Men in Shadows

Often expressed as anger, male depression is a hidden epidemic.

By Lisa James

November 2007

Their stories sound eerily alike: “Even in the happiest of times, I’ll wake up with a heavy head,” says Mel Renfro. “A bad day is when you can’t get out of bed and there’s this dark cloud hanging over your head,” says Wayne Chrebet. Andre Waters didn’t tell reporters how he felt; in November 2006, at the age of 44, he killed himself.

These men were among the finest players the National Football League ever produced. Today, as the NFL season charges towards the playoffs, Renfro, Chrebet and others are living with depression related to multiple concussions suffered on the gridiron. One study of more than 2,500 retired NFL players found that having at least three concussions tripled an individual’s chances of experiencing depression, and a sport in which this brain trauma has been too-often dismissed as simply “getting dinged” is starting to pay attention.

But just as helmets obscure the faces of men playing a violent game, the angry aggression that many view as normal “guy” behavior may mask depression—and a man need not suffer physical injury to feel its effects. In fact, it turns out that depression is more common among men than anyone ever knew. “Male depression has often been under-diagnosed because the standard diagnostic manual presents a picture that really only fits women,” says psychologist Dr. Archibald Hart. “It is estimated that 6 million men will be diagnosed with depression this year, but this does not account for the millions more who will go undiagnosed—and hence untreated.”

Code Red
The sad weepiness that characterizes “classic” depression is commonly found in women; a man is more likely to be short-tempered and snarly, as well as fatigued and uninterested in sex, work or hobbies. Ironically it is work—along with sports—that provide depressed men with a “significant distraction to their painful inner feelings,” says Hart, head of the Hart Institute (www.hartinstitute.com) and author of Unmasking Male Depression (Thomas Nelson). Men are also more likely to try drowning their pain in alcohol or drugs—and untreated depression helps explain why the male suicide rate is more than four times the female rate.

While there are hormonal differences in depression’s grip on each gender, one common factor is stress. “Elevated cortisol levels are playing havoc with both male and female neurotransmitters,” explains Hart, “so we are seeing depression becoming more and more prevalent.” But unlike women, men are expected to hide their sadness behind a strong, silent mask—which leads them to act out their feelings.

Bill, one of Hart’s patients, “sat up one day and found that he was overcome with a profound fatigue and a short temper,” the doctor recalls. “Usually he was slow to anger, but now everything aggravated him.” Afraid of alienating his wife, Bill would check in at the office and then, instead of making his usual sales calls, “spend the day sleeping in the back seat of his car” before going home as if nothing was wrong.

Turning the Corner
Bill only got help after his wife recognized his car at a local park. “She wisely realized that something was seriously wrong and immediately sought out my help,” says Hart.

Bill’s case is not unusual. (“Denial is the male’s best friend,” as Hart puts it.) This leaves a wife or girlfriend with the touchy job of trying to get her man to admit something’s wrong: “While some men are open to being told they are depressed, most only react with more anger.” Hart’s advice is to enlist the help of a trusted clergy member or health practitioner. If that’s not possible, “a very effective, but not exactly subtle, approach is to leave an article or book around the house for him to pick up.”

Severe depression requires prompt attention by a trained practitioner. In addition to various medical interventions, psychologists often recommend cognitive/behavioral therapy (CBT), a short-term, structured approach that helps change the thoughts believed to drive feelings and behaviors.

Once the worst is over, it’s important to maintain a depression-free lifestyle. Reducing stress is one component, as is finding social support—admittedly a difficult step for men who are used to conversations that revolve around scores and transactions. Good places to start are men’s groups at houses of worship or, if substance abuse is part of the problem, those associated with groups such as AA.

Fortifying the brain with depression-fighting nutrients is also a must. “The entire B vitamin complex is known to maintain and promote normal mental functioning,” writes Douglas Bloch in Healing from Depression (Celestial Arts); many depressed people are especially deficient in folic acid. Omega-3 fatty acids are required for building healthy brain cells, as is a substance called phosphatidylserine (PS). A number of herbs, including eleuthero, rhodiola and ginseng, can help the body adapt to stress. The herb St. John’s wort is a noted natural antidepressant, as is the nutrient SAMe, which the brain uses to make the chemical messengers—most notably serotonin—that are lacking in people with depression.

“The biggest mistake anyone can make is to trivialize depression,” says Hart. That applies to raging men just as much as it does to weeping women—and both can be helped.

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