Abstract
A large corpus of epidemiological research indicates a differential prevalence of depression by gender, with men experiencing depression at about half the rate of women. On the one hand, some researchers have argued that this is a true difference, with men more resilient to depression due to adaptive coping mechanisms and protective psychological orientations such as engaging in distracting activities and avoiding negative rumination. On the other hand, others have argued that the differential rates are largely artefactual, with male cases missed due to systematic measurement and diagnostic biases in clinical practice and epidemiological research. This has led to lively debate about the true nature and prevalence of male depression, leading to the development of emerging concepts such as male depressive syndrome and paternal postpartum depression. This chapter analyses and discusses this literature, while also providing an in-depth examination of various risk factors for male depression including: (i) low educational attainment; (ii) unemployment and financial strain; (iii) disability; (iv) homosexual orientation; (v) divorce; and (vi) ethno-racial status. Of note, surveys indicate that rates of health service utilization for depression are considerably lower for men compared to women, meaning that many men continue to suffer this serious mental disorder in silence.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Addis, M. E. (2008). Gender and depression in men. Clinical Psychology: Science and Practice, 15(3), 153–168. https://doi.org/10.1111/j.1468-2850.2008.00125.x
American Psychiatric Association (APA). (2013). Substance-related and addictive disorders. In In Diagnostic and statistical manual of mental disorders (5th ed.). Association.
American Psychological Association (APA). (2018, August). APA guidelines for psychological practice with boys and men. American Psychological Association. Retrieved July 23, 2020, from https://www.apa.org/about/policy/boys-men-practice-guidelines.pdf
Artazcoz, L., Benach, J., Borrell, C., & Cortès, I. (2004). Unemployment and mental health: Understanding the interactions among gender, family roles, and social class. American Journal of Public Health (AJPH), 94(1), 82–88. https://doi.org/10.2105/AJPH.94.1.82
Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: Current perspectives. Neuropsychiatric Disease and Treatment, 15, 603–609. https://doi.org/10.2147/NDT.S128584
Bengs, C., Johansson, E., Danielsson, U., Lehti, A., & Hammarström, A. (2008). Gendered portraits of depression in Swedish newspapers. Qualitative Health Research, 18(7), 962–973. https://doi.org/10.1177/1049732308319825
Blumberg, S. J., Clarke, T. C., Blackwell, D. L. (2015). Racial and ethnic disparities in men’s use of mental health treatments. NCHS data brief no. 206. National Center for Health Statistics (NCHS). Retrieved July 23, 2020, from https://www.cdc.gov/nchs/data/databriefs/db206.pdf
Case, A., & Deaton, A. (2020). Deaths of despair and the future of capitalism. Princeton University Press.
Cox, J. (2005). Postnatal depression in fathers. The Lancet, 366(9490), 982. https://doi.org/10.1016/S0140-6736(05)67372-2
Davis, L., Uezato, A., Newell, J., & Frazier, E. (2008). Major depression and comorbid substance use disorders. Current Opinion in Psychiatry, 21(1), 14–18. https://doi.org/10.1097/YCO.0b013e3282f32408
Degenhardt, L., & Hall, W. (2001). The relationship between tobacco use, substance-use disorders and mental health: Results from the National Survey of Mental Health and Well-being. Nicotine & Tobacco Research, 3(3), 225–234. https://doi.org/10.1080/14622200110050457
Department of Justice Canada. (2000). Selected statistics on Canadian families and family law: 2nd. Department of Justice Canada. Retrieved April 20, 2021 from https://www.justice.gc.ca/eng/rp-pr/fl-lf/famil/stat2000/pdf/stats.pdf
Diala, C. C., & Muntaner, C. (2003). Mood and anxiety disorders among rural, urban, and metropolitan residents in the United States. Community Mental Health Journal, 39(3), 239–252. https://doi.org/10.1023/A:1023342307323
Eaton, W. W., Shao, H., Nestadt, G., Lee, B. H., Bienvenu, J., & Zandi, P. (2008). Population-based study of first onset and chronicity in major depressive disorder. JAMA Psychiatry, 65(5), 513–520. https://doi.org/10.1001/archpsyc.65.5.513
