According to the World Health Organization, more than 264 million people are experiencing depression worldwide (WHO, 2020). But did you know that depression does not always manifest in the same way in women and men?
Male depression has very particular traits that do not correspond with our assumption of depression as “feeling sad.” This lack of awareness about the symptoms in men —especially during this time when the pandemic has affected the mental health of thousands of men globally, can result in severe consequences. Year after year, numerous men die to suicide because of this terrible —and often misunderstood—, illness.
In this post, we will explore the issue of male depression, its symptoms, causes, and healthy strategies that you can implement to overcome this mental illness.
An Overview of Depression
Let’s begin by defining depression. According to The American Psychiatric Association, “depression is a common and serious medical illness that negatively affects how you feel, the way you think and how you act” (APA, n.d.).
If you think this definition sounds rather vague or general, you are right! After all, many illnesses affect our emotions, cognitions, and behaviours. But there is a reason to speak about depression in such general terms. Depression is an illness that cannot be reduced to one cause or one symptom. Saying that depression is equivalent to sadness is far from accurate. Similarly, saying that the cause of depression is that a person does not want to see the positive of life is also a wrong approach.
The causes of depression are various. It may depend on genetics (family history of depression), biochemistry (brain’s chemical imbalances), physical conditions (chronic or severe illnesses), or environmental factors (socio-economic crisis, pandemic, family dynamics, etc.).
Additionally, signs of depression can emerge in various ways. At this moment, we will mention the ones that are more prevalent for the general population, and later we will explore the most common signs in men.
Symptoms of depression include:
- Diminished interest in most pleasurable activities
- Recurrent feelings of sadness or depressive mood.
- Sleep disturbance (insomnia or too much sleep).
- A significant loss of appetite or an increased in cravings.
- Lack of energy (feeling exhausted at all times).
- Slow movements or speech that others can perceive.
- Physical agitation (i.e., pacing, handwringing, or inability to be still).
- Lack of attention or concentration.
- Problems to make decisions.
- Isolation or withdrawal.
- Thoughts of death.
- Suicidal thinking or attempts.
There are different types of depressive disorders. To get diagnosed, symptoms need to last for at least two weeks.
Depression Symptoms in Men
Do men show signs of depression as the ones we mentioned above? Yes and no. While some men may certainly suffer from any of those symptoms, others may display different signs. This is primarily due to socio-cultural norms related to expectations around men, and their coping style to handle overwhelming emotions. Other internal and external factors can also come into play.
So, what are some of the signs you should watch for?
- Depressive moods in the form of anger, irritability, or aggressiveness.
- Increased feelings of anxiety or physical agitation.
- Frequent headaches, stomachaches, or physical aches.
- Loss of sexual desire, or problems with sexual performance not caused by a medical condition.
- Loss of interest in work performance, responsibilities, aspirations.
- Trouble focusing on activities or making decisions.
- Withdrawal from family and friends.
- Disturbances in sleep or eating patterns.
- Engaging in risky behaviour (dangerous sport, reckless driving, careless gambling).
- A significant increase in substance use (alcohol or drugs).
- Suicidal thoughts or attempts.
Why It’s Harder To Recognize Depression in Men
For years, Western societies have held socio-cultural standards about masculinity that have prevented men from engaging in a public display of sadness, despair, or talking about their feelings.
Most of us have heard thousands of times phrases such as “men don’t cry,” or “boy! you have to be strong.” Even within families, men have internalized that they cannot cry in front of their children or partners, and have to be a rock in times of crisis. Any sign of vulnerability can be taken as a sign of weakness. There is the expectation that men cannot be weak.
Research has shown that these assumptions about masculinity have often prevented men from seeking appropriate professional help. Instead, they may use unhealthy coping strategies to manage overwhelming feelings, such as substance use, gambling, violence, controlling, reckless behaviours. They may also display socially accepted “masculine” emotions such as anger or aggressiveness (Staiger, T. et al. 2020). Or lastly, they may look for help to manage their physical symptoms (i.e., sexual problems, physical aches), but not depression as the underlying mental health cause.
Why lack of awareness of male depression is a problem? Sadly, severe, or prolonged symptoms of depression, if untreated, can lead to death by suicide.
In Canada, “men die by suicide in numbers almost four times that of women. Although young men from 20-30 die in alarming numbers, men from 40-60 kill themselves most often.” Moreover, “almost as many men die by suicide every year in Canada as by prostate cancer” (Centre for Suicide Prevention, 2017).
Men, in general, are more likely to die by suicide because they use more lethal means (i.e., guns, hanging) than women. Among them, certain groups are at higher risk of dying to suicide, including:
- Men who experience a depressive disorder or another related mental illness that causes depression (i.e., bipolar disorder).
- Men who experience a chronic or severe physical illness.
- Men who lack a solid support system, live alone or are unable to maintain meaningful relations.
- Men who have been dramatically affected by unemployment.
- Men who abuse substances to cope with stressors.
- Men who have experienced abuse or past traumatic experiences.
