When Men Battle Depression

“Losing a spouse, retiring, leaving a social network, dealing with an illness, and even children leaving home can all contribute to depression in men,” said Dr. Meera Narasimhan.

The lyrics of this classic Beatles song capture one of life’s undeniable truths. Men get depressed. While they are only half as likely as their female counterparts to suffer from depression, they are certainly not immune from its throes.

“Men are not as overt as women with expressing their feelings, so depression goes more unrecognized in men,” said Meera Narasimhan, M.D., associate professor in the Department of Neuropsychiatry and Behavioral Science at the University of South Carolina School of Medicine. While both sexes exhibit similar symptoms, including loss of energy, inability to concentrate, weight loss or gain, and sleep difficulties, men are less likely to seek medical assistance for their problem. “Very often they will try to self-medicate through drug and alcohol addiction, affairs or gambling,” said Dr. Narasimhan.

While Dr. Narasimhan asserts that neuro-chemicals in the brain affecting depression are processed differently in men and women, she also acknowl-edges the role of environ-mental factors. “In our society men have different social demands on them. Having a job and a family are significant components of keeping their integrity together. Losing either of these predisposes them to a narcissistic injury. This psychological component adds to their tendency to develop depression,” she explained.

“Men do not feel like they can show their emotions even if something is going on,” said Dr. Narasimhan, explaining that males have been taught from an early age to keep their act together. She added, “Therefore, depressed men tend to be very isolated and very emotionally detached.”

As men age, their risk of depression increases, particularly if they are without a partner. “Losing a spouse, retiring, leaving a social network, dealing with an illness, and even children leaving home can all contribute,” said Dr. Narasimhan. And while men are four times more likely than women to commit suicide, that risk goes up when they are 65 and older.

The key for men comes in taking the step to seek medical attention. Eighty percent of depression is treatable, and Dr. Narasimhan has found good results with the nearly 50 antidepressant medications that are on the market and the use of psychotherapies like cognitive behavioral therapy.

“Pharmacological treatments and talk therapy work well when used in combination,” she said. While she feels that depressed men often seek help from their family practitioners or internists, Dr. Narasimhan cautions that a non-response or partial response to treatment warrants referral to a psychiatrist. “Some forms of depression need a more aggressive management with pharmacological agents,” she said.

Reprinted from Connections newsletter, April 2003

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