How depression might present itself in men
I received an interesting question from a 318 Forum reader that I would like to share with you.
“Dear Andy, I was recently ‘forced’ to go to anger management counseling by the HR department at my work. I was told I was being really irritable and yelled at a couple of co-workers. I also missed some days at work because I was too angry to deal with the people there. During the first visit, the counselor said she thought I had depression and that my anger was how I dealt with my unconscious feelings. I don’t sit around and cry and feel sad or depressed. Why would the counselor think I’m depressed?” “Dear reader, you bring up a very common issue with how men’s depression symptoms may often show very differently from women. Your counselor evidently noticed that may be the source of your anger is depression. It sounds like it would be helpful to dig deeper into your anger issues (at work and at home with your family) with your counselor to see if you can uncover hidden negative thoughts and feelings that may be triggering your irritability. It won’t be easy, but I think you will be happier at work, home and within yourself.”
This reader’s situation brings up an important issue I want to discuss, which is how men’s depressive symptoms can be very different from women’s. Due to this, it can be harder to recognize and diagnose.
Most of the traditional research and diagnosing criteria we have for depression are based on data collected about women in therapy. This is mainly because many more women than men get counseling. Therefore, the patterns of symptoms necessary to diagnose depression were based on how women presented their symptoms. This has historically been why men, women and even clinicians may miss the source of symptoms as being related to depression. More recently, we have some research on the similarities and differences between men and women who might be clinically depressed.
Some common symptoms of major depression disorder are deep sadness, crying spells, hopelessness and possibly feeling suicidal. Some additional symptoms we see mostly in men are irritability and angry outbursts, isolating, drinking or working more, mental and physical exhaustion, or no longer getting enjoyment from activities they previously used to do. Often men escape into themselves by watching TV (sports) or isolating away from others, or suffer from physical problems such as anxiety attacks, digestive problems and headaches. Many times, difficult life situations such as the death of a loved one, money problems, medical conditions or limitations, or sexual dysfunction can lead to depression.
Depression that goes on for a long time without getting help can be harder to treat. It’s definitely better to seek help from a medical doctor or counselor early. Anyone having suicidal thoughts, especially if they have a specific plan and the means (gun, pills, etc.), should seek professional help immediately. Any suicidal thoughts should be taken seriously. Suicide is the tenth leading cause of deaths in the U.S., and for children and young adults it is the third leading cause of death. Surprisingly, the largest population at risk for suicide are elderly males 75 years and older! Statistics show women tend to “attempt” suicide more often than men, but more men die from suicide attempts. This is because men tend to use deadlier means than women.
Some of the reasons why the risk of suicide is higher among men are that they are more impulsive, including with suicide attempts, and that they also show fewer outward signs of being suicidal. If any of you are having suicidal thoughts, please call the National Suicide Prevention Hotline at 800-273-8255 anytime day or night. If you are having persistent suicidal thoughts with a specific plan and the means to carry it out, please go immediately to the hospital emergency room to be evaluated and treated.
If you feel you may have depression, you might benefit from psychotherapy (talk therapy), where you can discuss your symptoms and problems with a no-stringsattached professional and get personal advice on how to improve your well-being. Therapy can help you learn healthier coping strategies, how to re-engage in activities (golf, tennis, fishing, camping bowling, etc.) and ways to challenge negative beliefs, thoughts and feelings. Along with counseling, sometimes certain medications like antidepressants or antipsychotics can be useful. You can talk to your medical health-care provider about this option.
Another really helpful thing you can do to manage stress and combat depression is regular exercise. Studies have shown that regular exercise can help with depressive symptoms similar to medications. Remember, don’t just tough it out alone, guys, reach out for help. While women tend to be more willing to seek therapy, men need to be willing, too. Sometimes men feel it’s not masculine to reach out for professional help, but isn’t the opportunity to improve your life and happiness worth it?
Andy Sibley, MA, LPC, LMFT is a psychotherapist in private practice and contracted counselor for “The Dr. Phil Show.” To Ask Andy a question about a difficult situation you may want advice with, please email him at Andy@ AndySibley.com or visit www.AndySibley.com.