Fear and shame often prevent men suffering from depression from seeking help. Unchecked, the situation can lead to a downward spiral of missed work days, substance abuse, broken families, and even suicide.
One of the paradoxes of our society is that while half as many men as women are reported to suffer from depression, the rate of suicide among men is far higher. Men commit suicide three times as often as women, an increasing figure that is probably under-reported due to the reluctance of coroners to return a suicide verdict without overwhelming evidence. Men aged between 18 and 24 form the highest suicide group in many countries.
Easy explanations for the high male-to-female suicide ratio are not readily available. It has been suggested that men principally suffer from severe depression while women are affected by a more tolerable mild to moderate depression, but this view has not been supported by clinical data. In addition, there is no evidence to suggest that women possess a greater sense of survival than men, or that while both sexes contemplate suicide in equal equations, women are less likely to contemplate the act.
It may, however, be accurate to assert that women will more readily admit to depression than men and seek treatment (women in general tend to visit health professionals more frequently than men). They also tend to find it easier than men to discuss their feelings. Frequently, men adopt the “stiff upper lip” approach to disappointment or loss and become emotionally numbed. They perceive depression as a sign of weakness: because they are strong it cannot possibly affect them.
Men suffering from the symptoms of depression – poor sleep patterns, fatigue, agitation and lack of appetite – are often reluctant to accept the diagnosis of depression. They will more readily find some other explanation for experiencing these symptoms such as stress. Stress is viewed as positive and acceptable, an acknowledgement that one is functioning to the limit of one’s capacity. Depression on the other hand is viewed negatively, an indication that a man cannot cope and requires help. It is viewed unsympathetically by many. Men persuaded to consult their GP will often deliberately mask their depressive symptoms, concentrating instead on a variety of physical ailments, which can render an accurate diagnosis impossible.
By not acknowledging that a problem exists and by endeavouring to shoulder the burden alone, a number of men become overtaken by feelings of helplessness and hopelessness. Many self medicate with alcohol or illegal drugs.
If such feelings of hopelessness intensify to the degree where they become unbearable, suicide man appear to be a viable option. Men frequently commit suicide by hanging or by falling under a vehicle or train. Such violent deaths may be viewed as an expression of anger: anger that no one listened to, anger that they could not seek help for. Such an act is extremely traumatic for the friends and family members who remain.
Help is available from the Depression Support Group, which is open Mondays to Fridays from 8am to 8pm, Saturdays from 8am to 5pm and Sundays from 9am to 1pm. Anyone may ring in for help and advice as well as free brochures and literature.
The high rate of male suicide is only one of the consequences of the under-diagnosis of depression. The illness is responsible for the loss of millions of work days, for inefficiency and underproduction in the workplace, and even impacts upon the burgeoning social security budget. More research is required to discover the role depression plays in accidents at work, in the home and on the roads.
In addition to the considerable economic costs, depression extracts a high social price from the community. We have yet to discover the full extent to which depression contributes to dysfunctional family life, to marriage breakdown, to physical or sexual abuse and to crime as well as drug or substance abuse. These factors all pose serious threats to the family unit.
Depression is the most democratic of all illnesses. It can affect anyone at any time and, on occasion, for no apparent reason. An educational campaign aimed at men is vital to bring about a change in attitudes, to dispel the myths surrounding depression and to develop a more tolerant and understanding society where men will feel at ease to acknowledge their depression.