Trigger warning for discussion of suicide, depression, and mental illness.
The core paradox of men and depression is this: women are more likely to be depressed; men are more likely to kill themselves. This makes literally no sense. Unless one is assuming a giant epidemic of men who wake up bright and early one morning, whistling a jaunty tune and thinking cheerfully about the day ahead, who then commit suicide because it seems like the thing to do, it’s simply bizarre.
One of the most obvious explanations for the paradox is that, for whatever reason, men who are depressed are much less likely to be diagnosed with depression.
Of course, one major factor affecting whether men get diagnosed with depression is that men in general far less likely to go to a doctor and get diagnosed with an illness. Where women are likely to go to the doctor when they’re suffering a mysterious pain, men are more likely to tough it out and be macho and endure. This is particularly true of emotional pain: if you believe boys don’t cry, you are not going to go to a psychologist because you feel sad and empty and hopeless all the time.
However, another reason is that many of the diagnostic criteria for depression are symptoms primarily shown by women, not symptoms primarily shown by men. Dr. Christopher Kilmartin describes women as tending to act in and men as tending to act out. That is, women tend to express their depression internally (crying, self-injury, worrying, fatigue, taking about sad feelings), while men tend to express their depression externally, through “chronic anger, self-destructiveness, drug use, gambling, womanizing, and workaholism.”
A study of young men by the Samaritans, a British anti-suicide group, provided some interesting results:
- Half of suicidal boys had been in trouble with the police.
- Suicidal boys are four times more likely to smoke than non-suicidal boys.
- Suicidal boys are three times more likely to drink than non-suicidal boys.
- Suicidal boys are ten times more likely to take illegal drugs than non-suicidal boys.
- Suicidal boys are four times more likely to smash something up when stressed than non-suicidal boys.
- A third of suicidal boys withdraw (i.e. “keep it to themselves,” “stay in their room”) when stressed.
- 59% of suicidal boys, as opposed to 33% of non-suicidal boys, believe boys are expected to cope with problems themselves.
- 58% of suicidal boys believe men are losing rights, compared to 39% of non-suicidal boys.
- 52% of suicidal boys believe a helpline can’t do anything to improve their lives, compared with 22% of non-suicidal boys.
Of course, correlation is not causation. For instance, getting in trouble with police may cause depression to the point of wanting to kill oneself or both getting in trouble with police and suicidal ideation may be caused by a certain personality trait (impulsiveness?). However, in total, these statistics create a portrait of “male-pattern” depression.
Powerlessness may be externalized, such as by blaming it on “feminism going too far,” in order to resolve the contradiction between the male gender role (which is supposed to always have control over others) and the lack of power characteristic of depression. Depressed men may self-medicate through alcohol, drugs and cigarettes in order to make themselves feel better in a socially acceptable way. Depressed men may withdraw and isolate themselves. Depressed men may channel their emotions into anger, since that’s more acceptable than crying or sadness.
And they will not seek help, because men don’t seek help.
I don’t mean to be gender-essentialist here. Many women express their depression through self-medication and anger; many men express their depression through crying and talking about being sad. However, in aggregate, there do seem to be tendencies for men to express their depression in a different way from women in order to express their masculinity properly.
Unfortunately, this leads to many men not receiving the treatment they need. Half of all prison inmates in the United States have at least one mental illness; the vast majority of prison inmates are male. Men are twice as likely as women to become alcohol dependent at some point in their lives. In Europe, women are only 20% of users of drug treatment centers which is impressive, given the general socialized tendency for men to not seek mental health help. Men who are depressed may find themselves in the prison or drug treatment system instead of seeking the help they need.
How can we fight this? There are three steps, I think:
1) Raise awareness among mental-health professionals and the public of male-pattern depression. Anger, withdrawal and self-medication may be serious signs of depression among men. Mental-health professionals should take these symptoms as seriously as they take typically feminine symptoms such as self-reported depression.
2) Encourage men to seek help by redefining seeking mental health help as masculine. Taking advantage of masculinity may help more men seek the help they need. Positively depict men getting mental health help as courageous, assertive, taking control of one’s life and being a leader. If I were running the world, I’d start an ad campaign with prominent masculine celebrities “coming out of the closet” about their experiences with mental illness and saying that seeking help is manly.
3) Get rid of toxic cultural ideas of masculinity. It is fuckstupid that two of the most prominent coping mechanisms for men are “taking illegal drugs” and “smashing stuff.” Seriously? That’s the best our culture can do? Women are encouraged to cry, talk to their friends and seek mental health help, and men are encouraged to cause harm to themselves, others and innocent inanimate objects? What the hell? The current cultural construction of masculinity is a mental health crisis.
