Past research on depression has suggested that men are diagnosed with depression less frequently than women. More recent findings, however, suggest that men may underreport depression, or be underdiagnosed or misdiagnosed because of unique ways in which many men experience depression.
What It Is
Traditional symptoms of depression, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) may include:
- Depressed mood for more than two weeks
- Loss of interest in normally pleasurable activities
- Significant weight change
- Loss of energy
- Sleep disturbance
- Feelings of hopelessness or worthlessness
- Trouble concentrating
Thoughts about death Although many depressed men may present with these symptoms, a significant number of men may not. Because of close adherence to traditional masculine gender roles, some men may instead experience unique, gender-related symptoms that may mask or replace more typical signs of depression.
What To Watch For
Research on men’s issues (e.g. Cochran & Rabinowitz, 2000) has identified masculinity-related signs or symptoms which may suggest depression. These include:
- Increased autonomy and interpersonal distance
- Increased conflict and anger in relationships
- Withdrawal from social contacts
- Heightened sensitivity to perceived threats to self-esteem
- Anger/disappointment with self
- Alcohol/drug abuse and dependence
- Inability to express emotions/feeling “numb”
- Decreased sexual interest (but not necessarily sexual activity)
- Physical/somatic complaints
- Work-related problems/conflicts
- Difficulties with motivation
What To Ask
In addition to direct questions about depression (which some depressed men may deny), health care professionals should also consider asking men these questions:
- Have you felt angry and/or irritated more often?
- Has it been harder to socialize lately?
- Are you or others concerned about your alcohol or drug use?
- Do you frequently feel emotionally flat or “numb”?
- Have you noticed yourself enjoying sex less?
- Are you frequently disappointed with your performance at work, in school, or in relationships?
- Are you having trouble completing tasks due to procrastination or a lack of motivation?
Positive responses to these questions could justify further evaluation, in order to rule out depression.
Reference: Cochran, S. & Rabinowitz, F. (2000). Men and Depression: Clinical and Empirical Perspectives. San Diego, CA: Academic Press.