When your man's got the blues

Susan Quilliam outlines what to do if your partner suffers from depression

Depression is almost twice as common in women than in men. However, men suffering from depression are more likely to deny the symptoms, fight shy of treatment, try to cope by drinking too much, end up with a heart attack and be up to four times more likely to kill themselves. These reactions to depression may make it hard for you to even spot that your man is depressed and, if you do, you'll need to handle the problem in a way that may seem counter to your natural instincts.

What causes depression?
Physical factors
Giving birth, life-threatening surgery, a bad dose of the flu and poor nutrition are all physical factors that are linked to depression. Hormone imbalances will make both men and women feel vulnerable, but there's a difference. Women's hormonal triggers for depression are likely to strike at specific times - e.g. before a period, after giving birth. Your man is more likely to suffer because of an ongoing hormonal imbalance. So you may have miserable days or weeks, but he may have miserable months or years.

Emotional factors
Life events such as bereavement, the breakdown of a relationship, feeling socially isolated and feeling unable to communicate with a partner or family can trigger depression and make people feel helpless and hopeless about life. Again, men and women react differently: men are more likely than women to feel down about life events tied up with success, such as job loss and financial problems, as society has a higher expectation of men to be successful than women.

As someone who is expected, in society's terms, to 'protect his loved ones' he's likely to feel depressed by disasters that he feels he should have or could have prevented. For example, if his mother dies, you are attacked or one of the children gets ill, he may well tip into depression, not just because something awful has happened, but also because he feels he should have prevented it.

Different symptoms
Men and women share many of the symptoms of depression, such as anxiety, overeating, insomnia, lack of concentration and loss of pleasure in the good things of life. Whilst women will commonly react by being sad and tearful, your man will be less likely to have these low-energy symptoms. He's been brought up to counter problems with action and he may respond with more energetic emotions, such as frustration, irritation and anger. He may lash out - verbally or physically. He may get ill - depressed men are particularly vulnerable to heart attacks. He may turn to drink or drugs or overwork in a desperate attempt to 'sort' his feelings. He may totally retreat and become suicidal.

Only when he's feeling truly overwhelmed will he retreat and become helpless - and then he'll do it big time, compulsively watching television, surfing the internet or just refusing to interact with you.

Different coping mechanisms
People with depression are often reluctant to admit they have a problem, either because they see mental illness as something to be ashamed of or because they do not recognise it as a condition that needs professional help.

Women are generally better at coping with depression than men and can talk through their concerns with friends or family without being seen as weak. But men often feel uncomfortable articulating their problems.

Your man will typically find it difficult to admit to depression. He may shrug off questions about feeling down. He may internalise his feelings, perhaps even completely cut off from you and from other people so that no one realises how bad he feels. All this may well make him feel better in the short term. But long term, of course, these strategies will not cure the real issues - physical or emotional - so he ends up feeling just as depressed or even worse.

Treatment options
People with depression often resist treatment initially, claiming they are just feeling under the weather or having a bad time at work.

Men are particularly wary of admitting they have a problem and are likely to be particularly suspicious of counselling because they won't believe it can help. Sure, it's a cliche to say that men won't discuss their feelings, but for many men the cliche's true. They want to fix things, not talk about things.

Instead, your man is more likely to be interested in the solutions offered by medication, because then he can see himself as having a physical condition - which isn't his fault - rather than a mental illness with the associated stigma.

Ten things you can do

  1. Recognise that your man's version of depression may differ from yours. Respect his ways of coping with desperation and hopelessness and support him.

  2. Don't be surprised if he feels down without any obvious cause - like you, he can be affected by his hormones. If he's suffered a series of life blows, watch out for depression even if he tells you he's coping.

  3. There's no excuse for addictions or violence - but if your man becomes extremely irritated or has bursts of frenetic but pointless activity, then be sympathetic; this might be depression rather than sheer awkwardness.

  4. Watch out for his trying to cope by denying the problem - shrugging off obviously worrying symptoms or refusing to talk. Be patient and don't put pressure on him; but if he wants to confide, listen sympathetically and without blame.

  5. Go for 'male' rather than 'female' solutions. Don't push him to 'open up about his feelings', but treat his mood as a practical problem that needs to be solved.

    1. Start with a visit to the GP. If antidepressants are prescribed, support your man to keep to the dosage over the months it will take for these to have an effect.

    2. List the factors that may contribute to his depression - job loss, exam failure, financial problems - and help him to take action.

    3. Read Undoing Depression by Richard O'Connor (Berkley Publishing Group, £12.95) and Men and Depression by Theresa Freunds-Chung and Robin Gray (Harper Collins, £9.99).

    4. Contact MINDinfoline (tel: 08457 660 163) for information and support.

    5. Keep telling him - and yourself - that in the vast majority of cases, depression is treatable. If you can help your man understand that however bad he's feeling, he can be cured, then he won't lose hope. And if he doesn't lose hope, then he will almost certainly recover.