Men ignore symptoms of clinical depression


How much equality is there between the sexes? In recent years women have made strides in their struggle to gain equality with men. But surprisingly in one area men are getting the short end of the stick. Today the majority of people being treated for depression are women. The majority of men, however, suffer silently from undiagnosed and untreated depression. Why the gender bias in this case? And how can wives and families recognize this problem and urge men to accept treatment?

Dr. John S. Tamerin, a psychiatrist and professor at Cornell Weill School of Medicine in New York City, says there are over six million men suffering from a depressive disorder in North America and the majority will never be treated for this illness.

Tamerin says in Consumer Reports on Health that, "Men are often incapable of acknowledging that they're depressed and unable to talk about it, and are poorly diagnosed, especially by male doctors. And the consequences can be deadly."

For instance, one large epidemiological study revealed that most of those seeking professional help for depression were women. But 75 per cent of those who committed suicide were men. Tamirin concludes, "Women seek help, men die."

Why are males so reluctant to accept the fact that they're depressed and need treatment? It's probably the result of our North American culture and the macho male image. Men are supposed to be strong, in control, and able to restrain their emotions.

Showing emotion is considered a feminine trait. After all, no man envisions Clint Eastwood on a crying jag, and there's a little of Eastwood's make my day machismo in all men. Admitting depression is acknowledging that they no longer measure up.

The result is that men are less likely to exhibit the typical mental signs of depression. Rather, they keep their feelings hidden and are more likely to talk about the physical symptoms of depression such as tiredness, sleeplessness and stress at work. And most refuse to believe that depression is the reason for their lack of sexual desire. In the process many men fool their doctors.

What happens is that many seek refuge in alcohol, careers fail, marriages break down, loneliness sets in, and all too often suicide results. Since men more often use guns, rather than drugs, death is the outcome.

It would probably take the Second Coming to get Clint Eastwood to break down and cry. It's equally difficult to convince depressed men to make the first move to see their doctor. This is where family and friends can be helpful.

Look for the symptoms of depression. Get suspicious when men lose interest in things they normally enjoy. Or when they dwell gloomily on the past, complain of insomnia or fatigue for no good reason, have little or no desire for sex and are unable to make even the smallest decision.

But what can a wife or a friend do? Since doing nothing can have a fatal outcome you must bite the bullet and suggest medical attention. You must accept that the initial Clint Eastwood reaction will be defensive and even hostile.

Don't be afraid to ask husbands, relatives and friends about thoughts of self-injury and suicide. The odds are that you are not suggesting something that they haven't already thought about. Rather, you are expressing fear and concern for their well-being and safety.

Another approach would be to show them this column while suggesting that they have all the symptoms mentioned and good sense demands medical attention.

You might even reassure them that if the diagnosis is depression they are in good company. Winston Churchill was not afraid to admit to what he called his "black dog of depression" and thoughts of suicide. Mike Wallace of 60 Minutes fame has often talked publicly about his episodes of despair. And William Styron wrote about them (Lie Down in Darkness).

Some psychiatrists say that group therapy sessions are more helpful. Men then realize they are not the only ones with this problem.

Today, the mainstays of treatment are the selective serotonin reuptake inhibitors (SSRIs) such as Prozac. These drugs, along with talk therapy, often rid men of the black dog of depression.