Men and Depression – a Hidden Illness

Definition: Depression is a medical illness that makes you feel sad and causes you to lose interest in life.  Physical symptoms include: low libido and interest in sex, loss of appetite, insomnia and slowed mental processing and body movements.  Depression can also mean frequent crying spells, unexplained body aches and pains as well as suicidal thoughts.  Depression upsets your life so that day-to-day activities become increasingly difficult and you often feel that life is not worth living.  Depression is not just a short episode of the blues; it’s not a personal weakness that someone can snap out of. 

Statistics: The CDC states that 9% of adults are depressed at least occasionally and 3.4% of adults suffer from major depression.  The prevalence of major depression increases with age, from 2.8% among people aged 18 to 24 to 4.6% of people aged 46 to 64.  However, those 65 and older reported less major depression with only 1.6%.  Researcher Jim Thornton writes that possibly 10% of patients over 50 who see a primary care physician are suffering from a major depression.  If you add in clients with a chronic low mood condition called dysthymia, that statistic zips up to 20 %.

Depression in Men Versus Women: The CDC does not know why depression is reported more frequently in women than in men.   Thornton’s research indicates that the reason might be that women are more able to seek help and reveal their depression than men.

Terrence Real in his book I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression  writes:  “It’s not considered unwomanly to be emotional and vulnerable, but a real man would never be so weak as to let his emotions get the best of him.  There’s a lot of shame involved, and this sets up what I call compound depression—a man gets depressed about being depressed.”

Therapist Real states that depressed men often try to hide or numb their pain with excessive drinking, gambling, uncontrolled sex or temper flares.  This reinforces negative behaviors which Real calls an “addictive defense.”  Dr. Barry Lebowitz says that men often talk about every symptom of depression except sadness, lacking the ability to reveal their feelings.

Suicide Rates: The bad news is that when depression is complicated by substance abuse, suicide completion rates rise, creating the big difference between men and women.  Though women attempt suicide 3 times more often than men as a cry for help, men are 4 times more likely to succeed.  Statistics for aging male boomers are distressing as currently older white males (85 +) are more than 10 times as likely as women to succeed in committing suicide.

Patrick McCathern recounted that he came within seconds of killing himself until his dog walked in.  “When my dog looked up at me with his bright beagle eyes, it was like he was saying ‘What about us? We love you.’ …If I died, who’d get my dogs water and feed them?” McCathern aborted his attempt and sought help.  The journey back was fraught with difficulty, but he made it and is content with his life. Life changes can often trigger depression and boomer men are seeing more than their share: retirement; loss of friends and family members; increasing health issues which come with daily pain; reduced activity; increased need of medications; and overall feeling that life is becoming more arduous than carefree.  

Medication and Therapy: Depression can be chronic, requiring long-term treatment, like diabetes or high blood pressure.  But if you are depressed don’t give up or get discouraged.  Medication and psychological counseling can definitely make a difference in your life.

The first-line drugs used by providers are called SSRIs, selective serotonin reuptake inhibitors—Prozac, Paxil, Zoloft, Celexa and Lexapro. The good news is these drugs work and are safe to use; the bad news is they do have some bothersome side effects including reduced libido and delayed orgasm as well as digestive problems, jitteriness, restlessness, headache and insomnia.  SSRIs do not abolish depression immediately, but take 4-6 weeks to relieve symptoms.

If the first SSRI doesn’t work or the side effects are hard to live with, your provider will probably try another one.  If together you decide this line of medication is not working, the next line of drugs are SNRIs, serotonin norephinephrine reuptake inhibitors like Cymbalta, Effexor, and Pristiq. Side effects are similar to SSRIs, and can also cause sweating, dry mouth, fast heart rate and constipation.  If sexual side effects are a deal breaker for you, ask your provider to prescribe Wellbutrin.  This medication is another anti-depressant well know to not inhibit libido.

Psychotherapy or the talking cure, should probably accompany your medication.  Though difficult for some men, counseling helps you resolve conflicts.  As you talk, you begin to see blockages in your pathway; with your counselor’s help, problems take on a new perspective.  You do the work and you find the resolve to tackle each problem in your life, one at a time.  Control returns.  Depression fades.         

  Autobiography in Five Short Chapters

1. I walk down the street; there is a deep hole in the sidewalk.  I fall in.  I am lost, I am hopeless but it isn’t my fault.  It takes me forever to find a way out.
2. I walk down the same street; there is a deep hole in the sidewalk.  I pretend I don’t see it and I fall in again.  I can’t believe I am in the same place, but it still isn’t my fault.  It still takes a long time to get out.
3. I walk down the same street.  There is a deep hole in the sidewalk; I see it there.  I still fall in—it’s a habit.  My eyes are open.  I know it’s my fault.  I get out immediately.
4. I walk down the same street.  There is a deep hole in the sidewalk.  I walk around it.
5. I walk down another street.

Anonymous

For more information on men and depression

Read more from Beth Havey on her blog, Boomer Highway