapy (CBT), interpersonal psychotherapy (IPT), and "insight-oriented" psychotherapy are frequently used.

What else do I need to know about depression in men?

It's hard to shake the old ideas about depression in men: "Real men don't cry," and "men sure as hell have to always be in control of their feelings." But it's time to add this new idea to the list: Depression is a medical illness that's biologically different from everyday sadness, and it can afflict both men and women.

You wouldn't ignore pneumonia or heart disease or diabetes. If you think you might have a clinical depression, be a real man and take care of yourself. Ask for help, and get treated. You deserve to feel better -- and with treatment, there is every reason to believe you soon will.

WebMD Medical Reference Reviewed by Smitha Bhandari, MD on March 18, 2019

Sources

SOURCES:  

Cochran, S. Professional Psychology: Research and Practice, 2003. 

WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Depression in Men." 

National Institutes of Mental Health: "Men and Depression." 

Zimmerman, M. Journal of Nervous and Mental Disease, 2006. 

Gotlib I, Hammen C. Handbook of Depression, Guilford Press, 2002. 

World Health Organization: "Is Depression a Disease of Poverty?" 

Rupke, S. American Family Physician, January 1, 2006. 

Mann, J. New England Journal of Medicine, 2005. 

National Institute of Mental Health: "Depression in Men."

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