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Grief can compel us to do some shitty things. Our mind can become so blinded by the internal rage of loss that at the moment we can find ourselves in places that we promised ourselves we would never tread. Our subjective morality ebbs away as if it was never there in the first place, and all that is left is the grief-stricken anger of an enraged monster ready to pounce.

I was such a person. I've written about my grief before and how it had impacted my life negatively. Grief isn't a feeling of eternal sadness that most people would think; grief is a mixture of many feelings. Rage, hurt, shame, sadness, distortion, and so much more. A person can be fully functioning in society with lovers, friends and family, but still suffering from grief.

I was a boy grieving over so many things in my life. It may have gone unnoticed but I grieved hard over not having an involved dad.

Some may say that to understand loss, you first have to have experienced what you lost. I disagree. I knew what it was like as a child, playing with my friends, going into their houses, watching what their fathers were like and how they handled their sons and daughters with love and appreciation. Yeah, I grieved that. It was like a burning empty hole in my stomach, that I had no-one to admire me with such love.

I grieved over not belonging. I watched as my friends and family belonged to something more important than themselves. A family mostly, but more so a sense of belonging to a community; a communal purpose of sorts. I was whisked all over the country - I had no sense of grounding, or where I was going. I would cling onto nonsensical feelings of belonging such as football clubs and street gangs.

I grieved over not feeling warm and comfortable inside. The relaxed feeling of satisfaction that I've grown to know over the last 10 years but was a distant hope as a teenager. The wretched knotting feeling in my stomach that would drive me to avoid some of the easiest social interactions and cower for cover anytime something difficult in life came along. I solved this with alcohol and drugs and for a brief moment at night would make me feel human again, if only for a small amount of time.

Through my grief I've isolated friends in the fear that they would be seen as better than me. That their popularity, their shine, their raw love for the world would have people liking them over me, and through that raw jealousy I would seek to discredit them, and to disempower them, ultimately pushing them away, when in reality they just liked me for.. me.

Grief is enveloping, constricting, and horrible. It can turn a once bright eyed and bushy tailed mind ready to explore the world into a maximum security prison with a lifetime sentence. Yeah, grief can be the abrupt ending to a prosperous future. Grief can kill.

The doctors didn't know what to do with me in hospital. Some thought I needed to, "man up" and see the world for what it was, others thought I had to take responsibility for my life, and some just didn't give a shit - only that I was pieced back together and sent on my merry way. None of it helped though, in fact I'd say I walked out of there worse than when I walked in - only that I wasn't excessively paranoid anymore.

Grief can have a young man with his whole life ahead of him with a noose that he tied with his shoelaces about to kick the chair from underneath him. Grief is not to be sneered at; "manning up" just doesn't cut the butter I'm afraid.

What helps is unbridled love and acceptance. A sort of raw heartwarming light shone onto the darkness of the soul. Light cures darkness, for wherever there is light there is no dark. The bright ultra rays of awesomeness extinguishing anything that could remotely pass as dark. Yes, I met such people in the end; they shone such brilliant light on me that I could no longer refuse the brilliance and I began to accept it over a long period of time.

But I was lucky. I know full too well I was one of the lucky ones. Others aren't that lucky. I've seen some people destroy themselves from the inside-out. I've had family die on me, friends overdose on me, and people that I know no longer want to associate themselves with anyone in the bright circle of life, because when you're used to the darkness, the light can blind you.

Don't let the light blind you.

Some people just like to give. I had to learn that the hard way.

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Originally Published on Narrative

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The Never Ending Abyss of Grief - The Good Men Project

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Grief can compel us to do some shitty things. Our mind can become so blinded by the internal rage of loss that at the moment we can find ourselves in places that we promised ourselves we would never tread.

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How does Men’s Loneliness Express Itself in Your Culture?

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How does Men’s Loneliness Express Itself in Your Culture?

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-#ManhoodGame Card of the Day-

Signs of loneliness in men:

A. Frequent visits to the mailbox, postal or virtual.

B. Reluctance to take accumulated weeks of holiday.

C. Anxiety when one's partner must be away for an extended time.

D. None of the above.

E. All of the above.

What is your answer?

Scroll Down to see ours.

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The manhood game cards were created and developed by Dr. George Simons as a way to reframe men's perceptions of themselves. As Dr. Simons writes in his intro post: Life is often played a game in which men's welfare is a pawn to be sacrificed. Today I invite you to join me in another game, diversophy Manhood, a game for reframing men's perceptions of themselves, for refreshing their mission in life, and disarming social biases that attack male health and limit the possible in their own eyes and actions. Each day I will post a new card from this game, a snippet of wisdom to GUIDE our exploration, a RISK to face, facts to test our SMARTS, a CHOICE to make, or an experience to SHARE. This post was originally published on George Simons LinkedIn and is republished here with his permission.

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More Manhood Game Cards:Flowers From Your Male FriendSorrow and Secret Emotions in MenSomething Feminine in Virile Men.C'mon Man, You Must Be GaySee all published Manhood Game cards here. Several new cards are published every week!

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Want a place to discuss the issues of masculinity in a forum with other people? Join our Masculinity Detox Facebook Group here.◊♦◊We are always looking for people to write about the changing roles of men in the 21st century. The Manhood Game Cards make great writing prompts. What is your view on how men's roles are changing? Can you write a post (300-750 words) that tells us your own unique point of view? If so, please join our writer's community and click here to submit via our submissions portal.

♦◊♦

The Good Men Project has pioneered the largest worldwide conversation about the changing roles of men in the 21st century. Your support of our work is inspiring and invaluable. If you believe in the work we are doing here at The Good Men Project, please join us as a Premium Member, today. All Premium Members get to view The Good Men Project with NO ADS. A $50 annual membership gives you an all-access pass. You can be a part of every call, group, class, and all our online communities. A $25 annual membership gives you access to one class, one Social Interest group and our online communities. A $12 annual membership gives you access to our Friday calls with the publisher and our online community. Need more info? A complete list of benefits is here.

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This post was previously published on www.linkedin.com and is republished here with permission from the author.
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Photo credit: Shutterstock

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How Does Men's Loneliness Express Itself in Your Culture? - The Good Men Project

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Signs of loneliness in men: A. Frequent visits to the mailbox, postal or virtual. B. Reluctance to take accumulated weeks of holiday. C. Anxiety when one's partner must be away for an extended time. D. None of the above. E. All of the above. What is your answer?

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How Often do We Unconsciously Fall into Residual GenderRoles?

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How Often do We Unconsciously Fall into Residual GenderRoles?

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#ManhoodGame Card of the Day

You chose as your partner a strong, self-subsistent woman. However, after a few years she slid into caring for you. Though you did not demand or even expect that caring, you accepted it without examining it. Despite your best intentions you had slipped into an old gender trap that is breaking your relationship.

What would you do?

The manhood game cards were created and developed by Dr. George Simons as a way to reframe men's perceptions of themselves.

As Dr. Simons writes in his intro post:
Life is often played as game in which men's welfare is a pawn to be sacrificed. Today I invite you to join me in another game, diversophy Manhood, a game for reframing men's perceptions of themselves, for refreshing their mission in life, and disarming social biases that attack male health and limit the possible in their own eyes and actions. Each day I will post a new card from this game, a snippet of wisdom to GUIDE our exploration, a RISK to face, facts to test our SMARTS, a CHOICE to make, or an experience to SHARE.
This post was originally published on George Simons LinkedIn and is republished here with his permission.

