Dr Dulcy tackles men’s clinical depression
REPORTS: MEN ARE FOUR TIMES MORE LIKELY TO COMMIT SUICIDE COMPARED TO WOMEN
Clinical depression was once considered a ‘woman’s disease’ even though more than 6 million men in the US are diagnosed with depression each year.
Depression in men can affect sexual desire and performance.
Clinical depression was once considered a “woman’s disease,” even though more than six million men in the US are diagnosed with depression each year (no definite statistics in South Africa). Unfortunately, the lingering image of depression as a female condition may keep men who are clinically depressed from recognising the symptoms of depression and seeking treatment. Depression affects both sexes.
It disrupts relationships and interferes with work and daily activities. The symptoms of depression in men are similar to the symptoms of depression in women. But men tend to express those symptoms differently. Common symptoms of depression include loss of interest in usually pleasurable activities, fatigue, changes in appetite, sleep disturbances, and apathy.
In women, depression may be more likely to cause feelings of sadness and worthlessness. Depression in men, on the other hand, may be more likely to cause them to become withdrawn or to feel irritable, aggressive, or hostile. A 2009 national survey shows that depression is undertreated in South Africa and that major depression occurs earlier in the younger generation.
The lifetime prevalence of major depression reaches 10% for people aged 18 to 29 and occurs seven years earlier than those aged 30 to 39. If major depression – with an estimated prevalence of about one in 20 adults (4.9%, according to the South African Stress and Health Study) – is untreated, the downward spiral can be catastrophic.
There are reports that men are four times more likely to commit suicide compared to women, which could be because of underdiagnosed depression in men.
Men are more prone to suicide because they are less likely to openly show depression and have somebody else recognise it early enough to treat it, or to have themselves recognise that they’re in trouble. Burnout and depression among men are hidden – and rising – afflictions in South Africa.
The number of men admitted to private psychiatric clinics for depression last year was nearly a third higher than in 2010 and absenteeism owing to stress among men, particularly executives, jumped between 2008 and 2013. Men tend to leave it until later and the presentation is of a more serious nature. The majority are depressed and not seeking treatment. When men get red-light signals from their bodies, they are more likely to take a substance, like alcohol and drugs, to make the signals go away.
Men are less willing than women to say they are burned out and more likely to have other diagnoses like addiction or post-traumatic stress disorder.
Depression in men can affect sexual desire and performance. Unfortunately, some antidepressants and other medications can do the same. Men often are unwilling to admit to problems with their sexuality. Many mistakenly feel the problems are related to their manhood, when, in fact, they are caused by a medical problem such as clinical depression.
Society and socialisation plays a particularly important role in identifying and treating male de-
pression.
Depression in men often can be traced to cultural expectations. Men are supposed to be successful. They should not openly express their emotions.
They are taught that boys don’t cry. They must be in control. These cultural expectations can mask some of the true symptoms of depression. Instead, men may express aggression and anger, which is seen as more acceptable “manly” behaviour.
Therefore they are more likely to deal with their symptoms by drinking alcohol, abusing drugs, or pursuing other risky behavior.
Elderly men may have medical conditions such as heart disease, stroke, cancer, or other stressors that may contribute to depression. Losses of friends, physical health, spouses, income and meaningful work may contribute. Retirement is difficult for many men because they end up with no routine or set schedule to follow.
These changes may increase the stress they feel, and a loss of self-esteem may contribute to depression. In addition, the death of family and friends, the onset of other health problems, and some medications can contribute to depression in men.
Causes and risk factors
You cannot say for certain what causes depression in anyone, it is for everyone. Sometimes a difficult time in you or your friend’s life can set off depression; sometimes it is caused by a combination of things that have built up over time. And sometimes, there is just no obvious cause at all. Family history does however play a role. Some risk factors for men developing depression include: physical health problems relationship problems employment problems social isolation significant change in living arrangements (eg separation or divorce)
drug and alcohol use.
SIGNS AND SYMPTOMS
Depression signs and symptoms can differ in men and women. Men also tend to use different coping skills, both healthy and unhealthy, than women do. It is not clear why men and women may experience depression differently. It may involve brain chemistry or hormones but socialisation and life experiences also play a major role.
Symptoms that are similar in both sexes include: Feel sad, hopeless or empty Feel extremely tired Have difficulty sleeping Not get pleasure from activities they once enjoyed Behaviours that are mostly seen in men that could be signs of depression include:
Escapist behaviour, such as spending a lot of time at work or on sports Alcohol or drug abuse Controlling, violent or abusive behaviour
Irritability or inappropriate anger
Risky behaviour, such as reckless driving These behaviours are not specific to mental illness, it is therefore important to seek professional help for an accurate diagnosis and appropriate treatment.
TREATMENT
Clinical depression cannot be self-managed, you need to get help from your doctor. Asking for help can be hard for men. But without treatment, depression is unlikely to go away, and it may get a lot worse.
Untreated depression can make you and the people close to you miserable. It can cause problems in every aspect of your life, including your health, career, relationships and personal safety.
Depression, even if it’s severe, usually improves with medications or psychological counseling (psychotherapy) or both. If you or someone close to you thinks you may be depressed, talk to your doctor or a mental health profesdifferent
sional.
It’s actually a sign of strength to ask for advice or seek help when you need it. Many effective treatments are available for depression. So don’t try “be a man about it” and think you can do this on your own because the consequences could be devastating.
Treatment with a doctor or mental health professional can help you learn healthy coping skills. These may include: Goals. Set realistic goals and prioritise tasks. Support. Seek out emotional support from a partner or family or friends.
Coping. Learn ways to manage stress, such as meditation and mindfulness, and develop problem-solving skills.
Decisions. Delay making important decisions, such as changing jobs, until your depression symptoms improve.
Activities. Engage in activities you enjoy, such as ball games, fishing or a hobby.
Health. Live a healthy lifestyle, including healthy eating and regular physical activity, to help promote better mental health. All aerobic activity stimulates brain chemicals that foster the growth of nerve cells; exercise also affects neurotransmitters such as serotonin that influence mood and produces ANP, a stress-reducing hormone, which helps control the brain’s response to stress and anxiety.
CONSEQUENCES
Depression in men can have devastating consequences. It is said that men are three to four times likelier than women to commit suicide. About 65% to 70% of all people who commit suicide are men. Though more women attempt suicide, more men complete the act of actually ending their lives. This may be due to the fact that men tend to use more lethal and violent methods for committing suicide, such as using a gun rather than taking an overdose of pills.