It’s not a sign of weakness, and it isn’t a ‘feminine’ problem. If you’re one of the millions of guys who struggles in secret, take heart. This is a battle you can win …but don’t go it alone.
“His mind is somewhere else. He’s not even interested in sex!” Jenny wondered: “Where is the man I married. He is just so unavailable that I can’t reach him. When I try to talk to him, he gets reactive and yells at me.” Bill and Jenny had come for marriage counseling, and she was describing her concern about and frustration with Bill’s recent behavior. He had become increasingly picky and verbally abusive. He wasn’t sleeping well; he was eating less; and he was avoiding intimacy.
Bill responded angrily with: “She just wants more than I can give, and I’m maxed out. …I just want to run away and hide.” Even though Bill couldn’t recognize it, he was depressed and it was dramatically affecting his life and marriage.
Millions of men struggle with some form of depression. According to The American Journal of Psychiatry, in a given year, about 8 percent of American men over the age of 30 exhibit major depressive disorder and millions more experience chronic low-grade depression. Sixty to 80 percent of depressed adults never receive professional help, according to organizations such as the National Institute of Mental Health. Men are at the top of this list.
One of the problems with treatment is that depression is often not properly diagnosed. Yet, 80 to 90 percent of men seeking treatment can get relief from their symptoms, organizations such as the American Psychological Association say. We are convinced that the majority of men are depressed at some point in their lives, and, yet, most of them either don’t realize it or won’t admit it.
Male depression comes in two types: covert and overt. In overt depression, men feel fatigue, are sad, and experience changes in sleeping and eating habits. In other words, their depression is apparent.
In covert depression, the symptoms are masked by self-medication, isolation and lashing out. A man self-medicating a covert depression may be drinking, using drugs, womanizing or living the life of a couch potato. Isolation can be keeping to himself, even if he has a family. Lashing out can mean becoming violent and abusing a spouse or child.
Some types of depression run in families. However, they can also occur in people who don’t have a family history of depression. Common symptoms of depression include a mood of sadness, despair or emptiness. An inability to experience pleasure (called anhedonia) often accompanies a lowering of one’s self-esteem. Apathy, low motivation and social withdrawal with an excessive emotional sensitivity can occur, as well as negative, pessimistic thinking and increased irritability.
True depression as a disorder or disease state should not be equated with brief mood fluctuations or the feelings of sadness, disappointment or frustration that can arise from daily stressors. Clinical depression can last weeks to months, and many of you readers have suffered for years.
The American Psychiatric Association uses the following criteria to diagnose depression. To be clinically depressed, a person must have at least five of the symptoms listed (including the first two) for the same two-week period. The symptoms can’t be the normal reaction to the death of a loved one:
Depressed mood most of the day, nearly every day
Marked diminished interest of pleasure in all, or almost all, activities most of the day, nearly every day
Significant weight loss when not dieting (more than 5 percent of body weight in a month) or decrease/increase in appetite nearly every day
An abnormal speeding up or slowing down of physical activities or mental processes, nearly every day, as observed by others
Fatigue or less energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt nearly every day (not merely self-reproach or guilt about being sick)
Diminished ability to think or concentrate nearly every day
Recurrent thoughts of death (not just fear of dying) or suicide with or without a specific plan, or a suicide attempt.
Self-harm is the most significant potential result of a serious depression. According to the National Vital Statistics Report, there are an estimated 765,000 annual suicide attempts in the United States. Women may attempt suicide more often, but according to Unmasking Male Depression by Archibald D. Hart, 80 percent of all “successful” suicides in the United States are men, with those over 65 years old the highest risk group. The male suicide rate at midlife is three times higher than average, but at 65 and older, it is seven times higher.
In fact, also in the National Vital Statistics Report, suicide ranks as the eighth leading cause of death in this country, with one suicide death occurring every 17 minutes. According to the World Health Organization, by the year 2020, acute depression (not hunger or infectious diseases) will be the world’s second leading cause of death and disability trailing only heart disease.
