National Alliance on Mental Illness
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The Mask of Male Depression
by Michelle Roberts
For a long time, Chuck P. didn't know what was wrong with him. A former customer service representative at Wal-Mart in Bowling Green, Kentucky, he sometimes lashed out at coworkers and shoppers. Eventually, he attended anger management classes only to learn that his problem wasn't anger at all. His therapist helped him identify that he was depressed—and that his irritability was a product of a biochemically-based brain disorder.
"It took me awhile to accept that I was depressed," says Chuck, 49. "Being a guy, people think that you need to man up and not talk about it. They accuse you of whining about the little things. They don't understand that depression for guys is difficult because we have all these expectations thrust upon us."
More than 14 million American adults suffered a major depressive episode in the past year; more than 35 million have had one at some point in their lives. Nearly two-thirds of both those groups are women. However, a chorus of mental health professionals believes that men may suffer from depression at a much higher rate than is documented because they don't recognize their symptoms or aren't willing to get help. Even so, more than 6 million men are known to have depression each year in the United States alone, according to the National Institute of Mental Health (NIMH).
In Canada, about 8 percent of adults will experience an episode of major depression and anxiety at some point in their lives and about 5 percent in a given year, reports Health Canada and Statistics Canada. Again, women account for more of those cases, but many mental health leaders say that male depression is underreported.
Part of the reason for this is that men who are depressed often fail to recognize their condition, chalking it up to apathy, low self-esteem, and anger. And as such, experts say, they experience depression differently than women, often masking the disorder by self-medicating with drugs or alcohol. In both countries, men are four times as likely to die by suicide.
"Men tend to feel that they need to rely only on themselves and that it is somehow weak to have to depend on someone else, even for a short time," says Frederick E. Rabinowitz, PhD, coauthor of Men and Depression: Clinical and Empirical Perspectives (Academic Press, 2000), written to help therapists work with men experiencing depression.
The way that men think about themselves can impede how they are identified and treated for depression, experts say. Compared with women, men tend to be far more concerned with being competitive, powerful, and successful. They often don't like to admit that they feel fragile or vulnerable, so they're less likely to talk about their feelings with their friends, loved ones, or even their doctors.
For Chuck, like many men, coming to terms with depression carries deep social and psychological challenges.
"With me, the more I talk about it the more I feel weird," he says. "If you're really a man, you're not supposed to feel this way." In our society, he adds, "it's still a problem for most guys to get up the nerve to seek the help or assistance they need to work through this stuff without feeling like it's going to come back at them in some sort of way. I feel damned if I do and damned if I don't."....
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