No, It’s Not Seasonal Affective Disorder if it Happens Every Season

With summer rapidly drawing to a close, I pose a riddle, particularly relevant, as the days get cooler and daylight dwindles. When are competitiveness and ambition not competitiveness and ambition? When they’re depression. Okay, so it’s not much of a riddle, but as it turns out neither is the reason why 24,000 of the 31,000 people who commit suicide each year are men or why nearly four times more men kill themselves than women. Think you’re immune?

It is often touted that male depression is not as much of an issue as it is with women because depression in women occurs more frequently. However, the most recent research indicates that this is grossly inaccurate. Why? Unsurprisingly, the discrepancy appears to come from the fact that men and women may in fact exhibit symptoms of depression in different ways (shocking, I know). Men it seems do not display the traditional indicators of depression such as feeling sad, tired, or disinterested in once-pleasurable activities. Instead they express it primarily through aggression and most often channel this aggression into intense physical activity and/or extreme ambition. It may begin as an occasional hobby and then slowly accelerate until it spirals out of control, often leading to a point where the person hopes for injury or death as a means of escape. In 2008, Men’s Health magazine highlighted a former Ironman and power-lifter Raymond Britt who would routinely arrive at the hospital with blood pressure readings of 90/50 and would need four bags of IV fluids to rehydrate. Men’s Health reported “He eventually did 42 marathons, 27 Ironman Triathlons, and six ultra-marathons in 11 years, covering 42,000 miles, the equivalent of running, swimming, and biking around the world 1 1/2 times.” However, Raymond Britt admits that nothing about his behavior seemed odd and more often than not, individuals who achieve such feats are looked upon as heroes and role-models and are given impressive labels such as “ultra-competitor” and “Ironman”. Given that these traits are generally what society considers as normal male behavior, it is not surprising that researcher and professor of psychiatry at Harvard University, William Pollack, has estimated that between 50 and 65 percent of men go undiagnosed, suffering from what many refer to as “covert depression”.

What could be responsible for such an under-reported and potentially fatal phenomenon? The most obvious culprit is the way in which men in our society are expected to behave. As reported by Men’s Health magazine, Terrance Real, an expert in male depression and a marriage and family therapist, wrote “There is a terrible collusion in our society, a cultural cover-up about depression in men…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.” Quite often we are led to believe that there is not as much pressure on “21st century men” to be the strong, stoic, emotionally-distant individual, all-but resistant to pain and suffering. Unfortunately most recent studies indicate that this does not in fact reflect reality. A German study published in the Journal of Affective Disorders found that the male-gender role is still characterized by all the traditional qualities such as invulnerability, aggressiveness, and fighting for control, dominance, and power. Furthermore, in the journal New Psychology of Men, research shows that while women and girls describe themselves in terms of positive traits such as caring, compassionate and an able to connect with others, men define themselves primarily through negatives. Men most often cited what it means to be masculine as not being weak, not being dependent on others, and not having a close connection to their mothers. This stigma has persisted despite countless studies dating back all the way to the 1950’s that “contact, affection, emotional communication, and genuine closeness are necessary for…humans, to maintain our health.” Additionally, men are conditioned to put less emphasis on creating and maintaining social support networks and it has been shown that isolation can have adverse effects on all systems of the body, including the brain.

The good news is that, once diagnosed, depression is easily treatable and no, I’m not talking about just with drugs. Therapy, healthy hobbies, good old family and friend support, or a combination of these can be just as effective and create a solid, lasting emotional base. Raymond Britt took up photography after being treated for his chronic depression and admits, “I never cared before. I never noticed the colors of a sunset. The electricity in a lightning strike. The glow of moonrise over a lake. They’ve always been there. But only recently have I begun to see them.” The really good news though is that we all have the ability to change the way we think, act and treat one-another. Let’s retain some of that traditional male independence and not let ancient societal dogma tell us how we ought to behave. From one 21st century man to another, I think it’s finally time we let go of the unrealistic, nauseating, and unhealthy aspects of the traditional male machismo to which we all tend to fall victim. Our physical health wants us to, our mental health wants us to and goodness knows the ladies in our lives want us to. I challenge you this Labor Day weekend to watch some football, drink some beer, and then watch I Love You, Man. After all, if you’ve seen Forgetting Sarah Marshall, you know Jason Segel is a pretty secure guy and if he can say it so can you.

References

Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. Moller-Leimkuhler, AM. J Affect Disord. 2002 Sep;71(1-3):1-9

Men’s Health magazine. Exercising Your Demons.

Luke Manley, MPH

View posts by Luke Manley, MPH
Luke grew up in and around Boston, Massachusetts before moving north to attend the University of Maine at Orono for his undergraduate degree. After living briefly in Portland, Oregon he is now working as a Research Phlebotomist and Grants Manager for the Psychiatry Department at the University of Southern California. His passion lies in travel and working internationally, especially in the Middle-East. He has spent time in Turkey, researching the Turkish Healthcare system and recently returned from Syria, Palestine, and Tunisia, assisting with the MedCHAMPS project, which is studying cardiovascular morbidity and mortality. In the Fall he will be moving to Washington, D.C. to pursue a PhD and begin his career in International Relations.

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