'Real men don't get depressed'

Glance through any women's magazine, and you'll think depression primarily is a female disorder.
Although the National Institute of Mental Health (NIMH) reports higher rates in women -- 12 percent compared to 7 percent -- men actually suffer from depression as often as women, and perhaps more, says David Rudd, Baylor professor of psychology and neuroscience. The statistical difference, he says, reflects that women are more likely to both recognize the symptoms and receive treatment.
Depression is a medical illness caused by changes in the brain that affect the body and mind (see sidebar for symptoms). Although the exact causes are unknown, depression is thought to stem from the malfunctioning of groups of nerves in the brain or to an imbalance in brain chemicals called neurotransmitters. There is evidence that genetics plays a role, and those with a family history of the disorder are at higher risk. Other predisposing factors reported by NIMH include prolonged or severe stress, the loss of a loved one and physical illness. 
Although the NIMH estimates that 6 million men each year experience depression, a much smaller number actually are diagnosed. "Real men don't get depressed -- that's the traditional view of masculinity that makes men hesitate to get help," Rudd says. 
Men are less likely than women to recognize the signs of depression, and they tend to attribute these to everyday stress. They also may experience different symptoms from women, for example being more irritable than sad, he says. 
Recognition and treatment of depression are all the more urgent because the worst outcome of the disorder -- suicide -- is more prevalent in men. Although women attempt suicide more frequently, four times more men die at their own hands, in part because their chosen method -- firearms -- is more lethal, Rudd says. 
There are a variety of effective treatments for depressive illness, including medication and various forms of psychotherapy. The NIMH recommends that men with symptoms of depression first seek an evaluation from their primary-care physician to rule out another physical cause. 
To raise awareness about this serious health threat to men, the NIMH has launched the Real Men Real Depression campaign. To learn more or to download a copy of the booklet, Men and Depression, go online to www.nimh.nih.gov or contact NIMH toll free at 1-866-227-NIMH (6464).
 

Beal is a lecturer in Baylor's Louise Herrington School of Nursing, where she teaches "The Experience of Illness." She received her BS from Columbia University and her MN from Emory. She is a freelance health and medical writer.