Wednesday, May 19, 2010


Various articles about depression, mostly a repost of an older Warcraft File post. The gist of it, men show different symptoms than women when it comes to depression - the number of men with depression is underestimated a reason why the male suicide rate is so high.....wall of text ahead:

Exercising Your Demons
Some people might call you highly competitive. Some might call you superfit. But a growing number of doctors would label you something else: Depressed
By: Laurence Gonzales

Sex Differences The study of how mental illness affects men and women differently is new and fraught with controversy. The first comprehensive survey was conducted between 1990 and 1992. Its aim was to estimate the general prevalence of mental illness. The research, known as the National Comorbidity Survey, was repeated, in more depth and on a larger scale, between 2001 and 2003, under the auspices of the World Health Organization and with funding from the National Institute of Mental Health. The principal investigator is Ronald C. Kessler, Ph.D., a jolly-looking, bearded professor in the department of health-care policy at Harvard University. The numbers seem to show that men and women suffer from various mental illnesses at about the same rate, with some notable variations and exceptions. One of the differences, long accepted as gospel by the psychiatric professions, is that twice as many women as men suffer from depression. Kessler says his numbers show that a woman is twice as likely as a man to have a single episode of major clinical depression in her life. After the first episode, however, men and women don't differ in the number of episodes they'll have during a lifetime, or in whether they'll have another episode. Only the first step differs, he says. Then the statistics flatten out to equal. But if repeat episodes of depression are equal for men and women, doesn't it stand to reason that they may be having first bouts at the same rate? Maybe the discrepancy lies not in the number of men and women who are depressed, but rather, in how depression is expressed. According to an increasing number of experts, the diagnostic tallies don't take into account the real experience of a lot of men like Britt. They also ignore the fact that women are much more likely to report depression and seek help. Men are more likely to try to fight through their depression, using strategies ranging from hard work to extreme exercise to drinking to violence. Nearly four times more men than women kill themselves. When women become depressed, they tend to show the classic symptoms described in the psychiatrist's handbook the Diagnostic and Statistical Manual of Mental Disorders. They feel sad and tired, and lose interest in the pleasures of life. In short, women generally get depressed in just the way that most people, including psychotherapists, think about depression. Men tend to get angry, and that anger expresses itself in a wide variety of intense activities, such as Britt's obsessive running. Some of these men even win marathons--on the streets of Chicago or in feats of work endurance--and look like heroes, which makes it even more difficult to diagnose their depression. (Feck: Do you see the problem? Depression is described by typical female syndroms! No wonder male suicide is epidemic. Noone saw it coming) […] Because we think of the word "depression" as fitting the woman's profile better than the man's, doctors and therapists don't tend to recognize the disease as readily in men, and men don't talk about it. William Pollack, Ph.D., a professor of psychiatry at Harvard, estimates that 50 percent to 65 percent of men suffering from what they call "covert depression" aren't diagnosed. It seems clear that men will do just about anything to avoid admitting to having the disease. They'd rather just suffer. Some of them would rather die.

 […] Some 31,000 people in the United States commit suicide each year. More than 24,000 of them are men. And that doesn't count the deaths from alcohol or drugs. In fact, some researchers are beginning to suspect that depression causes more deaths than auto accidents do.

 […] Maybe men need a different word for depression. Or maybe the brain researchers and psychologists simply need to redefine the condition so it includes the way men experience it, too. Cultural Cover-Up It's understandable that women are three times more likely than men to be treated for depression; our culture has put a feminine face on the disease, so women give themselves permission to feel it and to seek help for it. Pollack puts it this way: "We have in our society a feminized view of depression, coming out of a model of hysteria that dates back to Freud." Terrence Real, author of I Don't Want to Talk about It, and a marriage and family therapist in Massachusetts, wrote, "There is a terrible collusion in our society, a cultural cover-up about depression in men." And part of the cultural influence involves the way men are taught from early childhood to be strong, silent, independent, and resistant to suffering. As Real puts it, "Men have about a milli-second's tolerance for feeling [this type of] pain, and then they spring into action. A flight from shame into grandiosity lies at the heart of male covert depression."

