Depression can affect men of all ages and backgrounds. Around one in eight Australian men experience depression at some stage in their lives.
Since suicide is the leading cause of death for men under the age of 44, and 75 per cent of suicides in Australia are by men, it seems clear that many men are struggling in silence.
Social and cultural expectations about what it means to be a man can contribute to depression and suicide, and can be a hurdle to men seeking help.
"Masculinity norms are one of the contributing factors to men not seeking treatment," says Dr. Stephen Carbone from beyondblue.
Expressing problems and feelings may be seen as a sign of weakness by some men. This can mean that men bottle things up and choose not to reach out to others for advice or assistance when they need it.
In this article, we take a look at which men are most at risk of depression, and how depression manifests. We also explore the story of Jonathan, who was diagnosed with severe depression and anxiety at the age of 21.
Causes of male depression
The causes of depression are complex and diverse. They may include biological (genetic) factors, personality factors, adverse early life experiences, and current life stressors. Some episodes are triggered by a long-running build-up of pressures, while others are brought on by a specific issue or event, such as a relationship breakdown, a change in health or the loss of a job. At other times, depression can strike without apparent cause or warning.
Depression in men – who is most at risk?
Men from from all walks of life can experience depression, but some are at greater risk than others.
Mental health conditions often commence in adolescence or young adulthood, and rates of depression in the 16 to 24 age group are among the highest of all age groups. Some young men have a hard time finding their place in the world and making the transition to adulthood. Often their mood swings get passed off as teenage angst and go undiagnosed.
At the other end of the scale, older men are also vulnerable. A decrease in physical health, the death of a loved one, loneliness or moving from independent to assisted living can all take a toll on mental health.
Men from rural and remote areas can also be vulnerable to depression. Feelings of isolation, changing economic circumstances and the stress of rural life can all contribute.
Bullying, discrimination and prolonged or intense stress in the workplace have been shown to be major contributors to depression. By the same token, the stress of unemployment and dealing with financial burdens can also have a draining emotional effect on men, especially if they have been brought up to believe they have to be the provider for their family.
Groups who face discrimination and exclusion also suffer from higher rates of depression. This includes gay, bisexual and transgender men, Aboriginal and Torres Strait Islander men, and men with a disability, among others.
Signs of depression in men
Depression is characterised by feeling sad, down or miserable for more than two weeks, and losing pleasure and interest in life.
"The depressed mind starts to see everything in negative ways. You feel bad about yourself, bad about your life and bad about your future," says Dr. Carbone.
But there are other signs and symptoms of depression that may seem less obvious. You may experience physical pain (including back and muscular pain), headaches, sleeping problems, tiredness, significant weight gain or loss, and sexual dysfunction due to depression, but it's easy to attribute these to other factors such as physical ill-health, age or overwork.
Some men with depression may feel irritable, angry or violent. Others may develop uncharacteristic or reckless behaviour, such as reckless driving, drinking too much, drug misuse or compulsive gambling. Getting help sooner rather than later is the key to preventing the negative impacts these changes can have on your life.
A first step towards treatment
The first step towards successful treatment of depression is for men to understand that depression is a common condition and that there is no reason to feel ashamed.
Dr Carbone stresses that, "Depression is not your fault. It’s not a reflection of who you are, it’s a health condition that anyone can experience."
Jonathan remembers how hard it was to start talking openly about his depression. "There was some shame and embarrassment. Men are used to hurting a muscle playing sport, but not talking about things. It’s almost ingrained in us not to admit there’s something wrong," he says.
Modern treatments are very effective. They include lifestyle advice, psychological therapies and anti-depressants, and most men who do seek help will return to their previous levels of satisfaction with their life.
Jonathan tried many different things, but for him, medication and taking control of lifestyle factors such as alcohol, diet and exercise have been the key to overcoming depression. He urges other men to seek help when they need it.
It can be difficult to recognise depression in yourself, but easier to spot in others that you know well. If you think that someone you know is struggling, ask them how they're going. Have the conversation. As Dr Carbone says, "Keep an eye on the blokes in your life and the people around you."