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◊♦◊

Want a place to discuss the issues of masculinity in a forum with other people? Join our Masculinity Detox Facebook Group here.

◊♦◊
We are always looking for people to write about the changing roles of men in the 21st century. The Manhood Game Cards make great writing prompts. What is your view on how men's roles are changing? Can you write a post (300-750 words) that tells us your own unique point of view? If so, please join our writer's community and click here to submit via our submissions portal.
♦◊♦
The Good Men Project has pioneered the largest worldwide conversation about the changing roles of men in the 21st century. Your support of our work is inspiring and invaluable.
If you believe in the work we are doing here at The Good Men Project, please join us as a Premium Member, today.

All Premium Members get to view The Good Men Project with NO ADS.

A $50 annual membership gives you an all-access pass. You can be a part of every call, group, class, and all our online communities.
A $25 annual membership gives you access to one class, one Social Interest group and our online communities.
A $12 annual membership gives you access to our Friday calls with the publisher and our online community.

Need more info? A complete list of benefits is here.

-
Photo credit: Shutterstock

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How Often Do We Unconsciously Fall into Residual GenderRoles? - The Good Men Project

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You chose as your partner a strong, self-subsistent woman. However, after a few years she slid into caring for you. Though you did not demand or even expect that caring, you accepted it without examining it. Despite your best intentions you had slipped into an old gender trap that is breaking your relationship.

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Is a private Facebook group the 2017 version of the all-men's golf getaway? What's the difference between being "a good man" and "a real man"? In an honest and eye-opening conversation, Baby Boomer Michael Kimmel and his Generation Z son, Zachary, share their experiences of masculinity.

Michael Kimmel (TED Talk: Why gender equality is good for everyone) is a sociology professor at Stony Brook University in New York and the founder of its Center for the Study of Men and Masculinities. Yes, you read that right - masculinities, plural. He believes there is no one masculinity in society today but a number of masculinities, shaped by the intersection of gender and influences like race, class and sexuality. Age is also an important factor, and in June, Kimmel, 66, and his 18-year-old son, Zachary, discussed how their respective generations - Baby Boomer and Gen Z - understand and experience masculinity. ( Editor's note: the following conversation was edited for clarity and length.)

Michael Kimmel: Let me start by asking you, What do you think are the differences between being a man today as you experience it and what you perceive in previous generations?

Zachary Kimmel: While my experience might not represent the totality of all men's experiences, one noticeable and important change to me is the balance of work and family. I think there's an expectation for men of my generation that both work and family will be shared between the spouses/partners, and I can imagine that wasn't always the case for you.

Michael: That was a real issue for my generation. I remember my father telling me that when he was in college, he and his friends would ask each other, "Are you going to let your wife work?" And they said, "No, that's my responsibility. I take care of supporting the family. She should stay home with the kids."

Zachary: Another important shift that's happened between our generations is the acceptability of cross-gender friendships. For men now, it's far more acceptable to have females as friends, not only as romantic partners.

Michael: Yes. I go to a lot of campuses to speak, and when I started doing it 25 years ago, I'd walk into a class and ask, "How many of you have a good friend of the opposite sex?" Like ten percent of the class raised their hands. Now I could walk into any college classroom and ask, "Is there anybody here who doesn't have a good friend of the opposite sex?" I'd never see a hand.

Zachary: Absolutely.

Once upon a time, the whole world was a locker room - now there's women everywhere. I hear men my age say, "Where can a guy go where he can just relax and not get policed all the time?"

Michael: You've painted a pretty happy picture of your generation. At the same time, every day there seems to be a steady parade of young men behaving badly. For example, there was the Facebook page that the Marines had which shared nude photos of female service members and condoned violence against women, and the private Facebook group in which recently admitted students to Harvard said all kinds of bad things. Tell me a little bit about that side.

Zachary: Obviously, we haven't fully overcome the tendency for men, particularly in all-male groups, to degrade women and engage in activities like hazing or sexual assault. I think there might be a correlation between women becoming more integrated into the workforce and public sphere and some men retreating into insular, all-male groups - the fraternity, sports team and the online Facebook chat - to keep up that traditional understanding of masculinity.

Michael: Once upon a time, the whole world was a locker room - the corporate boardroom was a locker room, the faculty meeting was a locker room, and of course, the locker room was a locker room. Now there's women everywhere. I'd imagine this has affected my generation more than yours because it's new to us, we weren't prepared. We expected locker rooms everywhere. I hear men my age say things like, "Where can a guy go where he can just relax, say stupid stuff, and not get policed all the time?" Do you hear that from guys your age?

Zachary: Absolutely. The generational difference may be in the location of those conversations. Your generation invested in the man cave or the weekend golfing trip; we went online. We make Facebook groups, group chats, use all forms of social media to talk between men. Last year, sports teams from elite institutions - Harvard men's soccer, Princeton men's swimming and diving, Columbia wrestling - all got in trouble with their universities for their all-male team chats, group messages and texts. We've retreated to our online spaces.

Michael: My generation grew up with the expectation that our world would be pretty much like Don Draper's in Mad Men. My dad's world looked like that, and I expected my world to look like that. I feel like my generation has this sense of loss because we expected something we didn't get. You didn't expect it, so you aren't angry. That thwarted sense of entitlement fuels a lot of the angry men I've written about. But I want to switch topics. When we've talked before, you've used the word "toxic" to describe masculinity.

Zachary: Yes.

This traditional, inherited idea of masculinity is a recipe for loneliness, emptiness, a lack of connection and a suppression of compassion and empathy.

Michael: What about masculinity would you say is toxic or poisonous?

Zachary: Masculinity in its rigid, norm-driven form can harm men. It can cause physical harm when it's pressuring men to binge-drink or submit to hazing rituals to get into a group. It can also lead to an emotional shut-down in which men are discouraged from having women as friends or pursuing activities because they're worried about social consequences.

Michael: What you're saying is this traditional, inherited idea of masculinity is a recipe for loneliness, emptiness, a lack of connection and a suppression of compassion, empathy, etc. I take your point. But what I see in you and in many of your guy friends and in my generation are men facing tension in their notions of masculinity. Let me ask you, What does it mean to you to be a good man?

Zachary: Responsible, honorable, does the right thing, protector, provider, honest - all those words come to mind.

Michael: OK. Now tell me if those same ideas come up when I say, "Man up, dude! Be a real man."

Zachary: I get all kinds of other ideas - show no weakness, show no pain, real men don't cry, they get rich, they get laid, show no emotions.

Michael: That's pretty different.

Zachary: Vastly different.

Michael: Where do you learn those ideas?

Zachary: Other men, particularly older men, coaches or the captains on the sports teams when I played sports, media, music - a variety of sources.

If I'm in a group of guys and someone makes a sexist comment, instead of saying "Hey, don't say that word," I say, "Hey, man, please don't say that around me."

Michael: I've been asking this question a lot, and most guys say pretty much what you said. They list, in this order, my dad, my coach, my guy friends, my older brother. I don't want to say it's about toxic masculinity vs. healthy masculinity. I think every one of us knows what it means to be a good man and we want to live up to those ideals. Yet sometimes in the name of proving we're real men, we're asked to betray our values. Don't you think there were guys on the Harvard soccer team who were not down with what was going on?

Zachary: Absolutely.

Michael: But they can't say it because there's a tremendous amount of gender policing that goes on among guys. How do you deal when you're in a group and some guy makes a sexist comment?