 Another reason men leap into action, though, whether it's through intense exercise, overwork, pounding back martinis, or some other strategy, is that it actually does relieve the symptoms of depression, at least for a time. In fact, many therapists have begun using exercise as an adjunct to therapy, as explained in books like The Joy of Running, by Thaddeus Kostrubala, and The Exercise Prescription for Depression and Anxiety, by Keith Johnsgard. And research at Duke University confirmed their hunches in 1999. But exercise in itself doesn't treat the underlying condition. In fact, books called The Joy of Working 80 Hours a Week and The Drinking Prescription for Depression might reach a wide audience, because those strategies can effectively mask depression for years. That is, they can sort of work.

 […] Conditioning The social conditioning that leads to men's response to depression begins in infancy. Male babies receive less of every type of nurturing, including speech, touch, and comfort when they cry. And that is only the beginning of what will be, to one degree or another, a brutal upbringing for boys. In the 1960s, the crusading social psychologist Jeanne Block and her colleagues explored how differently parents treat boys and girls. For instance, moms and dads encourage boys to be competitive and to achieve. They don't like them to show their emotions. They encourage them to be less dependent; mothers push them away. They punish them more than they punish girls. And they are unaware that they treat boys and girls differently. By the time boys are on their way to the teenage years, the process of disavowing what they are is complete.

The book A New Psychology of Men describes research in which people were asked what it means to be feminine or masculine. Women and girls defined themselves by the ways they were connected to others, and by citing qualities like being caring or compassionate. Men and boys defined themselves by negatives: They weren't weak, dependent, or connected to their mothers. But there is not much in our cultural definition of what it means to be a man that is inherent in maleness. Children start off surprisingly alike, whether they're boys or girls. If there's a difference, it's the opposite of what the culture seems to expect: Boys are more sensitive. They give expression to their emotions more readily than girls. They affiliate with others in the same way as girls. Then someone starts telling them it's not okay to be that way. If you act like that, you're a pussy. As Real and others have explained, it is through this process of denial that men are primed for depression. And it is the cultural necessity of carrying out and carrying on this process that makes it so difficult for them to recognize and admit to depression when it comes. They not only don't acknowledge it to themselves, they often don't display the symptoms that psychotherapists use to diagnose depression. The cultural training that lays the groundwork for depression in men and for their denial of it later in life involves social isolation. That means telling people the truth about yourself and trusting that they'll do the same, a concept that seems terrifying to many men.

 […] Social isolation is a well-known killer of mammals. Countless studies going back to the '50s show that contact, affection, emotional communication, and genuine closeness are necessary for mammals, including humans, to maintain our health. Isolation wreaks havoc on everything from the immune system to the cardiovascular system to the brain. Conversely, staying socially connected helps protect men from mental illness, including depression. 

The new research done by Kessler and others shows that single men and women look no different when it comes to most kinds of mental illness. But when they get married, they veer off in different directions. "It's a very good deal to be married if you're a man," Kessler says. "It's associated with a dramatic improvement in mental health." Perhaps because they are forced into solitude as children, men are not as good at being alone as women are. Because of early socialization, women are better at relationships--with children, friends, and relatives. In general, women have more friends than men and are closer to those friends. This, of course, is the direct result of boys' having independence forced on them early in life, when what they need is emotional and physical contact with others. Socialization punishes women, too. When they have children, women's mental health suffers, while that of men doesn't change at all. That's because women, in general, take care of the kids. If there's trouble in the home, or work interferes with child rearing, they'll disproportionately suffer for it. Women also worry more than men. They care about a larger group of people who just don't appear on the emotional radar screens of men. In marriage, men share in the joys and are often protected from the pain. Just as the man will go downstairs to investigate a suspicious noise, the woman plays the role of emotional protector. Kessler uses this example: A wife reports (to the researcher) that she's very upset, because her daughter had an abortion and had to miss a number of days of school. The husband reports that his daughter had the flu and couldn't go to school. How could this be? The explanation is simple: The daughter got pregnant and went to her mother for help, saying, "Whatever you do, don't tell Dad." So the mother helped the daughter have an abortion and told the father the girl was home sick with the flu. The result is that the husband is exposed to less stress, while the woman is exposed to more. Not only does she have to deal with the abortion, but she also has to lie to her husband and orchestrate the protection of that lie. But throughout, her connections are reinforced and affirmed.

