Engaging men in health

March 2009

FocusEngaging men in health

Men and depression

Volume 38, No.3, March 2009 Pages 102-105

Kay A Wilhelm

Background

It is often reported that men have lower rates of depression than women, but this does not necessarily signify better overall mental health in the male population.

Objective/s

This article discusses the presentation of depression in men and how it may differ from that of women. It also provides strategies for improving the assessment of depression in men.

Discussion

Men’s lower overall rate of depression than women reflects a number of issues, including psychosocial barriers to seeking help. Depression rates vary according to age groups, and certain subgroups of men may be particularly vulnerable. Men often display different symptoms and behaviours in response to depression and experience anxiety disorders less frequently. Men’s greater risk taking and substance abuse have health outcomes that can impact on depression later in life. Women have greater emotional literacy and are more likely to volunteer how they feel, while men are more likely to do something about their negative affect. While men are usually wary about talking about their depression, they will discuss their feelings if provided with a safe environment in which to do so.

It is often reported that men have lower rates of depression than women; however, this does not necessarily signify better overall mental health. For example, the actual experience in established episodes of unipolar depression is similar for both genders. In a study of men and women presenting with diagnosed episodes of major depression,1 gender differences were related to levels of arousal and anxiety disorders, both higher in women,2 and repertoires for dealing with depression rather than depressive symptoms per se. There are also no differences in established episodes of melancholic depression, where rates are equal or higher in men.3 The differences are more in how the depression is expressed and dealt with by the individual.4 The differences in rates of unipolar depression vary with a number of psychosocial factors such as unemployment, single marital status and presence of heart disease, all affecting men.5 Similarly, there are no gender differences in rates or experience of bipolar depression, but men are more likely to present with a manic episode at first onset and display different comorbidity patterns, ie. substance abuse and 'acting out' behaviours.6

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Correspondence afp@racgp.org.au

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