Men Exhibit Depression Differently

An excerpt from Blues Busters: The Trouble with Men:

Even more men exhibit what he calls covert depression. ‘You don’t see the depression itself but the defensive maneuvers men use to evade or assuage it,’ says Real. Signs include:

  • Self-medication. First and foremost is drinking, but also abuse of other drugs.
  • Risk-taking, including compulsive gambling, womanizing, and acts of bravado that show up as high rates of accidental death. These are ‘desperate acts’ that both numb the pain and show the world ‘I’m a real man’ by denial of vulnerability. Says Dr. Pollack: ‘We see them as bad boys rather than sad boys.’
  • Radical isolation. Men withdraw from relationships, from their wives.
  • Lashing out. This can run the gamut from increased irritability to domestic violence, even homicide.

‘Women internalize depression and tend to blame themselves,’ says Real. ‘Men tend to externalize distress and blame others.’ They move into action–and distraction.

Such defenses may protect them from feeling depressed but not from being depressed. Real cites the example of author William Styron, who in Darkness Visible described how his depression revealed itself only when he stopped decades of heavy drinking. The depression was part of his character for a long time, managed with self-medication. When the self-medication stopped, the depression became visible.

The intoxicant defenses and lashing-out defenses, Real finds, represent men’s attempts to ward off the anguish of shame by inflating their own value. In short, he says, they transmute shame into grandiosity, what he calls ‘the central theme of masculinity.’ As he sees it, the inclination to bravado takes permanent hold at adolescence. Indeed, until then, boys and girls exhibit the same rates of depression.

The mental health establishment recognizes that grief and other forms of emotional pain in males may be expressed in acts as well as words throughout childhood. Drinking, substance abuse, and antisocial behavior are all cited in the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), as signs of depression among teens. But not among men.

‘Somehow, when a boy turns 18 we split depression off from the behaviors that make it up,’ says Real. ‘We stop seeing the acting out as due to an underlying depression and instead call it a character disorder. That’s not science, it’s morality.’

Suicide rates in teens tell a truer story, observes Pollack, pointing out that adolescent boys kill themselves at four to six times the rate of adolescent girls. The conventional explanation is that girls try more often but boys use more lethal means.

‘But we have to ask why boys use more lethal means,’ he implores. ‘Girls’ actions are often not meant to end their lives. When boys pick up a gun or a rope they don’t want to come back from it. The shame and the pain are so intense but they are not allowed to talk about it.

‘We have to recognize that there are socialization and cultural dynamics at work here,’ adds University of Iowa psychologist Sam V. Cochran, Ph.D. He is pushing for the recognition that depression in men is usually a masked disorder, one hidden behind other behaviors.

Prohibiting males from expressing grief, sadness, and loss makes their depression look different, but only at a superficial level. ‘Where there’s anger, irritability, rejection followed by self-medication, or compulsive behaviors,’ he says, ‘there’s usually a mood disorder going on.’

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4 Comments on “Men Exhibit Depression Differently”

  1. Chad Says:

    Re: first several paragraphs — hell, I coulda told ya that!

    On a related note — I have RAD duty all weekend! Stay tuned to see if I have more interesting stories on Tuesday.

    On a separate note — you’ve been very kind enough to give me feedback on my site redesigns, so I hope that you’ll not be offended when I tell you that the stark white and lavender trim is, well, depressing. And clinical. My suggestion is an off-white, like an eggshell or a bone sort of color. Although white works well in the title bar, and may work better than an eggshell in that instance.

  2. Kathryn Says:

    Thanks for the feedback. I tried the off-white, but it didn’t feel consistent. Yes, the contrast between violet, lavendar and white is a little clinical, but then, the goal I’m striving for is more formal. I like the cleanness of it.

    But I tried using the soft purple for the posts to offset the intensity of the white. Hopefully that will help?

  3. Chad Says:

    Much better. Maybe also leave the requirement off for an email addy in the comments. People like being anonymous when they speak to people like you.

    Which you probably already know, and maybe which influenced that decision to leave it required. *shrug*

  4. Kathryn Says:

    Glad you like the improvement; I do too. Less glaringly white.

    I’m new to MT, so I haven’t learned all the switches and stuff. Anonymous commenting is now enabled. Thanks for suggesting it.