The above numbers are shocking. Most men will not believe that these statistics apply to them because we are by nature prone to “emotional numbing.” As men, we become irritable and act out aggressively rather than admit emotional pain. Men in our society learn through modeling or social pressures to deny they have problems, because we are supposed to “be strong.” We tend to believe that being depressed is a sign of weakness or that it is a “feminine” problem.
This irrational belief sets us up for more pain and unnecessary suffering as we suppress our emotions and shut ourselves off from necessary intimacy with those that love us (our wives, children, friends, God). In our desire to escape our pain, we keep our minds distracted and look for quick fixes to feel good. We may turn to something we can be passionate about but doesn’t require much from us in return. As a result we engage in a world of “fantasy” or “affairs” which can include sports, pornography, sex, television, alcohol, even our jobs.
Joan came to counseling complaining that her husband, Jack, was irritable and distant but refused to come in with her because he believed she was the problem. He had lost his edge at work and at home. He just wanted to relax and watch television. He was not open to her sexual advances and was resistant to her pleas for time and attention. I (James) mentioned to her that I thought Jack was depressed and recommended she read —and try to get him to read —a book on male depression.
Two months later Joan discovered Jack’s affair with a co-worker and insisted on a separation. Faced with the consequences of divorce, Jack crashed, confessed and committed to addressing his depression and his relational “hiding strategies.” Depression can be a subtle enemy with many damaging side effects.
Twice as many women than men are diagnosed with clinical depression, but this does not necessarily mean that women are more prone to depression than men. Women tend to seek treatment far more readily than men, so they are more likely to be diagnosed. Also, the standardized criteria used to diagnose depression by counselors and physicians are more oriented to symptoms and manifestations of female depression than the symptom pattern displayed by men. Dramatic differences exist between the sexes in their outward display of depression.
In his book Unmasking Male Depression psychologist Archibald D. Hart offers some generalizations describing the differences between males and females in terms of how they may experience or express their depression:
A male will blame others for his depression, while a female will blame herself.
A man tends to act out his hostile and irritable emotions and attack when hurt, while a woman will feel her depression and withdraw when hurt.
A man wants to maintain control at all costs, while a woman has trouble maintaining control.
Men tend to turn to sports, television, sex and alcohol, while women turn to food and friends and will focus on their emotional needs.
A man is generally terrified to confront his weakness, while a woman often exaggerates or obsesses about her weakness.
A man will try to maintain a strong male image, while a woman may disintegrate at the slightest failure. Can you relate to any of these? It has been said that for men, depression is a secret struggle. We are encouraged to play through our pain —not admit it, which often makes matters worse before we own up and get help.
But what causes depression? Where does it come from? A variety of possible sources exist and often more than one factor contributes. In general, however, the causes can be grouped into the following categories: biological-genetic, physical, spiritual, personality and interpersonal.
Biological-Genetic and Physical Issues. Research is beginning to demonstrate that many depressive disorders are due to disturbances in brain biochemistry. They can be related to genetic influences, as well as environmental and life stress.
Serotonin is identified (along with the chemical messengers dopamine and norepinephrine) as being the primary neurotransmitters in the brain that account for variations in mood. In the last 15 years, the idea that abnormal levels of serotonin cause depression has been at the heart of most drug-development efforts. This hypothesis has been supported by the relative effectiveness of antidepressant medications that focus on increasing serotonin in the brain (also called SSRIs) such as Prozac, Paxil, Zoloft, Lexapro, and so on). Many researchers believe that this theory offers only a partial explanation.
According to a report in Science magazine, a “stress hypothesis” is creating new developments in depression research. The theory goes something like this: The hypothalamus in the brain produces corticotropin-releasing hormone (CRH) in response to stress. This hormone stimulates the pituitary gland, which triggers the release of glucocorticoids, such as cortisol. The problem is that excess cortisol damages existing brain cells (neurons) and impedes the growth of new brain cells.
Stress may lead to depression through these and related effects on neurons in the hippocampus (a brain structure that can actually start to atrophy). Although this may seem somewhat confusing, the bottom line is that untreated depression can lead to irreversible brain damage as well as increasing one’s risk for other medical problems (for example, hypertension, stroke and heart disease).
