The Many Masks of Male Depression

There are millions of men who are depressed, but don’t know it and millions more who know it, but are afraid to show it. It isn’t manly to be depressed. There is a double stigma for men. We can accept physical disability, but mental disability makes us feel helpless and out of control. Emotional problems are also seen by many of us as “feminine.” We cover our unhappiness with drink, drugs, excessive exercise, overwork, and angry moods.

Psychotherapist Terrence Real, author of I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression says: “Hidden depression drives several of the problems we think of as typically male: physical illness, alcohol and drug abuse, domestic violence, failures in intimacy, self-sabotage in careers.”[i]

Not only is it difficult for the men to recognize their depression, those around them tend to see the men as “bad” rather than “sad.” It isn’t surprising because men’s behavior seems more aggressive than passive, more wounding than wounded. “Because men are raised to be independent, active, task oriented, and successful,” say Drs. John Lynch and Christopher Kilmartin, authors of The Pain Behind the Mask: Overcoming Masculine Depression. “They tend to express painful feelings by blaming others, denying their feelings, and finding solutions for their problems in places outside of themselves.”[ii]

One of the largest studies of its kind in the world, the Epidemiological Catchment Area study, sponsored by the National Institute of Mental Health, sought to find out the percent of the population suffering from various kinds of mental illnesses. A total of 19,182 persons were interviewed. Although many believe that psychiatric disorders affect women more than men, the data showed that 36% of men suffer from some kind of psychiatric disorder, compared to 30% of women. It was found that 5.2% of men and 10.2% of women suffered from some kind of affective disorder such as depression. 23.8% of the men and 4.6% of women suffered from alcohol dependence. 7.7% of men and 4.8% of women suffered from drug dependence. 4.5% of men and .80% of women suffer from antisocial personality disorder.[iii]

“Interestingly, men outnumber women in alcohol-related disorders, drug-related use and disorders, antisocial personality, and any psychiatric conditions,” say Drs. Sam V. Cochran and Fredric E. Rabinowitz. “Additionally, the sex imbalance in these male-dominated disorders raises the question of how many men who might be ‘depressed’ are manifesting their depression in these categories or through other undocumented syndromes.”[iv]

I suggest that Irritable Male Syndrome is one of the categories where male depression is manifested. This idea was given additional credibility by two studies done in Denmark indicating that males and females show equal levels of depression when an irritability and aggressive component was added.[v]

[i] Terrence Real. I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression. New York: Scribner, 1997, p. 22.

[ii] John Lynch and Christopher Kilmartin. The Pain Behind the Mask: Overcoming Masculine Depression. New York: The Haworth Press, 1999, p. 7.

[iii] L. Robins & D. Reiger. Psychiatric Disorders in America. New York: Press Press, 1991. Summarized in Sam V. Cochran and Fredric E. Rabinowitz. Men and Depression: Clinical and Empirical Perspectives. San Diego, California: Academic Press, 2000, p, 13.

[iv] Sam V. Cochran and Fredric E. Rabinowitz. Men and Depression: Clinical and Empirical Perspectives. San Diego, California: Academic Press, 2000, p. 13-14.

[v] See Finn Zierau, Anne Bille, Wolfgang Rutz, Per Bech. The Gotland Male Depression Scale: A validity study in patients with alcohol use disorder. Nordic Journal of Psychiatry. Vol. 56, No 4., p. 265-271, 2002.

See also Rutz, W., et. al. Prevention of male suicides: lessons from Gotland study. Lancet. 345:524, 1995.

©2010 Jed Diamond

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Jed Diamond is the internationally best-selling author of seven books including Male Menopause, now translated into 17 foreign languages and his latest book, The Irritable Male Syndrome: Managing. The 4 Key Causes of Depression and Aggression. For over 38 years he has been a leader in the field of men's health. He is a member of the International Scientific Board of the World Congress on Men’s Health and has been on the Board of Advisors of the Men’s Health Network since its founding in 1992. His work has been featured in major newspapers throughout the United States including the New York Times, Boston Globe, Wall Street Journal, The Los Angeles Times, and USA Today. He has been featured on more than 1,000 radio and T.V. programs including The View with Barbara Walters, Good Morning America, Inside Edition, CBS, NBC, and Fox News, To Tell the Truth, Extra, Leeza, Geraldo, and Joan Rivers. He also did a nationally televised special on Male Menopause for PBS. He looks forward to your feedback. E-Mail. You can visit his website at

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