Mood Disorders in Men 1

Mood Disorders in Men:

Gender Constructs and Diagnostic/Treatment Failures

DuWayne E. Brayton

English 160: College Research and Writing

Professor Rivera

April 9, 2009
 Mood Disorders in Men 2

Abstract

Women are diagnosed with depression at twice the rate of men and the assumption for more than a

hundred years has been that women experience depression at far higher rates than men. Recent studies

have discovered that close adherence to archetypal male gender constructs and gender role conflicts

lead to an emotional repression that interferes with the diagnosis of mood disorders. The implication of

this is threefold. First, it belies traditional assumptions that there is a significant gender disparity that

assumes that women experience depression at such higher rates than men. Second, it demands that

considerably more research go into encouraging helps seeking in men and in the development of gender

specific diagnostic and treatment tools. Finally, it calls for more research into deconstructing

traditional masculine gender constructs that not only have a negative impact on society as a whole, but

cause significant damage to individual men. It is also important to note that these studies have a

profound impact on the field of women's studies and the research into why women experience

depression at such significantly higher rates than men.

 Mood Disorders in Men 3

Mood Disorders in Men:

Gender Constructs and Diagnostic/Treatment Failures

There is no question that women are diagnosed with affective mood disorders at much higher

rates than men. Granted the absolute rates of depression in women are a source of contention, but

multiple studies show that women are diagnosed with major depression and dysthemia at rates double

those of men. A great deal of study has gone into investigating the reasons for this, from biology to

oppression and other social conditions, even certain personality factors. Yet the causes of these higher

rates of depression and mood disorders have continued to elude researchers (Blehar & Oren, 1997, p.2).

It is not unreasonable to assume, based on these findings, that there simply must be something unique

to women, causing this disparity.

Very few psychologists and fewer researchers have considered the idea that rather than being a

women's issue, this disparity might just be a men's issue. It would seem rather difficult to figure out

just what's fueling this disparity, without looking at why men aren't diagnosed with depression at nearly

the rates women are. It would be incredibly hard to find the causal relationship that explains higher

rates of depression in women, if the base assumptions driving that research are mistaken in the first

place. But given the disparate focus of most gender studies on women and women's issues, it's

unsurprising that this seemingly obvious avenue of investigation is mostly lost in the mix.

The Gender Gap Fallacy

The sentiments expressed by Drs. Blehar and Oren are very consistent with the assumptions of

mainstream, modern psychology and women's studies. In their 2003 paper, The Depression Gender

Gap, Ronald Immerman and Wade Mackey actually claim that there is a consistent evolutionary history

at work in these higher rates of depression in women. Because they found that the median ratio of

depression between men and women, in several countries was close to 2:1, they claim this is just a part
 Mood Disorders in Men 4

of what it means to be human. Yet when we look at their own table, we see that while the figures do

come to that median, the ratio is far from consistent.

Figure 1. Site of survey and female to male ratio of prevalence of depression across nations and

communities. Note that three communities listed are expatriate communities in the UK. Note. From

Immerman, R. S., & Mackey, W. C. (2003, February). The depression gender gap: a view through a

biocultural filter. Genetic, Social, and General Psychology Monographs, 129(1), 5-35. Retrieved March

8th, 2009 from the Michigan E-Library, http://mel.org/

Avoiding the obvious logical fallacies that drive the entire notion of evolutionary psychology

that Immerman and Mackey dive into, there remains the important question of how men fit into this

equation. Because the underlying assumption that women experience depression at such significantly

higher rates than men, is called into question by Berger, Levant, McMillan, Kelleher and Sellers (2005),

finding that “ men who score higher on measures of gender role conflict and traditional masculinity
 Mood Disorders in Men 5

ideology tend to have more negative attitudes toward psychological help seeking.” This is probably due

the higher rates of alexythima (difficulty experiencing, thinking about and expressing emotions) in men

with high rates of gender role conflict (A. R. Fischer & Good, 1997). When the population of

comparison, in this case men, are unlikely to seek help for or even recognize that they have a problem,

they are also unlikely to be diagnosed with affective mood disorders. While these papers don't indicate

rates of depression in men, they certainly call into question the disparity in the rates of depression

between women and men.

