Depression is a widespread medical condition worldwide. However, depression doesn’t always present as people think it would, and many men are raised or influenced by circumstances to ignore or pretend they don’t have it.
Do you know that men are about 4 times more likely to die by suicide than women, but women are twice as likely as men to be diagnosed with depression? This happens mostly because of underreporting and misdiagnosis.
Millions of men are walking around with a compromised nervous system and don’t realize that the irritability, fatigue, or pain is a treatable, physiological condition.
Depression can cause several problems, including chronic fatigue, relationship destruction, cardiovascular disease, and a severely shortened lifespan.
What Is Depression?
Depression isn’t sadness. Sadness is a normal reaction to challenging situations. Depression is a medical disorder of brain chemistry, hormonal regulation, and nervous system function that continues despite life’s circumstances and does not go away just because things get better in life.
From a clinical point of view, depression is considered Major Depressive Disorder (MDD) if a person has five or more of its core symptoms for at least two weeks.
The World Health Organization estimates that depression ranks as one of the biggest causes of disability in the world. Every year in the United States, about 16 million adults suffer from a major depressive episode.
Types of Depression in Men
There are various forms of depression, and understanding the type that you may have is important in determining the right treatment:
Major Depressive Disorder (MDD): This is the most common type and is marked by a persistent low mood, loss of interest, and a group of physical and psychological symptoms that last for at least 14 days. It may happen once or many times.
Dysthymia: It is a milder version of depression that is persistent over a period of 2 years or more. Many men who have dysthymia are fine on the outside, but feel empty on the inside all of the time.
Seasonal Affective Disorder SAD: This type of depression occurs seasonally. It gets worse in the winter months when daylight hours are shorter. It is highly relevant in Texas, primarily in late fall and winter.
Melancholic Depression: This type is defined by a total lack of any experience of pleasure, or anhedonia. Men with this type tend to get up hours before the alarm and feel worse in the morning. They lose their appetite, weight, and withdraw completely. This is usually caused by very low levels of testosterone.
Situational Depression: This depression is caused by a particular circumstance in a person’s life, such as losing a job, separation from a partner, the death of a loved one, or financial strain. It is more intense and longer lasting than a typical grief or adjustment reaction.
What Causes Depression in Men?
The following are some of the key causes of depression in men:
1. Biological Causes:
Depression is associated with abnormalities in multiple neurotransmitter systems, particularly serotonin, norepinephrine, and dopamine. These hormones control your mood, drive, pleasure, energy, and sleep.
Sometimes, it begins in your gut. Your gut and the brain are physically connected by the vagus nerve. When you have a hidden gut infection, chronic dysbiosis, or leaky gut, systemic inflammation directly affects your brain functioning.
Low testosterone is an important and often overlooked cause of depression, especially in men. Testosterone has a direct effect on mood, motivation, energy, and libido. Men with clinically low testosterone (hypogonadism) have significantly higher rates of depression.
2. Genetic Factors
Depression runs in families. The risk of developing depression is double if you have a first-degree relative with depression.
3. Psychological Causes
One of the most frequent causes of depression in men is significant life stressors. The most common causes of depression in men are:
- Job loss
- Career setbacks
- Relationship breakup or divorce
- Grief
- Becoming a new father
- Retirement
- Health problems
- Financial stress
- Unprocessed trauma
4. Social and Cultural Factors
Culture plays a direct role in how depression develops and persists in men. Traditional masculine norms, such as the expectation of stoicism, self-reliance, and problem-solving ability, serve as a strong barrier for men to seek help. Many communities in Texas and the South have these cultural traditions.
Because of this, many men with depression fail to seek help until they have suffered the condition for months or years, and it has already become a serious problem.
Depression Symptoms in Men
Men and women experience depression in different ways. Because Many men with clinical depression do not cry and do not describe feeling sad. Most commonly overlooked depression symptoms in men include:
- Hopelessness
- Feeling empty
- Irritability
- Anger
- Low frustration tolerance
- Physical symptoms like chronic back pain, headaches, digestive problems, and chest tightness
- Loss of interest in things you used to love
- Increased alcohol use
- Pulling away from friends and family
- Ongoing conflict with family, partner, or spouse
- Obsessive sports involvement
- Spending a lot of time at work
- Controlling Behavior
- Abusive Behavior
- Unsafe behaviors like reckless or aggressive driving
- Trouble making decisions
- Trouble falling or staying asleep
- Thoughts of death
If you have been irritated, physically exhausted, drinking way more than normal, and withdrawn from things you used to enjoy for over 2 weeks, this is not a stress phase. These are signs of depression in men and must be evaluated by a clinician.
Postpartum Depression in Men
When people think of new parents and mental health, they almost exclusively focus on the mother. However, postpartum depression in males is a well-documented, very real medical condition, and it goes completely under the radar! Studies suggest that about 10% of new fathers suffer from postpartum depression.
A man’s testosterone is typically reduced by up to 30% upon the birth of a child. This directly raises the risk of depression in males.
