Tuesday, July 10, 2012

Depression in older men – It is NOT normal part of Aging

Depression in men is often overlooked

Depression is often considered a woman’s disease. But with the National Institute of Mental Health estimating that nearly 6 million U.S. men have depression each year, it’s clear this mental health condition has no gender bias.

Still, research shows that males are less likely to open up about depression - or seek treatment - than their female counterparts. This disparity may be based on the “tough guy” mentality, an idea among some men that depression is a weakness. One study from the University of Akron found that a man was less likely to see a therapist for depression if he agreed with “traditional” gender roles, ones like “men can handle whatever comes their way.”

Depression is not a sign of emotional weakness or failing of masculinity. It is a treatable health condition that affects millions of men of all ages and backgrounds, as well as those who care about them—spouses, partners, friends, and family. It can also lead to heart disease and other serious medical problems. Of course, it’s normal for anyone to feel down from time to time—dips in mood are an ordinary reaction to losses, setbacks, and disappointments in life. However, if intense feelings of despair and hopelessness take hold of you, and interfere with work, family, and your ability to enjoy life, you may be suffering from depression.

Unfortunately, depression in men can often be overlooked as many of us find it difficult to talk about our feelings. Instead, we tend to focus on the physical symptoms that often accompany depression, such as back pain, headaches, difficulty sleeping, or sexual problems. This can result in the underlying depression going untreated, which can have serious consequences. In fact, men suffering from depression are four times more likely to commit suicide than women. It’s important for any man to seek help with depression before feelings of despair become feelings of suicide. You need to talk honestly with a friend, loved one, or doctor about what’s going on in your mind as well as your body. Once correctly diagnosed, there is plenty you can do to successfully treat and manage depression.

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Male Depression through the lifespan

Male depression is being increasingly recognized in boys and adolescents. Before the age of 14, depression is diagnosed as frequently in boys as in girls. Research shows that depression is occurring earlier today than in the past. If untreated, depression in youth can lead to more serious depression as an adult. Adolescent male depression also carries higher risks for suicide and substance abuse. Symptoms can include frequent illness, disruptive behavior, mood swings, and trouble at school.

Depression impacts older people differently than younger people. In the elderly, depression often occurs with other medical illnesses and disabilities and lasts longer.

Depression in the elderly often increases their risk of cardiac diseases. Depression doubles an elderly person's risk of cardiac diseases and increases their risk of death from illness. At the same time, depression reduces an elderly person's ability to rehabilitate. Studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increases the likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack. For that reason, making sure that an elderly person you are concerned about is evaluated and treated is important, even if the depression is mild.

Depression also increases the risk of suicide, especially elderly white men. The suicide rate in people ages 80 to 84 is more than twice that of the general population. The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem.

In addition, advancing age is often accompanied by loss of social support systems due to the death of a spouse or siblings, retirement, or relocation of residence. Because of changes in an elderly person's circumstances and the fact that elderly people are expected to slow down, doctors and family may miss the signs of depression. As a result, effective treatment often gets delayed, forcing many elderly people unnecessarily struggle with depression.

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Signs and symptoms

Men can experience depression in different ways to women. You may develop the standard symptoms of depression and become sad and withdrawn, losing interest in friends and activities you used to enjoy. Or you may become irritable and aggressive, compulsively working, drinking more than normal, and engaging in high risk activities.

Unfortunately, men are far less adept at recognizing their symptoms than women. A man is more likely to deny his feelings, hide them from himself and others, or try to mask them with other behaviors. The three most common signs of depression in men are:
  • Physical pain. Sometimes depression in men shows up as physical symptoms—such as backache, frequent headaches, sleep problems, sexual dysfunction, or digestive disorders—that don’t respond to normal treatment.
  • Anger. This could range from irritability, sensitivity to criticism, or a loss of your sense of humor to road rage, a short temper, or even violence. Some men become abusive, controlling, verbally or physically abusive to wives, children, or other loved ones.  
  • Reckless behavior. A man suffering from depression may start exhibiting escapist or risky behavior. This could mean pursuing dangerous sports, driving recklessly, or engaging in unsafe sex. You might drink too much, abuse drugs, or gamble compulsively.