 The studies show that when a father dies, the children grow closer to the mother. They come around more. The mother has been maintaining those relationships all along, and they pay off in a crisis. Yet when a mother dies, the children come around less. That's because for years, when they called on Sunday, they talked to the mother, not the father. By filling the social role, the wife grows closer to the kids. That's why widowhood and divorce are so much worse for men. Their protection is ripped away, and they have no social network to catch them as they fall. The person who managed their emotional life is gone. As Kessler puts it, "You can hire someone to do most of the things the husband does in a marriage. But you can never hire someone to do what the wife does." Men can change this situation and possibly protect themselves from depression later in life by expanding the depth and breadth of their social networks.

 […] When men talk about depression, one of the recurring themes is how it sucks the color and flavor out of life. The birdsong that filled you with joy as a child has no effect at all. The people you love don't make your heart sing, even though you know they should. The colors of the world are tarnished and dull. […] Depression is well known for shutting down the senses Exercising Your Demons - Men's Health

 Do Men and Women Express Depression Differently?

The [above] article speculates that men suffer from depression as readily as women but the symptoms in men show up as pushing themselves too hard at sports, working too hard, drinking and anger:

 […] In my clinical experience with men and boys, it certainly seems that those around them are often clueless about their depression. I had one teen who was irritable and angry at school and often overreacted with other kids in class. When I met with the school staff to discuss some test results showing a significantly high level of depression, they were shocked. One female teacher said, "I never knew he was depressed -- when I am sad, I go home, cry and eat chocolate chip cookies, I don't get angry." "Well, maybe not," I said, "but then, you are not an adolescent boy who is being bullied at school." Once the staff understood the dynamics of this young man's depression, they started to change the way they dealt with him and worked on reducing the depression, with the result that his anger subsided some. Yet the depression would have gone untreated if the staff had continued to think depression was only expressed by crying, eating too many cookies, and withdrawal.

 In an article entitled Are Men Getting Shorted on Health? the author likens depression in men to heart disease in women: "Some experts think that depression contributes to these reckless and self-destructive behaviors, but that just as heart disease was initially defined by men's experiences and therefore ignored or missed in women, depression may have been framed by women's experiences and therefore may be missed and go untreated in men." It is often said that anger is depression turned outward and this is often true (of course anger can be other things, such as a response to a sense of injustice or unfairness). Dealing with men's depression means that one cannot be afraid of anger or the underlying emotions that go with it. But the key is to know the difference between typical masculine behavior and true depression and to not pathologize the former, while being sure to properly treat the latter. Dr. Helen: Do Men and Women Express Depression Differently?

 Depression From Mind (National Association for Mental Health)

 A number of recent studies suggest that depression occurs as often in men as in women, even though women get diagnosed and treated twice as often as men. 'Hidden' or 'covert' depression may also be a factor behind several of the problems we think of as being typically male – alcohol and drug abuse, domestic violence and failures in intimacy (see Mind's booklet 'Understanding depression') Noting the earlier factoid of 'Research suggests up to 70 percent of suicides are by people with depression' makes one wonder. Consider that 75% of all suicides are male. How many of those are due to a man/ boy's depression being ignored, or that same man/ boy putting on a strong face because he doesn't want to be perceived as weak etc?