Zachary: When I was younger and still learning how to engage in this stuff, I'd react in a didactic, holier-than-thou, "Don't say that, that is wrong" approach.

Michael: You'd police them back.

Zachary: I'd also get emotionally riled up and angry. Since I've had struggles and failures, I've taken on new strategies. Instead of saying "Hey, don't say that word," I say, "Hey, man, please don't say that around me." It's a little declaration that this is not cool with me. I think you bring up an interesting point about that tension between what I feel like I should be doing versus what I feel like I need to do to fit in, and how lonely that can feel. If you're in a situation and something is being done or said that doesn't fly with you and you say something, you almost hope or assume there will be somebody else in the group who agrees. You hope he has the courage and strength to stand with you. Once you have another person, it's far easier.

Michael: So how do you raise a boy to navigate this world between good and real? What advice would you give to parents on raising a good man?

Zachary: The first thing I'd say is beware of the birthday party effect. That's the name that some psychologists have given to the phenomenon in which as kids get older, particularly when they hit puberty, parents and kids subconsciously begin to narrow the people invited to their children's birthday party, by race and by gender.

Michael: Up until fourth grade, there's a rule you have to invite the entire class.

Because of the love and respect between you and Mom, and your egalitarian relationship, we never needed a conversation about what men are expected to do or what women are expected to do.

Zachary: Encourage boys to cultivate cross-gender friendships - these friendships are so valuable. The second thing I'd say is, Don't push your child into an activity that is stereotypically associated with their gender. If your son doesn't want to play football, allow them the space and give them the confidence and trust to find their own path. If it's ballet or tap dancing, I hope you're as equally loving and involved a parent as if they were playing quarterback. The third thing I'd say has to do with role modeling. In our family, we never spoke about gender roles when I was younger because I grew up in a house where it was likely that I'd come home from school and see you doing laundry or the dishes.

Michael: And I'm the family cook.

Zachary: Because of the depth of love and respect between you and Mom, and the egalitarian nature of your relationship, we never needed to have a conversation about what men are expected to do or what women are expected to do. It's just what I saw - my father is involved with me, he loves me, my mom has a career, she cares about work but she's involved with me as well.

Michael: So what would you say to men who are resistant to the idea that masculinity should change? How would you get them on board?

Zachary: That's the big question behind your work, and to a lesser extent, it's my work as well. Your thesis is that a more holistic understanding of masculinity and a rejection of rigid, toxic masculinity - to use that term - is good for men. It helps in all facets of our lives and allows men to live the lives they really want to live.

Michael: I couldn't agree more. Look, men should support gender equality because it's the right thing to do. I don't think it's minimizing the moral imperative to say, "It's also in your interest." But I don't think it's easy to tell men we need to change masculinity, because men will experience this as if you're saying, "Give up what has worked for you."

Zachary: Power, privilege, everything.

Michael: It's asking too much. Instead, you have to say, "You already are doing it; you just aren't recognizing it." Every single man is genetically connected to a woman. They know what it feels like to love a woman and want them to thrive. They're fathers, sons, brothers, partners, lovers, friends, husbands. We need support from other men to act. When a guy says "I'm going to take parental leave," his colleagues shouldn't say, "I guess you're not committed to your career, are you?" but "Good for you, man. You have your priorities straight."

Those brotherhoods in which you defend wrong behavior - those are inauthentic. They ask you to put your own self aside. I don't think that's being a good brother at all.

Zachary: So much of it is about men holding our fellow men accountable. There was a football team in which a few players were accused of rape and the university said, "You can't play in your bowl game." Rather than support the woman or condemn their teammates, the rest of the team said, "We're going to support the guys accused of rape." Too often, we get caught up in notions of brotherhood or solidarity that are harmful to each other and harmful to ourselves.

Michael: I want to push back a bit, because there are positive things about brotherhood.

Zachary: I agree.

Michael: Those brotherhoods in which you're defending the wrong behavior - those are inauthentic. They ask you to put your own self aside in order to be a brother. I don't think that's being a good brother at all.

Zachary: If you really are a brother, you have to say, "Hey man, this is not good for you. I wouldn't do this." You have to protect him.

Michael: That's right. A real brother says, "Dude, I love you, you are my brother. I'm not going to let you do this." The close guy friends you have, the fact that they don't compromise, they don't ask you to compromise your friendships with girls, that's great. This is a place where we older men can learn. Too often on college campuses at homecoming, I hear old grads say to the young guys, "You're not hazing them hard enough! We made them do all this horrible stuff. You guys are wusses." And the guys are like, "We've got to ramp it up here." The dads should just let them find their own way.

Zachary: I agree.

Michael: I think this is a good place for us to end. Zack, any last words?

Zachary: I wanted to say again that so many of the problems we see with men today can be solved by men holding their fellow men more accountable. Be the kind of brother who looks out for your fellow man.

Michael: I want to add one piece to that. It's not only about holding each other accountable; it's about being willing to be held accountable ourselves. I've grown most from the challenges I've gotten from other men and from feminist women friends who said, "We need to talk about this."

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center for the study of men and masculinities

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A father and son talk: What does it mean to be a man?

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Michael Kimmel (TED Talk: Why gender equality is good for everyone) is a sociology professor at Stony Brook University in New York and the founder of its Center for the Study of Men and Masculinities. Yes, you read that right - masculinities, plural.

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PsyCom.net - Mental Health Treatment Resource Since 1986

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One of the reasons I became a therapist is my interest in helping people suffering from anxiety, social awkwardness, bipolar disorder, and depression. Over the years I've observed that many men with depression have trouble admitting they are depressed. They often can't even verbalize the words, " I am depressed. " According to Mental Health America, six million men suffer from depression. Research conducted by US Department of Health and Human Services shows that depressive symptoms in boys have increased from 4.3 to 5.7% nationwide. Grim numbers for certain but the most worrisome aspect of all is the fact that untreated depression can lead to anti-social behavior and suicide.

Does depression in men really differ from depression in women? Yes, men seem to experience and cope with depression in different ways than women but it's important to consider the impact of societal ideals of masculinity on the differences. 1. There's a simplistic view that may be partially rooted in truth: women get sad, men get mad. Other male symptoms include: fatigue, body pain, severe sleep disturbances, and erectile dysfunction.

How Toxic Masculinity Hurts Men

In the American culture, and others, many men have difficulty expressing emotion due to toxic masculinity. Toxic masculinity refers to actions that discourage displays of emotion-other than anger-in men while also encouraging behavior that will deem the male "dominant" in a given situation. Even as children, young boys who express feelings are compared to girls in a negative context. Common responses to young males who become emotional include:

Boys don't cry!

Man up!

Don't be such a baby!

Don't cry like a girl!

Be a man-get over it!

You throw like a girl!

You've likely heard these phrases directed at you or someone around you. You have probably noticed them in dialogue or in storylines on television shows and movies. And, you may even be guilty of uttering them yourself.

Imagine being a young boy, crying over a painful injury or an emotional heartbreak that feels like the end of the world, and then being told to " man up," instead of being gently asked what's making you cry, how you feel about it, and what you think you can do about it.

When feelings are dismissed and gender-defining thinking is heard repeatedly, a young person learns to avoid expressing their real feelings and begins to bottle up sadness. Over time, such behavior can lead to a dysfunctional emotional expression and ultimately, depression.

