About

Generally speaking, there are 3 kinds of depressive disorders:

• Major depression. If you’re suffering from major depression, just getting through the day is a constant, uphill battle. It can undermine your performance at work, damage or destroy your relationships with family and friends, leave you feeling overwhelmed or cause you to do harm to yourself or someone else. Major depression could be triggered by a single event such as a divorce, the death of a loved one or a financial crisis. It’s also possible for major depression to appear for no clear reason.
• Minor depression (also called dysthymia). The symptoms are less severe with minor depression but they can last a lot longer and can leave you feeling less-than-good for months or years at a time. Having dysthymia also puts you at risk for major depression.
• Bipolar disorder (formerly called manic depression). People suffering from bipolar disorder cycle between severe depression and extreme, unnatural excitement.

WHAT CAUSES DEPRESSION?

No one is 100% sure what causes depression. Most experts agree, however, that it’s probably a combination of factors including:

• Genetics (depression often runs in families)
• An imbalance of certain brain chemicals (called neurotransmitters) which help brain cells communicate with each other.
• A disorder of the part of the brain that regulates mood, sleep, appetite, behavior, and thinking
• Major life events, such as the death of a loved one, divorce, financial problems, or the birth of a child.
• The build-up over time of many, smaller, negative life events.

Depression can also be caused by any number of other personal issues, especially those having to do with your family and work lives. For example, you might become depressed if you’re having ongoing conflicts with your partner about childrearing or if she continually makes you feel that you aren’t living up to her expectations. You could become depressed if you feel inadequate as a father, perhaps because your children get poor grades, are in trouble, you don’t have enough money to send them to better schools or simply because they’re growing up and don’t seem to need you as much as they used to. You might become depressed — even if you’re wealthy — because you don’t have as much as you feel you need or because you’re having trouble “keeping up with the Joneses.” Or you might feel depressed if you’re worried that a second (or third) marriage or relationship might not work out, if you don’t get along with her children from a previous relationship or she doesn’t get along with yours. For a lot of men, identity and masculinity are connected with job performance and salary. You could easily become depressed if you’re disappointed with where your career is at this point in your life, you hate your job or your boss, you aren’t earning as much as you think you should, you’re worried about your job security, you don’t have enough control over your work environment or because your boss or coworkers are making unreasonable demands.

For older men, retirement can be especially difficult. It’s not easy to lose the self-esteem and pride that come from working and earning money and it’s tough to make the transition from top performer to mentor and guide. However one thing is for sure: depression is not a “normal” or an inevitable part of aging. Most older men feel content with their lives.

DEPRESSION AND SEXUAL HEALTH

Depression can be treated with medications. You may also be taking medicine for anxiety, high blood pressure, spasticity, sleeping problems or allergies. Addressing these medical concerns can increase your sex drive. But know that some medication can also have side effects that interfere with your sex life. If your ability to enjoy sex has decreased since your stroke, talk with your healthcare provider about medicines that have fewer sexual side effects.

FYI

According to the National Institutes of Health, at any given time, an estimated six million men in the United States are suffering from one or more types of depression. In addition, somewhere between 10 and 25% of new fathers become depressed during that hectic first year of fatherhood. Overall, new dads are twice as likely as other men their age to have symptoms of depression.

Depression can strike at any age, from childhood into late life, and is responsible for a lot of unnecessary suffering.

Symptoms

One of the most difficult and confusing aspects of depression is that the symptoms can crop up in so many areas including mood, appetite, sleep patterns, sex drive, behavior, memory and concentration and more. As you read through each of the statements below, think about whether it applies to you.

• I frequently feel tired or have low-energy
• I find myself getting angry, irritated, restless, or frustrated easily
• I think I’ve lost my sense of humor
• I find myself spending a lot of time at work as a way of avoiding doing other things
• I drink too much or abuse drugs or prescription medication
• I take unnecessary risks (such as driving too fast, extreme sports, or unprotected sex)
• I often feel ashamed
• I don’t take good care of myself or go to the healthcare provider even when I know there’s something wrong
• I lose my temper easily or have been verbally or physically abusive to someone close to me
• I get into a lot of arguments
• I have a history of broken relationships
• I can’t seem to stay at a job more than a year
• I have lost interest in people and things I used to enjoy (such as work, activities, friendships, and sex)
• I have sleep problems (either falling asleep, getting up early and not being able to get back to sleep, or oversleeping)
• I feel isolated and avoid spending time with family and friends
• I often feel completely overwhelmed by life
• I often feel guilty, that no one cares about me, or that life is worthless
• I have lost a lot of weight recently without trying
• I am frequently late to work, school, or appointments
• I frequently feel sad, emotionally empty, or just can’t bring myself to care about things
• I sometimes cry for no reason
• I think about death or killing myself
• I have trouble concentrating or remembering things
• I have trouble making decisions or choices
• People describe me as cold or aloof
• I have few or no close friends
• I’m a new father
• My children are afraid of me
• I have frequent headaches, chronic pain, or stomach trouble that doesn’t seem to ever go away and doesn’t respond to ordinary treatment

If you answered “yes” to more than 3-4 of the questions above, you may be suffering from depression—and you’re far from alone.