Indeed, depression affects men in many many ways, especially with the expectations thrust upon them with little appreciation of the current social climate that men and boys have to live through. Discrimination in the workplace, feminised education systems, constant denigration of males in the media, ignorance of men's issues by the feminist government, society's instant dismissal of men who ever take an interest in their own health 'men can't handle being sick, they love to act like they're dying - hahaha silly men - and other inane responses from women around them, which leave men feeling isolated. A lack of funding into promoting men's health and encouragement to visit their G.P. allow such mental and physical health issues to accumulate.


 Men commit suicide at far greater rates than women across all age groups[1]. Trends in suicide rates by age group and gender have shown some marked differences in the last 25 years. For men aged 15 to 24, there were 16 suicides per 100,000 population in 2000, compared with a rate of 9 per 100,000 in 1974 and 10 per 100,000 a decade later (Chart 7.15). Suicide is now the cause of 22 per cent of deaths of men in this age group. The suicide rate for men aged 25 to 44 has increased considerably since the mid-1970s reaching a peak of almost 25.6 per 100,000 population in 1998;in 2000 the rate for that age group was 23.4 per 100,000. Conversely, the suicide rate for men aged 45 and over has fallen since the mid-1980s.Suicide rates among women are significantly lower than among men. The rate for 15 -24 year old women has remained relatively stable, at around 4 per 100,000 population since the mid-1970s, while the rates for older age groups have fallen. In the case of women aged 45 and over the rates have more than halved.[2]

 This is telling. What drives someone to suicide? Lack of focus, direction in life? Social pressures, feeling like one doesn't fit in, constant overbearing stress, life being torn apart by events, feeling like there is no way out, lack of support and interest in his problems? Maybe the constant dismissal of 'take it like a man' instead of 'why do you feel this way' contributes to the lack of understanding. I am no expert, but you can be sure that with figures such as these, there should be studies conducted to see why men and boys are killing themselves in such numbers. With the constant attention given to 'women's issues' this is being ignored. Or as one woman with whom I was arguing with the other day retorted when I mentioned the tragic numbers of male suicides: 'Yeah well, that's because boys can't handle life like women can.' Unfortunately, such attitudes are common.

* 75 per cent of suicides in the UK are by males
* Suicides in young men aged 15-24 are now 67 per cent higher than in 1982
* The overall UK suicide rate has been slowly declining since the early 1980s
* Between 1971 and 1996 the suicide rate for women in the UK almost halved
* Between 1971 and 1996 the suicide rate for men in the UK almost doubled
* Men aged 25-34 have the highest suicide rates

The suicide rate in male prison inmates is six times the male average (94% of prison inmates are men)[3]. Research suggests up to 70 per cent of suicides are by people with depression (men and women suffer from depression in similar numbers, but women get treated twice as much)[4]. In closing this section, I'll quote from The Camacho family welcomes you to which sums up the situation. There is a disturbing disparity between suicide rates in men and women. Britain and America are the only countries in the world which have diverging trends in male and female suicides. Between 1971 and 1998, the suicide rate for women in England and Wales almost halved, while in the same period the rate for men almost doubled. At the beginning of the twenty-first century, men appear to be more vulnerable to death by suicide than ever before: suicides by men make up 75 per cent of all suicides in the UK. Suicide rates for men are higher than for women across all age groups. In the 25-44 age range, men are almost four times more likely than women to kill themselves, while men aged 45 and over are more than twice as likely to commit suicide as women in the same age range.

What is causing this divergence in male and female suicide rates?[5] Suicide is the eighth leading cause of death for all U.S. men (Anderson and Smith 2003). Males are four times more likely to die from suicide than females (CDC 2004). Suicide rates are highest among whites and second highest among American Indian and native Alaskan men (CDC 2004). Of the 24,672 suicide deaths reported among men in 2001, 60% involved the use of a firearm (Anderson and Smith 2003). Groups At Risk Women reported attempting suicide during their lifetime about three times as often as men (Krug et al. 2002).

 Male Suicide in the U.S.

