Depression in Men

As a middle-aged man, I am at a point in my life when the idea of seeing a doctor for any reason has become a bit threatening. I am frightened of what the doc may find when he starts poking and prodding my aging body. As with any machine, the body begins to break down, and even with regular maintenance (exercise, meditation, and good food), it is still going to develop some minor problems.

But I guess it only makes sense to take it in for a bit of overhaul work—you know, that beyond-the-surface look into the deeper depths of this temple. The physical aspect of this feat is often daunting for us guys; after all, aren’t we supposed to be able to just pick ourselves up and keep on moving? And then there’s another arena we rarely want to examine: the mental aspect of our health. Depression and anxiety may go undiagnosed for years.


These mental problems may hide beneath the surface of “grumpy old men,” “workaholics,” or “isolated, moody grandpas.” Men are diagnosed with depression and anxiety much less often than women, but in terms of success at suicide we are far more effective. It is ironic that we won’t let ourselves be vulnerable to the diagnoses of these problems, but we will take action to end the pain.

Depression in men is often misunderstood because the symptoms are not always the classic symptoms of depression. Some usual symptoms of depression are problems sleeping and eating, lack of energy, poor concentration, thoughts of death or suicide, and not enjoying the hobbies you used to enjoy. For men, however, the typical symptoms may be more like edgy emotions, quickness to anger, isolation, always working, watching excessive TV, loss of interest in sex, thoughts of suicide, and poor energy. These symptoms often coincide with the aging process, so we may just attribute them to getting older and not give any thought to the possibility that we might be able to do something about it. We just keep on “showing up,” but really lack the emotional involvement we used to have.

First, we need to understand that depression and anxiety are very treatable. The research is clear: Both psychotherapy and medicines can have a real impact. If you are opposed to one of these treatments, the other is likely to be effective. If you try one treatment and it is not useful, then a combination of treatments may be more useful.

Here is the main point: If you think on some deeper level that you might be depressed or anxious, talk to someone about it. You don’t have to wait for your doctor to poke or prod you about it. You can bring it up with your spouse, a friend, the doc, a nurse educator, or a mental health professional. All you have to say is “I am worried that I might be depressed” and let the other person help you deal with the issue and find treatment. You do not have to suffer in silence; to be a truly “strong man,” have the courage to get the help you need now.

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Joe Nelson: Joe is a psychotherapist in private practice in Minnesota, where he specializes in the psychology of chronic disease and sexual problems and works with couples, families, children, and teens. He has been a Licensed Psychologist since 1985 and has earned a master’s degree from St. Mary’s College Winona, a bachelor’s degree in social work from the University of Minnesota, and an associate’s degree in human services from the College of DuPage in Glen Ellyn, Illinois.

Joe has worked with troubled youth in Chicago and Minnesota and on a special project on Turtle Mountain Reservation in North Dakota. He was the first social worker hired by an affiliate of the American Diabetes Association. He worked at the International Diabetes Center for 20 years, directing psychological services there for 12 years. A Certified Sex Therapist, Joe co-developed the Sexual Health Center at Park Nicollet Clinic.

Having practiced meditation for over 30 years, Joe offers instruction in mindfulness-based meditation to patients in groups and as individuals. Joe is married, has a 23-year-old daughter, and enjoys scuba diving, motorcycling, golf, and being outdoors doing almost anything.

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