Source - http://www.latimes.com/
By - Melissa Healy
Category - Hotels In Northern California
Posted By - Hampton Inn Santa Clarita
Depression can look very different in men and women. And many of its hallmarks — rage, risk-taking, substance abuse and even workaholism — can hide in plain sight.
Now researchers say that
when these symptoms are factored into a diagnosis, the long-standing
disparity between depression rates in men and women disappears.
That conclusion overturns long-accepted statistics indicating that,
over their lifetimes, women are 70% more likely to have major depression
than men. In fact, when its symptoms are properly recognized in men,
major depression may be even more common in men than in women, according
to a study published Wednesday by the journal JAMA Psychiatry.
The findings help unravel a mystery that has long puzzled mental health authorities: If men are so much less likely than women to be depressed, why are they four times more likely to commit suicide?
"When it comes to depression in men, to some extent we have blinders
on," said Dr. Andrew Leuchter, a psychiatrist who studies depression at UCLA. "We have not been asking about and taking into account a range of symptoms that may be gender-specific."
Health policy researchers from the University of Michigan and Vanderbilt University
set out to test the feasibility of two new checklists that might
diagnose depression in men as well as women with greater accuracy.
In addition to familiar depression symptoms such as sadness,
difficulty sleeping, feelings of guilt or worthlessness and loss of
interest in pleasurable activities, the researchers expanded the list to
include anger attacks, aggression or irritability, substance abuse,
risk-taking behavior and hyperactivity. They devised two scales — one
designed to be gender-neutral and one tuned toward the way the disease
manifests itself in men.
The researchers tested these diagnostic criteria in a group of nearly
5,700 American adults who had been interviewed as part of a long-term
study of mental health organized by researchers at Harvard Medical School; 41% of the participants were men.
The results of the analysis were striking.
When assessed using the "gender inclusive depression scale" that
included widely recognized depressive symptoms such as sadness and
hopelessness as well as symptoms commonly seen in men, 30.6% of men and
33.3% of women were found to have experienced a depressive episode at
some point in their lives. In research terms, that gap between men and
women was so narrow it may have been a statistical fluke.
And when the subjects were evaluated with the "male symptoms scale,"
26.3% of men and 21.9% of women were said to have experienced a major
depressive episode in their lifetimes. That difference was large enough
that it could not be due to chance, the researchers reported.
"Everything we think we know about depression is a reflection of how we defined it to begin with," Leuchter said.
That bias, he added, may have fostered the perception that depression
is predominantly a "woman's disease" — and that men don't need
treatment for emotional suffering.
Sigmund Freud, the father of psychiatry, portrayed depression as rage
turned inward. But for many men today, depression's rage appears not so
much directed at oneself as it is spat outward — at spouses, co-workers
and friends.
While women may not feel shame in acknowledging their sadness and
sagging self-esteem, mental health experts find that depressed men often
respond to such feelings with actions that look like their opposite:
They bluster and bully. They throw themselves into harm's way. They numb
themselves with sex, drugs and endless workdays.
If the emotional pain of many men is to be understood for what it is,
depression's definition should be expanded to include these
"externalizing" symptoms — the opposite of "internalizing" symptoms that
have long defined depression, some mental health professionals argue.
"These findings could lead to important changes in the way depression
is conceptualized and measured," the study authors concluded.
If psychiatrists update their official diagnostic criteria to reflect
these gender differences, that would be only a first step, Leuchter
said.
Doctors, including primary care physicians who now diagnose most
depression, would have to be educated to look for an expanded set of
symptoms, he said. Researchers would not only need to understand how
seemingly separate diseases such as substance abuse and depression
relate to each other, they would also need to assess whether the
treatments currently available — antidepressants and talk therapy —
would help men with these symptoms, he said.
For men as well as women, the checklists now in wide use to diagnose
depression may fail to capture the experience and language of the
emotional distress they feel, said study leader Lisa Martin, a health
policy studies professor at the University of Michigan.