The Problem of Help Seeking and Diagnosis

More disturbing than the tangential impact these papers have on the question of gender disparity

and mood disorders, are the implications for men and help seeking. The evidence indicates that there is

a substantial segment of the population that has serious problems even recognizing they might have

psychological problems, much less seeking help. The problem is further complicated by generalized

diagnostic criteria which are predicated on the understanding that the patient can identify and describe

their various emotional states. Without compensating for undiagnosed alexythima, or gender conflict

induced emotional disassociation, patients with potentially serious mood disorders will inevitably be

misdiagnosed, undiagnosed or the severity of the diagnosis may be seriously understated.

Mariola Magovcevic and Michael E. Addis , of Clark University have taken the initial steps in

the development of a masculine depressive index (appendix) to help diagnose depression in men who

tend to adhere closely to masculine norms (2008). The methodology is a significant improvement over

that of previous studies because the subjects were screened in for a recent (last three months)

depressogenic events, but the authors are also very clear about the limitations of this study. There is a

great deal more work to be done to develop a coherent and comprehensive diagnostic criteria for

depression in men and this study didn't look at any other affective mood disorders.
 Mood Disorders in Men 6

The obvious isn't always so obvious and therein lies a great deal of trouble when it comes to

dealing with the problems of encouraging help seeking, improving diagnostic criteria and treatment

protocols – this is very new territory. While traditionally the ratio of depression from men to women

has been assumed to be about 2:1, the ratio of bipolar diagnosis, for example, has been fairly even (

Blehar & Oren, 1997, p.2). The implications of higher rates of unipolar depression in men than

previously thought, would imply that the rates of bipolar disorder are also higher than previously

thought. Yet none of the articles cited in this paper and few of the articles read while preparing to write

this paper discuss the possibility of higher rates of any affective disorders besides depression.

The Gender Gap in Gender Studies

Though there have been several solid studies that have indicated these higher rates of depression

in men, there has been very little popular discussion of the findings. The assumption that women

experience significantly higher rates of depression than men is still a fundamental premise of most

women's studies programs. Not because the studies indicating otherwise are flawed, or because they

are being willfully ignored. Rather, they just haven't been noticed. This really shouldn't come as any

surprise to those involved in gender studies, especially men's studies. While virtually every college

with a psychology department has a women's studies program, there are very few that have a specific

men's studies program and there are no graduate men's studies programs in the U.S. An exhaustive web

search for men's studies texts, yields less than a dozen academic journals. In contrast, a cursory web

search turns up more than fifty core women's studies journals.

The most important implication of this evidence is the critical need for more focus on men's

studies for the sake of the mental health of a large segment of society. But there is a secondary

implication here. The findings discussed here have significant relevance to the study of depression in

women. First, it provides evidence that the disparity in diagnosis is considerably different than
 Mood Disorders in Men 7

traditionally considered. Second, this research points to the importance of gender specific diagnostic

and treatment models for depression and other affective mood disorders. It also makes a reasonable

argument for investigating whether gender specific approaches might be appropriate for other

neurological issues.

Men's Studies and Society

There is a broader social implication to the studies discussed here. Archetypal male gender

constructs and gender role conflicts are just as abusive to men, as they often are to women. They foster

emotional repression, health care problems, obsession with achievement and power, problems with

sexual and affectionate behaviors, and homophobia. GRCs often create an outright fear of anything

that could be mistaken as feminine in nature ( Magovcevic & Addis, 2008, p118; Blazina, Settle &

Eddins, 2008, p70). Aside from the impact of archetypal male gender constructs and GRCs on the

mental health and wellbeing of some men, there is also the impact on the rest of society to consider.

