Last week I talked to you about the male mental health crisis and how it has been claiming lives of thousands of men in silence each day. The response I got from that post got me thinking about why it is that such a huge discrepancy exists between help seeking in men and male suicide rates. What I found out along the way was so simple and yet made so much sense, I immediately felt like an idiot for not thinking of it sooner.

Male Suicides Are A Problem

You may think that why is it that I have been focusing so much on men throughout the new year. After all, there are many other sub-groups that also require help and have high rates of suicide eg. Students, farmers, divorced woman etc. The answer is a discrepancy. A discrepancy that makes no sense.

Women report higher rates of depression as well as attempt suicide more often than men. Why is it then that men complete suicide more often? In 2015, out of the ~ 133,000 suicides in India, 68.5% were men. In USA, the percentage is 73%.

Accidental Deaths & Suicides in India, 2015

It cannot be a coincidence, right?

Where does this discrepancy in male suicide come from? That is what I looked into in the last week.

The Male Suicide Puzzle.

A commonly used explanation for this discontinuity is that men are not expected to seek help for their personal issues. That is, if a man is suffering emotionally, it is likely that they will not seek help for it and hence ‘mask’ it in order to appear ‘manly’. I used to think of this theory as the right one all this time and am sure many others share the same feeling. But scientifically, you can think why this theory might be a problem.

Think about it this way,

How do we know a person has a problem if they are not willing to tell it to us? Mental illnesses rely heavily on self-reports for diagnoses. How do we know there is an illness if the patient won’t tell us anything about it?

It makes sense to think that men mask their problems to conform to the gender norms like, ‘Men don’t cry’, ‘Real men man up’ and so on but there is no way we can test this.

There is another theory though. One that overcomes this problem and explains the male suicide puzzle.

One that is way more terrifying when you think about it.

We Have Had It All Wrong

So far, depression is mostly theorized as an illness marked by loss of motivation, negative emotions, hopelessness, guilt, emotional numbing and so on. These are the major themes of the criteria in the DSM and is the focus of most introductions to major depressive disorder as a mental illness.  

What researchers in 2008 found out though, was that these criteria mostly apply only to women!

Think about it!

All the theories and the policies and the researches and everything that has been happening surrounding depression in the last half century has been based on incomplete information!

Interest in the experience men have with depression and how it differs from women is nothing new. In the 90s and early 00’s,Male Depression Syndrome’ was being theorized as a subtype of depression that solely affected men.

A question you may ask is, what’s the difference?

The difference lies in the experience and the expression.

Male Depression Is Real

Think of the kind of person that comes to your mind when you think of someone with depression.

The person is probably reserved, rarely smiles, displays very few emotions, cries often, cannot focus on simple things and has a severely hampered social and professional life.

Scientists suggest that in men, this experience is also marked by external reactions like constant agitation, anger outbursts, violent tendencies, substance abuse, risky behaviours and so on. Addis (2008) proposes various frameworks by which we can try and understand this discrepancy. He says that depression while currently understood with the lens of negative emotions, it doesn’t take into account the different ways in which men and women respond when they experience a negative emotion like disappointment or failure or guilt.

While the emotionally healthy thing to do is understand the origin of the emotion and manage it responsibly; men, like me, owing to the lack of knowledge on how to deal with these emotions tend to do what they have been taught to do since childhood.

We end up doing what we have been taught men do when they are feeling disappointed or heartbroken. We drink, we get aggressive, we isolate ourselves and we end up harming ourselves and those close to us. No help can be sought because that would break my norms, but we also get more destructive each day.

Lower help seeking and higher rates of aggression combine to form a lethal dose of death that takes the lives of so many men around the globe.

The people close to the men suffering from depression often end up suffering a lot due to the clear externalization of depression among men.

A Personal Experience

Another reason why this theory of Male Depression resonated so deeply with me was that it made so much sense for me. Between 2015-17 when I was severely depressed, I was often very agitated. I was hard to talk to, easily irritated and often threw things around in a fit of rage.

It was easily the darkest period of my life.

All this time ever since I recovered from then, I could never make sense of this frustration that was within me at that time. After all, acting out and aggression is not a symptom of depression classically. I could never make sense of it. Until now.

I used to think that that side of me was a dark side that came out when I was unable to control my emotions. Today I understand, it was the expression of an illness that had taken complete control of me.

I, and so many other men like me, undergo depression completely differently than women. It has been killing so many of us all along.

It is time, we recognized Male Depression and saved the lives of so many suffering in complete ignorance of their own illness. It is time we save not just the sufferers but also those around them who have to face the brunt of this illness.

It is what my self from 2015-17 needed. And what so many others need it, to this day.