This theory also helps explain why men are so vulnerable to depression. When we drive ourselves hard and generate extra adrenaline to meet life’s threats and demands, the resultant stress on our bodies damages us physically and emotionally, and eventually we will crash. A lack of sleep and regular exercise, poor diet, overwork or exhaustion, or some physical conditions (for example, underactive thyroid, chronic illness or pain, diabetes, influenza, anemia) further contribute to depression.
We have a wonderful example in 1 Kings 19:4 of an “adrenal exhaustion” depression that Elijah suffered following the great victory on Mount Carmel— “Lord, just let me die!” This is a very normal physiological reaction following a peak period of adrenal usage. The purpose of the depression in this case is to remove us from further stress, to set us aside, and give us time for rest and recovery.
Sometimes depression appears to be the result of sin, although this does not mean that depression is always due to personal sin.
Possible sin-related causes of depression include negative attitudes or feelings such as bitterness and hatred, guilt and lack of repentance, turning away from God and His Word, fear of the future and lack of trust in God as sufficient provider.
A biblical example of this type of depression is found in 1 Kings 21. In the story of King Ahab, when he could not have Naboth’s vineyards, we are told that he ” …turned away his face and would eat no bread” (v.4, KJV). He displayed the typical signs of a severe depression when he could not get his own way.
Difficult, painful, stressful times of trial or struggle may lead to periods of depression. Such God-sent trials, however, are meant to purify us so we can bear more fruit (see John 15:2; 1 Pet. 1:6-7). We live in a fallen world and may be exposed to spiritual warfare. Satan and his demonic forces attack and oppress people, which can lead to depression.
Personality or psychological factors. When a person is lonely and fearful and resists interacting with others, he sets himself up for depression. When one has unresolved anger or hurt, these feelings are “stuffed” or repressed, and depression may result.
For many men, this psychological problem can also be the result of the spiritual problem of unforgiveness. Other situations that can trigger depression are insults, rejection or failure; a lack of positive, reinforcing or rewarding events; success (when it is very taxing or stressful); or learned helplessness (in which a person comes to believe they can do nothing to change life events). All of these circumstances can easily set men up for depression.
It may not just be these triggering situations that cause depression, but the way a person thinks in response to those situations. Perfectionistic, rigid ways of thinking, irrational misbeliefs (“I am in charge of my life”) or unbiblical self-talk (“this is hopeless”) can distort views of oneself, the world and the future. Depression often follows and continues unless such thinking is challenged and corrected with the truth.
Interpersonal Issues. When one is experiencing serious relationship problems (either at home or at work), they are prone to depression. It’s not surprising that 50 percent of depressed people also experience chronic marital discord. Research has shown that marital difficulties and family dysfunction have an effect on the course of depression, and relapse is more common among individuals whose families have a high degree of criticism in their communication.
So how does the cause of depression relate to how I cope with it? When a person is depressed, something is wrong and needs to be addressed. Depression functions as a warning signal, letting us know that something is in need of attention. Think of a smoke alarm going off. It’s going off for a reason, and we need to respond.
Men have difficulty handling emotions, particularly the negative ones and the painful ones. I feel depressed for a reason and as long as I can identify the reason, or the trigger, and deal with what is causing the depression, then the depression is serving its purpose. It is important to recognize the function of depression and use it as an ally.
We’d like to do away with pain, but we need pain. Emotional pain tells us when we have reached our limits, when we reached the boundaries, when things need to be put right. The purpose of depression may be to slow us down so we can recover or move us to confess sin or strengthen our faith in a time of trial.
Depression can be a “healing emotion.” Since depression is legitimate, it must be experienced up to a point. Don’t fight or resist your depression. Don’t blame others for it. Force yourself to accept the idea that it is both normal and necessary, and allow yourself to be depressed. The sooner you recognize this, the quicker you will recover from depression.
When we cooperate with depression it produces a curative change in our values, our lifestyles and our commitments. Sometimes we won’t change through any other means. Anyone who has experienced victory over depression is likely to agree. The following suggestions will help you cope with and heal depression:
1. Learn to recognize your depression, and let your family and friends help you. This may seem obvious, but men may not notice they’re depressed unless someone else draws attention to it. Contract with people close to you to tell you whenever they think you are depressed. Try to be with other people and confide in someone; it is usually better than being alone and secretive. If you find yourself losing interest in all your activities, withdrawing from loved ones or escaping into bad habits, admit your depression and label it as such.
