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  • Brian Hayes

The Expression of Depression

It has been a widely held belief within the psychology profession that women experience depression more frequently than men. Studies have indicated that women are twice as likely to experience depression in their lifetimes than men. Among all Americans seeking psychotherapy, 63% are women. What then would explain the fact that men commit suicide at four times the rate of women?

A new study indicates that the rates of depression in men and women may be equal—it just may look different.

The diagnostic criteria for depression includes: difficulty concentrating, remembering details, and making decisions; fatigue and decreased energy; feelings of guilt, worthlessness, and/or helplessness; feelings of hopelessness and/or pessimism; insomnia, early-morning wakefulness, or excessive sleeping; irritability, restlessness; loss of interest in activities or hobbies once pleasurable, including sex; overeating or appetite loss; persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment; persistent sad, anxious, or "empty" feelings; thoughts of suicide, suicide attempts.

Yet while women are trained to recognize their feelings, many men, because of nature or social modeling, are inhibited when it comes to accessing their emotions. I have listened to many male clients as they tell stories of horrific childhood trauma, yet their faces remain expressionless. Asked what they are feeling, most cannot name their feelings, or even recognize sensations in their bodies. Yet they are suffering.

Women access health care services at a greater rate than men. Why wouldn’t they seek mental health care more readily than men?

Men are taught to tough it out, man up. They will ignore that nagging twinge in their chest until struck by a massive coronary. The same goes for emotional pains. Even if men don’t show their feelings, the feelings show themselves.

The research authors propose a new model for assessing depression in men. Instead of relying on internal symptoms like anxiousness, sadness, guilt, and hopelessness, to diagnose depression, they suggest that men may turn their feelings outward, numbing themselves with alcohol, drugs or sex, distracting themselves with excessive work, or turning their feelings outward in aggression and rage.

Perhaps the fact that three-out-of-four psychotherapists are women creates a barrier, in perception if not fact. Even if men are equipped to share their feelings with another person, who will listen?

It’s OK for men to talk about their feelings. It’s even OK for men to ask for directions.

It’s OK for men to cry.

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