Depression In Men
The low rate of major depression in men could be a misconception. It is often said that men do not like to admit, even to themselves, that they can be depressed. Men may feel that it is a sign of weakness or unmanly to show any sign of despair or self-doubt; they may dread what might occur if their employers or friends found out. So, they retreat into quiet suffering or develop a male depression syndrome in which the disorder appears as anger, irritability, alcoholism, or drug abuse.
Because the majority of men fail to seek treatment, their depression is seldom diagnosed or recorded. It is unconfirmed whether male unwillingness to accept feelings can account for all of the gender difference in depression; for example, surveys indicate that women have a higher rate of depression than men even amongst people who are not looking for professional help. In two ways, both related to the high male death rate, depression is known to be an even more serious matter for men than for women. Depression is a key risk factor for suicide, and men commit suicide four times more repeatedly than women and up to 10 times more often in their old age.
One speculation may be mens reluctance to project their feelings and find help when they are in despair. Another concern for men suffering from depression is cardiovascular disease. Depression can affect blood pressure, blood clotting, and the immune system. It is a recognized risk factor for coronary heart disease, heart attacks, and stroke. Men are especially vulnerable because they develop these conditions at a higher rate and at an earlier age than most women.
After a heart attack or bypass operation, some research shows that depression and anxiety are less likely and serious in men as it is in women. One recent large study found that this advantage lasted only for the first two years. The most important thing family and friends can do for a man who is showing signs of depression is to assist him in contacting a physician or mental health professional and if needed accompany him to locate treatment and encourage him to continue until his symptoms begin to show some signs of improvement.
Many authorities are now recommending that doctors screen adult patients for depression by asking these two standard questions: During the past two weeks, have you felt depressed or hopeless? During the past two weeks, have you felt little interest or pleasure in your usual activities? Screening can be very important for men as they are less inclined than women to even bring up the subject of depression themselves. The treatment itself is identical for both sexesspeaking with a therapist about any problems and taking antidepressants for symptoms. The talk may take the roll of psychotherapy, mutual support groups, or marital counseling.
Antidepressants are equally effective and have comparable side effects in both sexes, but one of those side effects, in up to 50% of its users, has exclusive implications for men. The most broadly used antidepressants, the selective serotonin reuptake inhibitors (SSRIs), tend to decrease sexual interest, desire, performance, and satisfaction and the ability to reach an orgasm. In men, this generally means the drugs prevent or postpone erection or ejaculation.
Sexual side effects, like other antidepressant side effects, may diminish with time. Other options are reducing the dose and changing to a different type of antidepressant, often bupropion (Wellbutrin). Changing is commonly not recommended unless the patients depressive symptoms are not showing any signs of improvement. The switch should be gradual to avoid a discontinuation. Another resolution for sexual dysfunction is to include a second medication. The majority of the drugs tested for this purpose have shown to be no better than a placebo. A few studies have suggested that including bupropion may help in this situation. Sildenafil (Viagra) has been found to be effective in three studies and is most likely the best choice in most cases.
Keith Bronson is a former panic disorder sufferer who supports the mental health community through his articles and web site http://www.severe-social-anxiety.com
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