Men Get Mad Not Sad

madThere are hundreds of papers written about why it is that women have a much higher rate of depression than men. A new article published in the journal JAMA Psychiatry (August 28, 2013) suggests that some if not all of that difference may have to do with the fact that men express and experience depression differently.


The authors of the paper, who are researchers at the University of Michigan reanalyzed results from the National Comorbidity Replication Survey (which is the largest study of psychiatric diagnoses in the general population), using two scales—the Gotland Male Depression Scale and the Masculine Depression Scale— in order to test the hypothesis that some of the difference in frequency of depression is an artifact of the diagnostic criteria (which gives more weight to the more “typical” female symptoms of sad mood and low energy). The two scales measure symptoms that have been hypothesized to be more typical of men who are depressed (who turn their upset outward or try to distract themselves from their feelings), these include anger attacks/aggression, using substances and taking risks.
Using the male depression scales researchers found that the proportion of people who met criteria for depression reversed itself and more men (26.3 percent) than women (21.9 percent) met criteria for depression. When they considered both “female type” and “male type” symptoms the researchers found men and women had roughly equal amounts of depression: 30.6 percent for men and 33.3 percent for women.“Although men were likely to endorse many traditional depression symptoms, men were significantly more likely to report symptoms of anger attacks/aggression, irritability, substance abuse, and risk-taking behaviors over symptoms such as withdrawal from friends, sleep problems, and feelings of complaintiveness,” the authors of the paper wrote. “These results suggest that relying only on men’s disclosure of traditional symptoms could lead to an underdiagnosis of depression in men and that clinicians should consider other clues when assessing depression in men.”
One final word, though, you may have noticed that the percentages of folks who met criteria for depression is this study was much higher (roughly double) what is usually seen in studies. In other words, if you include more symptoms you get more people who meet criteria. Whether the male depression scales actually capture a condition that is clinically significant is a question not yet answered.