Choosing to Scream Instead of Cry – Men and Depression – DW – March 20, 2024

Depression is considered typically female and is a taboo subject, especially among men. “All the things that are classically associated with femininity tend to be repressed in men and need to be compensated for. Aggressive behavior can be a way out,” says Anna Maria Möller-Leimkuhler of the Ludwig Maximilians University in Munich..

The World Health Organization (WHO) estimates that around 322 million people worldwide suffer from depression. In addition, there are a large number of unreported cases.

Traditional behavior patterns still apply

Showing emotions and talking about them seems to be primarily a woman's job. Men talk less about their feelings and problems. This lack of communication is one of the reasons why men are less often diagnosed with mental illness than women. And this despite the fact that men commit suicide more often.

Many men see their depression as a failure or feel that they can't keep up. According to the German Depression Relief and Suicide Prevention Foundation When depressed, men are more likely to withdraw and not want to admit their illness. “It's emotional control, just don't show any feelings of weakness—sadness, insecurity, fear, shame,” says Möller-Leimkuhler. On the other hand, it is socially acceptable for women to show weakness. Women are also more able to talk about their feelings, whether it's with their best friend or with other women in a group.

Pay attention to the first signs

The main symptoms of depression are the same in men and women. “Both feel guilty, both feel hopeless, have suicidal thoughts, sleep disturbances and feelings of exhaustion,” says Ulrich Hegerl of German Depression Aid.. But living conditions are different.

49. Depression. Serious illness

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There are also physical signs of depression. These should not only be recognized but also prescribed correctly: headaches, chest pains, joint or back pain, stomach and bowel problems, and fatigue. However, such symptoms are quite socially acceptable and are not seen as weakness, because they are completely “normal” diseases from which no one is immune and which are not taboo.

There are anatomical differences

It's not just traditional gender role or disposition that can be a trigger, brain anatomy has an effect as well. The two halves of a man's brain are not connected in the same way as a woman's, Möller-Laimkuhler says. “The human brain works a little more asymmetrically. The left hemisphere of the brain is more active. This is the part where logic and rationality are.”

Men aren't just more in touch with their own emotions than women. They often have trouble putting their feelings into words. Negative, depressive moods are not recognized as a signal in men. “Men feel internal tension and respond at the behavioral level with activity, aggression, repression, pettiness, and defensiveness. These defense mechanisms may also be reflected in higher alcohol consumption,” says Möller-Leimkuhler.

Depression is hereditary

Depression does not develop out of incompetence or failure. “Predisposition is an important point,” says Hegerl. “Victims must first understand that and also that they can't do anything about it. They may inherit this predisposition or acquire it from early childhood.”

What patients can do, however, is get help, and as quickly as possible. When depression sets in and becomes chronic, it becomes increasingly difficult to pull sufferers out of the black hole they are stuck in.

It is usually relatives and friends who get the ball rolling and ensure that the affected person seeks help afterwards. The cause is often personality changes, such as increased aggression, which causes those around you to become more alert.

In men, depression can manifest itself through aggressive behaviorImage: Adobe Stock

It is important to seek help

Men in particular often think that they can find a way out of depression without outside help. But that is a fallacy. An important first step is to talk to someone about your feelings and your own well-being. Most men need to learn this first.

Depression requires appropriate therapy and depending on the severity of symptoms, medical attention may also be required. The proven method is still psychotherapy, which is indispensable for the treatment of depression. The focus is on the conversation with the therapist. Sufferers learn, among other things, to talk about their feelings, fears and sensitivities and to understand which problems are associated with depression. It also involves experimenting with new ways of behaving and thinking.

It is often combined with drug therapy. This means that the patient is given medication, usually antidepressants, designed to restore mental balance, and this cannot be done alone.

“Depression is a dangerous disease, and not just because of the risk of suicide,” says Hegerl. People with depression often eat poorly. They don't move or barely move. For example, this increases the risk of heart attack, stroke or other serious diseases such as diabetes. This also explains that the life expectancy of people with depression is reduced by an average of 10 years.

Tablets for depression

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Gender specific studies are needed

One of the tools to support the suspicion of “depression” are questionnaires adapted to the clinical picture of “depression”. However, this means that men often experience fewer symptoms than women. This means that these men do not reach the clinical threshold and fall through the cracks. Therefore, possible depression remains undiagnosed.

In 2020, Möller-Leimcooler led studies to develop and evaluate “gender-sensitive depression screening”“, published in the National Library of Medicine. The GSDS It has been extensively studied and has been able to identify up to 18 percent more men at risk of depression compared to a gender-neutral questionnaire. This means that a “multidimensional, valid and reliable screening tool for gender depression” is available, says Möller-Leimkuhler. If the studies are gendered, more risk cases are found in men. mental illnesses.

Sources:

German Depression Relief Fund. Loneliness among German citizens and people with depression, 2023, https://www.deutsche-depressionshilfe.de/forschungszentrum/deutschland-barometer-depression

National Library of Medicine, Gender-Sensitive Development and Preliminary Validation Depression Screening (GSDS), 2020, https://pubmed.ncbi.nlm.nih.gov/31952089/

National Library of Medicine, Gender-Sensitive Depression Screening (GSDS) – Further Validation of a New Self-Assessment Tool, 2022, https://pubmed.ncbi.nlm.nih.gov/34921365/

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