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Depression is a serious but treatable medical condition - a
brain disease - that can strike anyone, including men. In
America alone, over 6 million men have depression each year.
Whether you're a company executive, a construction worker, a
writer, a police officer, or a student, whether you are rich or
poor, surrounded by loved ones or alone, you are not immune to
depression. Some factors, however, such as family history, undue
stress, the loss of a loved one or other serious illnesses can
make you more vulnerable.
If left untreated, depression can lead to personal, family and
financial difficulties, and, in some cases, end in suicide. With
appropriate diagnosis and treatment, however, most people
recover. The darkness disappears, hope for the future returns,
energy and desire come back, and interest in life becomes
stronger than ever
Depression can strike anyone regardless of age, ethnic
background, socioeconomic status, or gender; however, large
scale research studies have found that depression is about twice
as common in women as in men. In the United States, researchers
estimate that in any given one year period, depressive illnesses
affect 12 percent of women (more than 12 million women) and
nearly 7 percent of men (more than six million men).3 But
important questions remain to be answered about the causes
underlying this gender difference. We still do not know if
depression is truly less common among men, or if men are just
less likely than women to recognize, acknowledge, and seek help
for depression.
Types of Depression
Just like other illnesses, such as heart disease, depression
comes in different forms. This booklet briefly describes three
of the most common types of depressive disorders. However,
within these types, there are variations in the number of
symptoms, their severity, and persistence.
Major depression (or major depressive disorder) is manifested by
a combination of symptoms (see symptoms list below) that
interferes with the ability to work, study, sleep, eat, and
enjoy once pleasurable activities. A major depressive episode
may occur only once; but more commonly, several episodes may
occur in a lifetime. Chronic major depression may require a
person to continue treatment indefinitely.
A less severe type of depression, dysthymia (or dysthymic
disorder), involves long lasting, chronic symptoms that do not
seriously disable, but keep one from functioning well or feeling
good. Many people with dysthymia also experience major
depressive episodes at some time in their lives.
Depression
Persistent sad, anxious, or "empty" mood.
Feelings of hopelessness or pessimism.
Feelings of guilt, worthlessness, or helplessness.
Loss of interest or pleasure in hobbies and activities that were
once enjoyable, including sex.
Decreased energy, fatigue; feeling "slowed down."
Difficulty concentrating, remembering, or making decisions.
Trouble sleeping, early morning awakening, or oversleeping.
Changes in appetite and/or weight.
Thoughts of death or suicide, or suicide attempts. Restlessness
or irritability.
Persistent physical symptoms, such as headaches, digestive
disorders, and chronic pain that do not respond to routine
treatment.
Men and Depression
Researchers estimate that at least six million men in the United
States suffer from a depressive disorder every year. Research
and clinical evidence reveal that while both women and men can
develop the standard symptoms of depression, they often
experience depression differently and may have different ways of
coping with the symptoms. Men may be more willing to acknowledge
fatigue, irritability, loss of interest in work or hobbies, and
sleep disturbances rather than feelings of sadness,
worthlessness, and excessive guilt. Some researchers question
whether the standard definition of depression and the diagnostic
tests based upon it adequately capture the condition as it
occurs in men.
Men are more likely than women to report alcohol and drug abuse
or dependence in their lifetime;14 however, there is debate
among researchers as to whether substance use is a "symptom" of
underlying depression in men or a co occurring condition that
more commonly develops in men. Nevertheless, substance use can
mask depression, making it harder to recognize depression as a
separate illness that needs treatment.
Instead of acknowledging their feelings, asking for help, or
seeking appropriate treatment, men may turn to alcohol or drugs
when they are depressed, or become frustrated, discouraged,
angry, irritable, and, sometimes, violently abusive. Some men
deal with depression by throwing themselves compulsively into
their work, attempting to hide their depression from themselves,
family, and friends. Other men may respond to depression by
engaging in reckless behavior, taking risks, and putting
themselves in harm's way.
More than four times as many men as women die by suicide in the
United States, even though women make more suicide attempts
during their lives. In addition to the fact that men attempt
suicide using methods that are generally more lethal than those
used by women, there may be other factors that protect women
against suicide death. In light of research indicating that
suicide is often associated with depression, the alarming
suicide rate among men may reflect the fact that men are less
likely to seek treatment for depression. Many men with
depression do not obtain adequate diagnosis and treatment that
may be life saving.
Depression in Older Men
Men must cope with several kinds of stress as they age. If they
have been the primary wage earners for their families and have
identified heavily with their jobs, they may feel stress upon
retirementloss of an important role, loss of self esteemthat
can lead to depression. Similarly, the loss of friends and
family and the onset of other health problems can trigger
depression.
Depression is not a normal part of aging. Depression is an
illness that can be effectively treated, thereby decreasing
unnecessary suffering, improving the chances for recovery from
other illnesses, and prolonging productive life. However, health
care professionals may miss depressive symptoms in older
patients. Older adults may be reluctant to discuss feelings of
sadness or grief, or loss of interest in pleasurable activities.
They may complain primarily of physical symptoms. It may be
difficult to discern a co occurring depressive disorder in
patients who present with other illnesses, such as heart
disease, stroke, or cancer, which may cause depressive symptoms
or may be treated with medications that have side effects that
cause depression. If a depressive illness is diagnosed,
treatment with appropriate medication and/or brief psychotherapy
can help older adults manage both diseases, thus enhancing
survival and quality of life.