I think depression is worse than other things like anxiety/ocd/other disorders. Because on top of the social pressure of “men don’t cry/ask for help” is the crushing weight of depression itself which is constantly telling you that it can NEVER GET BETTER so – god! – why would you even bother asking for help because it won’t work? This is coming from someone who is married to a man with depression, who had to beg him to get help and medication. It doesn’t solve all the problems depression brings, and I still haven’t managed to get therapy/counseling into the equation… Read more »
“”The issue I have with your reasoning is that you cant reason clearly because of the suffering(emotional) you would obviously be in to want to die in the first place””
That doesn’t make much sense. If you are already suffering then you know very well if it is suffering you want to live through, if there is no way to stop it, and you don’t want to endure it, then what other option is there?
@f.
Thanks, and congrats on you accomplishments. 🙂
More women “attempt” suicide as a cry for attention. Thus, you get stuff like overdosing on pills, bag on the head, cutting wrists horizontally, or other methods that are almost always nonfatal. Not to say that doesn’t matter (it’s a pretty drastic step either way), but a lot of suicidal women aren’t actually, well, suicidal. They just want help.
TitForTat, I’m so sorry.
I definitely agree that most people who consider suicide while in the throes of depression, aren’t considering things rationally. From personal experience, while depressed I was convinced I was incapable of finishing my degree or finding a job. Today I have both of those things…
@Orangeyouglad
The reason I reacted so poorly is because my brother committed suicide but didnt die immediately. In fact he had enough time to regret his decision and did so while talking to my mother in the hospital. The issue I have with your reasoning is that you cant reason clearly because of the suffering(emotional) you would obviously be in to want to die in the first place, unless of course you are actually dying from a painful or debilitating disease.
@ dungone, very good point. On the last thread I mentioned that if women experience similar symptoms to the ones described, it probably won’t get caught in screenings either because that’s not how people would expect a depressed woman to act. It really solves nothing to add a gendered filter to discussions of depressive symptoms, imo. As Fnord says, it really may not help to posit two different “types” of depression either. It sounds like what is needed is a broader understanding of depressive symptoms, to include the things we’ve been discussing. And the fact that it’s considered a “disciplinary… Read more »
@Fnord, incidentally, it reminds me of how after returning from Iraq, myself and 120 other men got screened for mental health issues by psychologists from the local college who were mainly experienced at dealing with women. In hindsight, it’s no wonder they missed both of my friends who killed themselves. I saw and experienced those type b symptoms long before there were suicidal tendencies to be seen, especially in the one Marine who served under me, who developed a substance abuse problem and jumped off the roof of a 12 story building a couple months after leaving my fire team… Read more »
Living as trans presenting as assigned-sex can be a “worse than dying” thing. It certainly felt like it to me.
@Titfortat I think being depressed requires one to feel sad. Also, it’s not a matter of not realising that I don’t want to die, I’m usually very aware of this, I _don’t_ want to die. However, when one doesn’t want to die and doesn’t want to live through X (whatever that may be) then one has to weigh their options and if living through X is worse than dying and there is no available solution that would allow you to continue to live without experiencing X, then dying is the only way of avoiding living through X (already established as… Read more »
@Fnord, we’re just splitting hairs now I think we mostly agree. I don’t see how removing the gender from the list of symptoms hurts guys who suffer from type a or type b types. OTOH I think distinguishing between type A and type B can cut right down to the chase screen for the form of depression most likely to be injurious to self or others. Even if you are right and it’s an either/or scenario that would mean a guy like you could never again be properly diagnosed… I’ll take that any day over the current state of affairs… Read more »
@dugone: “Perhaps you experienced both sets of symptoms because you had two ailments at once, not because it’s really all the same exact thing? Depression is already divided into different types, i.e. major, dysthymic, and manic.” You’ll note that the different types of depression, like many mental disorders, are defined to exclude each other. “You may also have missed the other point in the type A and type B discussion, where it came to light that statistically, it takes 3 doctors and 10 years to properly diagnose a man with depression.” I don’t mean that the symptoms that some people… Read more »
Typically, when I am considering suicide, rather than depression I experience this pattern:(TIAGP)
The fact that you dont see that your pattern is not one of being depressed is mind boggling. The sad part is the one’s who realize it just a little too late.(Mommy I dont want to die). Fu……y………sorry for being emotional.