 A source for U.S. suicide data and other mortality data is located here at CDC Injury Mortality Reports. Based on the data at this site, the following information is available for suicide rates in the US for the indicated years. Homicides for the same year for both sexes (and from the same data source) are given for each year as a comparison. Note that in most years except 1981, 1982, 1991, 1992, and 1993, the number of male suicides exceeds the number of all homicides. More men and boys kill themselves every year than there are homicides of both sexes every year. Where is the media attention to this issue? Men's health - SupaWiki

 Facts about Male Depression
 By Bob Murray, PhD August 5, 2005

 Overwhelmingly depression has been seen as a woman's problem, and the rate of depression among women is usually estimated as twice that of men. However recent research has shown that men are actually just as likely to be depressed, if not more so. The difference is that depression symptoms in men and women differ and male depression tends occur at a different stage of life. According to Australian government statistics, and to a number of US researchers, depression typically affects men in their 40s and 50s, whereas the peak time for depression to show up in women is in their teens and twenties.

In men depression--and it's neurobiological identical twin, anxiety--typically occurs at a time of significant, and largely unrecognized hormonal changes similar to a woman's menopause. For example, during this "male menopause" men's ability to father children is greatly reduced (though, unlike women's ability to conceive, it never actually ends). Male hormonal change can lead to failure to maintain an erection, lethargy, mood swings and increased irritability. Diagnosing Depression in Men Depression in men often goes unrecognized--by themselves, colleagues, family and even physicians. Yet some researchers estimate the depression rate among middle-aged men approaches 40%--considerably higher than the rate among women (25%)!

Statistically it takes 10 years and three health professionals to properly diagnose depression in men. Often depression is not recognized until men are in their 60s or even 70s.

 Why is depression in men so often undiagnosed and undetected?

1. The symptoms of depression in men are different from the "blue mood" which typifies it in women.
2. Men typically resist seeking help and male friends and colleagues don't ask in depth questions.
3. Men don't equate sexual problems with depression.

 Nonetheless male depression can have devastating affects on the sufferer, as well as his family and colleagues. Depression can lead to a substantial drop in productivity and work performance (over 30% according to NIMH figures), divorce (the divorce rate of men in midlife is much higher than at other times and depression has been shown to be the main root cause of divorce) and even suicide (the suicide rate for men in their 40s and 50s is three times the US national average--and 80% of all suicides are men!).

 Gender Differences in Depression Men tend to act out their mood disorder while women typically turn it inward. Depression symptoms in men and women can be radically different, leading to lack of understanding and correct diagnosis. Based on the latest research findings here are some of the prime differences between male and female depression (of course not everyone will have the same symptoms, and almost certainly not all of them, this is just a rough guide):

Symptoms in men                      Symptoms in women
  Blames others                        Tendency to self-blame
  Anger, irritability, ego inflation   Feels sad, apathetic, worthless
  Feels suspicious, guarded            Feels anxious, frightened
  Creates conflict                     Avoids conflict
  Restlessness and agitation           Slows down, nervousness
  Compulsiveness                       Procrastination
  Sleeps too little                    Sleeps to much
  Becomes controlling                  Difficulty maintaining boundaries
  Shame (eg. sex performance)          Guilt
  Fear of failure                      Problems with success
  Becomes over status-conscious        Assumes low status
  Self-medicates through alcohol       Self-medicates through food
  Over use of internet/TV/email        Withdrawal
Depression in Men: Facts and Symptoms of Depression in Men versus Women

Depression Facts and Stats
 By Bob Murray, PhD and Alicia Fortinberry, MS Updated January 15, 2005

Depression is one of the greatest problems and killers of our time. Here we list the latest depression statistics, reveal surprising facts about underlying depression causes, the failure of standard treatments, and what works for depression in the long-term. Depression Statistics

* Depressive disorders affect approximately 18.8 million American adults or about 9.5% of the U.S. population age 18 and older in a given year. This includes major depressive disorder, dysthymic disorder, and bipolar disorder. [1]

