Do men and women have the same depression symptoms? Certainly, there's much overlap. But there are often times when our classic visual of what depression looks like tends to miss men altogether. And there are ways that their most common symptoms might not look like depression at first glance at all.

Join us today to talk about all things depression-- and especially to bust some stereotypes of how it comes across.

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Dr. Andrea Bonior: Depression. It's one of the most common psychological disorders there is, and signs of it have been increasing for some time. In the United States especially. Would it surprise you to know that sometimes depression looks profoundly different in men versus women?

Today we're talking about signs of depression and especially how they might look different than the stereotype when it comes to men. A lot of times, depression in men can be missed, not just because there may be more stigma in speaking out about it, but also because it might not be as easily recognizable in friends and family. If you're ready for some specifics about depression signs and symptoms that may not be what you typically think of, you'll want to listen to today's Baggage Check.

Welcome, and thank you for joining me today. It is very good that you're here. I'm Dr. Andrea Bonior, and this is Baggage Check: Mental Health Talk and Advice, with new episodes every Tuesday and Friday. Baggage Check is not a show about luggage or travel. Incidentally. It is also not a show about proper jigsaw puzzle technique. Signs of depression, both in the United States and worldwide, have been increasing for years, and there's evidence that they've spiked further since the pandemic. But while there's a lot of information out there about the classic signs of depression, there's not as much talk of how it might be expressed differently depending on gender. And while the stigma of men seeking help for depression is lessening, it still seems less socially acceptable for men to speak out about their depression. And in fact, sometimes their symptoms don't perfectly align with what we tend to think of as the classic picture of depression. Are, uh, there common male behaviors that we don't realize may actually be signs of deeper issues with mood? The answer to that is yes. Andrea. Yes, there are. So that's what we're talking about today, all the different ways that depression can be overlooked. In men in particular, we might have a stereotype of being overtly sad with depression, for instance, but that's not always the case, especially with men. If you or someone you know has just not been themselves, it's important to pay close attention. Depression, of course, raises the risk of suicide. It also raises the risk of substance abuse, impulsive behaviors, and reckless behaviors. But let's first take a step back and talk about classic symptoms of depression, because it occurs to me that we haven't really focused on depression in our show yet. So I don't want to jump ahead into the specifics of how depression looks different for men without at least talking about some of the basics of what depression tends to look like in more general cases. No doubt we'll have many future shows that focus on depression in particular, and I hope to have some guests to talk about their experiences. But right now, let's go over some of the main ways that depression shows up. People classically think of sadness, as I mentioned, and certainly that can often be the case. But what's a little bit more on target for depression is what we call anhedonia the loss of pleasure. So it's not just being sad. It's the idea that there's no longer that spark, that spark of joy, that spark of interest. Things that used to get you really excited don't really do it to the same extent anymore. You lose interest in things that you used to enjoy. They don't bring you the same pleasure or anticipation. This can often be hard to describe for people who haven't experienced it. It might feel like an emptiness or a darkness or just being cut off from engaging with the world. Social isolation also goes along with this. You might sort of start falling off the planet in terms of getting back to people or saying yes to invitations. You just don't do that anymore. Or you say yes and you just don't show up. A loss of energy, slowing down, feeling very fatigued, that's all very common in classic. Usually there are changes in sleeping patterns. So people sleeping either way more or way less than they used to. They might be in bed all night, but not actually falling asleep. Or they might be sleeping 14 hours a day and still feeling tired. Changes in eating patterns are a classic symptom as well. Maybe somebody starts eating more than they usually do, or maybe experiencing weight gain or binge eating. Or on the other hand, they might have a loss of appetite that actually makes them not that interested in food at all. Maybe makes them skip some meals, forget to eat or lose weight. There are lots of cognitive symptoms that go along with depression. Things about your thoughts, difficulty concentrating, feeling overwhelmed by small decisions and choices of daily life. Feeling helpless or hopeless or worthless. A sense of worthlessness is very common in folks struggling with depression. People with depression may be very angry at themselves