The Irritable Male Syndrome: What Is It, and Is It Real?

The Irritable Male Syndrome: Managing the Four Key Causes of Depression and Aggression
by Jed Diamond

From the bestselling author of Male Menopause comes another life-transforming book for men-and the women who love them-on overcoming the mood and behavior changes caused by fluctuating male hormones.

It turns out that it's not only women who suffer from hormone-related irritability. Depression, anger, fatigue, moodiness, anxiety, lethargy, low libido, and confusion are just some of the symptoms of a recently identified condition that affects men.

IMS (Irritable Male Syndrome) is in some ways similar to male menopause, but it can affect men of all ages. What often triggers IMS is acute or chronic stress. Focusing on two crucial times of life when male hormones are shifting rapidly - adolescence/young adulthood and midlife - Jed Diamond reports on the latest research from international experts on men's health and hormones, describes in detail the symptoms of IMS, explains how the volatile mood swings of the syndrome can wreak havoc with a man's closest relationships, and provides advice on preventing, diagnosing, and treating IMS.

Just as when he began researching his landmark book on male menopause, Diamond is at the forefront of this controversial subject. He offers readers the most comprehensive, insightful coverage of IMS and the practical wisdom he imparts will help millions.

Q: What do you call a man who is always tired, miserable, and irritable?
A: Normal.

Q: How can you tell if a man has Irritable Male Syndrome?
A: You ask him to pass the salt, and he yells, "Take, take, take—that's all you ever do!"

These little zingers, which appeared in London's Daily Mirror, illustrate some important aspects of what many men, and those who must live with them, are experiencing these days. First, it seems that stress has become a normal part of modern life and more men are taking out their frustrations on those who are closest to them. Second, men's irritability, blame, and anger seem excessive and more explosive. Ask a guy an innocent question, and he jumps down your throat. What's going on here?

For some men, this kind of irritability has come on slowly over a period of months and years. For others, it seems like someone has flipped a switch and Mr. Nice has turned into Mr. Mean. "God, it's like he's hormonal," one woman told me. When I told her she wasn't too far from the truth, she snapped back, "I knew it."

Since I began my study of this subject, I have received thousands of letters from men and women describing their experiences. What follows are typical of what women and men have told me.

A WOMAN'S VIEW

A letter I received recently, from a woman named Barbara, is typical of what women experience with men suffering from the Irritable Male Syndrome:

For about a year now (it could be even longer—it's hard to know exactly), I have gradually felt my husband of 22 years pulling away from me and our family. He has gradually become more sullen, angry, and moody. His general life energy is down, and his sex drive has really dropped off.

Recently, he has begun venting, to anyone who will listen, about how horrible we all are. He is particularly hard on our 19-year-old son, Mark. It's so surprising because our son has always been superindustrious and competent. My husband has always shared my view that Mark is one of the hardest working kids we know. But all of a sudden, that has all changed. Mark still works from 6:30 A.M. until 4:30 P.M. every day, but now his dad accuses him of being unmotivated, lazy, and anything else he can think to say that is negative.

If the kids aren't living up to his standards, it is my fault. When they're good, it is because he has been such a positive influence in their lives. If there's a problem, it must be because of the way I've raised them. I know that sounds bizarre, but that's how he thinks.

He blames me for everything these days. If his socks or underwear are missing, I must have put them somewhere or done something with them to piss him off. I'm not kidding— t hat 's what he tells me. The thing that bothers me the most is how unaffectionate he has become. I don't even get the hugs and affection like I did in the past. And when he does touch me, I feel grabbed rather than caressed. My husband used to be the most positive, upbeat, funny person I knew. Now, it's like living with an angry brick!

A MAN'S VIEW

Although men are generally not as aware of the problem or willing to admit that they suffer from the Irritable Male Syndrome, one man who filled out the questionnaire on the Men's Health magazine Web site was quite aware. He even responded to my request for more in-depth feedback about his experience. Rick is a 52-year-old married man with children ages 22 and 26. His responses are typical of many men who have spoken out.

I think my irritability is related to the time of life I am in and to the stresses that seem to be mounting both at work and at home. I'm an electrical engineer, and I work for a large company in the Midwest. There has been a great deal of "consolidation" over the past few years, and many people have been let go or forced into early retirement. Even though I have been here a long time and I don't think I am vulnerable to losing my job, I still worry.

There is always so much to do, and there never seems to be enough time to do it all. I have trouble staying on top of it all. I don't have much physical or mental energy these days. All of this is affecting my sleep. My wife keeps asking me what's wrong. I don't know what to tell her. I usually answer that nothing is wrong. When she persists, I often snap at her.

Although I love my wife, I feel we have grown apart over the years. We used to be very close, but now we often seem like opposites—and that creates its own kind of stress. I can feel unappreciated, unheard, uncared about. She expresses the same feelings. Even though we are aware of it, we don't seem to be able to do anything about it. It's very discouraging and depressing.