A Cycle of Depression in Men: Recognizing the Symptoms

When a young boy grows up after absorbing the negativity portrayed by others, they often raise their own children-especially boys- the same way. Society dictates that boys be raised to believe that confidence, strength, success, and composure are the core elements of being a man, and anything "emotional" is girly or womanly, and should therefore be stifled and ignored. For this reason, symptoms of depression in men often manifest differently then they do in women.

Signs and symptoms of depression in men include:

Eating disorders

Erectile dysfunction

Fatigue

Feeling sad or angry inside but showing rage and anger to appear masculine

Unable to perform daily chores

Increased irritability

Lack of concentration

Lack of interest at work and in family

Lack of sleep

Self-medication with street drugs

Suicidal thoughts

Men, Masculinity, and External Coping

Men raised in a system that promotes traditional masculinity have complicated feelings towards their own emotions. Often, they attempt to shut them off or avoid them completely. I believe that this is the reason why men are more likely to use external methods to cope with the inward turmoil and pain caused by depression. Men often deal with depression by over-working. They also self-medicate by turning to substances such as drugs and alcohol as a way to avoid dealing with depression and anxiety. Physiologist and medical doctor Sigmund Freud, who is widely regarded as the father of psychoanalysis, famously said people repress from their conscious mind what they believe are shameful thoughts. In other words, people bury what they are ashamed of. In 2003, the work of Harvard Professor of Psychiatry, EJ Khantzian, MD ² linked repression of emotion to self-medication as way of achieving emotional and psychological stability.

Lastly, many men express their internal conflicts by directing anger at those around them, like their partners or children. What do all of these external "coping" methods have in common? None of them actually help men cope with, or even face, what they are actually struggling with.

Changing Our View of Men and Depression

Unfortunately, I've had several male clients relay painful stories about the insensitive responses they received when they confided in a loved one about their struggles with depression. Sadly, they weren't met with sympathy or encouragement. Instead, remarks along the lines of, " Why are you depressed about, are you on your period?" are fairly typical.

Yes, the friend was joking and likely trying to make my client feel better, but of course had the opposite effect. It's easy to understand why men often prefer to keep depression to themselves-hidden from their friends and family members.

We need to change how we see depression in men; depression is not related to gender. No man or woman chooses to live with depression. Traumatic events lead to depression, and we need to accept this fact instead of dispiriting the problem and the sufferer.

What You Can Do

Here are some tips you that can help you build trust and encourage the men you love to be more comfortable sharing their emotions:

Avoid trivializing depression in men. Instead of saying, " Are you insane?" or " Why are you acting like an emotionally-challenged person? " use empathy and provide support to your male friends and family members who are depressed. Finding the right words can be difficult and saying them can feel awkward but being willing to listen, without judgment, is often the best thing you can do for someone who is depressed. Motivate them to share their feelings and emotions with you, and when they do, provide the moral support that they need instead of belittling them.

Change your expectations and reactions. As a therapist, I have witnessed that men suffering from depression never share their feelings because they would be mocked. The fact is that when someone is suffering from depression, sharing their feelings and emotions is necessary to help them cope with the problem. We need to be better friends, better partners and be the support that men need.

Be part of the solution by sincerely encouraging men to help them express emotions better. To help men you have to help them get rid of their hesitation in sharing their emotions. We must accept the fact that expressing emotion and crying are normal tendencies for all people, regardless of gender. Crying must not be associated with gender roles. Addressing and processing emotions is what makes us human, and crying is a fundamental emotion.

Each person is born with unique assets and challenges that affect how they grow and develop biologically, psychologically, and socially. Adult family members as well as adults in neighborhoods, schools and the broader community, can facilitate that person moving toward growth and development. Help them face risks and challenges by helping them achieve a positive outcome. We often refer to overcoming adversity as promoting resilience.

We can change the model of masculinity by telling children that it's fine for boys to express and show emotion. Male role models can practice what they preach by expressing affection and emotion: telling their children they love them; being comfortable hugging them; showing that it's okay to cry at weddings, funerals, when they are injured, etc. and discussing everyday emotions such as, " my day at work was overwhelming and I struggled with some low points." Teaching boys how to express their emotions adequately is the key to helping them become emotionally expressive. These lessons will have a positive effect on their life in the future.

It has been too long, that we have lived with the traditional model of masculinity and if you ask me, NOW is a great time to change how the society perceives emotional responses in men.

Depression is often a life-long illness. In most cases, long-term help may be needed to stay well, which includes sticking with treatment and developing and facilitating a plan for when symptoms return. Setbacks can happen to anyone even if you've been feeling well for a long time. Many men and women who live with depression learn to cope and are able to live fulfilling lives. Take it one step at a time, one day at a time. Your family, friends, and treatment team are resources.
If you are in crisis, you are not alone. Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, seven days a week. The service is open to anyone. All calls are confidential.

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Depression in Men: The Cycle of Toxic Masculinity

# data[].attributes.attachment_link.description
One of the reasons I became a therapist is my interest in helping people suffering from anxiety, social awkwardness, bipolar disorder, and depression. Over the years I've observed that many men with depression have trouble admitting they are depressed. They often can't even verbalize the words, " I am depressed.

# data[].attributes.attachment_link.provider_name
PsyCom.net - Mental Health Treatment Resource Since 1986

# data[].attributes.attachment_link.readable_text
One of the reasons I became a therapist is my interest in helping people suffering from anxiety, social awkwardness, bipolar disorder, and depression. Over the years I've observed that many men with depression have trouble admitting they are depressed. They often can't even verbalize the words, " I am depressed. " According to Mental Health America, six million men suffer from depression. Research conducted by US Department of Health and Human Services shows that depressive symptoms in boys have increased from 4.3 to 5.7% nationwide. Grim numbers for certain but the most worrisome aspect of all is the fact that untreated depression can lead to anti-social behavior and suicide.

Does depression in men really differ from depression in women? Yes, men seem to experience and cope with depression in different ways than women but it's important to consider the impact of societal ideals of masculinity on the differences. 1. There's a simplistic view that may be partially rooted in truth: women get sad, men get mad. Other male symptoms include: fatigue, body pain, severe sleep disturbances, and erectile dysfunction.

How Toxic Masculinity Hurts Men

In the American culture, and others, many men have difficulty expressing emotion due to toxic masculinity. Toxic masculinity refers to actions that discourage displays of emotion-other than anger-in men while also encouraging behavior that will deem the male "dominant" in a given situation. Even as children, young boys who express feelings are compared to girls in a negative context. Common responses to young males who become emotional include:

Boys don't cry!

Man up!

Don't be such a baby!

Don't cry like a girl!

Be a man-get over it!

You throw like a girl!

You've likely heard these phrases directed at you or someone around you. You have probably noticed them in dialogue or in storylines on television shows and movies. And, you may even be guilty of uttering them yourself.

Imagine being a young boy, crying over a painful injury or an emotional heartbreak that feels like the end of the world, and then being told to " man up," instead of being gently asked what's making you cry, how you feel about it, and what you think you can do about it.

When feelings are dismissed and gender-defining thinking is heard repeatedly, a young person learns to avoid expressing their real feelings and begins to bottle up sadness. Over time, such behavior can lead to a dysfunctional emotional expression and ultimately, depression.

A Cycle of Depression in Men: Recognizing the Symptoms

When a young boy grows up after absorbing the negativity portrayed by others, they often raise their own children-especially boys- the same way. Society dictates that boys be raised to believe that confidence, strength, success, and composure are the core elements of being a man, and anything "emotional" is girly or womanly, and should therefore be stifled and ignored. For this reason, symptoms of depression in men often manifest differently then they do in women.