Yet while there are a great number of women studying female gender constructs and developing

methods for women to transcend archetypal female gender constructs, very few men are studying

masculine gender constructs. There are unfortunately, more women involved in men's studies than

there are men. This is not to speak poorly of the women who are working in the fields of men's studies

or to disparage their work. It ultimately speaks poorly of men for not stepping up and dealing with

problems of masculinity and men.

The same gender conflicts that drive many men to emotional disassociation are probably largely

responsible for this gender gap in men's studies. It is important to recognize that the underlying

archetypal male gender constructs are a continuum, not a dichotomy (Tremblay & L'Heureux, 2005,

p56). Even though most men avoid the extremes of GRCs, most men still fall somewhere along that

spectrum and experience to some degree many of the problems discussed above. This means that while
 Mood Disorders in Men 8

the manifestation may not be as extreme as those discussed above, they are often prohibitive

nonetheless.

Deconstructing Gender

Women's studies are very important and the focus of gender studies on women's studies is

understandable – most of the people involved in gender studies are women. But it is important to

recognize that the lack of focus on men's studies affects women and even impacts feminine gender

constructs and the socialization of women. The ramifications of masculine gender constructs have a

profound affect on everyone, as do gender constructs across the spectrum. From the health and mental

wellbeing of men, to the impact of GRCs and even the average masculine norms on society as a whole.

The time has long since passed for an increased focus on male gender constructs that goes beyond

looking at whats wrong and focuses on how to make it right.

 Mood Disorders in Men 9

References

Berger, J. M., Levant, R., & McMillan, K. K. (2005). Impact of Gender Role Conflict,

Traditional Masculinity Ideology, Alexithymia, and Age on Men’s Attitudes Toward

Psychological Help Seeking. P sychology of M en & M asculinity, 6(1), 73-78.

doi:10.1037/1524-9220.6.1.73

Blazina, C., Settle, A. G., & Eddins, R. (2008, Winter). Gender role conflict and

difficulties: their impact on college men’s loneliness. The Journal of M en’s

Studies, 16(1), 69-81. Retrieved from http://0-find.galegroup.com.elibrary.mel.org/

Blehar, M. C., & Oren, D. A. (1997). Gender Differences in Depression. Medscape Women’s

Health eJournal. Retrieved April 6, 2009, from MedscapeCME Web site:

http://www.medscape.com/viewarticle/408844

Fischer, A. R., & Good, G. E. (1997). Men and psychotherapy: An investigation of alexithymia,

intimacy, and masculine gender roles. P sychotherapy: Theory, Research, Practice and

Training, 34, 160-170.

Franklin, D. J., Ed. (2003). Women and Depression. In P sychology Information Online.

Retrieved April 6, 2009, from http://www.psychologyinfo.com/depression/women.htm

Immerman, R. S., & Mackey, W. C. (2003, February). The depression gender gap: a view

through a biocultural filter. Genetic, Social, and General P sychology M onographs,

129(1), 5-35. Retrieved from http://0-find.galegroup.com.elibrary.mel.org/

Magovcevic, M., & Addis, M. E. (2008). The Masculine Depression Scale: Development and

Psychometric Evaluation. P sychology of Men & Masculinity, 9(3), 117-132.

doi:10.1037/1524-9220.9.3.117
 Mood Disorders in Men 10

O’Brien, R., Hart, G. J., & Hunt, K. (2007, Fall). “Standing out from the herd”: Men

Renegotiating Masculinity in Relation to their Experience of Illness. International

Journal of Men’s Health, 6(3), 178-200. Retrieved from http://0-

find.galegroup.com.elibrary.mel.org/

Tremblay, G., & L’Heureux, P. (2005, Spring). Psychosocial intervention with men.

International Journal of M en’s Health, 4(1), 55-72. Retrieved from http://0-

find.galegroup.com.elibrary.mel.org/
 Mood Disorders in Men 11

Appendix

Table 2
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Figure 2. The masculine depression index. Note From Magovcevic, M., & Addis, M. E. (2008). The

Masculine Depression Scale: Development and

Psychometric Evaluation. Psychology of Men & Masculinity, 9(3), 117-132.

doi:10.1037/1524-9220.9.3.117