Depression in men

Depression in men, as psychologists and psychiatrists claim, occurs much less frequently than in women. Obviously, this is due to the fact that the thinking process of men and women, as well as their psyche, have significant differences that are functionally determined and laid down by Nature in the mechanism of psychological sexual dimorphism.

The male brain - despite the ability for abstract spatial thinking and rationality - works asymmetrically, due to the right hemisphere.

It has long been recognized that men have less developed intuition, more limited emotional perception of information, life goals are specific, and the way to achieve them is straightforward and does not take into account many details.

And although the male principle implies a higher ability to quickly adapt to changing external factors, in general, the male part of humanity, like the female, is subject to mood disorders. And to the question - does depression occur in men? - the answer is unambiguous: it does, and in severe forms.

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Causes of Depression in Men

The most common causes of depression in men occur when external circumstances are unfavorable for the individual or stressful situations that cause dissatisfaction with the social, psychological or biological realities of everyday life. Depression is the body's response to psychological trauma, as well as to any extraordinary or tragic event in life that dramatically changes its usual way of life.

In many cases, stress is the cause of depression in men, since any stressful situation is associated with psychophysical and emotional overstrain and deterioration of general well-being. Moreover, men can experience stress with minimal external manifestation of emotions, but it takes so much energy that it often leads to their complete decline, up to attempts to "solve all problems" by voluntary withdrawal from life... And this is nothing more than depression - anxious, anesthetic, adynamic, apathetic, neurotic, psychotic, etc.

Among the most common causes of this mental disorder are: lack of professional success and social achievements, problems with work or business, conflicts at work or in the family, loss of a job, financial difficulties, family troubles, failures in personal life (including divorce), death of loved ones, experiences of violence, change in social status due to retirement, etc.

If we switch from external psycho-emotional causes of depression in men to their hormonal pathogenesis, then this may be a malfunction of the hypothalamus (where the centers of the autonomic nervous system are located); insufficient synthesis of thyroid hormones (hypothyroidism); excess cortisol produced by the adrenal glands (a hormone involved in the development of stress reactions). Depression can be caused by a decrease in the content of the main male sex hormone - testosterone. And deep depression in men after 50 years very often has a hormonal etiology, that is, it is caused by a gradual reduction in testosterone production.

The causes of depression in men may be associated with a pathological focus in the temporal lobes of the brain. If there was an injury or a tumor appeared in the temporal lobe on the right, classic vital (melancholy) depression is diagnosed; and if the temporal lobe on the left is affected, anxious depression is diagnosed.

Depression, including in men, is part of a complex of symptoms of neuroses, cerebral vascular pathologies (and cerebrovascular accidents), Parkinson's disease, Alzheimer's disease, diabetes, cancer of various localizations, HIV, as well as chronic alcoholism and drug addiction.

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Psycho-emotional factors causing depression in men

With all the variety of psycho-emotional factors that give impetus to the development of this disease, we will focus on the most typical cases.

Depression in men after divorce has several variants. Some, finding themselves single again, start "looking for adventure", changing sexual partners, drinking heavily and eating unhealthy food. Others fall into a state of confusion, bordering on stupor: one way or another, their comfortable life has ended, and what will happen next is unknown... And the man is left alone with his problems, gradually realizing that no one will take care of him or support him now. Depression and anxiety lead to a decline in strength, loss of appetite, decreased potency, sleep disorders, headaches and memory impairment.

Depression in a 40-year-old man coincides with a midlife crisis, when a man begins to sum up the first results of his life and, as often happens, loses the sense of the meaning of his achievements. At the same time, a feeling of complete dissatisfaction with what a man has managed to achieve may appear. In family men, depression occurs against the background of responsibility for a spouse and children, and if the family climate is far from ideal, then the depressive state can take the most radical forms, up to the loss of the meaning of life and alcohol abuse.

When a relationship breaks up and a beloved woman is lost, men often experience love depression. A man can perceive unrequited love as a collapse, a lack of recognition of his merits, betrayal... He loses the ability to analyze the situation objectively, becomes embittered, dreams of revenge and thus triggers the mechanism of self-destruction. Many in such a situation seek "consolation" in casual sexual contacts and alcohol. However, as psychologists say, this has never been of benefit to anyone. In order to perceive a failed romance as an experience and switch to a positive attitude, a man must want to maintain his self-esteem, heal from emotional trauma and move on.