Erickson, J., El-Gabalawy, R., Palitsky, D., Patten, S., Mackenzie, C. S., Stein, M. B., & Sareen, J. (2016). Educational attainment as a protective factor for psychiatric disorders: Findings from a nationally representative longitudinal study. Depression and Anxiety, 33(11), 1013–1022. https://doi.org/10.1002/da.22515
Esch, P., Bocquet, V., Pull, C., Couffignal, S., Lehnert, T., Graas, M., Fond-Harmant, L., & Ansseau, M. (2014). The downward spiral of mental disorders and educational attainment: A systematic review on early school leaving. BMC Psychiatry, 14(1), 237. https://doi.org/10.1186/s12888-014-0237-4
Ferrari, A. J., Somerville, A. J., Baxter, A. J., Norman, R., Patten, S. B., Vos, T., & Whiteford, H. A. (2013). Global variation in the prevalence and incidence of major depressive disorder: A systematic review of the epidemiological literature. Psychological Medicine, 43(3), 471–481. https://doi.org/10.1017/S0033291712001511
Furnham, A., Badmin, N., & Sneade, I. (2002). Body image dissatisfaction: Gender differences in eating attitudes, self-esteem, and reasons for exercise. The Journal of Psychology, 136(6), 581–596. https://doi.org/10.1080/00223980209604820
Gathergood, J. (2012). Debt and depression: Causal links and social norm effects. The Economic Journal, 122(563), 1094–1114. https://doi.org/10.1111/j.1468-0297.2012.02519.x
Gilbert, P., & Allan, S. (1998). The role of defeat and entrapment (arrested flight) in depression: An exploration of an evolutionary view. Psychological Medicine, 28(3), 585–598. https://doi.org/10.1017/s0033291798006710
Gili, M., Roca, M., Basu, S., McKee, M., & Stuckler, D. (2013). The mental health risks of economic crisis in Spain: Evidence from primary care centres, 2006 and 2010. European Journal of Public Health, 23(1), 103–108. https://doi.org/10.1093/eurpub/cks035
Grall, T. (2016, January). Custodial mothers and fathers and their child support: 2013. United States Census Bureau. Retrieved April 20, 2021, from https://www.census.gov/content/dam/Census/library/publications/2016/demo/P60-255.pdf
Grogan, S. (2017). Body image: Understanding body dissatisfaction in men, women and children (3rd ed.). Routledge.
Hart, A. D. (2000). Unmasking male depression: Recognize the root cause to many problem behaviors such as anger, resentment, abusiveness, silence and sexual compulsions. Thomas Nelson.
Hess, K., Johnson, S., Hu, X., Li, J., Wu, B., Yu, C., Zhu, H., Jin, C., Chen, M., Gerstle, J., Morgan, M., Friend, M., Satcher Johnson, A., Siddiqi, A., Hernandez, A., the HIV Incidence and Case Surveillance Branch, & the Data Management Team of the Quantitative Sciences and Data Management Branch. (2017). HIV surveillance report, volume 29. Diagnoses of HIV infection in the United States and dependent areas, 2017. Centers for Disease Control and Prevention (CDC). Retrieved July 23, 2020, from https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf
Hirshbein, L. D. (2006). Science, gender, and the emergence of depression in American psychiatry, 1952–1980. Journal of the History of Medicine and Allied Sciences, 61(2), 187–216. https://doi.org/10.1093/jhmas/jrj037
Horberg, M. A., Silverberg, M. J., Hurley, L. B., Towner, W. J., Klein, D. B., Bersoff-Matcha, S., Weinberg, W. G., Antoniskis, D., Mogyoros, M., Dodge, W. T., Dobrinich, R., Quesenberry, C. P., & Kovach, D. A. (2008). Effects of depression and selective serotonin reuptake inhibitor use on adherence to highly active antiretroviral therapy and on clinical outcomes in HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes, 47(3), 384–390. https://doi.org/10.1097/QAI.0b013e318160d53e
Inaba, A., Thoits, P. A., Ueno, K., Gove, W. R., Evenson, R. J., & Sloan, M. (2005). Depression in the United States and Japan: Gender, marital status, and SES patterns. Social Science & Medicine, 61(11), 2280–2292. https://doi.org/10.1016/j.socscimed.2005.07.014
James, S. L., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., Abdela, J., Abdelalim, A., Abdollahpour, I., Abdulkader, R. S., Abebe, Z., Abera, S. F., Abil, O. Z., Abraha, H. N., Abu-Raddad, L. J., Abu-Rmeileh, N. M. E., Accrombessi, M. M. K., et al. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1789–1858. https://doi.org/10.1016/S0140-6736(18)32279-7