Differences between male and female depression

Let’s compare how depression in men appears differently than depression in women:

Women with depression tend to:
  • Blame themselves
  • Feel sad, apathetic, and worthless
  • Feel anxious and scared
  • Avoid conflicts at all costs
  • Feel slowed down and nervous
  • Have trouble setting boundaries
  • Find it easy to talk about self-doubt and despair
  • Use food, friends, and "love" to self-medicate

Men with depression tend to:
  • Blame others
  • Feel angry, irritable, and ego inflated
  • Feel suspicious and guarded
  • Create conflicts
  • Feel restless and agitated
  • Need to feel in control at all costs
  • Find it “weak” to admit self-doubt or despair
  • Use alcohol, TV, sports, and sex to self-medicate

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Triggers for depression in men

There’s no single cause of depression in men. Biological, psychological, and social factors all play a part, as do lifestyle choices, relationships, and coping skills. Stressful life events or anything that makes you feel useless, helpless, alone, profoundly sad, or overwhelmed by stress can also trigger depression in men. These could include:
  • Overwhelming stress at work, school, or home
  • Marital or relationship problems
  • Not reaching important goals
  • Losing or changing a job; embarking on military service
  • Constant money problems
  • Health problems such as chronic illness, injury, disability
  • Recently quitting smoking
  • Death of a loved one
  • Family responsibilities such as caring for children, spouse, or aging parents
  • Retirement; loss of independence

Risk factors for depression in men

While any man can suffer from depression, there are some risk factors that make a man more vulnerable to the illness, such us:
  • Loneliness and lack of social support, being single, unmarried, divorced, or widowed.
  • Physical conditions like stroke, hypertension, atrial fibrillation, diabetes, cancer, dementia, and chronic pain further increase the risk of depression.
  • Inability to effectively deal with stress.
  • Family history of major depressive disorder.
  • A history of alcohol or drug abuse.
  • Fear of death.
  • Early childhood trauma or abuse
  • Aging in isolation, with few social outlets

Treating depression in men

Don't try to tough out depression on your own. It takes courage to seek help, but most men with depression respond well to treatments such as lifestyle changes, social support, therapy, or medication—or a combination of treatments.

The first step is to talk to your doctor. Be open about how you’re feeling as well as the physical symptoms you’re experiencing so your mental health specialist can make an accurate diagnosis.
  • Therapy. You may feel that talking to a stranger about your problems is ‘unmanly,’ or that therapy carries with it a victim status. However, if therapy is available to you, it can be an extremely effective treatment for depression in men. Opening up to a therapist can often bring a swift sense of relief, even to the most skeptical male.
  • Medication. Antidepressant medication may help relieve some symptoms of depression, but doesn’t cure the underlying problem, and is rarely a long-term solution. Medication also comes with side effects. Don't rely on a doctor who is not trained in mental health for guidance on medication, and always pursue healthy lifestyle changes and social support as well.
  • Lifestyle changes to treat depression in men
Lifestyle changes are extremely effective tools at treating depression in men. Even if you need other treatments as well, lifestyle changes can help lift depression and keep it from coming back.
·         Exercise regularly. Regular exercise is a powerful way to fight depression in men. Not only does it boost serotonin, endorphins, and other feel-good brain chemicals, it triggers the growth of new brain cells and connections, just as antidepressants do. It also boosts self-esteem and helps to improve sleep. For maximum results, aim for 30 to 60 minutes of activity on most days.
·         Eat well. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. While you may be drawn to sugary foods for the quick boost they provide, complex carbohydrates are a better choice. They'll get you going without the sugar crash. Deficiencies in B vitamins can trigger depression so take a B-complex vitamin supplement or eat more citrus fruit, leafy greens, beans, chicken, and eggs. Foods rich in certain omega-3 fats—such as salmon, walnuts, soybeans, and flaxseeds—can also give your mood a boost.
·         Get enough sleep. When you don't get enough sleep, your depression symptoms can be worse. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night.
·         Reduce stress. Make changes in your life to help manage and reduce stress. Too much stress exacerbates depression and puts you at risk for future depression. Set realistic goals and break them down into manageable tasks rather than burden yourself with huge objectives all at once. Figure out the things in your life that stress you out, such as work overload or unsupportive relationships, and make a plan to avoid them or minimize their impact.

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If you want to know more about depression and how to deal with it, feel free to browse my other blog, devoted entirely to the depression: http://depressivedisorder.blogspot.com/.

Sources and Additional Reading:

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