Mental Health Special: Care of American Veterans, Depression, PTSD, SuicidePage 19 of 40

8. Summary

From my forty years’ experience as a clinician, I have found one of the primary reasons male depression often goes unrecognized, undiagnosed, and untreated is that most depressed men act out their depression by becoming irritable, angry, and withdrawn, while women tend to act in their depression and become anxious, sad, and teary. Women’s response often brings sympathy and support, while men are often viewed as mean rather than depressed (see table).

Comparing Men’s and Women’s Responses to Depression

Women tend to:

Men tend to:

Blame themselves for problems

Blame others for problems

Feel sad and tearful

Feel irritable and unforgiving

Sleep more than usual

Have trouble sleeping or staying asleep

Be vulnerable and easily hurt

Be suspicious and guarded

Try to be nice

Be overtly or covertly hostile

Withdraw when feeling hurt

Attack when feeling hurt

Be more obviously depressed

Hide their depression and act out

Feel they were set up to fail

Feel the world is set up to fail them

Be slowed down and nervous

Be restless and agitated

Maintain control of anger/ May have anxiety attacks

Lose control of anger/ May have sudden attacks of rage

Be overwhelmed by feelings

Have blunted feelings, often numb

Let others violate boundaries

Have rigid boundaries; push others out

Feel guilty for what they do

Feel ashamed for who they are

Be uncomfortable receiving praise

Be frustrated if not praised enough

Accept weaknesses and doubts

Deny weaknesses and doubts

Fear success

Fear failure

“Blend in” to feel safe

Try to be “top dog” to feel safe

Use food, friends, and love to self-medicate

Use alcohol, TV, sports, and sex to self-medicate

Believe their problems could be solved if only they could be a better… (spouse, co-worker, parent, friend)

Believe their problems could be solved if only their… (spouse, co-worker, parent, friend) would treat them better

Wonder “Am I loveable enough?”

Wonder “Am I being loved enough?”

These are important times for those working in healthcare. As the everyday stresses increase for everyone, we healthcare professionals have to offer guidance and support. We also have to deal with stresses in our own lives and be sure we are taking care of ourselves. Understanding the gender-specific aspects of depression can go a long way in allowing us to help others while helping ourselves.

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