Postpartum depression in men is associated with the fact that after the birth of a child, the lion's share of the wife's attention, who has become a mother, is devoted to the baby, and the husband seems to fade into the background. Not all men respond adequately to changes in the family, especially since in the first period after childbirth, intimate relations between spouses can be problematic. And it is this factor that most often becomes the starting point of postpartum depression in men. It is expressed in the man's anger, his constant dissatisfaction with everything around him and unmotivated irritability, as well as a decrease in appetite, insomnia and rapid fatigue.

Symptoms of Depression in Men

Some symptoms of depression in men have already been mentioned above. But if most women in a depressive state become inhibited, tearful and feel inferior, then for men, sharp mood swings, aggressiveness (with bouts of unreasonable anger), nervousness, impulsiveness and irritability are more typical.

In addition, symptoms such as apathy and a feeling of melancholy; decreased performance and loss of interest in any active activity; absent-mindedness; pain in the chest, stomach or back; headaches; a sweet taste in the mouth without eating sweet foods or drinks; increased blood pressure; a feeling of emptiness, guilt and hopelessness; decreased libido and problems with potency; loss of the ability to make decisions; obsessive thoughts of suicide.

Depending on the severity of the depressive state, the combination and degree of expression of symptoms may vary. But, based on clinical experience over the past 15-20 years, psychotherapists say that the key symptom for diagnosing depression should be considered hypothymia - a state of the human psyche in which mood instability, decreased psycho-emotional background, apathy and a feeling of oppression are observed.

How long does depression last in men? According to statistics, in 80-85% of cases, the average duration of depressive symptoms is from six months to 9-10 months, the rest of the patients can be in a depressive state for up to two years or more.

Diagnosis of depression in men

According to many experts, diagnosing depression in men does not present any particular difficulties. However, when consulting doctors who do not specialize in psychotherapy, the correct diagnosis will be determined in no more than 4.5-5% of cases.

Typically, to diagnose depression, psychotherapists interview patients using specially developed structured clinical interviews: the Zung self-rating depression scale, the Hamilton Rating Scale for Depression, or the Beck Depression Inventory.

According to accepted diagnostic criteria, the diagnosis of "depression" can be considered correct if the patient has at least five symptoms of this disease for two or more weeks. In this case, the manifestations of the disease must be systematic, that is, daily.

Depression in men is diagnosed based on a study of the bioelectrical activity of the brain, for which patients undergo an electroencephalogram (EEG). Using electroencephalography, doctors determine the tone of the sympathetic part of the autonomic nervous system and make an appropriate conclusion. A study of the sleep structure is also conducted - the cyclicity and duration of its stages.

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Treatment of depression in men

Adequate treatment of depression in men allows in eight cases out of ten to completely overcome this painful condition. Many types of psychotherapy (psychoanalysis, cognitive behavioral psychotherapy, gestalt therapy, etc.), breathing and relaxation training, light therapy, sleep deprivation (deprivation), electroconvulsive therapy (ECT) are suitable for this. It should be noted that ECT is used only for the treatment of people with severe depression and a high risk of suicide or in patients who have not been helped by other methods of treatment, in particular medication.

The most appropriate and effective medications for the treatment of depressive states are recognized as antidepressants (a group of selective serotonin reuptake inhibitors by neurons of the brain) in combination with antipsychotic drugs (neuroleptics).

In case of depression and persistent mood deterioration, a drug such as Fluvoxamine (synonyms - Fevarin, Avoksin, Floxifral) is prescribed. The dosage is determined individually, with a minimum daily dose of 1 tablet (0.1 g) once a day (taken in the evening). The drug can cause side effects: nausea, vomiting, dry mouth, dyspepsia, drowsiness, tremor, anxiety and restlessness. Fluvoxamine is contraindicated in epilepsy, liver and kidney dysfunction, diabetes.

The antidepressant Sertraline (synonyms - Aleval, Asentra, Deprefolt, Zalox, Emothon, Sertran, Stimuloton, Torin) in tablets (25, 50 and 100 mg) does not cause addiction, is taken in the amount of 25-50 mg - once a day, regardless of food intake (morning or evening). During treatment, the dosage can be adjusted. Side effects of this drug include: allergic reactions, headache, dizziness, impaired coordination, diarrhea, constipation, dry mouth, dyspepsia, flatulence, nausea, vomiting, spasms in the stomach and abdomen, convulsions, decreased appetite, rapid heartbeat, edema. Sertraline is contraindicated in epilepsy.

The drug Citalopram (synonyms - Opra, Pram, Sedopram, Siozam, Cipramil, Citalift, Citalon, etc.) belongs to the same group of antidepressants. It is prescribed orally - 20 mg (2 tablets of 10 mg) once a day, regardless of food intake. The maximum daily dose is 60 mg. The drug can cause dizziness, nausea, insomnia (or drowsiness), constipation, palpitations, back pain, and urination disorders. The antidepressant effect of Citalopram occurs 2-4 weeks after the start of treatment.

