The Male Experience of Depression

TOPIC. Men's lived experience of depression METHODS. A qualitative study using grounded theory (N = 14) FINDINGS. The men interviewed experienced rigid, traditional role identities; expectations related to performance; emotional distance from others; the loss of control; the hidden self; depression as a force; substance use and abuse; suicide as a means of taking control; and late entry into treatment. CONCLUSION. Beliefs about being male are challenged by the illness, and challenge the process of treatment and recovery. Key words: Male depression, qualitative study Far more women than men in the United States receive the diagnosis of depression, while men are more likely to be diagnosed with antisocial personality disorder or alcoholism (Aneshensel, Rutter, & Lachenbruch, 1991). Since women with depression have been the clinical population studied," ... what women do when they are depressed constitutes the norm on which the criteria for depression are based" (Tavris, 1992, p. 259.) Men are diagnosed with clinical depression only when they present symptoms from the symptom pool associated with clinical depression. If the experience of depression is different for men than women, it is possible depression is overlooked in men, contributing to their prevalence of substance abuse, suicide, family distress, and violence in families and society. Riessman (1990) explored men's and women's experiences of divorce and discovered men suffered as much as women but didn't say so. Men did not present symptoms of depression, because these symptoms are not the "culturally approved idioms for men" (Riessman, pp. 156-157). Men whose lives were in shambles had low scores on standard depression scales. Riessman's findings supported Stapley and Haviland (1989) who described depression scales biased "toward measuring deviation from normal female emotional experience" and lacking sensitivity to the "male emotional experience" (p. 307). No qualitative research was found exploring the male experience of depression, though qualitative studies exploring women's experience of depression included Beck's (1992) work with postpartum depression, Jambunathan's (1996) case study of the lived experience, and two dissertations exploring women's explanations for depression (Rhea, 1989) and recovery (Steen, 1991.) Were depression described from a male's perspective, increased awareness of depression in men could lead to increased sensitivity by clinicians, earlier treatment, and decreased stigmatization of this mental health problem. Methods An exploratory, descriptive qualitative design was used. During semi-structured, in-depth interviews, 14 men talked about their experiences with depression and explored the meaning of those experiences. Sample The convenience sample was comprised of 14 men who had been diagnosed and treated for major depression. Additional axis I diagnoses were limited to generalized anxiety disorder and panic disorder. Ten of the men had histories of substance abuse, though all described no present use. Participants volunteered after hearing about the research from a healthcare provider. Ages ranged from 30 years to 51 ([Chi] = 42.5, s = 6.47). Nine (64%) of the participants were married, 3 (22%) were single and in relationships, and 2 (14%) were separated and divorcing. The average length of current relationships was 13.4 years (s = 8.6), and 6 of the 14 had been divorced. Thirteen men had education beyond high school, 5 had undergraduate degrees, and 3 had earned advanced degrees. Average years with current employer were 9.3 (s = 8.5) with 28% working in health care, 44% in management, 14% in the legal field, 7% in public service, and 7% in skilled labor. Average onset of the most recent depression was 2.25 years (s = 2.44), average number of times diagnosed with depression was 2 (s = 1.33), and 13 men reported at least three episodes of depression. …