- Men who are middle-aged and over (+40 years old).
How Depression Affects Men’s Life
For some men, identity and self-worth are linked to their professional lives. Having a purposeful life may be limited to having a successful career. The idea of being a stay-at-home parent or depend on someone else’s for financial support may be simply unacceptable. Personal circumstances or environmental factors —such as the current pandemic— may negatively impact people’s professional and financial stability.
Since last year, many men have lost their job, have seen their income reduced, or have become dependent on their families or governments’ aids. This type of situation has triggered in many people a profound sense of hopelessness, worthlessness, and an identity crisis. When people lose track of their worth and purpose in life, psychological suffering can lead to devastating consequences.
Inside The Family
Depression can be very hard on families. Not only for the men who suffered depression but also for their partners and children. Usually, when the male figure in the family experiences depressive episodes, the whole family begins to break apart due to their inability to find meaningful ways to connect with that person. Families are systems. When one part of the system is not functioning well, the whole system suffers.
In these circumstances, men may cope with their suffering by isolating themselves from their loved ones or engaging in hostile or aggressive behaviours. Men’s isolation can be adopted on a physical or mental level. The person may lock in his room for hours without having contact with the family or may spend countless hours sitting on the couch watching TV without caring about anything happening at home.
On the other hand, when men resort to anger and hostility that may frequently yell at the rest of the family, for no apparent reason. As you may guess, none of these strategies are appropriate ways to restore the balance and harmony of the family system.
Depression may affect men’s overall capacity to find joy and fulfillment in any or all areas of their lives. It may undermine a person’s aspirations and ability to find meaning in their work, romantic relationships, family life, friendships, and even in their spiritual belief systems. Once depression sinks in, it may deprive anyone of reasons to continue living. Life may turn into a dark and burdensome experience without any type of sparkle, pleasure, or joy.
Real Examples & What It Looks Like
“My wife and children are driving me crazy! We do not know how to live like a family anymore.”
Depression can have a significant impact on family dynamics. Because men are less likely to seek help than women, they may use inappropriate coping mechanisms such as hostility or isolation to handle their family relationships. Suppose the family is not well-prepared or well-supported to manage these types of depressive behaviours. In that case, they also may start to negatively react against the person experiencing depression, triggering more escalating behaviors and disruption.
“Since a few weeks ago, I wish I were dead.”
Thoughts about death or taking one’s life should always be taken seriously. Suicide can be prevented. People dying to suicide often give warning signs as a cry for help before deciding to put an end to their lives. Remember that mental health professionals are trained to assess and manage suicidal ideation. If you, or a loved one, are expressing this type of thoughts, be sure to seek help immediately.
You can reach out to the suicide prevention or crisis hotline, your local emergency phone number (911), or call a therapist.
Depression and Medication
Treatment of depression includes medication AND therapy. We highlight the “and” because antidepressants address the symptoms of this mental illness but do not get to the root cause. Does it mean that medication is ineffective?
No, what it means is that medicine serves a different purpose. For people experiencing severe symptoms of depression, antidepressants can stabilize their symptoms and prevent them from engaging in activities that would put their life at risk.
It is important to discuss the option of taking medication with a mental health professional or medical provider and get informed about the medication’s side effects.
As a side note, there are other types of medication to treat different illnesses that may trigger depressive symptoms as a side effect. That is why it is essential to seek help if depression’s symptoms do not go away. Medical and mental health professionals will rule out if a depressive episode is triggered by a person’s life circumstance, a particular medication, or a mental health disorder.
What To Do If I Am Experiencing Signs of Depression?
The first step is to recognize how you feel and share your concern with others. Emotions are part of who we are as human beings and not a sign of weakness. Depression can feel like an unending battle or a weighty burden. Still, you do not have to go through this painful experience alone.
If you are experiencing minor depressive symptoms that are not affecting your daily life activites, you can integrate healthy coping strategies in your life. Helpful strategies include:
- Talking to someone.
- Physical activities.
- A routine of healthy meals.
- Engaging in mindfulness or meditation practices.
If you are noticing that your depression is moderate or becomes severe, please seek professional help. Currently, there are many effective therapies to manage depression and help people regain control over their life. For your convenience, we have gathered a list of resources and treatments that we can offer you to manage depressive symptoms and increase your well-being.
What To Do Next?
If you, or a loved one, are experiencing signs of depression, do not hesitate to book a free 15-mins phone consultation with us. We will be more than happy to guide you in the process of finding alternatives and valuable treatments to manage your depression.
At Well Beings Counselling, we have a team of registered counsellors and psychotherapists with experience addressing depression and helping people navigate this complex illness.
Staiger, T., Stiawa, M., Mueller-Stierlin, A. S., Kilian, R., Beschoner, P., Gündel, H., Becker, T., Frasch, K., Panzirsch, M., Schmauß, M., & Krumm, S. (2020). Masculinity and Help-Seeking Among Men With Depression: A Qualitative Study. Frontiers in psychiatry, 11, 599039.
The American Psychiatric Association. (n.d.). What Is Depression?