@Fnord, the whole point of calling it type A and type B was to remove the gender essential-ism and recognize that both men and women can suffer from either set of symptoms. Perhaps you experienced both sets of symptoms because you had two ailments at once, not because it’s really all the same exact thing? Depression is already divided into different types, i.e. major, dysthymic, and manic. It would only make sense if the different constellations of symptoms and inherently different risks involved to the self and to others were recognized because, as has been noted by others, the traditional… Read more »
First of all, there seem to be quite a few people here ready to divide depression into Type A and Type B, or “male-pattern” and “female-pattern”, and some even questioning whether they represent the same disorder at all. I’d like to remind people that I had symptoms from both lists. Now, no one’s brain is exactly the same, so it follows that no one’s mental illness is exactly the same, but trying to divide this into to two separate disorders doesn’t seem appropriate. I had symptoms from both lists; it’s not like I had two separate illnesses with distinct effects… Read more »
S5 E3 of Voyager almost redeems the numerous times rape is handwaved off in the series. Torres becomes detatched and starts shirking her work to go for holodeck programs where she beats the crap out of things, skydives, etc. She becomes apathetic.
The doctor diagnoses her with depression.
It’s kind of sad that “male pattern depression” is only explored via a female, but Klingons are positioned as “The manliest of the men.” Definitely a caricature of masculinity.
Perhaps, though, I have to wonder what consequence to not finishing the book was so terrifying that would be the reaction. Though, as a paid author perhaps it was less an issue of needing to write a book and more an issue of grim finances with no other means of income…
TIGAP (that’s quite the acronym you have going on there)
What you’re describing sounds a lot like Oliver Sachs’ very literal deadline he once imposed upon himself: http://www.radiolab.org/2011/mar/08/me-myself-and-muse/
(I feel like this link needs a trigger warning for discussion of reasons for suicide?)
Okay, disclaiming this post with the fact that _I am not depressed_. Also, I would like it noted I am _extremely averse to emotions_. All emotions, whether good or bad (though, I am not inhuman so I cannot completely avoid them whether mine or other’s). So, I’d like request people avoid an emotion-based response. No “apologies” or “being sorry for” or any of that mess. Well, now that I’ve established I am a Not-Depressed Emotion-hater on to my point. : P I’ve formulated suicide plans before. I haven’t really been sure where or how or if I should post on… Read more »
Antidepressants sometimes lead to suicide for both men and women. I’s a terrible thing, because of each direct tragedy, and and because of how the fear of it discourages others from seeking help, but I don’t think it’s specifically anti-man. When bipolar disorder is wrongly diagnosed and treated as just depression, an antidepressant can send the person into a manic phase…with doctors thinking of depression as being largely a woman’s problem, I don’t know if they are more likely to recognize bipolar disorder in a man without confusing it with simple depression. Some people in deep depression feel hopeless and… Read more »
dungone: I think you’re taking a different meaning from what I meant. I meant that “using help” is a process you need to learn how to do in order to be able to do it. You can’t simply ask for help and have someone able to make you feel better if you don’t have ways of doing this already.
significantshrinkage: *hug* You should never feel ashamed of seeking the help you need. Patrick: It’s not about what men are doing wrong; it’s about how society is failing men. We are failing men by not recognizing their depression as depression; we are failing men by making them think they’ve failed if they are depressed. And, of course, antifeminism is not always due to depression. Depressed men are, however, significantly more likely to be antifeminist according to the Samaritans report. (This is, of course, a completely orthogonal issue to whether antifeminist beliefs are true. “Depressed people believe X more than the… Read more »
@machina, I don’t think that’s the problem. I don’t think that male depression/suicide has anything to do with habits that individual men have to learn. Your suggestion is not a new approach – it’s the same pull-yourself-up-by-your-bootstrap approach that everyone has always had to any issue that men face on a broad, societal scale. I’ve always, always heard that response, ever since I was a little kid – that if I, as a man, had a problem, then it’s all because of something that I failed to do correctly, including my personal failure to ask for help. Ironically enough, I… Read more »
The problem is also that being helped is something you need to learn to do. People who don’t talk about their problems and resolve the emotions tied up in them don’t know how to use help even if it’s available.
@f, let’s not forget that antidepressants that are typically given to women can actually make men even more suicidal. And the fact is, men and women can suffer from both kinds of depression, as we had observed on the other thread with the type A and type B depression… so it really can’t just be that the same exact thought patterns are manifested differently depending on sex. Also, I think these symptoms are indistinguishable from thought patterns. At least in contemporary mental health care, behavioral symptoms and neural patterns are one and the same. No one goes into their psychiatrist’s… Read more »