2. Don’t wait to seek medical attention. Men are notorious procrastinators when it comes to going to the doctor. Depression may be the result of another medical condition. If medication is necessary, your doctor can discuss this option with you. Don’t rule out talking with a counselor. Therapy is not a sign of weakness but represents strength in being proactive about your mental health. Counseling can help resolve personal and relational stressors.
3. Set realistic goals, and assume a reasonable amount of responsibility. Break large tasks into small ones, set some priorities, and do what you can as you can.
4. Clarify your values. All loss is related to values. If we don’t value something, it is not a loss when it is taken away. Am I majoring on the minors of life, or is my focus on what really matters? Do I have causes worth living for and life goals that bring meaning?
5. Participate in activities that may make you feel better. Mild exercise, going to a movie or participating in church and social activities may help. Try to avoid activities that tend to rev up your adrenaline, as these will make your depression worse or prolong your recovery.
6. Expect your mood to improve gradually, not immediately. Feeling better takes time. People rarely “snap out of” a depression. They feel a little better day by day. It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition —changing jobs, getting married or getting divorced —discuss it with others who know you well and have a more objective view of your situation.
Depression is inevitable for most of us, especially if we live demanding and active lives. You don’t have to suffer in secretive silence. Courageously embrace your depression and discover the message God has in it for you. Bring God and others in to help you recapture your heart, and move through to a place of true strength, healing and an abundant life.
The Male Brain: Wired for Depression?
Millions of men leave themselves wide open to depression and they don’t even know it. When you drive yourself hard (and most guys do), your brain triggers chemicals to meet life’s threats and demands. The resulting stress on your body damages you physically and emotionally until, eventually, you crash. This helps explain why men are so vulnerable to depression. Look under the hood and see for yourself:
When faced with a stressor, the pituitary gland in your brain cues the adrenal glands to release several types of hormones, including epinephrine (adrenaline) and cortisol. Adrenaline, the “emergency hormone,” prepares your body to deal with sudden danger or stress.
Adrenaline increases the rate of your heartbeat and breathing, raises your blood pressure and increases the sugar in your blood (as an energy source). This energy source goes to the muscles. Because you’re breathing faster, you have more oxygen in your lungs and muscles.
Glucose stored in your body is released to give extra energy —power to the muscles. Some of the blood and nutrients stored in your internal organs go to your heart, lungs and muscles. Your brain switches to a “super charged” state. Your senses are at their sharpest, and you’re aware of the slightest change around you.
This chronic state of readiness shuts down functions such as metabolism, causing indigestion, heartburn, fatigue, weight gain and decreased sex drive. The cortisol produced during the stress response makes you a target for a wide range of physical maladies: from cold and flu to heart disease and stroke.
The excess cortisol damages existing brain cells (neurons) and impedes the growth of new brain cells. Stress may lead to depression through these and related effects on neurons in the hippocampus (a brain structure that can actually start to atrophy). Untreated depression can lead to irreversible brain damage as well as increasing one’s risk for other medical problems (for example, hypertension, stroke and heart disease).
Eating right and exercising helps control stress and so does getting enough rest. You also need a strategy for dealing with the stress in your life. (Check out Richard A. Swenson’s book Margin if you need help with this.) You can’t avoid stress, but learning to manage it is essential if you want to steer clear of depression.
This article was originally featured in the former publication, New Man Magazine. Its source: the book, “Men’s Health for Dummies,” published by IDG Books Worldwide.
James Childerston is a psychologist in private practice in Hagerstown, Maryland. Doug Rosenau is a psychologist and sex therapist in Atlanta.
5 responses to “The Truth About Men and Depression”
I’ve had depression for 15 years now. I got to feeling so good about 3 years ago I took myself off of my Meds. I hit bottom hard. Started taking the same Meds that I was on but they didn’t help. Went to psychriatist every month and they couldn’t find a med that would help. I got bad and was bed ridden. I was admitted to a mental ward for a week because I was bottoming out. Saw a psychriatist for a year and a half and they couldn’t help so I changed to new one.
