Men’s Mental Health

Men are depressed, but what IS depression?

Some would say that our high-paced, stressful, and at times unnatural lifestyles lead us to feel unfulfilled, out of place, frustrated, and depressed. We are all familiar with depression as it is likely to affect us directly or someone close to us at least once in our lifetime, but what actually is it? Depression is colloquially referred to as simply “feeling down” or being of “low mood” but the condition is much more complicated than that, and the symptoms are not only mental but also physical. There is even a difference between situational depression and clinical depression [1]. We will all encounter normal times in our lives that make us feel depressed - such as the loss of a loved one, the breakup of a romantic relationship, or any stressful or overwhelming situations caused by work or in private life. Depressive episodes are first considered to be situational because an individual is likely to recover in time and symptoms can typically be managed with talking therapies, but if the individual does not recover then it is considered to be a major depressive episode which is a severe mental health condition [1].

What does depression look like?

It’s important for us all to be able to recognise the basic symptoms of depression so that we are more capable of recognising it in those around us, but also in ourselves. Many symptoms are easily recognised if they present in an obvious manner, but most symptoms are invisible and can be hidden by the individual suffering with them. The most visible and noticeable symptoms of depression are those that change social behaviour – the individual may begin avoiding social activities, they may also start to neglect hobbies and interests that they usually enjoy and may also develop difficulties in their personal and professional life. The physical symptoms of depression can look like any combination of the following – changes in appetite or weight, moving or speaking slower than usual, lack of energy, low libido, or disturbed sleep [2].

These symptoms have the possibility of being noticed, but what about those can’t be seen? Often the most serious symptoms are those that are invisible, all the while worsening while remaining completely hidden. An individual may be experiencing hopelessness, feeling guilt-ridden, being not motivated, have continuous low mood, find no enjoyment in life, and have intrusive and suicidal thoughts [2]. So, as you can see, depression is capable of being a totally silent killer as it remains unseen and may go unnoticed until it’s too late.

But what is really happening?

Now we have some understanding of the psychological and physical symptoms of depression, lets look at what is actually going on inside the brain to cause all this. Depression is typically the result of a chemical imbalance in the brain, and more specifically, involves how neurons communicate with each other and regulate hormone levels [3]. Serotonin helps regulate sleep and mood, and low levels of it have been linked to higher risk of suicide; Norepinephrine raises blood pressure and triggers anxiety response; Dopamine plays a role in perceptions of reality, delusions, and is even associated with psychosis, but is a hormone essential to movement. These integral neurotransmitters are the most significant chemicals that play an important role in symptoms of depression when they are not regulated properly [3]. Essentially, neurotransmitters are the “chemical messengers in the brain” [4] as put by Very Well Mind, so it’s understandable that if the messengers are having a problem getting important mood-regulating messages where they need to go, then mood regulation will suffer as a consequence, resulting in symptoms that we associate with depression.

Can we treat it?

The marvel that is modern medical science has developed effective treatments for managing depression and the most effective combination of treatments are antidepressant medication and talking therapies [5]. Antidepressants, more specifically known as SSRIs (which stands for selective-serotonin-reuptake-inhibitor) help to regulate the levels of serotonin in the brain that results in a stable and manageable mood for those taking it. Coupling this medication with talking therapies such as CBT (cognitive behavioural therapy), which breaks down the patient’s problems into their component parts and works on helping change unhelpful thoughts and behaviours, is proven to have the best results in treating depression [6]. Depression affects us all – it is the most common mental illness affecting men [7] – but it can be beaten.

If you find that you or someone you know may have depression, you can find further information and support on the NHS website, or speak directly to your GP. If you find yourself having a crisis, email Samaritans at jo@samaritans.org and they will get back to you within 24 hours, or call Samaritans directly at 116 123 for immediate support.

Reference List

[1] www.medicalnewstoday.com. (n.d.). Situational depression vs clinical depression: Difference and diagnosis. [online] Available at: https://www.medicalnewstoday.com/articles/314698.

[2] nhs.uk. (2021b). Symptoms - Clinical depression. [online] Available at: https://www.nhs.uk/mental-health/conditions/clinical-depression/symptoms/.

[3] Harvard Health Publishing (2017). What causes depression? - Harvard Health. [online] Harvard Health. Available at: https://www.health.harvard.edu/mind-and-mood/what-causes-depression.

[4] Schimelpfening, N. (2003). The Chemistry of Depression. [online] Verywell Mind. Available at: https://www.verywellmind.com/the-chemistry-of-depression-1065137. [5] March, John.S. (2007). The Treatment for Adolescents With Depression Study (TADS). Archives of General Psychiatry, 64(10), p.1132.

[5] Mental Health Foundation (2018). Men and mental health. [online] Mental Health Foundation. Available at: https://www.mentalhealth.org.uk/a-to-z/m/men-and-mental-health.

[6] NHS Overview- Cognitive behavioural therapy (CBT) https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/

[7] nhs.uk. (2021a). Overview - Cognitive behavioural therapy (CBT). [online] Available at: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/.