* Everyone, will at some time in their life be affected by depression -- their own or someone else's, according to Australian Government statistics. (Depression statistics in Australia are comparable to those of the US and UK.) [2]

* Pre-schoolers are the fastest-growing market for antidepressants. At least four percent of preschoolers -- over a million -- are clinically depressed. [3] [Pill-Popping Pre-Schoolers | Even Toddlers Get the Blues]

* The rate of increase of depression among children is an astounding 23% p.a. [4]

* 15% of the population of most developed countries suffers severe depression. [5]

* 30% of women are depressed. Men's figures were previously thought to be half that of women, but new estimates are higher. [6]

* 54% of people believe depression is a personal weakness. [7]

* 41% of depressed women are too embarrassed to seek help. [8]

* 80% of depressed people are not currently having any treatment. [9] 

* 92% of depressed African-American males do not seek treatment. [10]

* 15% of depressed people will commit suicide. [11]

* Depression will be the second largest killer after heart disease by 2020 -- and studies show depression is a contributory factor to fatal coronary disease. [12]

* Depression results in more absenteeism than almost any other physical disorder and costs employers more than US$51 billion per year in absenteeism and lost productivity, not including high medical and pharmaceutical bills. [13]

[1] NIMH. “The Numbers Count: Mental Illness in America,” Science on Our Minds Fact Sheet Series. [2] Australian Institute of Health and Welfare, 1998. “National Health Priority Areas Mental Health: A Report Focusing on Depression.” Depression statistics in Australia are comparable to those of the US and UK. [3] Study published in Psychiatric Services, April 2004. Reported in our health news archive: Pill-Popping Pre-Schoolers, Even Toddlers Get the Blues [4] Harvard University study reported in Harvard Mental Health Newsletter, February 2002. [5] World Health Organization (WHO) report quoted in BBC-Online January 9, 2001. [6] National Institute of Mental Health (NIMH). “The Numbers Count: Mental Illness in America,” Science on Our Minds Fact Sheet Series. [7] National Mental Health Association (NMHA) study reported in MSNBC Health Today, March 10, 2004. [8] NMHA Survey, 1996. NMHA factsheet on women and depression. [9] “National Healthcare Quality Report”, 2003. [10] D F Bailey, and J L Moore, III. “Emotional Isolation, Depression, and Suicide Among African American Men: Reasons for Concern.” In C Rubin (Ed), Linking Lives Across Borders: Gender-Sensitive Practice in International Perspective, (Pacific Grove, CA Books/Cole). [11] Agency for Healthcare Research and Quality, 2003. “National Healthcare Quality Report.” This is a widely quoted statistic, though some experts such as Dr Christopher L Summerville, Executive Director of the Manitoba Schizophrenia Society, member of the Board of Directors of Mood Disorders of Canada, have cited higher figures. [12] WHO report on mental illness released October 4, 2001. Health news stories: Depression Link to Heart Disease, Hostility, Depression May Boost Heart Disease [13] According to a 2004 Rand Corporation report. Depression Fact Sheet: Depression Statistics and Depression Causes

 Male Depresion
 Nov 1, 2005

We've been noticing a number of studies recently which have begun to show the depth of the problem of depression in men. Researchers are no venturing to say that, contrary to previous accepted knowledge, men - especially those in their 40s and 50s - may in fact be more prone to depression than women.

 The latest finding is that men who slide down the social ladder during their lifetime take the blow much harder than women in the same position, and be more prone to depression. In fact though women were twice as likely to be downwardly mobile they generally avoided the depression and poor psychological wellbeing that researchers found in men in the same position. Men who experienced a downward social shift were four times more likely to experience depression than men who improved their social status, whereas there was no marked difference in mental health between women who had moved up or down the social ladder.

 In the study, researchers from the University of Newcastle upon Tyne used the occupation of the head of the household as the marker for social status, and surveyed men and women born in 1947 in Newcastle from childhood to age 50. Their findings could be explained by the fact that men born in this era gained much of their self-esteem from their careers, whereas women found fulfilment from other social pursuits outside work, such as children and friendships.