I was suicidal so new psychriatist recommended ECT treatments. I had 8 of these and they did work. The psychriatist changed my Meds but no good. He finally put me on old Meds (MAOI) and they helped but not totally. Also during this time my wife and I were having problems. She didn’t want sex. I talked to her and asked what was the problem but she never gave me a reason. I pulled up 3 websites that Christian women had the same problem and they explained why they felt this way but changed there ways and were more responsive to their husbands. My wife would just close them and not read them.
I tried talking to her again but she wouldn’t give any reason. I finally told her if she didn’t respond to me about sex that she was putting a temptation in front of me. She told me she read the sites but she disagreed with all 3 women. Anyway I did have one affair. She asked if I did and I told her yes. She left the house and called my parents and told them that I had taken a whole bottle of pills and that she had left me. I was rushed to hospital and had pills filtered out of me. She filed for divorce after 28 years of marriage. Needless to say my world hit bottom.
My wife and our daughter won’t speak to me and her side of the family was mad at me and advised her to leave me. Talk about being hypocrites, her sister is on her 3rd marriage and her husband is on his 2nd. The sister had sex with other men while she was married to first husband and had sex while she was married to 2nd husband with her now husband.
Anyway I texted my daughter 9 times since her mom left. I quit texting her when she told my mom that I wasn’t texting her. That has been 3 months now. I haven’t talked to my wife for over a half of a year now. She has turned into the most bitter, hateful person that my parents say they are shocked how she is acting. She filed for divorce in March 2015 and I cannot contact her in any way. I worked hard all my life taking care of my family and have always put them first. Even she said that I didn’t spend for myself. I tried to be the best man I knew how but I get sick mentally and messed up one time out of 28 years and they cant find it in their heart to forgive me especially since like the article I just read explains the effects of depression.
I have drug resitant severe depression and generized anxiety disorder. I lost my job and was approved for mental disability. I had been off from work 2 and a half years earlier. I know I did wrong and I wanted to work on marriage but she left and hasn’t been back. She abandoned a sick man and I have shed many a tear over my sin and over my family but they at every turn keep shooting arrows of hate at me. I have gone from wanting to work on my marriage to I don’t even care if I ever see her again. She has hurt me at every turn yet she knows I have this mental problem but she doesn’t think it is as bad as other health issues.
I’m tired and don’t know or don’t care to even live anymore. If death comes to me I welcome it!! It would be better than the hell I live in my mind every day. I also have a torn rotator cuff and my arm hurts and I have a pinched nerve in my leg that I have piercing pain when I stand up or get out of bed. I also have 2 bulging discs in my lower back. I had back surgery 2 years ago and one of the bad discs is in the surgery site so it has just happened. I also have arthritis in lower back. Had spinal block 1 month ago on back and this new problem with leg showed up. My thigh goes to sleep and hurts when I stand. Also my arm with rotator tear goes to sleep and I lose feeling in arm and my fingers tingle.
HOW MUCH CAN A MAN TAKE !!! Please don’t smash me about my affair. I promise I have done enough of that to myself. There is a whole 2 chapters of me being in stressful situations but I have wrote enough for you to know and to help me. Please help me; don’t judge me, I have more than judged myself enough.
Four years ago I told my wife that I just can’t do the things I used to do before! I’m more tired as time has gone on, don’t care anymore! In this time frame my wife lost her mother, then I lost mine two weeks later; plus I had part of my lung removed from lung cancer a few weeks before they passed! Less than a year my dad passed away! When the holidays come around “Christmas,” when are mothers passed & “Thanksgiving,” when my father passed, holidays really suck! Then with the state of the country, with where we live “just out of Flint, Mi. “and my job – after 40 years I just don’t care! Sometimes I hope I get fired then I can walk away from my marriage, my house! Even though I know that’s not the answer!
I am getting a divorce, sadly, and think that my husband suffers (suffered) from depression. It is such a sad journey. His behavior was very much like several described in this article. Even though I know I am not to blame, I wish I could have helped him. Our teenage daughters are devastated, we are hurting financially. I urge men and women to seek help if they show signs of depression.
