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Health & Fitness

Understanding Male Depression

                You may have heard that statistically women are twice as likely to be diagnosed with depression as are men. This may be because the Diagnostic Statistical Manual of Mental Disorders (DSM-5) provides standard symptoms lists for various psychological disorders.

                The DSM-5 criteria for Major Depression are listed below:

·         Depressed mood.

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·         Diminished pleasure in activities.

·         Insomnia (trouble sleeping).

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·         Hypersomnia (sleeping too much).

·         Significant weight loss (without dieting) or weight gain.

·         Psychomotor agitation (nervousness/recklessness).

·         Psychomotor retardation (sluggishness).

·         Fatigue/loss of energy.

·         Feelings of worthlessness/guilt.

·         Diminished ability to concentrate, or indecisiveness.

·         Recurrent thoughts of death.

It is possible women are diagnosed with depression more often than men because the diagnostic criteria for depression seem to be based on the kind of symptoms women tend to experience and express.

Feelings of sadness and guilt, crying, self-blame and worry sometimes form a pattern of symptoms referred to as “acting in” because the patients focus in on the internal feelings rather than external behaviors and experiences. Women tend to “act in” because of a cultural gender role that encourages women to express feelings and focus on internal judgments about their inadequacies. For a depressed woman the conflict is expressed in a direct manner:

CONFLICT ->          NEGATIVE EMOTION->        DEPRESSION

(psychological loss)       (sadness)           (feeling sad, lack of energy/interest)

 

So How Does Male Depression Work?

                In most cultures it is widely accepted  that men are not to act in any of the ways the symptoms above describe. That is to say societies tend to frown on men who cry, mope around, and express self-doubt. So when men experience emotional conflict they mask the pain. To do so they employ tactics such as anger, self-destructiveness, and often choose to partake in distractive behaviors such as drinking, drug use, gambling, womanizing, or becoming a workaholic. From the time they are young boys men are taught they need to be competitive, successful, active, independent, and task-oriented problem-solvers. To achieve this mandate, men must express their painful feelings in ways that are not counter-productive to their assigned task. So, they might blame others, deny their true feelings and look outward “acting out” to find solutions to their problems. Whereas women tend to “act in” in reaction to their negative feelings, men, as a rule, “act out.” It follows that most men are not aware of their depression. The reason it goes un- diagnosed is because men are generally disconnected to their feelings, and their behaviors to not appear to fit the criteria of classic depression. It is not uncommon for men to be unaware they are suffering from depression. It is also easily overlooked by their wives, girlfriends and families. Many men may not seek counseling for months, or even years. The depression simply goes untreated.

Emotional Disconnection

                Based on gender socialization, a process exists that works to focus individuals toward a set of accepted, implicit, rules about how men and women should think, feel and behave. Women are raised to be feeling oriented, non-competitive, introspective and willing to be helpful to others around them.  Men are encouraged to be self-focused, active, task-oriented and independent. If something troubles a woman she is likely to examine her own short-comings, to focus on relationship losses, and to openly share her painful feelings. Men, on the other hand, have been raised to seek explanations and solutions for depressed feelings in the external world. They are taught to control their feelings rather than express them.

                So, while men do grapple with a wide range of emotions, they are also conditioned to neither experience them nor reveal them to others. Yes men need intimate relationship to survive psychologically and at the same time must integrate this need with being independent, unfeeling, and in complete control of their emotions. In an attempt to achieve this daunting task men learn to detach themselves from any awareness of vulnerable feelings. As a result there is an emotional void in the lives of many men.

                If men are asked how they feel they may reply, “About what?” and proceed to tell you what they think. If asked to talk about their wives or girlfriends men may deny the importance of these intimate relationships. This hits close to the issue. Because they are being asked about the feelings they have been conditioned to avoid. By avoiding feelings men can remain true to their task; which is never to be vulnerable, sentimental or attached.

How Do Men Cope?

                Often the coping is not very successful and may prolong the pain men are trying to avoid. The mandate is that men must limit direct expression of feeling and are to find other ways to express themselves. Men are generally allowed to express feelings in three basic ways:

·         A direct conscious expression in relation to the source of the feeling. This comes out when a man expresses that he gets angry or disappointed when someone does something that he does not like or approve of.

·         The other two expressions of feelings are indirect, presenting as either changes in behavior or as physical symptoms. For example, a man might yell at his children or suddenly develop stomach or head pain in response to his wife’s behavior. In fact we can see the indirect effect of negative emotional experience in some of the typical physical illnesses suffered more frequently by men than women; low back pain, heart disease, ulcers, even cancer.  Although all of these problems have physiological bases, many studies have documented psychological contributions to these illnesses as well.

What Can Be Done to Help?

In future articles I will shed light on other aspects of male depression and what can be done to alleviate the suffering for men and their families. If you’re a man and wonder or suspect that you may be suffering from depression, I invite you to contact my office and arrange for an evaluation. Proper assessment and diagnosis is the key to getting you the help needed to begin healing. If you are a wife, girlfriend or adult child of a man, who you suspect is suffering from depression, I invite you to call as well, or encourage your loved one to seek counseling.

Evaluations are available by appointment - call 310-560-7883 to arrange for an assessment.

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