It's also possible that women are more emotionally resilient in this type of situation, say the researchers. The study is published today in the Journal of Epidemiology and Community Health. Lead researcher, Dr Paul Tiffin said: "The Newcastle Thousand Families Study gave us an opportunity to try and understand more about how socioeconomic circumstances throughout life might be linked to mental well-being in middle age. With an increasing emphasis on the promotion of good health, findings such as these are likely to challenge those involved in health and social policy. Having robust mental health is just as important as good physical health - the two are often interdependent. Depression can lead to a vicious circle where poor mental health and lack of engagement with society becomes the norm for an individual.

Unemployment Strikes a Blow on Men's Mental Health
 February 18, 2004

 We have been saying for some time that unemployment strikes men harder than it does women and the reasons stem from our hunter-gatherer past. It's true that women typically have higher rates of unemployment than men, however the mental health of unemployed men tends to be worse than that of unemployed women has been confirmed by a recent study. Unemployment had a higher impact on men's mental health than on women's, especially among married people. Other factors affecting the unemployed people's mental health included whether they received unemployment compensation and whether they had family responsibilities or not.

 For married men, unemployment struck a harder blow to their mental health than those single, whereas for unemployed women, having children living at home tended to bolster their mental outlook in the face of losing a job. We believe that the problem for men lies in the fact that the workplace is the modern substitute for the hunting band. It was within this group that men got their sense of purpose and formed their closest attachments. Expulsion from the band meant not only shame, but also real fear for a man's very survival. Men tend to form fewer relationships outside of work for this reason. Men also need to feel that they are the providers (even if this was never really the case since the women in a hunter-gatherer band brought in most of the food).

For a man loss of employment means loss of status. Other recent research has shown that "house husbands"--who are performing what they consider lower status work--are four times more likely to die of a heart attack that those who are employed. Unemployment can also mean the loss of the family car, an essential mobility symbol. Without mobility a hunter can't hunt. No wonder unemployed males become depressed and more prone to suicide!

Depression "Boosts Fatal Stroke Risk"
 January 7, 2002

 Middle-aged men who have symptoms of psychological distress, such as depression and anxiety, are more than three times as likely to have a fatal stroke, research suggests. A research project involving 2,124 middle-aged men in South Wales has shown that depression makes a man three times more likely to suffer from a fatal stroke even though psychological distress was not linked to a significantly increased risk of having a non-fatal stroke.

Further there was no apparent link between mood disorders and an increased risk of the mini-strokes that sometimes precede a major attack. Each man in the study was subjected to a battery of physical and psychological tests, and then monitored over the course of the next 14 years. In that time 137 strokes occurred, including 17 which were fatal. In general, men who had strokes were older, heavier and had higher blood pressure levels than men who did not have strokes. The men who had strokes were also more likely to be current smokers and to have at least one other chronic disease.

 However, analysis of the data also revealed that they had also reported more symptoms of anxiety and depression. This was particularly true among those who died from their stroke. The worse the depression and anxiety, the greater the risk. Professor Robert Carney, of Washington University School of Medicine in St Louis, has examined the findings. He believes there are several possible explanations for the link between depression and fatal strokes. He said: "Depressed people often don't take medicines as prescribed so some of the men may not be taking medicines for high blood pressure, thereby increasing their risk for stroke." 

However, there is also evidence to suggest that depression and anxiety has an effect on the way the autonomic nervous system works. This system regulates heart rate and the contraction of the blood vessels. "Those changes may produce alterations that contribute to the severity of stroke or heart attack." Professor Carney said that the findings of the study should impress on both doctors and patients the need for vigilance. Depression and anxiety are often downplayed by physicians who fail to ask about psychological health and patients who are reluctant to discuss depression. Recent News and Research into Men's Health and Men's Issues

 A study says that about 10 per cent of fathers experience depression around the time their children are born. (iStock)