I have been diagnosed with moderate to severe depression. I am awaiting my visit and hoping to get this under control. I recently got divorced (it was my fault, but I did NOT want it). I have experienced a lot of the symptoms talked about here. For me, it was the sexual “satisfaction” to hide my emotional state. As I look back on it all, I can say I have been this way for the past 6-8 years.
Depression is a real issue, as a man, I can tell you all that I ignored it for a long time, but, after my divorce, and LOTS of prayer, I have sought help. Don’t be too macho to not ask for help. I did just that and I lost my marriage, my best friend! Divorce sucks, but in reality, I did this to myself. Go get help, don’t lose what’s most important to you.
My husband had his pituitary gland removed in 1993 due to a tumor. He has to take 14 pills a couple times a day in order to stay alive since he has an insufficient adrenal system. He was then made to medically retire from the Air Force because of the medication he needed; he had served 18 years.
In 1995 he started working for the US Postal Service and was forced to resign due to a confrontation with his supervisor in 2009. Based on all of this I gave up my career and we relocated to a remote area that was much cheaper for us to live until his Disability Benefits came through. His disability came through in 2012. In 2016 he decided we needed to relocate to live two doors down from our daughter and granddaughter. I didn’t think it was a good idea but did it anyway because he was bringing in the money, not me.
Things were going pretty good and then 2018 he was diagnosed with a tumor on his kidney. He went in for surgery September 2018 and thank God he didn’t end up losing the kidney. In August of 2019 he decided to have a knee replacement. I tried to get him to wait one more year so that he could recover more from the kidney surgery. Medical issues seem to hit him harder than regular people, due to his condition.
Well the knee surgery didn’t go so well and after five weeks of healing they had to go back and do a revision. So now we aren’t just back were we started he has to take it real easy for 12 weeks. I grew more and more resentful as I didn’t feel he ever took my feelings into account. As time went on and when I would drink too much I continued to voice my displeasure and would tell him I was going to leave him. Over time this started getting to him and making him withdraw from me. He felt with everything that he had been through that he wasn’t good enough for me any longer and stopped trying to work on us. Since he was withdrawing I withdrew as well and never alleviated his fears of me leaving.
By October 2020 we weren’t doing so well; he was clinically depressed and I didn’t really understand that because I was wrapped up in having to do virtual learning and babysitting our 10 year old granddaughter and making sure my elderly parents were staying safe. All throughout the summer we had been dealing with very high PSA’s and he was finally diagnosed with Prostate Cancer on October 9, 2020. Surgery was scheduled for December 23, 2020.
In August, he had started playing a virtual reality game where you would go on raids and build up your own life in the game. He had told everyone in his alliance and a female took special interest in him and reached out and she gave him her number for when he needed to talk. Well, he called her and explained that not only did he just find out he had cancer but his wife was leaving him and he loved me and didn’t know how he could get me to stay. He only spoke to her 4 times in October and he says every phone call always was about him venting and saying he wanted me to stay cause he loved me and how desperate he was for me to stay.
He had to have an MRI on November 2, 2020. We received the results on November 10, 2020 and based on the results the surgery was canceled and he was placed on active surveillance. Well, this should have been good news except for the fact that I had told him I would see him through the surgery and then I would leave. Once he realized that there was no surgery and I could leave at anytime he says he spiraled out of control; he felt as if he was a zombie and he couldn’t breathe.
He called her again and told her what was happening he says he was crying and frantic and a couple days later she started sexting him while they were only playing the raiding part of the game. When they were just in the regular part of the game the conversation was normal. She also set up an email where they could share inappropriate pictures and such. He replied to her emails 4 times with one of them being inappropriate and then he told her no more and started slowing down on the sexting because he was trying to let her down easy so she wouldn’t blackmail him.
What I am trying to figure out is if he suffered from some kind of psychotic break down and where do we go from here. He is madly in love with me and doesn’t want to lose me and I love him as well. We will be married 40 years January 9, 2021 and he has never done anything remotely like this. The only thing he is guilty of is loving me more than himself.