My Q Health | Recognizing Depression In Men
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Recognizing Depression In Men

Recognizing Depression In Men

Harvard Mental Health Letter

Physical complaints, substance abuse, and other stealth symptoms may mask the problem.

In many respects, men fare worse than women when it comes to health problems. Men are more likely to have heart attacks than women, for example, and more likely to die of cancer. But men are only half as likely as women to develop one of the most disabling disorders worldwide — major depression. Men are also less likely than women to develop dysthymia (chronic mild to moderate depression) and may be less likely to experience bipolar depression (even though the rate of bipolar disorder is the same in both genders).

It is unclear what underlies this gender difference. The leading theory is that some combination of genes, hormones, and environmental stress contributes to it.

Still, although men are less likely than women to develop depression, it remains a significant mental health problem for them. About 10% to 17% of men will develop major depression at some point in their lives. Moreover, depression may be more deadly for men than for women. Depression is a key risk factor for suicide, and four times as many men compared with women die from suicide. One reason may be men’s reluctance to convey their feelings and seek help when they are in despair.

Another mortal concern for men with depression is cardiovascular disease. Depression is a well-known risk factor for coronary artery disease, heart attack, and stroke. Men are especially vulnerable because they develop these diseases at a higher rate and at an earlier age than women.

Given the toll depression takes on men, it’s important that those who need help receive it. But often the symptoms of depression are different in men than in women — partly because of cultural pressures for members of each gender to behave in certain ways — a factor that may contribute to missed diagnoses.

Stealth symptoms

An analysis of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, one of the largest investigations of depression in “real world” settings, found that while men and women shared some symptoms of major depression (such as low mood), the overall pattern of symptoms varied by gender. Women were more likely to gain weight when depressed; men were more likely to lose weight. Women reported symptoms overlapping with anxiety disorders; men reported symptoms more typical of obsessive-compulsive disorder. Women felt less energetic; men became agitated. Men were also more likely than women to develop alcohol or substance abuse in conjunction with major depression.

Other research has found that because of cultural pressure to act “manly,” men may feel that it is weak to show despair or self-doubt. As a result, symptoms of depression may masquerade as anger or irritability. Research by the National Institute of Mental Health revealed that many men were not aware that physical problems such as headaches, stomach problems, and chronic pain might be symptoms of depression.

Men also may be reluctant to admit to depression because they are worried about how their boss, co-workers, or neighbors will react. Because of these concerns, when men develop depression they may actually work longer hours or engage in more volunteer activities — all in an effort to avoid confronting or revealing symptoms of depression.

To read full article, visit Harvard Health Publications of Harvard Medical School.


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