Identifying and treating depression in older adults is critical.
There is a common misperception that suicide rates are highest
among the young, but it is older white males who suffer the
highest rate. Over 70 percent of older suicide victims visit
their primary care physician within the month of their death;
many have a depressive illness that goes undetected during these
visits. This fact has led to research efforts to determine how
to best improve physicians' abilities to detect and treat
depression in older adults.
Approximately 80 percent of older adults with depression improve
when they receive treatment with antidepressant medication,
psychotherapy, or a combination of both. In addition, research
has shown that a combination of psychotherapy and antidepressant
medication is highly effective for reducing recurrences of
depression among older adults. Psychotherapy alone has been
shown to prolong periods of good health free from depression,
and is particularly useful for older patients who cannot or will
not take medication.18 Improved recognition and treatment of
depression in later life will make those years more enjoyable
and fulfilling for the depressed elderly person, and his family
and caregivers.
A depressive disorder is not the same as a passing blue mood.
Depression can strike anyone regardless of age, ethnic
background, socioeconomic status, or gender; however, large
scale research studies have found that depression is about twice
as common in women as in men.In the United States, researchers
estimate that in any given one year period, depressive illnesses
affect 12 percent of women (more than 12 million women) and
nearly 7 percent of men (more than six million men) But
important questions remain to be answered about the causes
underlying this gender difference. We still do not know if
depression is truly less common among men, or if men are just
less likely than women to recognize, acknowledge, and seek help
for depression.
Symptoms of Depression
Not everyone who is depressed or manic experiences every
symptom. Some people experience only a few; some people suffer
many. The severity of symptoms varies among individuals and also
over time.
Depression
Persistent sad, anxious, or "empty" mood.
Feelings of hopelessness or pessimism.
Feelings of guilt, worthlessness, or helplessness.
Loss of interest or pleasure in hobbies and activities that were
once enjoyable, including sex.
Decreased energy, fatigue; feeling "slowed down."
Difficulty concentrating, remembering, or making decisions.
Trouble sleeping, early morning awakening, or oversleeping.
Changes in appetite and/or weight.
Thoughts of death or suicide, or suicide attempts.
Restlessness or irritability.
Persistent physical symptoms, such as headaches, digestive
disorders, and chronic pain that do not respond to routine
treatment.
Depression can coexist with other illnesses. In such cases, it
is important that the depression and each co occurring illness
be appropriately diagnosed and treated.
Research has shown that anxiety disorderswhich include post
traumatic stress disorder (PTSD), obsessive compulsive disorder,
panic disorder, social phobia, and generalized anxiety
disordercommonly accompany depression. Depression is especially
prevalent among people with PTSD, a debilitating condition that
can develop after exposure to a terrifying event or ordeal in
which grave physical harm occurred or was threatened.
Traumatic events that can trigger PTSD include violent personal
assaults such as rape or mugging, natural disasters, accidents,
terrorism, and military combat. PTSD symptoms include: re
experiencing the traumatic event in the form of flashback
episodes, memories, or nightmares; emotional numbness; sleep
disturbances; irritability; outbursts of anger; intense guilt;
and avoidance of any reminders or thoughts of the ordeal. In one
NIMH supported study, more than 40 percent of people with PTSD
also had depression when evaluated at one month and four months
following the traumatic event.
Substance use disorders (abuse or dependence) also frequently co
occur with depressive disorders. Research has revealed that
people with alcoholism are almost twice as likely as those
without alcoholism to also suffer from major depression. In
addition, more than half of people with bipolar disorder type I
(with severe mania) have a co occurring substance use disorder.
Men and Depression
Researchers estimate that at least six million men in the United
States suffer from a depressive disorder every year. Research
and clinical evidence reveal that while both women and men can
develop the standard symptoms of depression, they often
experience depression differently and may have different ways of
coping with the symptoms. Men may be more willing to acknowledge
fatigue, irritability, loss of interest in work or hobbies, and
sleep disturbances rather than feelings of sadness,
worthlessness, and excessive guilt. Some researchers question
whether the standard definition of depression and the diagnostic
tests based upon it adequately capture the condition as it
occurs in men.
Men are more likely than women to report alcohol and drug abuse
or dependence in their lifetime; however, there is debate among
researchers as to whether substance use is a "symptom" of
underlying depression in men or a co occurring condition that
more commonly develops in men. Nevertheless, substance use can
mask depression, making it harder to recognize depression as a
separate illness that needs treatment.
Instead of acknowledging their feelings, asking for help, or
seeking appropriate treatment, men may turn to alcohol or drugs
when they are depressed, or become frustrated, discouraged,
angry, irritable, and, sometimes, violently abusive. Some men
deal with depression by throwing themselves compulsively into
their work, attempting to hide their depression from themselves,
family, and friends. Other men may respond to depression by
engaging in reckless behavior, taking risks, and putting
themselves in harm's way.
More than four times as many men as women die by suicide in the
United States, even though women make more suicide attempts
during their lives. In addition to the fact that men attempt
suicide using methods that are generally more lethal than those
used by women, there may be other factors that protect women
against suicide death. In light of research indicating that
suicide is often associated with depression,17 the alarming
suicide rate among men may reflect the fact that men are less
likely to seek treatment for depression. Many men with
depression do not obtain adequate diagnosis and treatment that
may be life saving.
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