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Johns Hopkins Health Alert

Men and the Blues

Is depression really less common in men than in women? Researchers are beginning to wonder. In fact, some experts believe that depression may actually be just as common in men as in women but is often overlooked because of its different symptoms.

Rather than feeling sad, weepy, worthless, or guilty, as women usually do, men are more inclined to get angry and irritable, feel an increasing loss of control over their lives, take greater risks, become more aggressive, and complain about problems at work. But the consequences of depression in men -- and of not being diagnosed and treated -- can be even more dangerous than for women.

Tragically, men are four times more likely than women to commit suicide. And while depression is associated with a greater risk of coronary heart disease in both genders, a study in the Archives of Internal Medicine shows that only depressed men, not depressed women, suffer a higher death rate from heart disease.

Researchers believe that men are more vulnerable than women to stressful life changes that can trigger depression, such as divorce, loss of a spouse, unemployment, or retirement. All too often, men fail to get treatment because they may not recognize the symptoms of depression or, even if they notice something is wrong, they can't admit they have a problem for fear of being perceived as "weak" or "dependent."

Typically, when men try to cope with depression on their own, they often become argumentative and combative, withdraw from relationships, engage in dangerous sports or unprotected sex with multiple partners, and self-medicate with alcohol or drugs. Ultimately, these risky behaviors only make the condition much worse.

The stigma surrounding depression is lessening in this country, even for men, as researchers are learning about the physical basis for depression -- it's not a sign of weakness, but rather a brain disorder that can be treated. Because of the change in thinking, men are slowly coming around to the idea that it's okay to get help for a mental illness. So if you've noticed that you're feeling more irritable or withdrawn than usual, be sure to tell your primary care doctor about it. He or she can perform tests to check for illnesses that could be causing depression, assess whether your medications are a contributing factor, and evaluate the need for antidepressant medication or psychotherapy.

Bottom line on men and depression: Assistance is readily available in a variety of treatments that can help manage depression and make you feel better. The good news is that men who receive treatment respond as well as women do to medication and psychotherapy. There is no disgrace in seeking help -- and no one except you and your doctor needs to know you're doing so. The only shame is in letting outdated notions about depression and masculinity stop you from taking advantage of the support that is available.

Posted in Depression and Anxiety on January 21, 2009
Reviewed July 2009

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The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.




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