The Many Masks of Male Depression
There are millions of men who are depressed, but
dont know it and millions more who know it,
but are afraid to show it. It isnt 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
Dont 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
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 isnt surprising because
mens 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
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
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
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
[i] Terrence Real. I Dont 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.
* * *
Wealth can't buy health, but health can buy
wealth. - Henry David Thoreau
is the internationally best-selling author of seven
books including Male
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
Mens Health and has been on the Board of
Advisors of the Mens Health Network since its
founding in 1992. His work has been featured in
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