The Danger of "Toughing It Out”–How To Recognize Depression In Men and Get the Best Treatment

Many people think of depression as a woman's problem and for the most part that's true. Depression tends to affect twice as many women as men.

What often gets overlooked: Depression takes a huge toll on men as well, and an increasing body of research shows that it can have a wide variety of devastating consequences for them.

That's why it's vital to know how and why depression affects men…

Dangerous Complications

Depression often goes undiagnosed and untreated in men. That's because men, in general, are less likely than women to admit that they feel depressed and will often downplay their emotions.

Baldness May Predict Prostate Cancer

In a recent study of 214 men (median age 64) who had a prostate biopsy for suspected cancer, those who had male-pattern baldness (in which the hairline gradually recedes) were 2.4 to 2.5 times more likely to have cancer than men who had not lost hair.

Possible explanation: Prostate cancer, like baldness, is driven by the hormone androgen.

Men who have male-pattern baldness: Ask your doctor about more frequent prostate-specific antigen (PSA) testing.

They also are less apt to seek help, thinking they can "tough it out." Many men dislike sharing their feelings and may view seeking treatment for depression as being unmanly or weak.

Men also are less likely than women to replace the friendships that they lose throughout the years, which contributes to loneliness-a key risk factor for depression and suicide. Research shows that older men are more likely than any other demographic group to commit suicide. The rate of male suicides for those age 65 and older was 5.4 times greater than that of female suicides in the same age group.

Research has shown that depression is an independent risk factor for coronary artery disease. A study published in the journal Psychophysiology found that people who had depression had slower heart rate recovery after exercise, a finding that may explain the link.

In addition, depression can cause men to suppress their feelings and become more aggressive and irritable, which can wreak havoc on relationships with a spouse, children and colleagues. And it can make it difficult to function at work.

Recently Approved Prostate Cancer Medicine Extends Lives

Men given the hormone pill enzalutamide (formerly known as MDV3100) lived an average of 18 months after starting treatment, compared with less than 14 months for men given a placebo. The survival edge was substantial enough that the study was halted early so that men taking a placebo could be offered enzalutamide. The pill attacks testosterone and its related hormones called androgens that fuel prostate cancer growth. In August 2012 the Food and Drug Administration approved enzalutamide for use.

Spotting Depression In A Man

Some sadness in life is normal. After all, life is filled with ups and downs. But pinpointing a depression diagnosis based solely on mood can be difficult. Diagnosing depression involves a variety of symptoms.

What isn't normal: When you no longer take pleasure in activities you once enjoyed. It is especially problematic if the loss of enjoyment is accompanied by persistent feelings of sadness, hopelessness and helplessness.

Changes in sleep habits–such as difficulties falling asleep or staying asleep or oversleeping–are another major sign of depression, as are a sharp drop in energy levels and difficulty focusing and concentrating.

Unlike women, who tend to express their feelings of hopelessness and helplessness, men often try to hide their depression with short-term "fixes" and risky behavior such as extramarital sex and drug and alcohol abuse. Additionally, depressed men may become obsessed with hobbies such as golf or work very long hours.

Treating Male Depression

Even though it can be hard for men to ask for help, getting treated for depression is critical.

The first step toward treatment is acknowledging the problem. The next step is to have an honest conversation with your primary care physician, who may treat you or refer you to a mental health professional. Possible treatments for depression include…

• Physical activity. Regular exercise has been found to have a profound effect on mood. For example, doing just 45 minutes of brisk walking three times a week can make a difference.
  
• Cognitive behavioral therapy (CBT). This type of psychotherapy involves changing negative thought patterns that are contributing to depressive thoughts. When combined with medication, CBT is especially effective.
  
• Medication. Some individuals achieve relief with medication. Drugs to treat depression include selective serotonin reuptake inhibitors such as fluoxetine (Prozac) and sertraline (Zoloft)...norepinephrine reuptake inhibitors such as duloxetine (Cymbalta) and venlafaxine (Effexor)...tricyclics such as amitriptyline (Elavil) and nortriptyline (Aventyl)...and monoamine oxidase inhibitors such as phenelzine (Nardil) and isocarboxazid (Marplan). Some antidepressants cause sexual side effects such as erectile dysfunction.
  

If you have sexual side effects: Try scheduling sexual activity before taking your antidepressant. Or try switching to one of the drugs less likely to cause sexual side effects such as bupropion (Wellbutrin). You could also ask your doctor about adding a medication to improve sexual function such as sildenafil (Viagra) or tadalafil Cialis).

Tell your doctor if you take any medications or supplements other than the antidepressant, since antidepressants can interact with both. Be aware that depression may worsen in the first weeks after starting or changing the dose of an antidepressant. Report any severe symptoms, including thoughts of suicide, to your doctor. If you or someone you know is contemplating suicide, immediately call the American Association of Suicidology hotline at 800-273-TALK (8255).

• Behavior activation therapy. This treatment works by altering your behaviors to change your mood. Working with a mental health professional, you create a hierarchy of activity goals for the week, starting with the easiest (or most necessary) and advancing to the most difficult. A depressed person who has been housebound, for instance, may start by stepping outside the house, then advance to walking to the mailbox before going to a neighbor's house to visit.
  

Bald Men Appear More Powerful

Men with shaved heads are seen as being more masculine, dominant and better able to lead others than men with thinning hair or longer locks.

Results of three studies that tested people's perceptions of men with shaved heads by researchers at The Wharton School, University of Pennsylvania, Philadelphia, published online in Social Psychological and Personality Science.

• Socializing. It's crucial for depressed men to find people or even one person) they feel comfortable sharing their feelings with-someone who listens without judging and who will not tell them how to think or feel.
  

Participating in social activities, such as a weekly golf game, alumni groups, church committees and other forms of socializing, also can play a critical role in alleviating depression. Even weekly phone calls to friends and connecting with others on social networking sites such as Facebook can be beneficial.

Helping a depressed man: A concerned wife, partner or loved one should first urge the individual to seek professional help if he has not done so already. Once the diagnosis has been made, a partner can help by stressing that depression is nothing to be ashamed of, listening to concerns and being patient.

Turn Off the Game If You're Trying to Conceive

According to a recent study, men who watched more than 20 hours of TV a week had sperm counts that were 44% lower than those who watched less.