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What is Depression?

Depression in Men

Do I have Depression?

What to do if you have Depression

If you know someone with Depression

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"I have of late - but wherefore I know not - lost all my mirth, forgone all custom of exercises; and indeed it goes so heavily with my disposition that this goodly frame, the earth, seems to me a sterile promontory, this most excellent canopy, the air, look you, this brave o'erhanging firmament, this majestical roof fretted with golden fire, why, it appears no other thing to me than a foul and pestilent congregation of vapours. What a piece of work is a man! how noble in reason! how infinite in faculty! in form and moving how express and admirable! in action how like an angel! in apprehension how like a god! the beauty of the world! the paragon of animals! And yet, to me, what is this quintessence of dust? man delights not me: no, nor woman neither."
Hamlet, Act 2 Scene 2.

First things first. There are far more similarities between male and female experiences of the illness than differences. The pattern of Depression is similar for both sexes: low self-worth; suicidal thoughts; the pleasure drained out of life; a sudden liking for the works of the Smiths and Leonard Cohen. It is equally harrowing for men and women. That aside, what I want to do here is concentrate a bit on the aspects of the illness that are specific to men, or that make it difficult for men to get help when they have it.

'But men don't get Depression'
The strangest thing about Depression is the idea that it is a female disease. What, like breast cancer? Men are physically unable to get Depression then? It is the case that mental illness in general is stigmatised as 'unmasculine'. The word 'hysteria' comes from the Greek for 'womb', and in the 19th Century it was thought to be caused by an infertile womb shrivelling up. Oh, those Victorians. The legacy of this remains in the general treatment of the mentally ill, who have throughout this century been treated much like women were in the 19th Century, i.e. like children. Society's treament of women has since progressed farther than its treatment of the mentally ill.

Some mental illnesses are considered more 'feminine' than others, and Depression is top of the list. Being a male psychopath is generally OK - there are plenty of male role models for that, and Quentin Tarantino has even made being a psycho quite cool. He is apparently under the impression that murderers like to say something cool and witty prior to offing some poor bugger. Being a psychopath can be a positive asset in the business world (true: the incidence of psychopathic disorders is far higher among succesful businessmen than in the general population).

Sadly, you haven't been diagnosed with a proper, macho illness like that. You've got Depression, which you previously listed with PMT and thrush under 'women's problems'. Hard luck. You've got the short straw. Even the nurses in psychiatric hospitals are more likely to be brawny, tatooed Glaswegians trained in the art of restraining the deranged and violent than pretty young things ready with the offer of a soothing bedbath for you. Tough shit.

There is a bit of a double standard in the characterisation of Depression as a feminine illness. Melancholia, as it used to be called, was romanticised during the Edwardian era as fetchingly feminine and vulnerable. It was quite acceptable for Edwardian ladies to become distressed at apparently minor provocation, to shut themselves away from the world and to generally behave like a pre-Raphaelite model. Something of that lingers on today. Women can be depressed and still be feminine in a way that men can't. I'm not suggesting that the stereotpye of Depression as a product of feminine vulnerability doesn't harm women, in fact I think the opposite is the case. It is just that this stereotype also inhibits men from understanding their illness, and other people from understanding them. It is like admitting to impotence in public. We just won't do it.

The sterotype prevents us talking about the illness, and also can shape other people's reactions. We are often afraid of how wives, girlfriends, work colleagues and so on will react to a display of vulnerability, and prefer not to find out. Sometimes our fears are justified, and other men and women think that you are being unmanly. Their response is that, as a man, you should just grin and bear it. Yet a list of famous depressives includes Winston Churchill and Ernest Hemingway, hardly an 'unmanly' lot. Depression is no more 'unmanly' than cancer.

However, if you choose to speak about your illness you will often be surprised by the depth of support and understanding that you can draw on. More than that, you will find out just how many people suffer Depression and have never talked about it until you told them about your illness. You will not only be helping yourself, but helping them as well.

Sex
Okay, enough social history, let's get on to the important stuff. Depression causes big changes in appetite, reducing most of them to a low level. Sex is no exception. For most depressed people, men and women, their sex drive reduces markedly or shuts down altogether while they are ill (a few become more promiscuous).

Anti-depressant medication can make things worse. I know from experience that it is impossible to have an orgasm on certain SSRIs. Strangely, they don't cause impotence. It's still possible to have an erection, it just becomes impossible, or extremely difficult, to bring yourself to orgasm. Of course, your partner may quite like it if it takes you an hour to come instead of your previous best of thirty seconds. I lost all interest in sex when I started taking the inappropriately named Lustral (mind you, I hadn't had a shag in six months anyway, so it was purely academic, but I liked to think I could have had one if I wanted).

I read in some self help manual that you should force yourself to have sex if depressed, even when you don't want to. I think this is plain lunacy. Trying to have sex when you don't want is going to make yourself feel worse. Sure, initiate as much sexual contact with your partner as you both enjoy, but only as much as that. Depression breeds fear of intimacy and sex with someone you love can help a lot, as well as restoring some of your sense of self-worth. Forcing it further than you can bear will only make sex feel like a duty, and your partner will not like the thought of you not enjoying yourself during sex either.

So if you can do it, and enjoy it, then do. If you can't or won't, then give the old thing a rest for the moment. Take it as far as you feel good about, but no further. When you are feeling better you will have the shag of your life. If you have a partner, involve her. Talk to her about it. Make sure she understands that if you don't feel up to it, it's not her fault. This will be hard for her, but if she has stuck with you this far she should understand.

If you do happen to be feeling horny, don't use your illness as an excuse to get a sympathy shag from your female friends, okay? Oh, what the hell, go on then.