It is well known that maternal depression, both prenatal and postpartum, is common and can harm both the mom, the family and the child's development. Less is known about the prevalence, risk factors and effects of depression among new fathers. To find out more, pediatrics professor James Paulson and co-author Sharnail Bazemore of the Eastern Virginia Medical School in Norfolk, Va., reviewed 43 studies involving 28,004 participants looking at depression in fathers between the first trimester and the first year after the birth of a child, when parents may feel disconnected from the newborn and overwhelmed. "It's not a really pleasant creature most of the time during early infancy," Paulson said. "It's a red, screaming poop machine that just wants to be fed and doesn't really give anything back, not right away. You can see how that's really stressful … for a father who might not be able to get in there and get involved or have the kind of role they envisioned." The findings included:
  • The overall estimate of paternal depression was 10.4 per cent compared with an estimated 4.8 per cent among men in the general population over a year.
  • The three- to six-month postpartum period showed the highest rate (25.6 per cent) and the first three postpartum months showed the lowest rate (7.7 per cent).
  • There was a "moderate correlation" between depression in fathers and mothers.
The prevalence finding "suggests that paternal prenatal and postpartum depression represents a significant public health concern," the study's authors concluded. Psychosocial causes such as lack of social support, marital strain, isolation and financial burdens are consistently linked with depression in moms and can affect dads just as much, Paulson said. The parents aren't the only ones affected. When fathers or mothers are depressed, children tend to have more emotional and behavioural problems by the time they are preschoolers, and an increased rate of psychiatric disorders by age seven, Paulson noted. CBC News - Health - Postpartum depression can affect dads

 Paul Farmer, the chief executive of Mind, says men are just as likely to suffer from mental distress as women of the same age and are far more likely to kill themselves: the highest suicide risk group in the UK is now men aged between 40 and 49. But because of the emphasis on typically female issues and symptoms under the categories used to understand how depression works, the extent of the problem among men is largely hidden. While depressed women can turn in on themselves, men suffering from the illness can become animated, aggressive and angry. Middle-aged men are also far less likely to talk to friends and relatives about their feelings, relying heavily on their partner, which can push them towards marital breakdown and further isolation.

[...] “We are working on recommendations for GPs encouraging them to look out for some of the more male symptoms of depression, such as anger or aggression,” said Farmer, “and also calling for the increased provision of mental health services tailored for men, such as all-male service user groups, which are tremendously successful where they exist.” “Statistics tell us that women are more likely to have depression than men, but in reality men are just as likely to experience depression, but are far less likely to seek help, be diagnosed or receive treatment,” said Farmer. “Stereotypes such as ‘real men don’t cry’ can hold men back from getting help, and we are worried that the true extent of men’s mental health problems is further masked by the fact that the symptoms of depression that we look for are more commonly experienced by women than men, such as tearfulness. “With diagnostic criteria being more geared towards women, we have heard that men’s depression isn’t always picked up and men who do try to reach out are slipping through the net and not receiving the support they need – support that can prove to be life saving.

Men make up three quarters of all suicides, and we have to start looking beyond the statistics.” His call was backed by Peter Baker, head of the Men’s Health Forum, who said that men needed male-only clinics and groups, just like women already have, to help deal with the taboo of depression and anxiety. “We’re not trying to start a competition between men and women about who is worse off,” said Baker. “But the often quoted figure that middle-aged women suffer from depression at twice the rates of men is just not what we find to be true; it is clear that the standard diagnostic tools being used pick up depression aren’t working for men. “The male mental distress manifests itself in other ways and is not always about sitting morosely in a corner; nobody likes being around people being aggressive, which mitigates the kind of sympathy men can receive. “Men are also less comfortable in the GP’s surgery than women and are not brought up to ask for help; they want to appear in control and not weak or vulnerable. But when men can’t cope, they are the ones who go missing, who kill themselves, or who end up on the streets. Women are streets ahead in asking for and getting the services they need.” UK: Men suffer depression...

 Depressing....isn't it? (Wow that was lame)

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