Depression is a serious but treatable medical condition that can strike anyone regardless of age, ethnic background, socioeconomic status, or gender. However, depression may go unrecognized by those who have it, their families and friends, and even their physicians. Men, in particular, may be unlikely to admit to depressive symptoms and seek help. But depression in men is not uncommon: in the United States every year, depressive illnesses affect an estimated seven percent of men (more than six million men).

Depression comes in different forms, just as is the case with other illnesses such as heart disease. The three main depressive disorders are: major depressive disorder, dysthymic disorder, and bipolar disorder (manic-depressive illness). Not everyone with a depressive disorder experiences every symptom. The number and severity of symptoms may vary among individuals and also over time.

Symptoms of depression include:

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
• Decreased energy, fatigue, being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Trouble sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Restlessness, irritability
• Persistent physical symptoms, such as headaches, digestive disorders, and chronic pain, which do not respond to routine treatment

Research and clinical findings reveal that while both men and women can develop the standard symptoms of depression, they often experience depression differently and may have different ways of coping. Men may be more willing to report fatigue, irritability, loss of interest in work or hobbies, and sleep disturbances rather than feelings of sadness, worthlessness, and excessive guilt.

Some researchers question whether the standard definition of depression and the diagnostic tests based on it adequately capture the condition as it occurs in men. Men are more likely than women to report alcohol and drug abuse or dependence in their lifetime; however, there is debate among researchers as to whether substance use is a "symptom" of underlying depression in men, or a co-occurring condition that more commonly develops in men. Nevertheless, substance abuse can mask depression, making it harder to recognize depression as a separate illness that needs treatment.

Instead of acknowledging their feelings, asking for help, or seeking appropriate treatment, men may turn to alcohol or street drugs when they are depressed, or become frustrated, discouraged, angry, irritable and, sometimes, violently abusive. Some men may deal with depression by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends; other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm's way. Four times as many men as women die by suicide in the United States, even though women make more suicide attempts during their lives. In light of research indicating that suicide is often associated with depression, the alarming suicide rate among men may reflect the fact that men are less likely to seek treatment for depression. Many men with depression do not obtain adequate diagnosis and treatment, which may be life saving.

More research is needed to understand all aspects of depression in men, including how men respond to stress and feelings associated with depression, how to make them more comfortable acknowledging these feelings and getting the help they need, and how to train physicians to better recognize and treat depression in men. Family members, friends, and employee assistance professionals in the workplace also can play important roles in recognizing depressive symptoms in men and helping them get treatment.

Seek Help for Depression

If you are having symptoms of depression or know someone who is, seek help. There are several places in most communities where people with depressive disorders can be diagnosed and treated. Help is available from family doctors, mental health specialists in mental health clinics or private clinics, and from other health professionals.

A variety of treatments, including medications and short-term psychotherapies (i.e., "talking" therapies), have proven effective for depressive disorders: more than 80 percent of people with a depressive illness improve with appropriate treatment. Not only can treatment lessen the severity of depression, but it may also reduce the duration of the episode and may help prevent additional bouts of depression.

Tags: Depression

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The National Institute of Mental Health (NIMH) is one of 27 components of the National Institutes of Health (NIH), the Federal government's principal biomedical and behavioral research agency. NIH is part of the U.S. Department of Health and Human Services.