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What is depression?
Everyone has times in their lives when they
feel down or depressed. But if the depression goes on for a long
time, or becomes very severe, you may find yourself stuck and
unable to lift yourself out of it. This is what doctors call a
‘depressive illness’.
What are the signs and symptoms?
If you are depressed, you will probably notice
you feel unhappy. It just won’t go away and can be worse at a
particular time of day, often first thing in the morning. You can’t
enjoy anything, can’t concentrate properly, feel guilty about
things that have nothing to do with you, become pessimistic and
perhaps even suicidal. Physical symptoms include not getting to
sleep, waking early in the morning and/or throughout the night,
losing interest in sex, not eating and losing weight.
Is depression different for men?
There is no evidence for a completely separate
type of ‘male depression’. But men tend to be more competitive and
concerned with power and success than women. They don’t like to
admit that they feel fragile or that they need help, but feel that
they should rely on themselves. So they are less likely to talk
about their feelings with their friends, loved ones or their
doctors. This may be why they don’t get the help they need. There
is also evidence that some symptoms of depression are more common
in men than in women. These include irritability, sudden anger,
increased loss of control, greater risk-taking and aggression. Men
are also more likely to commit suicide.
How do men deal with depression?
Men are more likely than women to use drugs
and alcohol rather than asking for help. This usually makes things
worse, certainly in the long run. Your work will suffer and alcohol
often leads to irresponsible, unpleasant or dangerous behaviour.
Men may also focus more on their work than their relationships or
home life. This can cause conflicts with partners. All of these
things make depression more likely.
What factors are linked to depression in men?
Relationships: for married
men, research has shown that trouble in a marriage or long-term
relationship is the single most common problem associated with
depression. Men tend not to cope with disagreements as well as
women. Arguments can make feel physically uncomfortable so they try
to avoid both disagreements and difficult discussions. The partner
will want to talk about a problem, but some men will try to avoid
it. The partner then feels ignored and tries to talk about it more,
which makes the man feel he is being nagged. So, he withdraws
further, which makes his partner feel even more ignored and so on.
This can destroy a relationship.
Sex: when men are depressed,
they feel less good about their bodies and less sexy. Many go off
sex completely. Several recent studies suggest that, in spite of
this, men who are depressed have intercourse just as often, but
they don’t feel as satisfied as usual. A few depressed men actually
report an increase in sexual drive and intercourse, possibly as a
way of trying to make themselves feel better. Another problem may
be that some antidepressant drugs reduce sex-drive in a small
number of men. However, the good news is that, as the depression
improves, so will sexual desire, performance and satisfaction.
Impotence: difficulty in
getting or keeping an erection can bring about depression. Again,
this is a problem for which it is usually possible to find
effective help.
Pregnancy and children: only
recently we have realised that more than one in ten fathers suffer
psychological problems after having children. This shouldn’t really
be surprising. We know that major events in people’s lives, even
good ones like moving house, can make you depressed. Having
children changes your life more than any other event. Suddenly, you
have to spend much more of your time looking after your partner,
and possibly other children, and you may be very tired. New mothers
tend to be less interested in sex for a number of months. Sheer
exhaustion is the main reason, although you may take it personally
and feel that you are being rejected. You may have to adjust,
perhaps for the first time, to taking second place in your
partner’s affections. You may also find that you can’t spend so
much time at work. New fathers are more likely to become
depressed if their partner is depressed, if they aren’t getting on
with their partner, or if they are unemployed.
Unemployment and
retirement: leaving work, for any reason, can be
stressful. Recent research has shown that up to one in seven men
who become unemployed will develop a depressive illness in the next
six months.
Temperament: you are more
likely to become depressed if you are shy, if you don’t have a
close relationship or if you don’t manage to find another job.
Depression itself can make it harder to get another job.
Retirement: even retiring
from work at the usual age can be difficult for many men,
especially if your partner continues to work. It can be hard to
adjust to losing the structure of your day and contact with
colleagues.
Gay men and depression: on
the whole, gay men do not suffer from depression any more than
straight men. However, it seems that gay teenagers and young adults
are more likely to become depressed, possibly due to the stress of
‘coming out’.
Suicide: men are around three
times more likely to kill themselves than women. Suicide is
commonest among men who are separated, widowed or divorced and is
more likely if someone is a heavy drinker. Over the last few years,
men have become more likely to kill themselves, particularly those
aged between 16 and 24 years and those between 39 and 54 years. We
don’t yet know the reason for this.
Violence: some studies have
shown that men who commit violent crimes are more likely to get
depressed than men who don’t. However, we don’t know if the
depression makes their violence more likely, or if it’s just the
way they lead their lives.
Getting help
Helping yourself
If you’ve had a major upset in your life, try
to tell someone how you feel about it. Keep active. Taking some
exercise, even if it’s only a walk, will help to keep you
physically fit and you will sleep better. Ensure you eat a balanced
diet, with lots of fruit and vegetables. Avoid alcohol and drugs as
they will make you more depressed in the long run. You can also use
relaxation techniques for example yoga, massage
or aromatherapy. Do something you enjoy at least one thing
every week, Check out your lifestyle. A lot of people who have
depression are perfectionists and tend to drive themselves too
hard. You may need to set yourself more realistic targets and
reduce your workload. Take a break as it can be really helpful to
get away and out of your normal routine for a few days. Read about
depression. Books and websites can give you ideas on how to cope,
and also help friends and relatives to understand what you are
going through.
Changing your perspective
It can help to see depression as a result of
chemical changes in the brain and/or as the inevitable cost of
living in a demanding and difficult world. It is nothing to do with
being weak or unmanly and it can be treated. Both talking and
medication can be important ways to help you get better.
Professional help
The best place to start is your GP who can go
over your options and discuss any worries you have about
confidentiality. Many men are concerned that information held by
their GPs may need to be given in medical reports, and so may
damage their chances in work. It's important to remember that, in
the UK, it is illegal for an employer to fire you – or not hire you
– solely because you have a diagnosis of a certain disorder. Their
only grounds for this are that your condition (whatever it is) will
actually interfere with your ability to do the job. Even if it does
interfere to some extent, under the Disability Discrimination Act,
an employer is expected to make reasonable adjustments to ensure
that someone with a recognised condition - including depression -
can be supported in their job rather than dismissed.
Depression may be due to physical illness, so
you need to get a proper physical check-up. If you are already
having treatment for a physical illness, your GP will need to know.
Your GP might recommend a course of psychotherapy. You could also
try the Samaritans.
For more information see our main leaflet.
This leaflet is made 
available through the generosity of the Charitable Monies
Allocation Committee of the mental health charity St Andrew's,
Northampton
© June 2009 Royal
College of Psychiatrists. This is an abridged version of our main
leaflet.
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