Depression: It’s for everyone
I recently saw a commercial for Cymbalta, an antidepressant, which had some spot-on assertions about what depression feels like. Depression is painful, it’s anhedonic, it’s tiring and so on. All of these fairly characterize what depression is.
There was at least one aspect of the commercial, however, that did a great injustice. Every person portrayed as depressed was a young woman. There was not a single mentally ill man in the commercial.
Unfortunately, there exists a pervasive conception that depression is for women. I won’t get into a whole debate about whether all gender stereotypes are harmful, but it’s clear that certain ones are. The stigma surrounding male mental health issues does nobody any good, and more resources and attention need to be brought to finding and helping clinically depressed men.
In terms of resource allocation, critics will immediately point out that women have higher incidences of major depression, and this is true. However, there is surely underreporting among men because of the stigma associated with mental illness in male culture. Moreover, men are more likely to successfully commit suicide, which could indicate a lack of treatment. Contrary to popular belief, suicidal people will not always “find a way.” People who attempt suicide and fail rarely repeat the attempt. Identification, prevention and treatment can literally save a young man’s life.
Whatever the numbers, the stigma surrounding mental illness in male culture is real and troubling. In this column, the first of two, I’d like to address some reasons why depression in men may go unnoticed. In my next column, I’ll explore easy ways to address these issues.
It’s easy to dismiss the underreporting of depression in men as a cultural stress on masculinity and stoicism. I certainly think this is a factor. However, I think the biggest issue is that men may manifest the “symptoms” of depression differently from women, making depression harder to identify in men. I’ll provide a few examples of seemingly common male behaviors that could be signs of depression.
First off, we all have a conception of self-harm as something like cutting. Cutting is clear, visible and obviously abnormal. This makes depressed people who cut easier to identify, thereby making intervention easier.
However, there are many types of self-harm, and men often induce self-harm through less obvious means like substance abuse, dangerous physical acts and risky sex. These things are often chalked up to boys being boys, i.e., these unhealthy behaviors are just what young men do. But say we had a young man who comes to college, ignores his classes and drinks himself into a stupor every night. Is he irresponsible or is he depressed? It’s a surprisingly common phenomenon that’s almost invariably chalked up to an irresponsible young man being unable to handle the independence of college. But maybe moving to college has been a triggering factor, leading him to be depressed. It’s hard to tell, but ignoring these behavioral changes could be ignoring a serious underlying issue.
Likewise, risky behaviors can manifest in something seemingly benign, like speeding in a car. Teenagers are supposed to be irresponsible drivers, right? I had a friend, however, who would speed constantly because he didn’t care if he crashed and died. Similarly, it’s not uncommon for a car crash to be a suicide attempt. Ultimately, risky behavior in men could be a manifestation of self-loathing and hopelessness associated with major depression or the mania associated with bipolar depression.
Another example may be the idea that men have fewer “body issues” than women – i.e., they’re supposedly more comfortable with their appearance. But a man’s insecurity with his body is quite common. He may become obsessed with exercise, diet and muscle growth.
I’ve provided these examples to show that the common conceptions of depression symptoms can blind us to people in need. Now, I’m not saying that someone who drinks, speeds or over-exercises is clinically depressed.
But I am saying that depression isn’t just young women cutting, sleeping excessively or losing interest in life. We should all be cognizant of the people around us and realize that we can’t truly know what they’re going through until we ask.
Look for Chris’ second column on depression after spring break. Until then, contact him at herriesc@stanford.edu.