For me, depression and irritability are closely linked. I don't really lash out that often. I mostly hold the feelings in. I don't want to fight, but sometimes things erupt, and I blow up at her. I can tell she's hurt. I feel guilty, and that makes me angrier. It seems to be a vicious cycle. She says I am often sarcastic and cutting. I don't think I am, but maybe she's right.

When we're out having fun, I can go from being happy-go-lucky to crabby in the blink of an eye. Something small will happen. I take it personally and become irrationally angry. For instance, I'll be at a bar with some friends, and if the waitress is slow in getting to the table, it infuriates me. Sometimes I'll say something hurtful, like "It's about time you got around to doing your job." Other times, I'll just leave and go home, fuming all the way.

I know I lack a sense of general well-being much of the time. I have come to doubt my ability to be a reliable, dependable, likable person. My confidence in myself is low. When I feel hateful or annoyed with everyone, I just want to isolate myself. That way, I don't have to deal with them, and I won't do things I'll regret later. As a result, I have become estranged from my wife and children. Even at work, which used to be a place where I felt comfortable and had a lot of friends, I feel cut off and isolated.

This depression/irritability "syndrome" affects everything in my life. I feel that I have achieved very little of what, as a young man, I had hoped to achieve. I long to be much more confident and competent, much more relaxed, much more self-sufficient, and much more successful.

A MULTIDIMENSIONAL PROBLEM IN LIFE

IMS is a multidimensional problem that affects, and is affected by, hormonal, physical, psychological, emotional, interpersonal, economic, social, sexual, and spiritual changes. One of the reasons it is so difficult to understand and deal with is its complexity. In our 21st-century world of high technology and specialization, we tend to see every problem in either-o r terms. It's either physical or psychological; biological or social; personal or interpersonal. The result is that we go to one specialist to treat our hearts, a diff e rent one to take care of our psyches, and still a third to deal with physical pain. No one deals with the whole person, much less the person in the context of his family, community, and social environment. We are learning about the very nature of life, how our genes lay the foundation for who and what we are. But we seem to be losing the larger picture of what it means to be a healthy human being.

Who do we go to see about the increasing stress in our lives? Where do we learn about andropause (male menopause) and the changes in men as we age? How do we find out about the hormonal tides that affect males at all ages? What do we do when our problems are larger than can be understood by looking at our own lives? We are social beings and can't be understood apart from our mates, our children, our parents, our friends, our communities, the world we live in, and our view of the spiritual world beyond.

WHAT IS IMS?

In trying to describe something that is new, it is difficult to come up with a short, accurate, and useful definition. In some sense, this whole book is my attempt to define what I mean by the Irritable Male Syndrome. What follows is my current definition. I expect it will change through time as we gather more information and conduct further research.

Irritable Male Syndrome: A state of hypersensitivity, anxiety, frustration, and anger that occurs in males and is associated with biochemical changes, hormonal fluctuations, stress, and loss of male identity.

Let me share with you what went into this particular definition. Working with males who are experiencing IMS (and those who live with them), I have found there are four core symptoms that underlie many others.

The first is hypersensitivity. The women who live with these men say things like:

• "I feel like I have to walk on eggshells when I'm around him."
• "I never know when I'm going to say something that will set him off."
• "He's like a time bomb ready to explode, but I never know when he'll go off."
• "Nothing I do pleases him."
• "When I try to do nice things, he pushes me away."
• "He'll change in an eye-blink. One minute, he's warm and friendly. The next, he's cold and mean."

The men don't often recognize their own hypersensitivity. Rather, their perception is that they are fine but everyone else is going out of their way to be irritating. The guys say things like:

• "Quit bothering me."
• "You know I don't like that. Why do you keep doing it?"
• "Leave me alone."
• "No, nothing's wrong. I'm fine. Quit asking me questions."
• "The kids always___." Fill in the blank: It's always negative.
• "The kids never ___." Fill in the blank with any one of the "right" things.
• "Why don't you ever ___?" Fill in the blank: "want sex," "do what I want to do," "do something with your life," "think before you open your mouth," "do things the right way."
• "You damn ___." Fill in the blank: "fool," "nag," "bitch." As IMS progresses, the words get more hurtful.

Or they don't say anything. They increasingly withdraw into a numbing silence.

One concept I have found helpful is the notion that many of us are "emotionally sunburned, "but those around us don't know it. Think of a man who is extremely sunburned and gets a loving hug from his partner. He cries out in anger and pain. He assumes that she knows he's sunburned and that since she's "grabbed" him she must be trying to hurt him. She has no idea he is sunburned and can't understand why he reacts angrily to her loving touch. You can see how this can lead a couple down a road of escalating confusion.

The second core IMS emotion is anxiety.