or have high levels of guilt or shame. They may replay things frequently in their head, things that they did wrong, mistakes that they've made. People with depression may be preoccupied with death. They may be having active suicidal thoughts. And that's something to take very seriously. In the United States, the National Suicide Prevention Lifeline can now be reached by just dialing 988 or by visiting the website 988Lifeline.org. Take all of these symptoms seriously in your friends and your family and in yourself. But as I mentioned, what I want to do a little bit of a deeper dive into today is the way that depression symptomology might look different in men and boys for that matter. Men certainly tend to experience many of the same symptoms that I just mentioned, but it also might be a little masked. So here are eight extra signs of depression that might be more common to see in males. And they do run the risk of being mistaken for something other than depression or dismissed altogether. Of course, none of these signs alone absolutely mean that somebody's experiencing depression, but they're worth paying attention to. M number one increased anger and irritability. Irritability and anger are very common in depression, but they might be more externally expressed in men. Again, I'm talking in generalities here. There's certainly a ton of overlap among people with different expressions of depression. But you might see in men more snapping at their partners, maybe even becoming more aggressive with strangers. They might be seen as just being in a more foul mood, even if it doesn't seem like sadness. They might be more negative and cynical with how they talk about work. They might be less forgiving, less patient, more likely to lose their cool. Maybe it starts turning into things like road raging or even getting into fights, getting physically aggressive. I think it's very common to just see men as getting angry or stressed without necessarily saying that it could be symptoms of depression. But that's really important to pay attention to. Number two reckless behavior. This is another common manifestation of depression in men in particular. Now, of course, certain types of reckless behavior could be seen as, ah, signs of bipolar disorder. A, uh, manic phase, which today we're just mainly talking about. Depression will certainly revisit bipolar disorder in the future. But when depressed men might start showing less conscientiousness about their health or their safety or their finances, maybe they're driving faster than they usually do. And again, that could also be anger and irritability and aggressiveness as well. Maybe they're making reckless financial choices that they wouldn't normally engage in. They're trying to lose themselves in gambling or some illadvised crypto scheme, or just spending more money online impulsively. Maybe they're just being harder on their bodies, getting injured more because they're just not bothering to take care of themselves or treat themselves well, which is one of the fundamental tenets of depression when you think about it. Number three increased substance abuse. A lot of men, and certainly women and a lot of other folks try to mask their emotional pain through substance use. But in general, I think men's can be more overt. And we might be lured into thinking something's just a willpower problem with how much they're drinking, rather than being a deep seated psychological issue. So drinking more, using more marijuana, being under the influence of anything more is very common among depressed men. They might be digging themselves into a financial hole with how much they're using. They might be experimenting with drugs that could potentially be very detrimental to their body, taking risks again, that they wouldn't normally take. They might be spending more time drunk or hung over or high. You might see it impair their lives more. Maybe they miss work, or they fall into bad patterns, or they're not as available a parent to their children. It's really important to pay attention to, and it's not hard to imagine how dangerous this can be. Number four sexual symptoms. For a lot of men, a loss of interest or pleasure is manifest in their sex drives. If their sex drives have plummeted or their sex drives just don't exist anymore, maybe it's more subtle though. They've gradually started to lose interest or initiative in sex. Or they have other types of changes. Like sex itself becomes different. Maybe more aggressive or less romantic with their partner. Maybe their partner notices this, that something feels off that they're disengaged. Or maybe they're seeking out sexual experiences that they wouldn't normally seek out as a mask for their depression. They're making choices that aren't good for them or their relationship. Or they're increasingly seeking out porn or seeking out sex workers or seeking out affair partners. So any kind of change in this area or anything that's getting in the way that has to do with sex, it's definitely something to pay attention to. And depression could be at the root of it. Number five increasingly losing themselves on screens. I know we probably have a stereotype of a 25 year old dude sitting in his parent's basement playing video games, but I've seen this cycle over and over again in terms of depression. We might look at it culturally as a failure to