Up Close With Dr. E

Depression in men


For the few minutes it takes to read this column, set aside pre-conceived ideas about clinical depression. If you can do this, you might end up saving the life of your son, brother, father or husband. If you are a man reading this article, the life you save may be your own. Consider these mind-numbing facts:

1. Men commit suicide at a rate five times that of women.

2. Men’s lives are more often destroyed by drug and alcohol addiction than women.

3. Anger problems in men lead to high rates of divorce, domestic violence and incarceration.

What does anger, addiction, jail time and suicide have to do with depression in men? Before answering this question, fasten your seat belts as we take a journey into the inner workings of a man’s mind (three stops till the top floor).

Stop #1: The six rules of manhood. For men, these rules define strength: Don’t cry, don’t show pain, never ask for help, don’t show fear, don’t feel (anything) and anger is OK to show because it commands respect.

Stop #2: Bury and erase emotions. Men use repression — the ability to bury feelings, and denial — the refusal to acknowledge events, as tools for achieving manhood. This is not always unhealthy: As a fireman rushes into a burning inferno to rescue a trapped child, the “fear knob” is turned down to zero (don’t show fear). Precious objects (like your life) are put into mental compartments whose doors are welded shut and keys are tossed aside (I am invincible — this fire can never hurt me).

Stop #3: Depression takes hold. Unhealthy repression, on the other hand, when used over time, begins to put too much pressure on the mental machinery. Instead of working through and talking about how a bad boss inflames you, we men swallow anger. This sets up a chain reaction: Raw anger surges through body tissues, especially the muscles of the back. As the back tenses, blood vessels are squeezed, which reduces oxygen to back muscles and causes continued back pain. As more emotions are repressed, other changes occur — To self-medicate a newly formed depression, drug, and alcohol use increases. Negative and self-destructive thinking patterns emerge, which rip off chunks of self-esteem. Eventually, the mental machinery breaks down and a full-blown depression erupts and explodes on family members.

The Top: What to do? 30 years of counseling men has taught me three basic strategies:

1. Separate the man from the depression. Winston Churchill, the great leader of Britain during Wordl War II, suffered from severe depression. When he would be hit with a bout of depression, he would put this sign outside his door — “Black dog is out, Do Not Disturb.” Churchill separated his depression (the black dog) from himself. In this way, he managed his depression by not blaming himself. By providing men with an accurate description of how their depression operates, a new perspective occurs, and I hear this: “Up to now, I saw myself as a monster, all filled up with rage; now I realize that it was the depression, not me, causing the hostility and negativity.”

2. Take Action. Once the problem is identified (you have a depression), men are eager to act and learn how to attack the depression. Modern, 21st century treatments for depression have a good track record of success.

3. A new definition of strength. Many men have told me that after recovering from their depression, they find themselves fundamentally changed. “I no longer believe being strong means I can’t feel, or not reach out for help-my new strength is my ability to connect, by using new emotions, to those I love.”

The content of this article is for educational purposes only, and should not be used as a substitute for treatment by a professional.


Dr. Richard Elghammer contributes his column each week to the Journal Review.


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