Are Males a Happier Bunch?
During the past tumultuous months, many people in this country have found themselves confronted by a new demon: the blues. In the week after the Sept. 11 attacks, a staggering 71% of Americans said they felt depressed, according to the Pew Research Center for the People and the Press. Those rates have gradually declined in subsequent surveys, but one theme has remained constant: Women were much more likely than men to say they felt depressed.
That women are more likely to acknowledge depression in the aftermath of recent events is not that surprising, considering that, nationally, about twice as many females as males suffer from depressive disorders, according to National Institute of Mental Health statistics. Further, a report published by the Centers for Disease Control and Prevention in July determined that antidepressants are second only to hormone therapy as the prescription drug most often used by U.S. women, while mood-stabilizing medications “are not commonly prescribed for men” in this country, according to the CDC.
These statistics made me wonder: Are American men really such a happy-go-lucky bunch? Some observers think a lot of chronically sad fellows are going uncounted. “Studies indicate that men reach out for help much less frequently than women do,” says psychotherapist Terrence Real, author of “I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression” (Fireside, 1998). Not only are men more likely than women to bite the bullet when they feel badly, says Real, but our health care system does a lousy job of detecting depressed men. Family physicians and mental health workers, he says, “tend to think of depression as a woman’s disease and look for it in women--and skip over it in men.”
The problem, Real believes, is that men and women tend to act differently when they become depressed. Women are more likely to have familiar symptoms. They appear miserable and cry a lot, lack energy and develop appetite and sleep problems, among other common signs. “That’s not how men express depression,” says Real. “With the majority of depressed men, you don’t see it directly. What hits the surface are the defensive moves the man is making to try and escape the depression.”
In other words, men are more likely to take action against feeling depressed, though their “defensive moves” are often self-destructive. Some men might mask their pain by devoting themselves to working or exercising for long hours, for instance. Or they might abuse alcohol or drugs, withdraw from society or become violent. Oddly, says Real, these behaviors are considered classic symptoms of depression in adolescent males. Yet, when an adult male drinks too much, for example, society tends to define him as morally flawed instead of asking why he is drinking in the first place. If a man were asked, Real believes, he would probably reveal that he is trying to numb intense inner pain with alcohol.
Real believes that many depressed males in this country are simply mis-categorized by official estimates. For instance, men are far more likely than women to be identified as substance abusers or as having personality disorders, such as being antisocial. If you add those figures to the estimates of depressed people in the United States, Real notes, it makes the total number of men and women come out about equal. “Isn’t that an amazing coincidence?” he asks.
Not all psychologists accept Real’s premise. “Very often, if you treat the depression, the substance abuse doesn’t go away,” says psychologist Susan Nolen-Hoeksema of the University of Michigan at Ann Arbor. She, like others, believes that drug and alcohol abuse, as well as antisocial behavior, are distinct problems from depression, though they can occur in the same people.
Nolen-Hoeksema says many studies, using different methods, confirm the theory that men are only half as likely as women to experience depression. Some scientists believe that women may be more at risk because the female brain has a different chemical reaction under stress, though the evidence is preliminary. Nolen-Hoeksema’s own theory holds that women suffer more depression because they experience more emotional strain in their lives, such as oppression and sexual abuse. And when they feel emotional pain, women are more likely to ruminate, or brood, says Nolen-Hoeksema, which can cause simple negative feelings to snowball into full-blown depression.
Though mental health experts disagree about the prevalence and appearance of depression in men and women, certain aspects of the disease are not in dispute. “Depression is underdiagnosed, there’s no doubt. But it’s highly treatable,” says psychiatrist Marc Graff, a spokesman for the California Psychiatric Assn.
Statistics suggest that only about one-third of men and women with major depression receive proper treatment. Yet, more than 80% who get help lead normal, productive lives despite their illness. For more information about the symptoms of depression and treatment options, see the National Depressive and Manic-Depressive Assn.’s Web site at https://www.ndmda.org.
