|
Depression Unmasked: His and Hers
I think of male depression as being masked. Those
of us who live with depression wear a mask that
hides what we are really feeling from others and
even from ourselves. People don’t know we are
depressed because what they see doesn’t look
like the kind of depression they are familiar with.
We also mask our depression with other things like
anger, alcohol, and chronic withdrawal.
As a result, the common view is that depression
is predominantly a female problem. We think of
teenage girls who are sullen and sobbing. We
picture young women who become depressed after the
birth of a child. We hear about mothers who are
overwhelmed by the stresses of keeping a house and
raising children (and now increasingly having to
work). We read about the “empty nest”
syndrome and know of women whose lives lose meaning
after their children leave home.
We don’t usually associate the idea of
“male” with the idea of
“depression.” Male and aggression, yes.
Male and depression, no. This view that depression
is more common in women is borne out by a number of
major research studies. Susan Nolen-Hoeksema,
author of Sex Differences in Depression, found that
depression is about twice as common in women as in
men.[i] “One of the most consistent
findings in the epidemiological study of mood
disorders over the past 50 years in the United
States,” say Drs. Sam V. Cochran and Fredric
E. Rabinowitz, authors of Men and Depression:
Clinical and Empirical Perspectives, “is that
women suffer from depression at approximately twice
the rate of men.”[ii]
Similar results were found in two large-scale
studies, the Epidemiological Catchment Area study
(ECAS) and the National Comorbidity Survey (NCS).
Both these studies are noteworthy in that they
interviewed people in the general population rather
than surveying people who are already in treatment.
The ECAS was sponsored in part by the National
Institute of Mental Health and used trained
interviewers to survey samples from five population
centers (New Haven, Connecticut; Baltimore,
Maryland, Raleigh-Durham, North Carolina; St.
Louis, Missouri, and Los Angeles, California. A
total of 19,182 persons were
interviewed).[iii]
The study reported lifetime prevalence estimates
of psychiatric disorders by gender. For the
affective disorders as a whole (Depression, bipolar
disorders, dysthymia) women outnumbered men two to
one. Interestingly though, men outnumbered women
five to one in alcohol abuse and dependence and
antisocial personality disorders. I will return to
this point shortly.
The NCS was designed, in part, to minimize
gender bias in the reporting of symptoms of mental
disorders, including depression. This study sampled
a total of 8,098 men and women between the ages of
15 and 54. Although considerably more females than
males reported symptoms of depression, the ratio
was 1.6 to 1 rather than 2 to 1.[iv] It was
believed that more men reported symptoms of
depression because the interviews were done in such
a way to counteract the male tendency to forget or
underreport symptoms. However, neither study looked
at the possibility that the symptoms of male
depression may be quite different than those for
women.
Although the generally accepted view is that
women are much more likely to be depressed than
men, these findings may be biased in the following
ways:
- Different behavior of reporting symptoms.
Men tend to be less in touch with feelings than
women and less likely to discuss feelings when
asked. In addition we often view being
“down” as being “unmanly”
and hence less likely to discuss these kinds of
feelings.
- Since men don’t seek professional help
as often as women, there tends to be a bias that
women are more likely to be depressed.
- Problems that are more common in men such as
alcohol dependence, personality disorders, or
acting out may mask depression.
- When depressed, women often ruminate and
re-play situations and feelings in their minds.
Hence they are more likely to remember and be
able to report them. Men tend to project their
feelings on to others and avoid or deny
problems. They are, therefore, much less likely
to describe themselves as depressed.
- Male role conditioning is such that we see
ourselves as independent. If there are problems
we are action oriented and solve them ourselves.
We don’t focus on our feelings or share
them with others. Women are conditioned more
towards sharing what is going on inside them
whether or not there is a solution.
- Finally, symptoms that characterize female
depression may be quite different from symptoms
of male depression.
[i] Susan Nolen-Hoeksema. Sex
Differences in Depression. Stanford, Ca: Stanford
University Press, 1990.
[ii] Cochran and Rabinowitz, 2000, p.
11.
[iii] Lee Robins and Darrel Regier.
Psychiatric Disorders in America. New York: Free
Press, 1990.
[iv] R. Kessler, K. McGonagle, C.
Nelson, M. Mughes, M. Swartz, & D. Blazer. Sex
and Depression in the National Comorbidity Survey.
II. Cohort effects. Journal of Affective Disorders,
30, 1994, 15-26.
©2010 Jed
Diamond
See Books,
Issues
+ Suicide
* * *
Wealth can't buy health, but health can buy
wealth. - Henry David Thoreau
Jed Diamond
is the internationally best-selling author of nine
books including Male
Menopause,
The
Irritable Male Syndrome: Managing. The 4 Key Causes
of Depression and
Aggression. and
Mr.
Mean: Saving Your Relationship from the Irritable
Male Syndrome. His
upcoming book, Tapping Power: A Man’s Guide to
Eliminating Pain, Stress, Anger, Depression and
Other Ills Using the Revolutionary Tools of Energy
Psychology will be available next year. 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 www.menalive.com
Contact
Us |
Disclaimer
| Privacy
Statement
Menstuff®
Directory
Menstuff® is a registered trademark of Gordon
Clay
©1996-2023, Gordon Clay
|