Signs and symptoms of depression in men include:

Eating disorders

Erectile dysfunction

Fatigue

Feeling sad or angry inside but showing rage and anger to appear masculine

Unable to perform daily chores

Increased irritability

Lack of concentration

Lack of interest at work and in family

Lack of sleep

Self-medication with street drugs

Suicidal thoughts

Men, Masculinity, and External Coping

Men raised in a system that promotes traditional masculinity have complicated feelings towards their own emotions. Often, they attempt to shut them off or avoid them completely. I believe that this is the reason why men are more likely to use external methods to cope with the inward turmoil and pain caused by depression. Men often deal with depression by over-working. They also self-medicate by turning to substances such as drugs and alcohol as a way to avoid dealing with depression and anxiety. Physiologist and medical doctor Sigmund Freud, who is widely regarded as the father of psychoanalysis, famously said people repress from their conscious mind what they believe are shameful thoughts. In other words, people bury what they are ashamed of. In 2003, the work of Harvard Professor of Psychiatry, EJ Khantzian, MD ² linked repression of emotion to self-medication as way of achieving emotional and psychological stability.

Lastly, many men express their internal conflicts by directing anger at those around them, like their partners or children. What do all of these external "coping" methods have in common? None of them actually help men cope with, or even face, what they are actually struggling with.

Changing Our View of Men and Depression

Unfortunately, I've had several male clients relay painful stories about the insensitive responses they received when they confided in a loved one about their struggles with depression. Sadly, they weren't met with sympathy or encouragement. Instead, remarks along the lines of, " Why are you depressed about, are you on your period?" are fairly typical.

Yes, the friend was joking and likely trying to make my client feel better, but of course had the opposite effect. It's easy to understand why men often prefer to keep depression to themselves-hidden from their friends and family members.

We need to change how we see depression in men; depression is not related to gender. No man or woman chooses to live with depression. Traumatic events lead to depression, and we need to accept this fact instead of dispiriting the problem and the sufferer.

What You Can Do

Here are some tips you that can help you build trust and encourage the men you love to be more comfortable sharing their emotions:

Avoid trivializing depression in men. Instead of saying, " Are you insane?" or " Why are you acting like an emotionally-challenged person? " use empathy and provide support to your male friends and family members who are depressed. Finding the right words can be difficult and saying them can feel awkward but being willing to listen, without judgment, is often the best thing you can do for someone who is depressed. Motivate them to share their feelings and emotions with you, and when they do, provide the moral support that they need instead of belittling them.

Change your expectations and reactions. As a therapist, I have witnessed that men suffering from depression never share their feelings because they would be mocked. The fact is that when someone is suffering from depression, sharing their feelings and emotions is necessary to help them cope with the problem. We need to be better friends, better partners and be the support that men need.

Be part of the solution by sincerely encouraging men to help them express emotions better. To help men you have to help them get rid of their hesitation in sharing their emotions. We must accept the fact that expressing emotion and crying are normal tendencies for all people, regardless of gender. Crying must not be associated with gender roles. Addressing and processing emotions is what makes us human, and crying is a fundamental emotion.

Each person is born with unique assets and challenges that affect how they grow and develop biologically, psychologically, and socially. Adult family members as well as adults in neighborhoods, schools and the broader community, can facilitate that person moving toward growth and development. Help them face risks and challenges by helping them achieve a positive outcome. We often refer to overcoming adversity as promoting resilience.

We can change the model of masculinity by telling children that it's fine for boys to express and show emotion. Male role models can practice what they preach by expressing affection and emotion: telling their children they love them; being comfortable hugging them; showing that it's okay to cry at weddings, funerals, when they are injured, etc. and discussing everyday emotions such as, " my day at work was overwhelming and I struggled with some low points." Teaching boys how to express their emotions adequately is the key to helping them become emotionally expressive. These lessons will have a positive effect on their life in the future.

It has been too long, that we have lived with the traditional model of masculinity and if you ask me, NOW is a great time to change how the society perceives emotional responses in men.

Depression is often a life-long illness. In most cases, long-term help may be needed to stay well, which includes sticking with treatment and developing and facilitating a plan for when symptoms return. Setbacks can happen to anyone even if you've been feeling well for a long time. Many men and women who live with depression learn to cope and are able to live fulfilling lives. Take it one step at a time, one day at a time. Your family, friends, and treatment team are resources.
If you are in crisis, you are not alone. Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, seven days a week. The service is open to anyone. All calls are confidential.

# data[].attributes.attachment_link.title
Depression in Men: The Cycle of Toxic Masculinity

# data[].attributes.attachment_link.description
One of the reasons I became a therapist is my interest in helping people suffering from anxiety, social awkwardness, bipolar disorder, and depression. Over the years I've observed that many men with depression have trouble admitting they are depressed. They often can't even verbalize the words, " I am depressed.

# data[].attributes.attachment_link.provider_name
PsyCom.net - Mental Health Treatment Resource Since 1986

# data[].attributes.attachment_link.readable_text
One of the reasons I became a therapist is my interest in helping people suffering from anxiety, social awkwardness, bipolar disorder, and depression. Over the years I've observed that many men with depression have trouble admitting they are depressed. They often can't even verbalize the words, " I am depressed. " According to Mental Health America, six million men suffer from depression. Research conducted by US Department of Health and Human Services shows that depressive symptoms in boys have increased from 4.3 to 5.7% nationwide. Grim numbers for certain but the most worrisome aspect of all is the fact that untreated depression can lead to anti-social behavior and suicide.

Does depression in men really differ from depression in women? Yes, men seem to experience and cope with depression in different ways than women but it's important to consider the impact of societal ideals of masculinity on the differences. 1. There's a simplistic view that may be partially rooted in truth: women get sad, men get mad. Other male symptoms include: fatigue, body pain, severe sleep disturbances, and erectile dysfunction.

How Toxic Masculinity Hurts Men

In the American culture, and others, many men have difficulty expressing emotion due to toxic masculinity. Toxic masculinity refers to actions that discourage displays of emotion-other than anger-in men while also encouraging behavior that will deem the male "dominant" in a given situation. Even as children, young boys who express feelings are compared to girls in a negative context. Common responses to young males who become emotional include:

Boys don't cry!

Man up!

Don't be such a baby!

Don't cry like a girl!

Be a man-get over it!

You throw like a girl!

You've likely heard these phrases directed at you or someone around you. You have probably noticed them in dialogue or in storylines on television shows and movies. And, you may even be guilty of uttering them yourself.

Imagine being a young boy, crying over a painful injury or an emotional heartbreak that feels like the end of the world, and then being told to " man up," instead of being gently asked what's making you cry, how you feel about it, and what you think you can do about it.

When feelings are dismissed and gender-defining thinking is heard repeatedly, a young person learns to avoid expressing their real feelings and begins to bottle up sadness. Over time, such behavior can lead to a dysfunctional emotional expression and ultimately, depression.

A Cycle of Depression in Men: Recognizing the Symptoms

When a young boy grows up after absorbing the negativity portrayed by others, they often raise their own children-especially boys- the same way. Society dictates that boys be raised to believe that confidence, strength, success, and composure are the core elements of being a man, and anything "emotional" is girly or womanly, and should therefore be stifled and ignored. For this reason, symptoms of depression in men often manifest differently then they do in women.