Anxiety is a state of apprehension, uncertainty, and fear resulting from the anticipation of a realistic or fantasized threat. As you will see as you delve more deeply into the book, IMS men live in constant worry and fear. There are many real threats that they deal with in their lives: job insecurities, sexual changes, relationship problems. There are also many uncertainties that lead men to ruminate and fantasize about future problems.

These kinds of worries usually take the form of what-ifs: What if I lose my job? What if I can't find a job? What if she leaves me? What if I can't find someone to love me? What if I have to go to war? What if something happens to my wife or children? What if my parents die? What if I get sick and can't take care of things? The list goes on and on.

The third core emotion is frustration.

Princeton University's WordNet offers two definitions that can help us understand this aspect of IMS.

1. The feeling that accompanies an experience of being thwarted in attaining your goals. Synonym is defeat.

2. A feeling of annoyance at being hindered or criticized.

WordNet also offers an enlightening example to illustrate the use of the word: "Her constant complaints were the main source of his frustration."

IMS men feel blocked in attaining what they want and need in life. They often don't even know what they need. When they do know, they often feel there's no way they can get it. They feel defeated in the things they try to do to improve their lives. The men feel frustrated in their relationships with family and friends and on the job. The world is changing, and they don't know where, how, or if they fit in.

Author Susan Faludi captures this frustration in her book Stiffed: The Betrayal of the American Man. It's expressed in the question that is at the center of her study of American males: "If, as men are so often told, they are the dominant sex, why do so many of them feel dominated, done in by the world?" This feeling, often hidden and unrecognized, is a key element of IMS.

The fourth core emotion is anger.

Anger can be simply defined as a strong feeling of displeasure or hostility. Yet it is a complex emotion. Outwardly expressed, it can lead to aggression and violence. When it is turned inward, it can lead to depression and suicide. Anger can be direct and obvious, or it can be subtle and covert. Anger can be loud or quiet. It can be expressed as hateful words or hurtful actions, or in stony silence.

For many men, anger is the only emotion they have learned to express. Growing up male, we are taught to avoid anything that is seen as the least bit feminine. We are taught that men "do" while women "feel." As a result, men are taught to keep all emotions under wrap. We cannot show we are hurt, afraid, worried, or panicked. The only feeling that is sometimes allowed men is anger. When men begin going through IMS, anger is often their primary emotion.

Whereas anger, frustration, and anxiety can occur quickly and end quickly, the first IMS emotion, hypersensitivity, can last a long period of time and can trigger the other three feelings over and over again. It can have a major impact on men's whole lives. "When we're in a mood, it biases and restricts how we think," says Paul Ekman, Ph.D., a psychology professor and the director of the Human Interaction Laboratory at the University of California, San Francisco, School of Medicine.

In describing this kind of negative mood, Dr. Ekman, one of the world's experts on emotional expression, continues: "It makes us vulnerable in ways that we are normally not. So the negative moods create a lot of problems for us, because they change how we think. If I wake up in an irritable mood, I'm looking for a chance to be angry. Things that ordinarily would not frustrate me, do. The danger of a mood is not only that it biases thinking but that it increases emotions. When I'm in an irritable mood, my anger comes stronger and faster, lasts longer, and is harder to control than usual. It's a terrible state . . . one I would be glad never to have."

As we explore IMS in more depth, be aware that we are talking about a problem that isn't easily categorized or circumscribed. It is slippery and elusive. It can wreak havoc in the lives of men and those who love them, and it can remain hidden from scrutiny. I know—IMS nearly destroyed my family and me.

UP CLOSE AND PERSONAL

One of the reasons I wrote The Irritable Male Syndrome was to help the many men and women who suffer from a problem they don't understand. As a therapist, I'm sad to see so many midlife couples split up at the very time they could be enjoying each other the most. I'm often frustrated to see the tension that builds between young men and their families—tensions that can tear a family apart and can lead to alcohol or drug abuse, aggression, or violence. It angers me to see so many of our young men—good, caring guys—end up involved with the criminal justice system.

The other reason I wrote this book is a lot more personal and close to home. After many years of a wonderful marriage, something seemed to be eating at the very roots of the joy and commitment between my wife and me. Carlin and I had both been married before and had merged our families when we got together. She had three sons, and I had a son and a daughter. We raised her youngest son and my daughter together. There were difficulties, stresses, and strains, but we worked through them pretty well. We each felt we had found the love of our life, the person with whom we would spend the rest of our days. We felt that we had learned a lot about ourselves, that we had healed a good deal of our past wounds, and that we knew how to create a healthy marriage and family.

The change was nearly imperceptible at first. Looking back, it seems to have begun close to the time our last child left home.

© 2004 by Jed Diamond. All rights reserved. No Part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any other information storage and retrieval system, without the written permission of the publisher.

About the Author

Jed Diamond a licensed psychotherapist for 38 years and director of the health program MenAlive, is the author of seven books, including the international bestseller Male Menopause. He is on the board of advisors of the Men's Health Network and also serves on the international scientific board of the World Congress of Men's Health.