Is depression in men overlooked?
Depression is widely reported to be more common in women than in men. Women are diagnosed with depression twice as often as men and advertisements for antidepressants typically feature females.Footnote 1, Footnote 2 Most depression research that considers gender has also focused on women.Footnote 3 Is men's depression really so rare, or is there more to the story?
A silent epidemic
Depression in men may be more common than we think. In Canada, men account for four out of five deaths by suicide.Footnote 4 Men's global suicide rates are even higher than reported rates of male depression, which suggests depression in men could be going undetected and untreated.Footnote 5 "Men typically don't present with the characteristic signs and symptoms of depression," says University of British Columbia (UBC) psychiatry Professor Dr. Ogrodniczuk.Footnote 6 Diagnostic methods tend to assess symptoms that may be more commonly presented by women—such as sadness and crying—and ignore symptoms of depression that tend to be more common among men—such as anger or irritability.Footnote 1, Footnote 7 Surprisingly, even when men and women have the same symptoms, physicians tend to diagnose fewer men with depression.Footnote 8 Men's depression can also go unnoticed because men are less likely to seek medical attention overall, and in particular are less likely to seek help for depression.Footnote 1, Footnote 3 Researchers have found that men often associate seeking help for depression or suicidal thoughts with powerlessness, vulnerability, and a loss of masculinity, which makes reaching out for help less likely.Footnote 5, Footnote 9, Footnote 10, Footnote 11
Destigmatizing men's depression and suicide
Dr. John Oliffe, Professor in the School of Nursing at UBC, studies depression in Canadian men across the lifespan. "Depression and suicide are wrapped up in a lot of stigma and a lot of stoicism," says Dr. Oliffe, "and many men are reluctant to seek help."
Through interviews with college students, Dr. Oliffe and Dr. Ogrodniczuk have found that talking about or seeking help for depression is often viewed as contradictory to expected male behaviour. College men reported feeling like it wasn't socially acceptable to show emotion and were concerned about being judged for reaching out.Footnote 12 As a way to cope, many participants adopted aspects of idealized masculine identities—such as increased risk taking or solitariness —which could both mask and worsen depression. Among middle-aged and older men, traditional views about masculinity and the stigma of depression prevented some men from seeking help: "It's the culture of the stoic warrior… it's not okay to ask for help, it's not okay to admit any kind of weakness," said one study participant.Footnote 5 At the same time, masculine ideals made some men more resilient, particularly when they considered seeking help to be a rational and responsible choice.Footnote 4 Attitudes toward men's depression also seem to be changing. "We're finding that there's a real willingness to either talk with peers—other men who might be having issues—or professional counsellors," says Dr. Oliffe.Footnote 13
To combat the stigma of depression and provide resources for Canadian men, the website Men's Depression Help Yourself shares key findings from Dr. Oliffe's and Dr. Ogrodniczuk's research, as well as video interviews with mental health professionals and men who have depression. According to Dr. Oliffe, web-based resources can empower depressed men who are hesitant to reach out by providing an anonymous way to access information about self-care and professional treatment.Footnote 1
Social expectations about gender-appropriate reactions to depression have a significant influence on men's symptoms, coping strategies, and help-seeking behaviours. Until recently, men's experiences with depression have been largely overlooked by researchers and health care professionals. Although many men with depression and suicidal thoughts want help, pressure to conform to traditional masculine ideals can make reaching out difficult. Web-based tools such as the Men's Depression Help Yourself website play a role in destigmatizing men's experiences with depression and provide an anonymous way for men to get help.
About the research
Funded by the Canadian Institutes of Health Research, the Men's Depression Help Yourself website chronicles and synthesizes Oliffe's and Ogrodniczuk's research on men's depression. Most recently, Movember funded the duo's ongoing work through the Men's Depression and Suicide Network. Dr. Oliffe is the founder and lead investigator of UBC's Men's Health Research program and a professor at UBC's School of Nursing. Dr. Ogrodniczuk is a professor and director of the Psychotherapy Program at UBC's Department of Psychiatry.
- Footnote 1
Oliffe, J. L., & Phillips, M. J. (2008). Men, depression and masculinities: A review and recommendations. Journal of Men's Health, 5(3), 194-202.
- Footnote 2
Munce, S. E., Robertson, E. K., Sansom, S. N., & Stewart, D. E. (2004). Who is portrayed in psychotropic drug advertisements? The Journal of Nervous and Mental Disease, 192(4), 284-288.
- Footnote 3
Möller-Leimkühler, A. M. (2002). Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. Journal of Affective Disorders, 71(1), 1-9.
- Footnote 4
Butler-Jones, D. (2012). The Chief Public Health Officer's report on the state of public health in Canada, 2012: Influencing health – The importance of sex and gender. Ottawa: Public Health Agency of Canada.
- Footnote 5
Oliffe, J. L., Ogrodniczuk, J. S., Bottorff, J. L., Johnson, J. L., & Hoyak, K. (2012). "You feel like you can't live anymore": Suicide from the perspectives of Canadian men who experience depression. Social Science & Medicine, 74(4), 506-514.
- Footnote 6
Aboutmen.ca (n.d.). Symptoms of Depression in Men. Retrieved October 31, 2014, from Aboutmen.ca website.
- Footnote 7
Ogrodniczuk, J. S., & Oliffe, J. L. (2011). Men and depression. Canadian Family Physician, 57(2), 153-155.
- Footnote 8
World Health Organization (n.d.). Gender and women's mental health. Retrieved October 31, 2014, from World Health Organization website.
- Footnote 9
Sierra Hernandez, C. A., Han, C., Oliffe, J. L., & Ogrodniczuk, J. S. (2014). Understanding help-seeking among depressed men. Psychology of Men & Masculinity, 15(3), 346-354.
- Footnote 10
Cleary, A. (2012). Suicidal action, emotional expression, and the performance of masculinities. Social Science & Medicine, 74(4), 498-505.
- Footnote 11
Oliffe, J. L., Robertson, S., Kelly, M. T., Roy, P., & Ogrodniczuk, J. S. (2010). Connecting masculinity and depression among international male university students. Qualitative Health Research, 20, 987-98.
- Footnote 12
Oliffe, J., Galdas, P., Han, C. S., & Kelly, M. T. (2012). Faux masculinities among college men who experience depression. Health: 1363459312447256.
- Footnote 13
O'Brien, A. (2009, March 13). Macho men opening up about depression: Researchers. Canwest News Services. Retrieved from Canada.com website.
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