Signs and symptoms of depression in men include:

Eating disorders

Erectile dysfunction

Fatigue

Feeling sad or angry inside but showing rage and anger to appear masculine

Unable to perform daily chores

Increased irritability

Lack of concentration

Lack of interest at work and in family

Lack of sleep

Self-medication with street drugs

Suicidal thoughts

Men, Masculinity, and External Coping

Men raised in a system that promotes traditional masculinity have complicated feelings towards their own emotions. Often, they attempt to shut them off or avoid them completely. I believe that this is the reason why men are more likely to use external methods to cope with the inward turmoil and pain caused by depression. Men often deal with depression by over-working. They also self-medicate by turning to substances such as drugs and alcohol as a way to avoid dealing with depression and anxiety. Physiologist and medical doctor Sigmund Freud, who is widely regarded as the father of psychoanalysis, famously said people repress from their conscious mind what they believe are shameful thoughts. In other words, people bury what they are ashamed of. In 2003, the work of Harvard Professor of Psychiatry, EJ Khantzian, MD ² linked repression of emotion to self-medication as way of achieving emotional and psychological stability.

Lastly, many men express their internal conflicts by directing anger at those around them, like their partners or children. What do all of these external "coping" methods have in common? None of them actually help men cope with, or even face, what they are actually struggling with.

Changing Our View of Men and Depression

Unfortunately, I've had several male clients relay painful stories about the insensitive responses they received when they confided in a loved one about their struggles with depression. Sadly, they weren't met with sympathy or encouragement. Instead, remarks along the lines of, " Why are you depressed about, are you on your period?" are fairly typical.

Yes, the friend was joking and likely trying to make my client feel better, but of course had the opposite effect. It's easy to understand why men often prefer to keep depression to themselves-hidden from their friends and family members.

We need to change how we see depression in men; depression is not related to gender. No man or woman chooses to live with depression. Traumatic events lead to depression, and we need to accept this fact instead of dispiriting the problem and the sufferer.

What You Can Do

Here are some tips you that can help you build trust and encourage the men you love to be more comfortable sharing their emotions:

Avoid trivializing depression in men. Instead of saying, " Are you insane?" or " Why are you acting like an emotionally-challenged person? " use empathy and provide support to your male friends and family members who are depressed. Finding the right words can be difficult and saying them can feel awkward but being willing to listen, without judgment, is often the best thing you can do for someone who is depressed. Motivate them to share their feelings and emotions with you, and when they do, provide the moral support that they need instead of belittling them.

Change your expectations and reactions. As a therapist, I have witnessed that men suffering from depression never share their feelings because they would be mocked. The fact is that when someone is suffering from depression, sharing their feelings and emotions is necessary to help them cope with the problem. We need to be better friends, better partners and be the support that men need.

Be part of the solution by sincerely encouraging men to help them express emotions better. To help men you have to help them get rid of their hesitation in sharing their emotions. We must accept the fact that expressing emotion and crying are normal tendencies for all people, regardless of gender. Crying must not be associated with gender roles. Addressing and processing emotions is what makes us human, and crying is a fundamental emotion.

Each person is born with unique assets and challenges that affect how they grow and develop biologically, psychologically, and socially. Adult family members as well as adults in neighborhoods, schools and the broader community, can facilitate that person moving toward growth and development. Help them face risks and challenges by helping them achieve a positive outcome. We often refer to overcoming adversity as promoting resilience.

We can change the model of masculinity by telling children that it's fine for boys to express and show emotion. Male role models can practice what they preach by expressing affection and emotion: telling their children they love them; being comfortable hugging them; showing that it's okay to cry at weddings, funerals, when they are injured, etc. and discussing everyday emotions such as, " my day at work was overwhelming and I struggled with some low points." Teaching boys how to express their emotions adequately is the key to helping them become emotionally expressive. These lessons will have a positive effect on their life in the future.

It has been too long, that we have lived with the traditional model of masculinity and if you ask me, NOW is a great time to change how the society perceives emotional responses in men.

Depression is often a life-long illness. In most cases, long-term help may be needed to stay well, which includes sticking with treatment and developing and facilitating a plan for when symptoms return. Setbacks can happen to anyone even if you've been feeling well for a long time. Many men and women who live with depression learn to cope and are able to live fulfilling lives. Take it one step at a time, one day at a time. Your family, friends, and treatment team are resources.
If you are in crisis, you are not alone. Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, seven days a week. The service is open to anyone. All calls are confidential.

# data[].attributes.attachment_link.title
Depression in Men: The Cycle of Toxic Masculinity

# data[].attributes.attachment_link.description
One of the reasons I became a therapist is my interest in helping people suffering from anxiety, social awkwardness, bipolar disorder, and depression. Over the years I've observed that many men with depression have trouble admitting they are depressed. They often can't even verbalize the words, " I am depressed.

# data[].attributes.attachment_link.title
How depression can look different for men

# data[].attributes.attachment_link.description
Depression in men may be masked by unhealthy coping behaviors, so it often goes undiagnosed and can have devastating consequences when untreated.

# data[].attributes.headline
Why is Depression in Men Not Commonly Recognized?

# data[].attributes.subject
Why is Depression in Men Not Commonly Recognized?

# data[].attributes.attachment_link.readable_text
While clinical depression was once considered a "woman's disease," more than 6 million men in the U.S. have depression each year. Unfortunately, the lingering image of depression as a female condition may keep men who are clinically depressed from recognizing the symptoms of depression and seeking treatment.

Depression actually affects both sexes. It disrupts relationships and interferes with work and daily activities. The symptoms of depression in men are similar to the symptoms of depression in women. But men tend to express those symptoms differently. Common symptoms of depression include loss of interest in usually pleasurable activities, fatigue, changes in appetite, sleep disturbances, and apathy. In women, depression may be more likely to cause feelings of sadness and worthlessness. Depression in men, on the other hand, may be more likely to cause them to become withdrawn or to feel irritable, aggressive, or hostile.

Why is depression in men commonly not recognized?

There are several reasons why the symptoms of clinical depression in men are not commonly recognized. For example, men tend to deny having problems because they are supposed to "be strong." And American culture suggests that expressing emotion is largely a feminine trait. As a result, men who are depressed are more likely to talk about the physical symptoms of their depression -- such as feeling tired --- rather than symptoms related to emotions.

Does depression in men affect sexual desire and performance?

Yes. Depression in men can affect sexual desire and performance. Unfortunately, some antidepressants and other medications can do the same. Men often are unwilling to admit to problems with their sexuality. Many mistakenly feel that the problems are related to their manhood, when, in fact, they are caused by a medical problem such as clinical depression.

What are some observable symptoms of depression in men?

Men are less likely to show more "typical" signs of depression such as sadness. Depression in men may cause them to keep their feelings hidden. Instead of expressing a depressed mood, they may seem more irritable and aggressive.

For these reasons, many men -- as well as doctors and other health care professionals -- may fail to recognize the problem as depression.

Continued

What are the consequences of untreated depression in men?

Depression in men can have devastating consequences. The CDC reports that men in the U.S. are three to four times likelier than women to commit suicide. A staggering 75% to 80% of all people who commit suicide in the U.S. are men. Though more women attempt suicide, more men complete the act of actually ending their lives. This may be due to the fact that men tend to use more lethal and violent methods for committing suicide, such as using a gun rather than taking an overdose of pills.

Why is depression in men so hard to accept?

Understanding how men in our society are brought up to behave is particularly important in identifying and treating their depression. Depression in men often can be traced to cultural expectations. Men are supposed to be successful. They should rein in their emotions. They must be in control. These cultural expectations can mask some of the true symptoms of depression. Instead, men may express aggression and anger -- seen as more acceptable "tough guy" behavior.