Jefferis, B. J., Nazareth, I., Marston, L., Moreno-Kustner, B., Bellón, J. Á., Svab, I., Rotar, D., Geerlings, M. I., Xavier, M., Goncalves-Pereira, M., Vincente, B., Saldivia, S., Aluoja, A., Kalda, R., & King, M. (2011). Associations between unemployment and major depressive disorder: evidence from an international, prospective study (the predict cohort). Social Science & Medicine, 73(11), 1627–1634. https://doi.org/10.1016/j.socscimed.2011.09.029
Johnson, J. L., Oliffe, J. L., Kelly, M. T., Galdas, P., & Ogrodniczuk, J. S. (2012). Men’s discourses of help-seeking in the context of depression. Sociology of Health & Illness, 34(3), 345–361. https://doi.org/10.1111/j.1467-9566.2011.01372.x
Karazsia, B. T., Murnen, S. K., & Tylka, T. L. (2017). Is body dissatisfaction changing across time? A cross-temporal meta-analysis. Psychological Bulletin, 143(3), 293–320. https://doi.org/10.1037/bul0000081
Kendler, K. S., & Gardner, C. O. (2014). Sex differences in the pathways to major depression: a study of opposite-sex twin pairs. American Journal of Psychiatry, 171(4), 426–435. https://doi.org/10.1176/appi.ajp.2013.13101375
Kendler, K. S., Hettema, J. M., Butera, F., Gardner, C. O., & Prescott, C. A. (2003). Life event dimensions of loss, humiliation, entrapment, and danger in the prediction of onsets of major depression and generalized anxiety. JAMA Psychiatry, 60(8), 789–796. https://doi.org/10.1001/archpsyc.60.8.789
Kim, P., & Swain, J. E. (2007). Sad dads: Paternal postpartum depression. Psychiatry (Edgmont), 4(2), 35–47.
King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., & Nazareth, I. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8, 70. https://doi.org/10.1186/1471-244X-8-70
Kposowa, A. J. (2003). Divorce and suicide risk. Journal of Epidemiology & Community Health, 57(12), 993. https://doi.org/10.1136/jech.57.12.993
Leathers, S. J., & Kelley, M. A. (2010). Unintended pregnancy and depressive symptoms among first-time mothers and fathers. American Journal of Orthopsychiatry, 70(4), 523–531. https://doi.org/10.1037/h0087671
Lee, C., Oliffe, J. L., Kelly, M. T., & Ferlatte, O. (2017). Depression and suicidality in gay men: Implications for health care providers. American Journal of Men’s Health, 11(4), 910–919. https://doi.org/10.1177/1557988316685492
Lorant, V., Deliège, D., Eaton, W., Robert, A., Philippot, P., & Ansseau, M. (2003). Socioeconomic inequalities in depression: A meta-analysis. American Journal of Epidemiology, 157(2), 98–112. https://doi.org/10.1093/aje/kwf182
Martin, L. A., Neighbors, H. W., & Griffith, D. M. (2013). The experience of symptoms of depression in men vs women: Analysis of the National Comorbidity Survey Replication. JAMA Psychiatry, 70(10), 1100–1106. https://doi.org/10.1001/jamapsychiatry.2013.1985
McMullin, J. A., & Cairney, J. (2004). Self-esteem and the intersection of age, class, and gender. Journal of Aging Studies, 18(1), 75–90. https://doi.org/10.1016/j.jaging.2003.09.006
Meltzer, H., Bebbington, P., Brugha, T., Jenkins, R., McManus, S., & Stansfeld, S. (2010). Job insecurity, socio-economic circumstances and depression. Psychological Medicine, 40(8), 1401. https://doi.org/10.1017/S0033291709991802
Modini, M., Joyce, S., Mykletun, A., Christensen, H., Bryant, R. A., Mitchell, P. B., & Harvey, S. B. (2016). The mental health benefits of employment: Results of a systematic meta-review. Australasian Psychiatry, 24(4), 331–336. https://doi.org/10.1177/1039856215618523
Munce, S. E., Robertson, E. K., Sansom, S. N., & Stewart, D. E. (2004). Who is portrayed in psychotropic drug advertisements? The Journal of Nervous and Mental Disease, 192(4), 284–288. https://doi.org/10.1097/01.nmd.0000120887.30063.9b
Nishimura, A., & Ohashi, K. (2010). Risk factors of paternal depression in the early postnatal period in Japan. Nursing & Health Sciences, 12(2), 170–176. https://doi.org/10.1111/j.1442-2018.2010.00513.x
Nolen-Hoeksema, S. (1987). Sex differences in unipolar depression: Evidence and theory. Psychological Bulletin, 101(2), 259–282. https://doi.org/10.1037/0033-2909.101.2.259
Nolen-Hoeksema, S. (2003). Women who think too much: How to break free of overthinking and reclaim your life.. Macmillan.