The drug Azafen (synonyms - Azaxazin, Disaphen, Pipofezin) belongs to the group of tricyclic antidepressants. It is available in the form of tablets of 25 mg. It acts as a sedative (calming) and thymoleptic (improving mood) agent and is especially recommended by doctors for mild and moderate forms of depression, as well as for alcoholic depression with anxiety and inhibition. The standard daily dose is 1-2 tablets (after meals), the dose can be adjusted to a daily maximum of 0.4 g. This drug has virtually no pronounced side effects, dizziness, nausea and vomiting may occasionally occur.

The neuroleptic Tiapride (in 100 mg tablets) is prescribed for depression in men against the background of alcoholism with psychomotor agitation. Take one tablet three times a day. After the condition improves - one tablet per day. Taking this medicine may cause drowsiness.

Hypericin (generics - Deprim, Turinayrin, Negrustin, Neuroplant) is a drug based on the medicinal plant St. John's wort (in tablets, capsules and dragees). Biologically active substances of St. John's wort have a modulating and stabilizing effect on neurotransmitter processes of the autonomic and central nervous systems, help eliminate the feeling of depression, relieve such symptoms of depression in men as apathy, weakness, loss of appetite, sleep disorders. The recommended daily dose is 3 dragees - one per day. A skin reaction resembling sunburn (photosensitivity) is noted as a possible side effect of Hypericin.

Vitamins for depression for men have a certain therapeutic effect. Experts recommend taking B vitamins, especially vitamins B6 and B12, which participate in the regulation of the nervous system. The vitamin complex Neurovitan contains vitamins B1, B2, B6 and B12. It is taken 1-4 tablets per day for a month. Taking this drug is incompatible with alcohol consumption.

How can a man get out of depression?

Professional advice on how to get a man out of depression can be found by contacting a psychotherapist. What can he recommend?

First, admit to yourself that the problem exists. Second, set a clear goal for yourself – to get out of the depressive state, otherwise…

The fight against depression begins with removing the "emotional armor". To do this, it is best to retire from prying eyes and start doing "incredible things": jumping, screaming, dancing to loud music, singing, boxing with an invisible opponent, tumbling, doing push-ups on a horizontal bar, chopping wood... In general, relieve emotional tension.

Then it is useful to take a shower and rest. For example, get a good night's sleep. And when you get enough sleep and feel hungry, do not eat fast food under any circumstances, but fry a piece of meat and make a salad of fresh vegetables.

Gather with friends not at a table with alcohol and snacks, but on the river bank - for fishing. In the evenings, do not sit in front of the TV or at the computer, but walk along the streets or play with children on the sports ground.

Change your style of clothing, buy a good cologne or eau de toilette, take care of your appearance and don't forget to look in the mirror. But, standing in front of it, you need to straighten your back and shoulders, raise your drooping head and... smile at yourself and hold this position for 15 seconds. And only after that can you go about your business. Smile at your neighbors, co-workers, loved ones. At first it will be difficult, but day by day this emotional self-recharge begins to work.

It can and should be strengthened. How? This is covered in the next section.

Prevention of depression in men

So, depression prevention in men is in the hands of the men themselves. Or rather, in moderate physical activity and changing a sedentary lifestyle to an active and motor one.

One hour a day is enough for this.

Absolutely everything will do: jogging in the morning, regular exercise, cycling, visiting a gym or swimming pool. If you have children, be sure to involve them in physical education.

The diet should include more vegetables and fruits, which will replenish the body with essential vitamins and microelements. Do not forget about sea fish, especially fatty fish: in addition to phosphorus and iodine, it contains Omega-3 polyunsaturated fatty acids. One of them, docosahexaenoic acid, is part of the gray matter of the human brain. When it is deficient, the process of transmitting nerve impulses slows down, thinking abilities decrease, and memory deteriorates.

In addition, you need to get enough sleep. At least seven hours of sleep at night will help your brain cells and the entire body work without failures.

Prognosis for depression in men

We are forced to note that if this pathological condition is ignored, the prognosis for depression in men is far from optimistic. The same clinical statistics claim that spontaneous recovery of protracted depressions does not exceed 10 cases out of 100.

The consequences of depression in men are a significant deterioration in the quality of life and a direct threat of recurrent attacks of the disease, since depression takes almost 20% of the life of those who have suffered a depressive episode. In addition, according to the results of a recent study, it was concluded that depression in men significantly increases the risk of stroke.