Not for Women Only: Depression in Men

Depression in men can sometimes look different than in women. A man might not openly cry or talk about feeling down. Instead he may act withdrawn and excuse himself as being "distracted." Depression is common in men, but can go undiagnosed. This is because men may discount the seriousness of their symptoms or not recognize them as signs of depression.

What is depression?
Depression is an illness, just like diabetes or heart disease. It's thought to be related to an imbalance of certain brain chemicals, such as serotonin. The cause of this imbalance is still not clear. It's likely a combination of factors, including genetics and environment. Loss, stress or trauma can sometimes trigger it. And depression often runs in families.

Depression can affect how you think, feel and act. It is not a sign of weakness or anything to feel ashamed about. When you have depression, you can't just snap out of it. Without treatment, it can last for months or even years. It can destroy your quality of life and affect your physical health. But there are effective treatments. Most people are able to control depression with medication, counseling or a combination of both.

What are the symptoms?
According to the Diagnostic and Statistical Manual of Mental Disorders, if you have five or more of the following symptoms (including one or both of the first two symptoms) for at least two weeks, you may be depressed and should see your doctor:

• A sad or empty feeling that doesn't go away
• Loss of interest or pleasure in most activities
• Losing or gaining a lot of weight without trying, or eating more or less than usual
• Sleeping more or less than usual
• Feeling tired or having no energy
• Feeling hopeless, helpless, nervous, worthless or guilty
• Trouble concentrating or making decisions
• Thinking often about death or suicide

Alert: If you have been thinking about suicide, call 9-1-1 and get medical help right away. Or, call the suicide hotline number listed in your local telephone directory.

How do men experience depression?
Some experts think men experience symptoms differently than women. But more studies are needed to see if this is true.

Still, experts report that when men are depressed they:

• Feel detached or alienated
• Lose interest in work or hobbies
• Withdraw from family and friends
• Engage in reckless behavior
• Focus on physical symptoms, such as fatigue, headaches, pain or sleep problems

What can you do about it?
Many men do not realize they are depressed or seek help for it. They may try to mask their feelings by working compulsively or abusing alcohol or drugs. If you think you or your spouse or partner may have symptoms of depression, don't wait it out. See your doctor for an evaluation. Depression is a medical condition and can be treated effectively. Treatments may include:

• Prescription antidepressants. These medications can help rebalance your brain chemicals. Most antidepressants take several weeks to start working completely. The most common antidepressants are called serotonin reuptake inhibitors, or SSRIs. Many men fear the sexual side effects that go along with antidepressants, but not all men react the same to these medications. If you do have sexual side effects, there are other types of antidepressant medications. Don't stop taking your medicine or change how much you take without talking with your doctor first.
• Psychotherapy or counseling. Talking with a mental health professional can often help you figure out ways to cope with things in your life.

Men may feel that they should be able to handle depression on their own. But anyone with depression needs help to get better. The sooner you see your doctor, the sooner you may get back to feeling like your old self again.

Anyone being treated with antidepressants, particularly people being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior. Close watching may be especially important early in treatment or when the dose is changed - either increased or decreased. This warning applies for everyone - adults, teens and children. Bring up your concerns immediately with a doctor.

Related Articles Depression: Overview Understanding Depression

External Sources American Psychiatric Association. Mood Disorders. In: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Arlington, VA: American Psychiatric Publishing; 1994. Text Revision, 2000. Kilmartin C. Depression in men: communication, diagnosis and therapy. The Journal of Men's Health & Gender. 2005;2(1):95-99. National Institute of Mental Health. Depression. Accessed January 14, 2008. National Institute of Mental Health. Real men. Real depression. Accessed January 14, 2008. Robbins A. Biopsychosocial aspects in understanding and treatment depression in men: a clinical perspective. The Journal of Men's Health and Gender. 2006;3(1):10-18.

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