Is a stigma attached to depression in men?

Yes. And men generally have a hard time dealing with the stigma of depression. They are more likely to deal with their symptoms by drinking alcohol, abusing drugs, or pursuing other risky behavior. Many men avoid talking about depressed feelings to friends or family.

Is depression common in elderly men?

Although depression is not a normal part of aging, senior men may have medical conditions such as heart disease, stroke, cancer, or other stressors that may contribute to depression. For example, there may be excessive losses (such as friends, physical health, spouses, income, meaningful work). Retirement is difficult for many men because they end up with no routine or set schedule to follow. These changes may increase the stress they feel, and a loss of self-esteem may contribute to depression. In addition, the death of family and friends, the onset of other health problems, and some medications can contribute to depression in men.

Continued

How is depression in men treated?

More than 80% of people with depression -- both men and women -- can be treated successfully with antidepressant medication, psychotherapy, or a combination of both. If you are uncertain about whom to call for help with depression, check out the following list from the National Institute of Mental Health:

Community mental health centers

Employee assistance programs

Family doctors

Family service/social agencies

Health maintenance organizations

Hospital psychiatry departments and outpatient clinics

Local medical or psychiatric societies

Mental health specialists such as psychiatrists, psychologists, social workers, or mental health counselors

Private clinics and facilities

State hospital outpatient clinics

University or medical school affiliated programs

Sources

SOURCES:

National Institute of Mental Health: "Depression."

National Institute of Mental Health: "Men and Depression."

American Psychiatric Association, Practice Guideline for the Treatment of Patients with Major Depression, 2000.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.

Fieve, R. Bipolar II, Rodale Books, 2006.

Cleveland Clinic: "Sexual Problems and Depression."

National Institute of Mental Health: "Suicide in the US: Statistics and Prevention."

# data[].attributes.attachment_link.title
Depression in Men: Symptoms and Physical Effects

# data[].attributes.attachment_link.description
While clinical depression was once considered a "woman's disease," more than 6 million men in the U.S. have depression each year. Unfortunately, the lingering image of depression as a female condition may keep men who are clinically depressed from recognizing the symptoms of depression and seeking treatment. Depression actually affects both sexes.

# data[].attributes.attachment_link.readable_text
While clinical depression was once considered a "woman's disease," more than 6 million men in the U.S. have depression each year. Unfortunately, the lingering image of depression as a female condition may keep men who are clinically depressed from recognizing the symptoms of depression and seeking treatment.

Depression actually affects both sexes. It disrupts relationships and interferes with work and daily activities. The symptoms of depression in men are similar to the symptoms of depression in women. But men tend to express those symptoms differently. Common symptoms of depression include loss of interest in usually pleasurable activities, fatigue, changes in appetite, sleep disturbances, and apathy. In women, depression may be more likely to cause feelings of sadness and worthlessness. Depression in men, on the other hand, may be more likely to cause them to become withdrawn or to feel irritable, aggressive, or hostile.

Why is depression in men commonly not recognized?

There are several reasons why the symptoms of clinical depression in men are not commonly recognized. For example, men tend to deny having problems because they are supposed to "be strong." And American culture suggests that expressing emotion is largely a feminine trait. As a result, men who are depressed are more likely to talk about the physical symptoms of their depression -- such as feeling tired --- rather than symptoms related to emotions.

Does depression in men affect sexual desire and performance?

Yes. Depression in men can affect sexual desire and performance. Unfortunately, some antidepressants and other medications can do the same. Men often are unwilling to admit to problems with their sexuality. Many mistakenly feel that the problems are related to their manhood, when, in fact, they are caused by a medical problem such as clinical depression.

What are some observable symptoms of depression in men?

Men are less likely to show more "typical" signs of depression such as sadness. Depression in men may cause them to keep their feelings hidden. Instead of expressing a depressed mood, they may seem more irritable and aggressive.

For these reasons, many men -- as well as doctors and other health care professionals -- may fail to recognize the problem as depression.

Continued

What are the consequences of untreated depression in men?

Depression in men can have devastating consequences. The CDC reports that men in the U.S. are three to four times likelier than women to commit suicide. A staggering 75% to 80% of all people who commit suicide in the U.S. are men. Though more women attempt suicide, more men complete the act of actually ending their lives. This may be due to the fact that men tend to use more lethal and violent methods for committing suicide, such as using a gun rather than taking an overdose of pills.

Why is depression in men so hard to accept?

Understanding how men in our society are brought up to behave is particularly important in identifying and treating their depression. Depression in men often can be traced to cultural expectations. Men are supposed to be successful. They should rein in their emotions. They must be in control. These cultural expectations can mask some of the true symptoms of depression. Instead, men may express aggression and anger -- seen as more acceptable "tough guy" behavior.

Is a stigma attached to depression in men?

Yes. And men generally have a hard time dealing with the stigma of depression. They are more likely to deal with their symptoms by drinking alcohol, abusing drugs, or pursuing other risky behavior. Many men avoid talking about depressed feelings to friends or family.

Is depression common in elderly men?

Although depression is not a normal part of aging, senior men may have medical conditions such as heart disease, stroke, cancer, or other stressors that may contribute to depression. For example, there may be excessive losses (such as friends, physical health, spouses, income, meaningful work). Retirement is difficult for many men because they end up with no routine or set schedule to follow. These changes may increase the stress they feel, and a loss of self-esteem may contribute to depression. In addition, the death of family and friends, the onset of other health problems, and some medications can contribute to depression in men.

Continued

How is depression in men treated?

More than 80% of people with depression -- both men and women -- can be treated successfully with antidepressant medication, psychotherapy, or a combination of both. If you are uncertain about whom to call for help with depression, check out the following list from the National Institute of Mental Health:

Community mental health centers

Employee assistance programs

Family doctors

Family service/social agencies

Health maintenance organizations

Hospital psychiatry departments and outpatient clinics

Local medical or psychiatric societies

Mental health specialists such as psychiatrists, psychologists, social workers, or mental health counselors

Private clinics and facilities

State hospital outpatient clinics

University or medical school affiliated programs

Sources

SOURCES:

National Institute of Mental Health: "Depression."

National Institute of Mental Health: "Men and Depression."

American Psychiatric Association, Practice Guideline for the Treatment of Patients with Major Depression, 2000.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.

Fieve, R. Bipolar II, Rodale Books, 2006.

Cleveland Clinic: "Sexual Problems and Depression."

National Institute of Mental Health: "Suicide in the US: Statistics and Prevention."

# data[].attributes.attachment_link.title
Depression in Men: Symptoms and Physical Effects

# data[].attributes.attachment_link.description
While clinical depression was once considered a "woman's disease," more than 6 million men in the U.S. have depression each year. Unfortunately, the lingering image of depression as a female condition may keep men who are clinically depressed from recognizing the symptoms of depression and seeking treatment. Depression actually affects both sexes.

# data[].attributes.attachment_link.readable_text
Physical complaints, substance abuse, and other stealth symptoms may mask the problem.

In many respects, men fare worse than women when it comes to health problems. Men are more likely to have heart attacks than women, for example, and more likely to die of cancer. But men are only half as likely as women to develop one of the most disabling disorders worldwide - major depression. Men are also less likely than women to develop dysthymia (chronic mild to moderate depression) and may be less likely to experience bipolar depression (even though the rate of bipolar disorder is the same in both genders).