Nolen-Hoeksema, S., & Girgus, J. S. (1994). The emergence of gender differences in depression during adolescence. Psychological Bulletin, 115(3), 424–443. https://doi.org/10.1037/0033-2909.115.3.424
Office for National Statistics (2019, December 2). Disability and employment, UK: 2019. Office for National Statistics. Retrieved July 23, 2020, from https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/bulletins/disabilityandemploymentuk/2019#:~:text=Labour%20Force%20Survey%20(LFS)%20data,%25%20for%20non%2Ddisabled%20people.
Oliffe, J. L., & Phillips, M. J. (2008). Men, depression and masculinities: A review and recommendations. Journal of Men’s Health, 5(3), 194–202. https://doi.org/10.1016/j.jomh.2008.03.016
Panagioti, M., Gooding, P., & Tarrier, N. (2012). Hopelessness, defeat, and entrapment in posttraumatic stress disorder: Their association with suicidal behavior and severity of depression. The Journal of Nervous and Mental Disease, 200(8), 676–683. https://doi.org/10.1097/NMD.0b013e3182613f91
Patten, S. B. (2001). Long-term medical conditions and major depression in a Canadian population study at waves 1 and 2. Journal of Affective Disorders, 63(1-3), 35–41. https://doi.org/10.1016/S0165-0327(00)00186-5
Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA, 303(19), 1961–1969. https://doi.org/10.1001/jama.2010.605
Pearson, C., Janz, T., & Ali, J. (2013, September). Health at a glance: Mental and substance use disorders in Canada. Statistics Canada. Retrieved July 23, 2020, from https://www150.statcan.gc.ca/n1/en/pub/82-624-x/2013001/article/11855-eng.pdf?st=zKUFXIsh
Public Health Agency of Canada. (2016, June 2). Report from the Canadian Chronic Disease Surveillance System: Mood and anxiety disorders in Canada, 2016. Government of Canada. Retrieved July 23, 2020, from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/report-canadian-chronic-disease-surveillance-system-mood-anxiety-disorders-canada-2016.html
Quiroga, C. V., Janosz, M., Bisset, S., & Morin, A. J. S. (2013). Early adolescent depression symptoms and school dropout: Mediating processes involving self-reported academic competence and achievement. Journal of Educational Psychology, 105(2), 552–560. https://doi.org/10.1037/a0031524
Rabkin, J. G. (2008). HIV and depression: 2008 review and update. Current HIV/AIDS Reports, 5, 163–171. https://doi.org/10.1007/s11904-008-0025-1
Remes, O., Lafortune, L., Wainwright, N., Surtees, P., Khaw, K. T., & Brayne, C. (2019). Association between area deprivation and major depressive disorder in British men and women: A cohort study. BMJ Open, 9(11), 1–12. https://doi.org/10.1136/bmjopen-2018-027530
Richards, D. (2011). Prevalence and clinical course of depression: a review. Clinical Psychology Review, 31(7), 1117–1125. https://doi.org/10.1016/j.cpr.2011.07.004
Rosenthal, D. G., Learned, N., Liu, Y., & Weitzman, M. (2013). Characteristics of fathers with depressive symptoms. Maternal and Child Health Journal, 17, 119–128. https://doi.org/10.1007/s10995-012-0955-5
Ross, C. E., & Mirowsky, J. (2006). Sex differences in the effect of education on depression: Resource multiplication or resource substitution? Social Science & Medicine, 63(5), 1400–1413. https://doi.org/10.1016/j.socscimed.2006.03.013
Rotermann, M. (2007). Marital breakdown and subsequent depression. Health Reports, 18(2), 33–44.
Sargent, J. T., Crocker, J., & Luhtanen, R. K. (2006). Contingencies of self-worth and depressive symptoms in college students. Journal of Social and Clinical Psychology, 25(6), 628–646. https://doi.org/10.1521/jscp.2006.25.6.628
Sbarra, D. A., Emery, R. E., Beam, C. R., & Ocker, B. L. (2014). Marital dissolution and major depression in midlife: A propensity score analysis. Clinical Psychological Science, 2(3), 249–257. https://doi.org/10.1177/2167702613498727
Scarff, J. R. (2019). Postpartum depression in men. Innovations in Clinical Neuroscience, 16(5-6), 11–14.
