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Approved by Dr Adil Jawad MBBS, DPM, FRCPsych — Clinical Lead for MindClinix

Before we can explore depression in men, it feels appropriate to investigate the idea of gender stereotypes. A person in their mid-50s would have had grandparents who, quite probably, were the stereotypical couple of that time. The husband would go to work and earn the main household income whilst his wife would take care of the home, children and, quite possibly, have a part-time job as ‘pin money’! The suggestion that the ‘man of the house’ could have depression was unheard of. 

Medical historian, Dr Alison Haggett wrote a blog whilst a Senior Research Fellow at the Centre for Medical History, University of Exeter. She examined the topic of men seeking help for psychological disorders throughout history. Of particular note was the male view of depression in the Georgian era:  

‘…the Georgians viewed nervous disorders as a sign of ‘good breeding’… as a result, men were more comfortable being reflective about their own physical and psychological experiences.’ 1

Fast forward to Victorian times and the concept of men being able to express their emotions was unthinkable. A stoic, level-headed, unemotional and dominant male was lauded. Moving on to the 1960s, the attitude had not changed much at all: 

‘In the workplace, debates about sickness absence have historically been dominated by concerns about productivity, resulting in a failure to investigate male psychological illness at work.’ 2

Gender Socialisation

Think about the birth of a child. Here begins the process of ‘gender socialisation’. The gender is confirmed and the child is dressed in the ‘appropriate’ clothing, going through life with the knowledge that this is ‘how it is’. It becomes part of the belief system that men are strong and unemotive and women are the more sentimental, empathetic members of society. 

A study by Dr Jennnifer Wade et al (2011), on the effect of gender socialisation on the presentation of depression among men compiled startling statistics:

‘It is particularly alarming that men, regardless of their degree of masculinity or psychiatric distress, overwhelmingly do not disclose emotional distress to their physicians, even if the content of their distress involves suicidal thoughts. This is very concerning given that the rate of successful completion of suicide among men is 3 to 5 times greater than that of women.’ 3

Childhood Trauma

Dan (54) had experienced a great deal of childhood trauma. He internalised his feelings, as there was little support at home, and as he matured very little changed:

“My family did not communicate. We certainly didn’t talk about feelings or emotions.  My father was the strong, unemotive stereotype, instilling discipline through fear. I put on a great front to the outside world but inside I felt beaten. Education was a struggle and when I started work I wouldn’t speak up if anything was bothering me. I would bottle it all up. Eventually the stress got too much and I had a breakdown and spiralled into depression. It was one of the worst times of my life.”

Men’s Minds Matter, a not-for-profit community interest company aimed at the prevention of suicide, helps men understand the importance of emotions: 

‘It’s important to understand what your emotions are telling you. The stronger the emotions – particularly negative emotions – the more attention they demand from us to make sense of them. Because most of us have never been taught how to use emotions effectively, many people struggle with them.’ 4

Accessing Support

Dan’s wife, Beth, urged him to get support but he was reluctant.  

“The thought of talking to someone about how I was feeling, horrified me. It wasn’t a natural instinct. I was always angry, which I’ve since discovered is a sign of depression in men.”

Beth insisted and eventually Dan spoke to his GP, who recommended a multi-disciplinary approach of medication and Cognitive Behavioural Therapy through a local counselling service. This was a positive step in the right direction considering that: ‘Men are less likely to access psychological therapies than women: Only 36% of referrals to NHS talking therapies are for men.5

Five years on and Dan is in a much better place:  

“I’m a work in progress’, he said, “But I’m much further ahead than 20, 30 or even 40 years ago. I talk to my family about how I’m feeling and encourage them to do the same. I’m starting to understand that talking about emotions is more a sign of strength than weakness.”

Men’s Minds Matter provides a list of information about emotions:

  • Emotions are central to forming and sustaining relationships with others.  
  • Emotions connect us to ourselves, others and the world.
  • They allow us to make sense of what is happening around us and enable us to respond to situations as they happen. 
  • Uncomfortable emotions let us know when something is wrong. They propel us into working out what the problem is so that we can do something about it, if we can. 
  • We prioritise uncomfortable emotions, particularly emotions that indicate threat like anger, anxiety, sadness and shame. 
  • Comfortable emotions let us know when things are going well. They attract us towards them and propel us into seeking out more of a good thing. 
  • Recognising how we are feeling, and why, can help us to overcome our struggles. 

Signs of Depression in Men

Signs of depression in men vary. In some cases there are few or no signs at all. Men’s Health magazine6 provides an extensive list of the psychological, physical and social signs of depression, which include:

  • Persistent low mood or sadness. 
  • Low self-esteem. 
  • Little motivation or interest in things.
  • Feeling anxious or worried. 
  • Disturbed sleep.
  • Appetite changes.
  • Avoiding social activities. 
  • Poor performance at work.

Whilst this list is not exhaustive it’s crucial to remember that depression affects everyone differently. There are no rules governing how it should be managed, but one thing is certain. Depression in men should no longer be the elephant in the room. Open the door, seek support and set the herd of emotions free. The NHS advises that if you experience symptoms of depression for most of the day, every day, for more than two weeks, you should consult your GP. 

Did you know that only 1 in 5 people who contact the Samaritans are suicidal, so this is also a resource for people suffering from mild, moderate and severe depression. The Samaritans can be contacted in the UK on 116 123. 

If you’re looking for further information on any mental health issue, MIND can be contacted on 0300 123 3393. Lines are open 9am to 6pm, Monday to Friday.

Written by Beverley Nolker, Education Development Officer for Psychiatry-UK and the HLP-U Clinics.

All content within the MindClinix website is provided for general information purposes only and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. MindClinix.co.uk is an independent website and a source of information.  If you wish to contact individual services for support, please contact them directly. MindClinix is not responsible for any diagnosis made by a user based on the content of this website. Any links to external websites have been carefully selected, however, MindClinix is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advertised on these linked sites. Listing shall not be taken as endorsement of any kind. The site is hosted by HLP-U Ltd, an independent company affiliated to Psychiatry UK LLP and the views and opinions on the site reflect the ethos of this organisation and are expressed with the aim of improving wellbeing. Always consult your own GP if you’re in any way concerned about your health. You should always promptly consult a doctor for all matters relating to physical or mental health, particularly concerning any symptoms that may require diagnosis or medical attention.