It is unclear what underlies this gender difference. The leading theory is that some combination of genes, hormones, and environmental stress contributes to it.

Still, although men are less likely than women to develop depression, it remains a significant mental health problem for them. About 10% to 17% of men will develop major depression at some point in their lives. Moreover, depression may be more deadly for men than for women. Depression is a key risk factor for suicide, and four times as many men compared with women die from suicide. One reason may be men's reluctance to convey their feelings and seek help when they are in despair.

Another mortal concern for men with depression is cardiovascular disease. Depression is a well-known risk factor for coronary artery disease, heart attack, and stroke. Men are especially vulnerable because they develop these diseases at a higher rate and at an earlier age than women.

Given the toll depression takes on men, it's important that those who need help receive it. But often the symptoms of depression are different in men than in women - partly because of cultural pressures for members of each gender to behave in certain ways - a factor that may contribute to missed diagnoses.

Stealth symptoms

An analysis of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, one of the largest investigations of depression in "real world" settings, found that while men and women shared some symptoms of major depression (such as low mood), the overall pattern of symptoms varied by gender. Women were more likely to gain weight when depressed; men were more likely to lose weight. Women reported symptoms overlapping with anxiety disorders; men reported symptoms more typical of obsessive-compulsive disorder. Women felt less energetic; men became agitated. Men were also more likely than women to develop alcohol or substance abuse in conjunction with major depression.

Other research has found that because of cultural pressure to act "manly," men may feel that it is weak to show despair or self-doubt. As a result, symptoms of depression may masquerade as anger or irritability. Research by the National Institute of Mental Health revealed that many men were not aware that physical problems such as headaches, stomach problems, and chronic pain might be symptoms of depression.

Men also may be reluctant to admit to depression because they are worried about how their boss, co-workers, or neighbors will react. Because of these concerns, when men develop depression they may actually work longer hours or engage in more volunteer activities - all in an effort to avoid confronting or revealing symptoms of depression.

Possible protective factors

The research suggests that several factors help buffer men against depression. Men - and women - who integrate these protective strategies into their lives may improve their odds of avoiding this mood disorder.

Physical activity. Men engage in more moderate to intense physical activity on a regular basis than do women. It's not clear whether this is because men are more likely to be employed in occupations that involve activity (such as construction work) or whether they are more likely to exercise for recreation. No matter how men get this exercise, the research suggests it has a positive impact on their mental health.

Psychology. Men are less likely than women to ruminate over past events, are more likely to feel in control of their lives, and more likely to feel positive about themselves and their situation. Men with these psychological traits may have a mental buffer against depression.

Getting help

The most important thing others can do for a man who shows signs of depression is to help him contact a primary care physician or mental health professional. Taking that first step is often the hardest. If necessary, accompany him to an appointment.

Clinicians can routinely screen adults for depression by asking two standard questions:

Over the past two weeks, have you felt depressed or hopeless?

In the same period, have you felt little interest or pleasure in your usual activities?

Screening can be especially important for men because they are less likely than women to bring up the subject of depression themselves. Just keep in mind that men may have other symptoms as well, and it may be worth asking about them (see "Symptoms of major depression").

Symptoms of major depression

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) describes symptoms of major depression, but some are more common in men.

Classic symptoms (in men and women)

Symptoms men are more likely to experience than women

Depressed mood, feeling sad or empty

Less interest in or pleasure from daily activities

Significant weight loss or gain, or appetite changes

Insomnia or excessive sleepiness

Physical agitation or lethargy

Fatigue and lack of energy

Feeling worthless or excessively guilty

Inability to think or concentrate

Recurring thoughts of death or suicide

Irritability

Loss of interest in work or hobbies

Sleep problems

Physical problems such as headaches, digestive disorders, and chronic pain

Alcohol or substance abuse to self-medicate for depression

Changes in behavior, such as becoming abusive, controlling, or violent

Taking physical risks, such as aggressive driving or unsafe sex

Treatment is the same for men and women - talking with a clinician about problems, taking an antidepressant for symptoms, or both. If symptoms of depression are mild or moderate, it is often reasonable to start with either medication or psychotherapy alone. Generally, if symptoms are more severe, it is more important to consider medication earlier in treatment.

Improvement takes time. Although some patients experience symptom relief within one or two weeks after beginning a medication, for example, more often it takes from four to eight weeks for antidepressants to take effect.

Selective serotonin reuptake inhibitors (SSRIs) are the medications most often prescribed for depression. Although in general, the side effects of SSRIs may be quite manageable, one drawback is that they frequently dampen sexual response, delay orgasm, or lead to erectile dysfunction. These side effects may subside in time on their own. It's also possible that lowering the dose of a medication may help.

Switching to a new drug may also make sense. Mirtazapine (Remeron) and some older antidepressants - tricyclic antidepressants and monoamine oxidase inhibitors - are less likely to cause sexual side effects than SSRIs.

If erectile dysfunction remains a problem, men may obtain relief with an erection drug such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra). Another option is adding bupropion (Wellbutrin) to an SSRI, as this medication sometimes counters SSRI-induced sexual dysfunction, boosts sexual drive and arousal, and increases the intensity or duration of an orgasm. Another drug, buspirone (BuSpar), can restore the ability to have an orgasm and increase libido.

Sticking with treatment

Following a treatment plan can be a challenge, not only because medications can cause side effects and psychotherapy takes time - but because of stigma. Men with depression may feel at times as though they are all alone in their struggle. Support groups may be of help in this regard. (To find more information about support groups, contact the National Alliance on Mental Illness at www.nami.org, or the Depression and Bipolar Support Alliance at www.dbsalliance.org.)

And if a first depression treatment doesn't provide sufficient help for a man, it's important to explore alternatives. Perseverance, a trait that many men are proud to embrace, may be the most important characteristic when it comes to finding relief.

Leach LS, et al. "Gender Differences in Depression and Anxiety Across the Adult Lifespan: The Role of Psychosocial Mediators," Social Psychiatry and Psychiatric Epidemiology (Dec. 2008): Vol. 43, No. 12, pp. 983-98.

Lehti AH, et al. "The Western Gaze - An Analysis of Medical Research Publications Concerning the Expressions of Depression, Focusing on Ethnicity and Gender," Health Care for Women International (Feb. 2010): Vol. 31, No. 2, pp. 100-12.

Liu RT, et al. "Stress Generation in Depression: A Systematic Review of the Empirical Literature and Recommendations for Future Study," Clinical Psychology Review (July 2010): Vol. 30, No. 5, pp. 582-93.

Marcus SM, et al. "Gender Differences in Depression: Findings from the STAR*D Study," Journal of Affective Disorders (Aug. 2005): Vol. 87, No. 2-3, pp. 141-50.

Miller M, editor. Understanding Depression (Harvard Medical School, 2011).

National Institute of Mental Health. Men and Depression (2005).

Pitychoutis PM, et al. "Of Depression and Immunity: Does Sex Matter?" International Journal of Neuropsychopharmacology (June 2010): Vol. 13, No. 5, pp. 675-89.

Surveillance Epidemiology and End Results (SEER). "SEER Stat Fact Sheets: Cancer," 2011.

For more references, please see www.health.harvard.edu/mentalextra.

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Recognizing depression in men - Harvard Health

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Although men are less likely than women to develop depression, it remains a significant mental health problem for them. About 10% to 17% of men will develop major depression at some point in their lives. Moreover, depression may be more deadly for me...

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