Sex and Depression: A Gender-Specific Approach to Healing

By Jed Diamond, PhD, LCSW

Depression runs in my family. I became aware of that fact when my father took an overdose of sleeping pills when I was five years old. Growing up I had little understanding of what had happened or why he was hospitalized and disappeared from our lives. But I did grow up with a hunger to understand depression and a terror that I would become depressed myself and face my own suicidal demons.

When I was 40 and going through my own bouts of depression, I found a journal my father had written in the year before he was hospitalized and I got a better understanding of his suffering and my own. Here are a few of the entries:

June 4th: 

Your flesh crawls, your scalp wrinkles when you look around and see good writers, established writers, writers with credits a block long, unable to sell, unable to find work. Yes, it’s enough to make anyone, blanch, turn pale and sicken.

August 15th:

Faster, faster, faster, I walk. I plug away looking for work, anything to support my family. I try, try, try, try, try. I always try and never stop.

November 8th:

A hundred failures, an endless number of failures, until now, my confidence, my hope, my belief in myself, has run completely out. Middle aged, I stand and gaze ahead, numb, confused, and desperately worried. All around me I see the young in spirit, the young in heart, with ten times my confidence, twice my youth, ten times my fervor, twice my education.

Yes, on a Sunday morning in early November, my hope and my life stream are both running desperately low, so low, so stagnant, that I hold my breath in fear, believing that the dark, blank curtain is about to descend.

Six days after his November 8th entry, my father tried to end his life. Though he survived physically, emotionally he was never again the same. For nearly 40 years I’ve treated more and more men who are facing similar stresses to those my father experienced. The economic conditions and social dislocations that contributed to his feelings of shame and hopelessness continue to weigh heavily on men today.

During that period my mother also became depressed, but it was quite different than my father’s experience. Where he was often irritable and angry, she was more often sad and weepy. While he pushed people away who wanted to help him, she drew close to her friends and neighbors. In working with men and women over the years I’ve found other differences in the ways males and females deal with their pain and suffering. Here’s a summary of my experience.

Female: Blames herself; Male: Feels others are to blame

Female: Feels sad, apathetic, and worthless; Male: Feels angry, irritable, and ego-inflated

Female: Feels anxious and scared; Male: Feels suspicious and guarded

Female: Avoids conflict at all costs; Male: Creates conflicts

Female: Tries to be nice; Male: Overtly or covertly hostile

Female: Withdraws when feelings are hurt; Male: Attacks when feelings are hurt

Female: Has trouble respecting self; Male: Demands respect from others

Female: Feels born to fail; Male: Feels the world has set him up to fail

Female: Slowed down and nervous; Male: Restless and agitated

Female: Chronic procrastinator; Male: Compulsive time keeper

Female: Sleeps too much; Male: Sleeps too little

Female: Trouble setting boundaries; Male: Rigid boundaries and need for control

Female: Feels guilty for what she does; Male: Feels ashamed for who he is

Female: Uncomfortable receiving praise; Male: Frustrated if not praised enough

Female: Finds it easy to talk about weaknesses and doubts; Male: Terrified to talk about weaknesses and doubts

Female: Strong fear of success; Male: Strong fear of failure

Female: Needs to “blend in” to feel safe; Male: Needs to be “top dog” to feel safe

Female: Uses food, friends, and “love” to self-medicate; Male: Uses alcohol, TV, sports, and sex to self-medicate

Female: Believes her problem could be solved if only she could be a better (spouse, co-worker, parent, friend); Male: Believes his problems could solved if only his (spouse, co-worker, parent, friend) treated him better

Female: Constantly wonders “Am I loveable enough?”; Male: Constantly wonders “Am I being loved enough?”

Likewise, understanding the difference ways that men experience depression can save millions of men’s lives who might otherwise be lost.  We know that the suicide rate for males in the U.S. is 3 to 18 times higher than it is for females.  Many men die and suffer from undiagnosed and untreated depression because we haven’t understood the ways in which male depression manifests.

Gender-Specific Medicine Saves Lives

For too long, we’ve assumed that sex and gender differences are not important in health care. But a new field of gender-specific medicine is emerging that can save lives. We now know that there are differences in everything from rheumatoid arthritis to Alzheimer’s.  For instance, it was once thought that symptoms of an impending heart attack were the same for women and men. Now we know that women often have different symptoms than men and millions of women are getting proper treatment as a result.

I have made it my life quest to help men, and the women who love them, to live well at all stages of their lives. At MenAlive our team brings together people and resources from all over the world to help people realize their dreams of a fulfilling life. I hope you’ll join us. Please use this blog as a resource and share with a family member or friend that would benefit. Together we can heal.

Males are more likely to act out their inner pain and turmoil, while women are more likely to turn their feelings inward.Certainly there are depressed men who fall on the female side and vice versa, but generally I’ve found these differences to hold true for most depressed men and women I’ve worked with over the years.

Jed Diamond, PhD, MCSW, is the Founder and Director of the MenAlive, a health program that helps men live long and well. Though focused on men’s health, MenAlive is also for women who care about the health of the men in their lives. Diamond’s book, MenAlive: Stop Killer Stress with Simple Energy Healing Tools, brings together the wisdom accumulated in 40 years helping more than 20,000 men, women, and children.