MEN AND DEPRESSION
Researchers estimate that at least 6 million men in the United States suffer from a depressive disorder every year. Research and clinical evidence reveal that while both women and men can develop the standard symptoms of depression, they often experience depression differently and may have different ways of coping with the symptoms. Men may be more willing to acknowledge 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 upon 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 abuse is a "symptom" of underlying depression in men, or a 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 drugs when they are depressed, or become frustrated, discouraged, angry, and irritable. Some men 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.
Aging male syndrome (AMS), also called andropause or male menopause, generally affects men between the ages of 35 and 65 — typically between 40 and 55 — when their hormone levels begin to go down. Men can begin to have declining testosterone levels as early as their 20's. Testosterone is the male hormone that helps maintain sex drive, sperm production, pubic and body hair, muscle and bone. Though declining testosterone levels are normal in healthy males as they age, every man is not the same and men have different experiences. Some men's hormone levels go down more than others, and some have more symptoms than other men do. So how do you know if you have AMS? Here are many of the signs:
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If you have any of the symptoms of low testosterone, talk to your doctor about getting a simple blood test to evaluate your testosterone level. If you do have low testosterone, think about asking for a referral to a doctor that specializes in natural hormone replacement therapy, a endocrinologist or urologist, who can work with you to treat the problem.
The most important thing anyone can do for a man who may have depression is to help him get to a doctor for a diagnostic evaluation and treatment. First, try to talk to him about depression — help him understand that depression is a common illness among men and is nothing to be ashamed about. Then encourage him to see a doctor to determine the cause of his symptoms and obtain appropriate treatment.
Occasionally, you may need to make an appointment for the depressed person and accompany him to the doctor. Once he is in treatment, you may continue to help by encouraging him to stay with treatment until symptoms begin to lift (several weeks), or to seek different treatment if no improvement occurs. This may also mean monitoring whether he is taking prescribed medication and/or attending therapy sessions. Encourage him to be honest with the doctor about his use of alcohol and prescription or recreational drugs, and to follow the doctor's orders about the use of these substances while on antidepressant medication.
Men must cope with several kinds of stress as they age. If they have been the primary wage earners for their families and have identified heavily with their jobs, they may feel stress upon retirement-loss of an important role, loss of self-esteem-that can lead to depression. Similarly, the loss of friends and family and the onset of other health problems can trigger depression. Nevertheless, most elderly people feel satisfied with their lives, and it is not "normal" for older adults to feel depressed. Depression is an illness that can be effectively treated, thereby decreasing unnecessary suffering, improving the chances for recovery from other illnesses, and prolonging productive life.
However, health care professionals may miss depressive symptoms in older patients, who are often reluctant to discuss feelings of hopelessness, sadness, loss of interest in normally pleasurable activities, or extremely prolonged grief after a loss, and who may complain primarily of physical symptoms. Also, it may be difficult to discern a co-occurring depressive disorder in patients who present with other illnesses, such as heart disease, stroke, or cancer, which in themselves may cause depressive symptoms, or which may be treated with medications that have side effects resembling depression. If a depressive illness is diagnosed, treatment with appropriate medication and/or brief psychotherapy can help older adults manage both diseases, thus enhancing survival and quality of life.