Scott, K. M., Wells, J. E., Angermeyer, M., Brugha, T. S., Bromet, E., Demyttenaere, K., de Girolamo, G., Gureie, O., Haro, J. M., Jin, R., Nasser Karam, A., Kovess, V., Lara, C., Levinson, D., Ormel, J., Posada-Villa, J., Sampson, N., Takeshima, T., Zhang, M., & Kessler, R. C. (2010). Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders. Psychological Medicine, 40(9), 1495–1505. https://doi.org/10.1017/S0033291709991942
Smith, D. T., Mouzon, D. M., & Elliott, M. (2018). Reviewing the assumptions about men’s mental health: An exploration of the gender binary. American Journal of Men’s Health, 12(1), 78–89. https://doi.org/10.1177/1557988316630953
Swami, V., Barron, D., Smith, L., & Furnham, A. (2019). Mental health literacy of maternal and paternal postnatal (postpartum) depression in British adults. Journal of Mental Health, 29(2), 217–224. https://doi.org/10.1080/09638237.2019.1608932
Szymanski, D. M., & Henning, S. L. (2007). The role of self-objectification in women’s depression: A test of objectification theory. Sex Roles, 56, 43–53. https://doi.org/10.1007/s11199-006-9147-3
Tiffin, P., Pearce, M., & Parker, L. (2005). Social mobility over the lifecourse and self reported mental health at age 50: Prospective cohort study. Journal of Epidemiology & Community Health, 59(1), 870–872. https://doi.org/10.1136/jech.2005.035246
US Bureau of Labor Statistics. (2020a, December 16). Table 1. Fatal occupational injuries by selected demographic characteristics, 2015-19. Retrieved March 12, 2021, from https://www.bls.gov/news.release/cfoi.t01.htm
US Bureau of Labor Statistics. (2020b, November 4). Table EH1. Number of nonfatal occupational injuries and illnesses involving days away from work by selected worker and case characteristics and medical treatment facility visits, all U.S., private industry, 2019. Retrieved March 12, 2021, from https://www.bls.gov/iif/oshwc/osh/case/cd_eh1_2019.htm
US Social Security Administration. (2020, October). Annual statistical report on the social security disability insurance program, 2019. Retrieved March 12, 2021, from https://www.ssa.gov/policy/docs/statcomps/di_asr/2019/
van der Noordt, M., Ijzelenberg, H., Droomers, M., & Proper, K. I. (2014). Health effects of employment: A systematic review of prospective studies. Occupational and Environmental Medicine, 71(10), 730–736. https://doi.org/10.1136/oemed-2013-101891
Walther, A., Breidenstein, J., & Miller, R. (2019). Association of testosterone treatment with alleviation of depressive symptoms in men: A systematic review and meta-analysis. JAMA Psychiatry, 76(1), 31–40. https://doi.org/10.1001/jamapsychiatry.2018.2734
Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 603–613. https://doi.org/10.1001/archpsyc.62.6.603
Whitley, R. (2013). Fear and loathing in New England: Examining the health-care perspectives of homeless people in rural areas. Anthropology & Medicine, 20(3), 232–243. https://doi.org/10.1080/13648470.2013.853597
Wight, R. G., LeBlanc, A. J., & Badgett, M. V. L. (2013). Same-sex legal marriage and psychological well-being: Findings from the California Health Interview Survey. American Journal of Public Health, 103(2), 339–346. https://doi.org/10.2105/AJPH.2012.301113
Williams, D. R., González, H. M., Neighbors, H., Nesse, R., Abelson, J. M., Sweetman, J., & Jackson, J. S. (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean Blacks, and Non-Hispanic Whites: Results from the National Survey of American Life. Archives of General Psychiatry, 64(3), 305–315. https://doi.org/10.1001/archpsyc.64.3.305
Winkler, D., Pjrek, E., & Kasper, S. (2005). Anger attacks in depression–Evidence for a male depressive syndrome. Psychotherapy and Psychosomatics, 74, 303–307. https://doi.org/10.1159/000086321
Winkler, D., Pjrek, E., & Kasper, S. (2006). Gender-specific symptoms of depression and anger attacks. Journal of Men’s Health, 3(1), 19–24. https://doi.org/10.1016/j.jmhg.2005.05.004
Zarrouf, F. A., Artz, S., Griffith, J., Sirbu, C., & Martin, K. (2009). Testosterone and depression: Systematic review and meta-analysis. Journal of Psychiatric Practice, 15(4), 289–305. https://doi.org/10.1097/01.pra.0000358315.88931.fc
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Whitley, R. (2021). Risk Factors and Rates of Depression in Men: Do Males Have Greater Resilience, or Is Male Depression Underrecognized and Underdiagnosed?. In: Men’s Issues and Men’s Mental Health. Springer, Cham. https://doi.org/10.1007/978-3-030-86320-3_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-86320-3_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-86319-7
Online ISBN: 978-3-030-86320-3
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)