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Joseph W. LaFleur, MSW, MBA, LICSW

Men and Depression and Anxiety

Men are not invincible. They do suffer from depression. And why shouldn't they. Like women, they experience broken relationships, some go through divorce, they lose jobs, they experience death of friends and the list goes on. These experiences cause pain. They cause emotions that are unfamiliar. Most often then not, they are unequipped to handle these unfamiliar emotions and that frightens them. And rightly so! Men are attempting suicide and succeeding at alarming rates.

Depending on age, men complete suicide a least 3 times and as high as 8 times more frequently than women. Even though women appear to make suicide gestures more often than men, the numbers are unmistakable. Men are killing themselves in alarming numbers, especially as they get older.

Studies have shown that men underrepresented in the tally of most of the common psychiatric disorders. This is particularly true for mood disorders (depression) and the anxiety disorders. However, more men than women suffer from alcoholism, drug abuse and dependencies, and personality and coping problems.

Gender roles in society have a strong influence on the experience and expression of emotional states in both men and women. These roles help shape an understanding of depression in men and women.

For little boys, our culture stresses suppression of emotions. As development progresses boys become less emotionally expressive, defensive, and independent. Emotionally expression is expressed primarily through anger and aggression.

Culture reinforces the belief that men should be strong. They are to have well-defined traditional and stereotypical gender identities. He should have a strong sense of self. He should be successful, in control, and capable of handling problems without help. He should hide certain emotions. To have problems, struggle with depression and anxiety is considered weak. To show vulnerability is considered taboo. These unrealistic expectations provide a breeding ground for depression in men.

Grief and Trauma seem to be a man's best kept secret.

Trauma is a painfully inflicted experience or series of experiences from outside of oneself. It causes a severe disturbance of an individual's mental and emotional life.

There is both Active trauma and Passive trauma. Active trauma involves obvious and dramatic violations of trust, such as child sexual abuse, witnessing or being the victim of physical violence, or the death of one or both parents.

Passive trauma involves subtle breaches of trust. This can include a parent not meeting a child's need to be loved, seen or valued. Although not as obvious, passive trauma can have a profound effect, since its source may not be found in conscious memory. A man may be left with an unexplained feeling of loss, pain, or emptiness following an interpersonal slight. He may not know the rationale for the feelings' existence.

Men also experience Grief. It is defined as the physical and emotional state and the behaviors that accompany the permanent loss of a significant other. This may include the loss of a wife or lover. It can also include family members or friends. It can also include job loss; a shift in career, unattained goals and expectations, or unresolved regrets. In American culture, seldom are men allowed to outwardly grieve through tears, or other overt emotional expression of sadness.

Many times, gender-role expectations force males to utilize maladaptive coping strategies. These strategies interfere with effective management of trauma and grief. In fact, it prolongs or derails it. The natural healing processes to repair ones self does not take place.

Instead males experience conflict between experiencing and coping with trauma, and the externally imposed gender-role norms of our culture. Sadly, the conflict causes boys and men to erect defenses. The result is an increasing reservoir of unspeakable pain, grief, and sadness. This leaves many men vulnerable to depressive states at various times throughout the life span.

Below are common features of Depression and Anxiety in Men:

• Strain between gender-role expectations and performance

• Assertions of autonomy and interpersonal distance, increased conflict, and anger in relationships

• Withdrawal from and decreases in social contacts

• Perceived threats to self-esteem and self-respect, disappointment in self

• Alcohol and other drug abuse and dependence

• Inability to cry

• Antisocial, narcissistic, and compulsive personality traits

• Decreases in sexual interest but not sexual activity

• Somatic Complaints

• Work-related problems and conflicts

• Difficulties with concentration and motivation

• Over involvement with work activities

• Denial of pain

• Avoiding the help of others: 'I can do it myself'

• Increase in intensity or frequency of angry outbursts

• Denial of Sadness

• Harsh self-criticism

• Impulsive plans to have loved ones cared for in case of one's death or disability

• Impulsive Moods

• Concentration, sleep, weight problems

• Appetite shift

Sometimes physicians have a hard time identifying depression in men. Encouraging news! In spite of the fact that fewer men than women seek psychotherapy, those men that do seek treatment are helped a great deal. Both psychotherapy, and pharmacological treatments (medicine) have been proven effective in relieving depression in men. If you or someone you know may need help, encourage going for an evaluation. Simply talking things out with someone can make a tremendous difference.