Prevention

It may be hard to prevent depression and you may experience mild depression from time to time. However, there are several things that you can do to minimize the impact it may have on your life. This involves:

• Reaching out to family and friends, especially when you may have something stressful  going on in your life.
• Seeing your healthcare provider as soon as you notice any symptoms of depression to help prevent depression from worsening.
• If diagnosed with chronic depression, consider long-term treatment to help prevent a relapse of symptoms.
• Eating a healthy diet, exercising, taking time to relax, not overworking, and doing things you enjoy with your loved ones, are all effective strategies that can help to minimize depression.

Diagnosis

With proper diagnosis and treatment, the vast majority of men with depression can be helped and will go on to lead normal, happy lives. However, the condition is often misunderstood and many men don’t recognize, admit or seek help for their depression. As a result, they don’t get the treatment they need. In addition, healthcare providers are less likely to suspect depression in men than in women, in part because men and women often have very different symptoms and ways of coping. In a sentence, women get sad and men get mad. For example, a woman who feels down, helpless, worthless, hopeless, or guilty will probably visit her healthcare provider. But a man who’s feeling tired, irritable, angry or discouraged, is having trouble sleeping or has lost interest in his work or hobbies will usually do one of three things:

• Deny to himself and everyone else that he might have a problem.
• Try to mask the problem by turning to drugs or alcohol or throwing himself into his work in an attempt to avoid dealing with the issue.
• Act out by behaving hostilely or aggressively or doing something dangerous or self-destructive.

Unfortunately all of these behaviors make it harder for men to get diagnosed and treated and can actually make the depression worse. If left untreated, the symptoms of depression can last for years, getting progressively worse with time. This is especially true if you’re a military veteran. Military veterans have a higher incidence of depression and other mental health problems.

One study found that 1 in 5 soldiers who served in Iraq or Afghanistan has suffered from major depression or Post-Traumatic Stress Disorder. Besides making everything in life less enjoyable and making you less fun to be around, your depression can reduce your productivity at work (which can threaten your job), hurt your relationships with friends and family and increase your risk of getting divorced.

Depression can also severely damage your physical health and even shorten your life. To start with, many men turn to drugs or alcohol to cope with their depression. They may act out their depression by behaving recklessly, taking unnecessary risks or committing crimes. According to the Mayo Clinic, men with depression are more than twice as likely as men without depression to die of any cause. Men are four times more likely to commit suicide than women and veterans are more than twice as likely as other men to commit suicide. And contrary to popular belief, older men — not teenagers or young men — have the highest suicide rate of all.

Questions to Ask Your Health Care Provider

It’s important that you become proactive in your healthcare to get the best treatment. Here are some questions you can ask your healthcare provider about depression.

• Why do you think I have a depressive disorder and what form of depressive disorder do you think I have?
• What are the symptoms associated with this disorder?
• Might there be another cause for my depression symptoms, such as medication or a medical condition?
• What factors do you think may have contributed to my depression?
• Might this type of depression be hereditary or related to environmental factors? If so, are other members of my family at increased risk for developing a depressive disorder?
• What type of treatment options do you recommend and why?
• What are the side effects and benefits of the available treatment options?
• What can I do to help myself feel better during treatment for depression?
• About how long do you expect it to take for my condition to respond to treatment?
• Do you recommend medications to treat my depression? Why or why not?
• What types of severe side effects may occur?
• What should I do if my condition worsens or I experience severe medication side effects?
• If my depression symptoms do not improve or return after treatment, what other therapies or medications may be prescribed?
• Do you recommend that I do to therapy? If so, what type of therapy?
• Can you recommend any support groups or other local resources to help me manage my condition?

Treatments

Look at the symptoms of depression. If you honestly feel that one or more of the symptoms you checked have lasted for more than a few weeks or are interfering with your life in any way, it’s important to start making some changes right now.

The simplest place to start is with yourself. There are a number of things you can do on your own that have a good chance of improving your symptoms. For example:

• Get some exercise. It doesn’t really matter what you do, just as long as you do it for 20-30 minutes three or four times a week. (Of course if you haven’t exercised in a while or you have any physical limitations, check with your healthcare provider before you run that marathon). In the short term, exercise can boost your mood immediately. In the long term, exercise can make you feel better about yourself, and several studies have found that exercise may be as effective as anti-depressant medications.
• Spend time with other people. Suffering alone won’t help and will make you feel even worse. It’s important to find friends and family who you know will be supportive and encouraging. You may even want to seek out people who have some experience with depression. Those who haven’t might not truly “get” it and the last thing you need to hear right now is, “Snap out of it.”
• Do something you enjoy — even if you have to force yourself. Doesn’t matter whether it’s seeing a movie, going to a ball game, taking a walk around the block or having sex.
• Don’t make any major decisions now. Wait until you’re feeling better.
• Prioritize. Of all the things you need to do on any given day, which ones are the most important and which can wait? And honestly, what would happen if you didn’t do a few of the tasks on your list at all?
• Set realistic goals. Setting the bar too high — and then not reaching it — will feed your depression and make you feel even less confident. Breaking tasks down into smaller pieces and celebrating your small achievements will make you feel much better about yourself.
• Be patient with yourself. Chances are your depression didn’t happen overnight and it’s not going to go away overnight either — even with medication and therapy.