launch or what we might call screen addiction. But either way, we're talking about somebody feeling trapped in a cycle of playing video games over and over again and it getting in the way of their life. Oftentimes that immersive world of screens can be an escape for the helplessness and the darkness of depression. Or maybe it's not video games per se, but it's somebody disengaging with the life in front of them more and more and more by being on their smartphone all the time, passively scrolling so that they can tune out the world and tune out their loved ones. And their loved ones are taking notice. Let's face it, going on a screen is one of the most accessible and um, available itch scratchers that there is when it comes to avoiding uncomfortable feelings. So it's often ground zero for depressed people. And of course, if it makes them feel worse because they're not being as productive or as social as they'd like to be, then that's going to become a vicious cycle. Number six stopping taking care of themselves physically again. I think we have a little bit of a stereotype here that can be off the mark. The bachelor pad and what that looks like and what goes into it. But when you really start to see things take a turn, people not changing clothes, letting the recycling and trash pull up their fridge is completely empty except for some ketchup packets. That's a sign that maybe some helplessness has set in, um, that they're losing a bit of spark in terms of wanting to take care of themselves and nourish themselves. And of course, this feeds on itself. Once you've gotten used to not showering for a couple of days, for instance, showers can feel like all too much effort to put in. Once you've stopped brushing your hair or shaving, it can become the status quo pretty easily. Or maybe somebody who always used to make a point to work out has stopped completely because after a few weeks it feels impossible to start up again. And of course, uh, that's a vicious cycle because exercise really does have some solid data about helping with depression symptoms. Once somebody starts digging themselves into that hole and they're just not feeling particularly presentable or attractive or healthy, that lack of self confidence or that feeling down on themselves can just start a vicious cycle. Number seven emotional flattening or disconnection. As we've mentioned, men may be less likely than women to say they're sad or to seem sad when they're depressed. It might be more of a sense of detachment or emptiness. They're just starting to disengage. They forget an important work deadline, or they don't seem to care about their upcoming birthday. You might even see it in their facial expressions or their tone of voice that things just got flatter. They don't seem to be as connected to anything anymore. They forget more things. Of course, this goes hand in hand with the anecdonia that we talked about a lack of spark, a lack of energy, a lack of motivation, a lack of pleasure, and what they normally would find pleasure in. But it also can be about just not keeping up with responsibilities, not being on top of things that they normally were on top of. It's worth taking seriously. And then, finally, number eight. Somaticizing this is the idea that maybe they're not saying that they're experiencing psychological or emotional symptoms, but there have been a lot of increased physical issues. They're experiencing gastrointestinal stuff or chronic back pain or headaches when they didn't used to have headaches before. There's some evidence that culture matters when it comes to how we experience physical symptoms of depression. And part of this might be our own expectations about what's acceptable. To express the stigma of saying I feel depressed and sad versus saying my body hasn't felt good, for instance. The latter may be deemed more acceptable in many cultures. And I think when we bring masculinity into the equation, it can be true here too. And of course, the stress response itself, or depression itself, can be very hard on the body. So we're not talking about anybody faking, but just more where the focus is. Of course, whenever there's physical stuff going on, a full medical workup is always a good idea. But sometimes when new aches and pains and physical issues crop up, there may be an emotional cause as well. So I hope it was helpful to hear some of these symptoms. Remember, no two people are alike, no matter what their gender. And it's important to reach out and connect if you're concerned about somebody and ask them how you're feeling, express your concern again, I hope to have many future shows where we really get into the nitty gritty of depression. Real stories that, uh, defy the stereotypes. And it might be surprising to you, but for now, I hope this is giving you something to think about. I appreciate you having been here with me.

Thanks for joining me today. Once again, I'm Dr. Andrea Bonior, and this has been Baggage Check, with new episodes every Tuesday and Friday. Join us on Instagram @BaggageCheckPodcast. Give us your take and opinions on topics and guests. And you know you've got that friend who listens to, like, 17 podcasts. We'd love it if you told him where to find us. Our original music is by Jordan Cooper, cover art by Daniel Merity and my studio security? It's Buster the dog. Until next time, take good care.