Signs of depression in men
Road rage. Angry outbursts. Irritability and agitation. Mood swings and anger in men can be concerning for everyone around them but may in fact be a sign of depression.
While these symptoms of depression in men may show up at any time, male depression peaks in midlife. This pattern may be due to a variety of factors unique to men between 40-50 years old, including:
- Health and physical changes
- Family and relationship stressors
- Career and financial challenges
Do men and women have different symptoms of depression?
In women, depression symptoms often include:
- Sadness
- Hopelessness and inadequacy
- Excessive crying
- Physical fatigue
While men may have the same symptoms as women, signs of depression in men can manifest differently as:
- Aggression
- Irritability
- Increased risk taking
- Loss of control
- Sudden anger
- Reliance on alcohol, drugs or other substances
- Decreased work productivity
- Withdrawing from social interactions
The link between anger and depression in men
While a man may lose control or have an angry outburst unrelated to depression at any stage of life, repeatedly showing these signs of male depression may indicate a deeper problem. Often, anger is linked to feelings of hurt, failure or shame and may be considered a more socially acceptable "male" emotion. Over time, this anger can develop into a habitual reaction.
"Culturally, men are conditioned to be more aggressive. To focus on fighting things and not to talk about feelings, which may be seen as a sign of weakness," says Stephen Mechanick, MD, chairman of the Department of Psychiatry at Bryn Mawr Hospital, part of Main Line Health. "For some men, it's easier to act out anger or express it in some other way."
Dr. Mechanick is quick to caution against generalizations, however. He encounters many male patients who are insightful and thoughtful and are able to easily express how they're feeling and why.
"Anger doesn't necessarily mean depression. Anger is a symptom of something, just like fever is a symptom of something. It's not always depression," explains Dr. Mechanick.
Why do men get depressed?
Some men can identify what may be causing anger and upset in their lives. However, others may not realize how stress is impacting their physical and emotional health or how environmental factors are having an effect on their behavior.
There are a number of reasons why men may feel this way, but common causes of depression in men are:
- Disappointments in life – Mid-life may prompt a man to assess his achievements and failures, whether in his career or in relationships. While these may be explored with healthy perspective, a man susceptible to depression may internalize loss, failure and grief tied to life's disappointments.
- Aging and mortality – A man who is dealing with aging and illness in himself or his loved ones may be grappling with his own mortality and coming to terms with death as a fact of life. Thoughts of sadness and loss may fuel feelings of anger and frustration.
- Financial stress – A man may feel burdened by the expectation to provide financially, especially if he has a family to support. Fear of not being able to meet obligations or dealing with the constant strain of not earning enough to pay for expenses can be mentally and emotionally draining.
- Partner/relationship issues – Lack of fulfillment in a relationship is one of the most stressful things for a man and may lead to anger, aggression and other destructive behaviors. A relationship that brings out the worst in a man may erode his self-confidence and feelings of masculinity over time and can lead to deepening depression.
- Medication side effects – Certain types of blood pressure meds, proton pump inhibitors (PPI) for acid reflux and pain relievers can cause depression as a possible side effect. Some men may have no side effects while others may experience severe depression.
- Health changes – The probability of developing a medical condition increases the older we get. Health challenges such as high blood pressure, high cholesterol or diabetes, may trigger feelings of anxiety and concern, or fear of losing strength and masculinity. Erectile dysfunction may also contribute to these concerns.
- Behavior/lifestyle factors – Weight gain, addiction issues and lack of time or attention to well-being and physical exercise, can all lead to a depressed mood and associated symptoms, including anger and lashing out at others. This connection between lifestyle and depression isn't always obvious, especially if it's been going on for a long time.
- Hormonal changes – Male hormones such as testosterone and androgen naturally decline with age. While this change is very gradual and doesn't usually produce noticeable symptoms, it may cause irritability and affect self-esteem and sex drive. The effects of low testosterone remains a controversial topic, however, and according to Dr. Mechanick it is not usually the cause of depression or other emotional problems.
Treatment for depression in men
Recognizing that there's a problem is the first step to treat depression. Some men may notice symptoms of depression or recognize certain aspects of their lives are not working as well as they should. However, they may still be in denial about the need for therapy. On the other hand, some men may recognize that anger and irritability are a result of depression. And some men may have experienced depression in the past and are better able to identify it.
"If symptoms of depression are causing distress to a man, seeking help is a logical step," says Dr. Mechanick. Depending on the severity of the male depression symptoms, there are a number of treatment options available which may be prescribed individually or in combination. These include:
- Counseling – A skilled mental health professional, such as a psychologist or licensed clinical social worker, can support men with depression by helping them talk through what they're dealing with in life. Therapy can help men develop new skills and coping mechanisms for working through anger and other signs of male depression.
- Support groups – Talking to a group of men with similar issues may also be helpful. Groups are often dedicated to specific and common concerns such as a bereavement support group or divorce support group.
- Medication – A psychiatrist is able to holistically provide therapy and prescribe medication with optimal benefits and minimal side effects, such as an antidepressant. For men who are dealing with feelings of anxiety or panic attacks, an anti-anxiety medication may be prescribed along with establishing new behaviors such as meditation and exercise.
- Inpatient or partial hospital psychiatric (PHP) treatment – Some men with severe depression or whose safety or the safety of others is at risk or who is unable to care for himself due mental illness, may need extra care and oversight in a 24-hour inpatient psychiatric unit. Under clinical supervision, men with clinical depression can participate in group, individual and family counseling. These programs provide a mix of treatments as well as medication to help manage psychiatric illness with the goal of returning to normal functioning and life in his home and community. Partial hospital psychiatric programs provide intensive outpatient treatment without the need to stay overnight in a hospital.
- Drug and alcohol treatment – Depression and substance use often go hand in hand, with one fueling the other in an endless cycle of self-destructive thought and behavior. For men with mental health and addiction issues (dual diagnosis), getting help is critical. Removing the alcohol or drugs and recovering from substance misuse can help reveal underlying mental health issues made worse by relying on the substance.
"We encourage people to seek help early while your depression is potentially easier to correct and when there has been less suffering," adds Dr. Mechanick. "You don't get a prize for suffering."
Dr. Mechanick talks about men's mental health for Well Ahead Philly
Next steps:
Learn more about behavioral and mental health care at Main Line Health
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