YOU AND YOUR HEALTHCARE PROVIDER:  TREATMENT OPTIONS

If you think you’re depressed and you don’t notice any improvement after trying the steps above, call your healthcare provider’s office, tell them you’re feeling depressed and ask for an appointment within the next few days. If you’d prefer not to mention your depression over the phone, just say that you’re feeling weak and tired —  the appointment length for evaluating those symptoms is the same as it would be for depression.

Once you’re in the office, talk frankly and honestly with your healthcare provider. He or she should be your safest ally — if not, start looking for a different healthcare provider. You may feel uncomfortable talking about your mental health with your friends or co-workers but no matter how ashamed you feel, you can always talk about these issues with your healthcare provider. He or she has definitely heard it all before, so don’t feel shy or ashamed to discuss what’s going on — or at least what you think is going on in your health. A trusted healthcare provider needs to know everything about what you’re feeling, when your symptoms started and your family’s history of depression.

Please note that if you live in a rural area or a small town, getting help may be especially difficult. There may not be a healthcare provider nearby. Or, if the person you’d turn to is a friend, a neighbor or a member of your place of worship, you may worry about whether what you tell him will stay between the two of you. These are all common concerns. However, we strongly encourage you to keep looking until you find the right person. And rest assured, anything you say to a medical professional will remain completely confidential.

One thing to consider is that you may simply have a hormone deficiency — something as basic as an underactive thyroid gland. In addition, many men over 50 have low testosterone levels and replenishing that hormone may make you feel better. If you do have a medical condition, you and your healthcare provider will work together to come up with an action plan for how to deal with it. If the medical tests come back negative, talk with your healthcare provider about getting a depression screening Admitting that you need help takes a lot of courage but you can’t get better if you don’t admit it.

Once your diagnosis of depression has been confirmed, you’ll have three basic treatment options:

• Psychotherapy, either individual or group
• Antidepressant medication
• A combination of therapy and prescription medication is an option that is usually more successful than either of the other options.

STARTING YOUR TREATMENT

Just as every man’s depression is unique, so is his treatment—there are dozens of different therapy and medication options out there—and it’s essential that you take an active role in your own treatment. This means:

• You may need to interview several different mental health professionals before you find the one whose personality and approach “click” with you. So make appointments with more than one, and don’t feel that you have to go with the first person your healthcare provider recommends.
• You may need to try several different medications, doses, or combinations before finding the one that’s best for you. Most drugs have minor side effects that generally disappear within a few weeks. These may include insomnia, tiredness, headaches, feeling jittery, and sometimes sexual problems (reaching orgasm, achieving an erection, or a decreased sex drive).
• Keep your healthcare provider in the loop. Once you start feeling better, it can be tempting to quit therapy or stop taking the medication. Do not do either without consulting your healthcare provider first.
• Never take anyone else’s medication. What works for a friend may not work for you—and could potentially cause severe problems.
• Ask your healthcare provider to think outside the box. Meditation, relaxation, herbs, massage, and other alternative therapies have been shown to be effective in reducing symptoms of depression in some cases. However, before starting any of these non-traditional approaches, be sure to discuss it fully with your healthcare provider.
• Keep your expectations realistic. Regardless of the method of treatment you and your healthcare provider decide on, it’s important to understand that you’re probably not going to see results overnight. So, talk with your healthcare provider about how long it might take before you start to feel better.

FAMILY AND FRIENDS: HOW YOU CAN HELP

If someone close to you is experiencing more than two or three of the symptoms of depression and is not taking active steps to seek out treatment, your loved one needs you. The most important thing you can do is to be understanding and supportive. Talk with him about what he’s feeling and remind him that depression is treatable and doesn’t mean he’s weak or flawed in any way. Encourage him to go out for a walk with you or to participate in an activity that he used to enjoy. And remember that comments like, “Snap out of it!” are not helpful. One of the major symptoms of depression is lack of energy and motivation. Your support and gentle pushing could be enough to get the man in your life on the path toward recovery.

If you feel that he needs more help than you can provide, help him get what he needs. This may mean that you’ll have to take the initiative and make medical appointments for him and take him there if he’s unwilling or unable to do it himself. Most importantly, be patient. Recovering from depression will take some time.

Finally, be sure to take care of yourself. Your man’s depression can spill over into the lives of everyone around him. Caring for a depressed person requires love, commitment, and patience. And you can’t possibly be an effective caregiver if you’re slipping into depression yourself.

Resources

Visit the following to find out more about depression:

Anxiety and Depression Society of America
Medline Plus
National Institute of Mental Health
Men’s Health Network