This leaflet is provided by the Royal College of Psychiatrists, the professional body responsible for education, training, setting and raising standards in psychiatry. They also provide readable, user-friendly and evidence-based information on various mental health problems.
This leaflet is for:
- Any man who feels depressed.
- Anyone whose husband, partner, brother, father or male friend seems depressed.
Men seem to suffer from depression just as often as women, but they are less likely to ask for help. This leaflet gives some basic facts about depression, how it can affect men, and how to get help.
Why is it important?
Depression can be very unpleasant and is a major reason for people taking time off work. Many - perhaps most - men who kill themselves have been depressed - so it can even be fatal. However, depression can be helped - the sooner the better.
What's the difference between just feeling miserable and being depressed?
Everyone has times in their lives when they feel down or depressed. It is usually for a good reason, does not dominate your life and does not last for a long time.
However, if the depression goes on for weeks, months, or becomes very bad, you may find yourself stuck and unable to lift yourself out of it. It can start to affect every area of your life - and this is when you may need to get help. Depression is not a sign of weakness - it has affected many famous and successful men.
What about bipolar disorder (manic depression)?
Some people have severe depression - but also times when they become elated and over-active. These 'high' periods can be just as harmful as the periods of depression. This used to be called manic depression, but is now bipolar disorder.
What are the signs of depression?
If you are depressed, you will probably notice some of the following:
In your mind, you
- Feel unhappy, miserable, down, depressed. The feeling just won’t go away and can be worse at a particular time of day, often first thing in the morning.
- Can’t enjoy anything.
- Lose interest in seeing people and lose touch with friends.
- Can’t concentrate properly.
- Feel guilty about things that have nothing to do with you.
- Become pessimistic.
- Start to feel hopeless, and perhaps even suicidal.
In your body, you may find that you
- Can’t get to sleep.
- Wake early in the morning and/or throughout the night.
- Lose interest in sex.
- Can’t eat and lose weight.
- 'Comfort eat' more and put on weight.
Other people may notice that you
- Make mistakes at work or just can't focus.
- Seem unusually quiet and withdrawn.
- Worry about things more than usual.
- Are more irritable than usual.
- Complain about vague physical problems.
- Stop looking after yourself properly - you don't shave, wash your hair, look after your clothes.
- Stop looking after your home properly - you stop cooking, don't tidy, forget to change the sheets on your bed.
Some men also feel very anxious when they become depressed. You feel on edge all the time, worried, fearful, and may find it hard to go out or to face people. Anxiety can often also cause physical symptoms - dry mouth, sweating, shakiness, palpitations, breathlessness, stomach churning and diarrhoea.
Is depression really different for men?
There doesn't seem to be a completely separate type of ‘male depression’. However, some symptoms are more common in men than in women. These include:
- Sudden anger
- Increased loss of control
- Greater risk-taking
Men are also more likely to commit suicide.
Different ways of coping
Men are diagnosed with depression less than women, but do seem to drink and use illegal drugs more heavily than women. It may be that, instead of talking, men use drugs and alcohol as 'self-medication' to cope with their depression.
Men’s attitudes and behaviour
- Some men are particularly competitive and concerned with power and success. If you are like this, it may be harder to tell someone that you feel fragile or that you need help. You may feel strongly that you have to do it on your own.
- You may also worry that if you do talk to your partner - or anyone else - about how you feel, they will not be sympathetic.
These attitudes can stop you from talking to your loved ones and doctors about how you're feeling - so you don't get the help that you need.
- Shy men seem to be more likely to become depressed.
- However, depression can happen to anyone, even powerful personalities. Winston Churchill called it "his black dog".
- Instead of talking about how you feel, you may use alcohol or drugs to feel better. This usually makes things worse, certainly in the long run. Your work will suffer and alcohol often leads to irresponsible, unpleasant or dangerous behaviour.
- You may also focus more on your work than your relationships or home life. This can cause conflicts with your wife or partners.
What makes men depressed?
Trouble in a marriage or important relationship is the single thing most likely to make you depressed.
A difference in communication 'style' can be a problem, particularly between a man and a woman. If a disagreement or argument makes you feel uncomfortable, you may just try not to talk about it. But if your partner still wants to discuss it, they can feel ignored. When they try to get you to talk about it, you feel nagged and will tend to withdraw further which can make your partner feel even more ignored.
Separation and divorce
- Men have traditionally seen themselves as being in charge of their families’ lives. However, women are more likely to start the process of separation and divorce.
- Depression is more common and more severe in men who are divorced. This may be because, as well as losing your main relationship:
- You often lose touch with your children.
- You may have to move to live in a different place.
- You often find yourself short of money.
Pregnancy and children
- We have known for many years that some mothers become depressed after having a baby. We now know that more than 1 in 10 fathers also have problems at that time.
- This shouldn't really be surprising. We know that major events in people's lives, even good ones like moving house, can make you depressed. And becoming a parent will change your life more than almost any other thing. Suddenly, you have to spend much more of your time looking after your partner, and possibly other children. You may get very tired.
- A new mother will tend to be less interested in sex for a number of months. Simple tiredness is the main problem, although it's easy to take it personally and feel that you are being rejected.
- You may have to adjust, perhaps for the first time, to taking second place in your partner's affections.
- You may have to re-balance the demands of home and work - there's a lot more to do at home and you just can't spend so much time at work.
- A new father is more likely to become depressed if his partner is depressed, if he isn't getting on with his partner, or if he is unemployed.
- If you get depressed at this time, it will affect your partner.
Work, unemployment and retirement
Work can be stressful. If your work makes you depressed, you won't be able to cope as well which makes you feel worse and less able to cope ... which makes you feel even worse.
After relationship difficulties, unemployment is the thing most likely to push a man into a serious depression. Recent research has shown that up to 1 in 7 men who become unemployed will develop a depressive illness in the next 6 months.
Your work may be a large part of what makes you feel good about yourself. If you lose your job, you may lose other things that are important to you, such as a company car. It can be hard to adjust to being at home and looking after the children while your wife or partner becomes the bread-winner.
From a position of being in control, you may face a future over which you have little control, especially if it takes a long time to find another job. And depression itself can make it harder to get another job.
You may even find it hard if you retire at the usual time, especially if your partner carries on working. Although life may be less stressful, you may miss the structure of your day, your social life with colleagues and the sense that you make a difference.
What other problems can depression cause?
Problems with sex
- When men are depressed, they feel less good about their bodies and less sexy. Many go off sex completely.
- Some men who are depressed have intercourse just as often, but they don't feel as satisfied as usual.
- A few depressed men seem to have sex more often, perhaps as a way of trying to make themselves feel better.
- Some antidepressant drugs can reduce your sex drive.
The good news is that, as the depression improves, your sexual desire, performance and satisfaction will return.
It's worth remembering that it can happen the other way round. Impotence (difficulty in getting or keeping an erection) can bring about depression. Again, there are effective ways to help this.
Content used with permission from the Royal College of Psychiatrists website: Depression and men (February 2014, due for review February 2016). Copyright for this leaflet is with the Royal College of Psychiatrists.