Men don’t have a sudden decrease in estrogen, but they have a major hormonal and lifestyle shock. Men don’t get screened for postpartum depression and end up suffering in silence, sometimes drinking or working overtime to avoid the pressure at home during this joyful time.
When fathers experience postpartum depression, it affects more than just them. Studies have shown that impaired father-infant bonding due to fathers’ postpartum depression can be responsible for behavioral or emotional difficulties in children.
How Is Depression Diagnosed?
No blood tests can be used to diagnose depression. The diagnosis is made with careful assessment of your symptoms, their duration, and the impact on your function. Here’s how it is diagnosed:
PHQ-9 or PHQ-2 screening questionnaire: A depression severity instrument that gives a baseline score and can be used to monitor the patient’s progression through treatment.
Testosterone and hormone panel (total and free testosterone, SHBG, LH, and FSH). Men with low testosterone levels can be clinically depressed and should be evaluated.
Sleep assessment: Sleep apnea is underdiagnosed in men and can lead to significant daytime tiredness, emotional instability, depression, and impaired cognitive function. A sleep study is recommended if there is any evidence of the presence of sleep-disordered breathing.
Thyroid function: Hypothyroidism can lead to symptoms similar to those of depression, which can be mistaken for primary depression. TSH and Free T4 are essential baseline labs for checking for thyroid dysfunction.
Metabolic panel and CBC: All anemia, blood sugar dysregulation, and liver function changes can cause fatigue, mood changes, and cognitive changes that may mimic depression.
Vitamin D level: Vitamin D deficiency is strongly associated with depression and is extremely common, especially in men who work indoors. A 25-OH vitamin D level is a standard test used to check this deficiency.
Full clinical history: Your provider will try to know your alcohol and substance history, recent life events, family history of depression, work and relationship context, and physical activity levels. This is the information used to make your treatment plan.
Standard Medical Treatment and Why it Fails So?
Commonly-used medications for depression are SSRIs (Selective Serotonin Reuptake Inhibitors) such as Zoloft or Lexapro.
The problem is many men are depressed, not because of a lack of serotonin, but because of unchecked inflammation, grossly low T levels, or elevated cortisol levels. The use of SSRIs will not resolve these problems.
In addition, antidepressant medications have side effects that can be harmful for men, such as weight gain and severe sexual dysfunction.
For a man who already feels he is losing his edge, losing his libido and ability to perform often makes the depression much worse.
Who’s Most at Risk?
The following group of men is at a higher risk of developing a depressive disorder:
- Untreated sleep apnea and chronic snoring men
- Those with the Provider Burden.
- Individuals who have metabolic syndrome. Too much belly fat turn testosterone into estrogen, they may experience “andropause” and depression.
- Men who have history of head trauma like sports, car accidents or military service stress
How to Deal with Depression for Men?
This is exactly what you need to do:
Check Your Biology: First, don’t talk to a therapist, you have to look at your biology with a deep dive hormone and inflammation panel. Request a full blood panel that checks total and free testosterone, a full thyroid panel, fasting insulin, Vitamin D, and a high-sensitivity CRP. If you don’t know what chemicals are off, you can’t correct a chemical imbalance.
Rule Out Sleep Apnea: If you wake up unrefreshed or snore, get a home sleep study. The quickest way to get rid of brain fog and reduce cortisol is to fix your oxygen at night.
Challenge with intensity: Men’s brains love a good workout! You must engage in heavy resistance training or high-intensity interval training. This is because, weightlifting directly increases your dopamine and testosterone.
Avoid Inflammation Drivers: Your brain cannot heal if it’s on fire. Try to cut back on refined sugars, processed seed oils and excessive alcohol consumption right away. Eat good quality protein, healthy fats (particularly omega-3 from wild caught fish), and cruciferous vegetables to reduce inflammation in your body.
Consider Targeted Amino Acid Therapy: Don’t go to SSRIs right away, try targeted precursors first. If you’re very unmotivated and unenthusiastic about life, L-Tyrosine can help restore dopamine. 5-HTP or GABA can help to calm an overactive nervous system when anxiety is high.
If you have thoughts of self harm or suicide, this is a medical emergency. Call or text 988 the Suicide and Crisis Lifeline, available 24/7 across the United States, including Texas. If you are in immediate danger, call 911 or seek help at the nearest emergency room.
Bottom Line
Depression is one of the most treatable and preventable causes of suffering, broken families and lost potential. It can be present for years, masked as anger, a demanding work ethic, or a midlife crisis, until it present itself as a heart attack, a divorce, or a severe health crisis.
At Kairos Integrative Care, Lola, one of our integrative health practitioners, will look at your advanced lab work and create a personalized, easy-to-follow plan to rebalance your brain chemistry, optimize your testosterone, and help you get your edge back, without relying solely on a prescription.
We see patients in Houston, Sugar Land, Richmond, and nearby areas (77046 & 77478) and accept major insurance plans, including Blue Cross, Aetna, Ambetter, Cigna, and more.
New patients are always welcome, and if visiting the clinic isn’t possible, telemedicine appointments are available across the entire state of Texas.
Book your appointment today and enjoy a healthier holiday season.
