The Secret Men Won’t Admit

When he seems ticked off or withdrawn, it may not be what you think. Learn more about the under-reporting of male depression.

By Susan Freinkel from Reader's Digest | January 2007

Sadness isn’t macho — this Eric Weaver knew. When depression engulfed the Rochester, New York, police sergeant, it took a different guise: anger.
To the former SWAT team leader and competitive bodybuilder, it was manly, and easy, to be mad.

The father of three, then in his early 30s, stewed in a near-constant state of anger. “One minute I’d be okay and the next minute I’d be screaming at my kids and punching the wall,” he recalls. “My kids would ask, ‘What’s wrong with Daddy? Why’s he so mad all the time?’ I probably heard that 1,000 times.” For years, Weaver didn’t know what was wrong. “I just thought I was a jerk.” The possibility that he was depressed never occurred to him until the angry facade began to crumble, leaving him with no feelings except utter despair. The tears finally came one night when he admitted to his wife the painful truth: “I’ve thought about committing suicide every day.”

Weaver’s confusion about what afflicted him was not unusual. Roughly a third of the 18 million or more Americans who suffer depression each year are men. Yet all too often, experts say, men fail to recognize the symptoms and get the treatment they need. “Men don’t find it easy to ask for help,” says Thomas Insel, MD, director of the National Institute of Mental Health (NIMH). “That’s a gene that must be on the Y chromosome.” In an effort to redress that masculine blind spot, in 2003 NIMH launched an educational campaign featuring real men talking about their experiences with depression. Their stories were markedly different from women’s.

For years, experts suspected that gender makes a big difference in depression. Studies from New York to New Zealand have repeatedly found the same startling statistic: About twice as many women as men suffer from depression. That finding was considered one of the bedrock facts of modern mental health. Yet it has recently come under attack from critics who, concerned about under-reporting of male depression, are raising the heretical question: Do men actually experience it as much as women do?

The Depression Gender Gap
Harvard psychologist William Pollack, PhD, is leading the charge against the well-entrenched depression gender gap. Director of the Center for Men at McLean Hospital, Pollack argues that men’s rate of depression may be nearly equal to women’s. Just look at suicide rates, he says: Male suicides outnumber females four to one. That ratio “is way too high to say that men’s depression numbers are so low,” he notes.

Pollack and others contend that male depression goes unrecognized because, unlike the female version, it often doesn’t fit the textbook signs — at least in the early stages, when it’s easiest to intervene. A full-bore clinical depression looks much the same in both sexes. But in the prelude to a breakdown, that deepening despair is often expressed in very different ways. Unlike women, “men don’t come in talking about feeling sad or depressed per se,” says Sam Cochran, PhD, a psychologist at the University of Iowa and co-author of Deepening Psychotherapy With Men. “They come in complaining about problems at work or their performance on the job.” Instead of being weepy, men are more apt to be irritable and angry — moods that aren’t included in the classic diagnostic tests. “Their sadness and helplessness are hidden behind a mask of anger,” says Pollack. Often, unfortunately, neither doctors nor men themselves recognize that as a red flag.

“Men tend to act out” to avoid dealing with uncomfortable feelings, adds Fredric Rabinowitz, PhD, Cochran’s co-author and a psychologist at the University of Redlands in California who works primarily with men. If they feel bad, they’re apt to get into fights on the job or at home, withdraw from family and friends, become obsessed with work or hobbies. Most significantly, men often turn to drinking or drugs.