According to the World Health Organization, by 2020,
depression will be the leading cause of disability (Watkins, Green, Rivers,
& Rowell, 2006). The American
Psychological Association defines depression as extreme feelings of sadness or
despair that last for two weeks or longer and interfere with daily functioning. These feelings may lead to hopelessness and
thoughts of suicide. That definition is
great for a clinical diagnosis. However,
depression does not look the same in everyone and it certainly presents
differently in men and women.
While women will be openly tearful and talk about their
feelings, men will not. Women will
eagerly seek help from a therapist; most men will not. Honestly, there are many times that men’s
symptoms get overlooked as a physical illness or simply a character flaw. Sometimes, the only two people who ever even
see the symptoms of male depression are their significant other and maybe their
primary care physician. That’s why it’s
important to know whether you are seeing signs of depression in yourself or
your man.
For men, symptoms of depression include the typical loss of
interest in pleasurable activities, feeling sad, irritable, or angry, and maybe
even thoughts of suicide. However, the
rest of their symptoms may not seem like depression when they really are. According to Marc Bain, as cited in Scelfo
(2007), these include:
- talking very negatively or being excessively critical
- acting recklessly or without concern for others
- abusing alcohol or drugs
- behaving violently and/or picking fights
- withdrawing from family/friends
- losing interest in work or school
- talking suddenly about separation or divorce
- losing the ability to concentrate
- eating too much or too little
- sleeping too much or too little
Again, these behaviors can be overlooked as “Oh, that’s just
how he is” when a man is really struggling with depression. And because he won’t talk about it, no one
will know unless someone is paying attention.
Our society has embedded an idea of what a man is in our brains and the
acceptable definition does not include “depressed.” A successful man is upbeat, strong, and in
control. Even Tony Soprano portrayed the
“strong, silent type” to his therapist (Scelfo, 2007).
Men’s experience of depression is much different than women’s
experience. For example, men are less likely
to cry, overeat, self soothe, talk about it, or seek help. They are more likely to withdraw, abuse
substances, and act out risky behaviors (Wilhelm, 2007). Because men’s experience of depression can be
so different than the standard diagnostic criteria, they may not even know how
to label what they are feeling. Not
knowing how they feel can lead to feelings of fear, vulnerability, weakness,
and loss of control. These are not
feelings that men like to feel or will readily admit to, much less talk
about. So, they are left to repress their
depressive feelings and hope they will simply go away. Unfortunately, this buildup of emotions, or
emotional repression, can lead to physical illnesses such as sudden cardiac
death, hypertension, and heart disease - which is the leading cause of death in
men (CDC, 2010).
Wilhelm (2007) offers “The Big Build” model to explain what
happens to men the more they repress their feelings of depression. The continuum builds up like this:
- Avoiding it – avoidant behavior (e.g., over involvement in work)
- Numbing it – self-medicating (e.g., withdrawal, watching TV)
- Escaping it – escape behavior (e.g., drug and alcohol abuse, sexual affairs)
- Hating me, hurting you – feelings of aggression towards self and others (e.g., increase in intensity or frequency of angry outbursts, rage, or violence)
- Stepping over the line – deliberate self-harm (e.g., suicidal ideation or attempt)
So, what can women do to help? First of all, women must pay attention to the signs and symptoms they see in their
significant other. Once depression is
suspected, the biggest thing we can do is to be respectful of a man’s feelings – not just his feelings of
depression but the feelings of fear and vulnerability that come along with
that. Understand that men do not want to be seen as weak or out of
control. You will want to reassure him that you see him as
strong, or stronger, for confronting his feelings and getting help. Encourage
him to open up and talk about what he is feeling, either with you, with his
doctor, or with a therapist. Most
importantly, do not ever laugh at,
joke about, or use his feelings against him.
In fact, you need to be a safe
space for him to put his feelings out where he will not be judged, discounted,
dethroned, or emasculated. Finally, be patient with him, understanding that
he will have to process his feelings in his own way and in his own time. You
cannot “fix” this for him [as much as I know you want to]. All you can do is love and support him through the storm and applaud him once he makes it to the brighter side.
References
Centers for Disease
Control and Prevention. (2010). Leading causes of death in males. Retrieved
from http://www.cdc.gov/men/lcod/2010/LCODrace_ethnicityMen2010.pdf
Scelfo, J. (2007,
February 26). Men and depression. Newsweek,
43-49.
Watkins, D.C., Green,
B. L., Rivers, B.M. & Rowell, K. L. (2006). Depression and black men: Implications
for future research. The Journal of Men’s
Health & Gender, 3(3), 227-235.
doi:10.1016/j.jmhg.2006.02.005-Watkins_etal2006.pdf
Wilhelm, K. A.
(2009). Men and depression. Australian Family Physician, 38(3),
102-106.
