Depression in Men Predicted to Rise

Tough Economic Times, Societal Change May Raise Rates of Depression in Men to Those Seen in Women

Megan Brooks

March 01, 2011

March 1, 2011 — Tough economic times and profound societal change currently under way may mean rates of depression among men from Western nations are likely to increase, predict the authors of a commentary published in the March issue of the British Journal of Psychiatry.

It's well known that women are nearly twice as likely as men to develop major depressive disorder in their lifetime, but this difference may well change in the coming decades, argue Boadie W. Dunlop, MD, director of the Mood and Anxiety Disorders Program at Emory University School of Medicine in Atlanta, Georgia, and his Emory colleague and coauthor Tanja Mletzko, MA.

Dr. Boadie W. Dunlop

Western economies are undergoing a "profound restructuring," they point out, with traditional male jobs in manufacturing, construction, and other physical-labor jobs being outsourced to low- and middle-income nations or becoming obsolete due to technological advances.

The current economic downturn has hit men particularly hard, Dr. Dunlop and Ms. Mletzko note in their article. They point to research showing that roughly 75% of jobs lost in the United States since the beginning of the recession in 2007 were held by men, leading some to dub this recession the "Mancession."

And the odds that traditional male jobs will return in significant numbers with economic recovery are slim. "Western men, particularly those with low education, will face a difficult road in the 21st century," Dr. Dunlop and Ms. Mletzko write.

"I really am worried about what some men in this country are going to do; it really is an issue," Dr. Dunlop told Medscape Medical News. "Not everybody," he added, "is cut out for higher education, and many people in this country are going to college unprepared; we are seeing that in the failure-to-graduate rates. We need to improve precollege education."

Changing Roles

Dr. Aaron Rochlen

Aaron Rochlen, PhD, a psychologist and associate professor in counseling psychology at the University of Texas at Austin, said he wouldn't be surprised if the occupations traditionally held by a high percentage of men continue to be those most affected by layoffs.

"Of course, it's very difficult to 'link' this with depression, but it's not uncommon for men to struggle with a range of mental health consequences when faced with unexpected layoffs. Therefore, I think men need to prepare themselves and 'diversify' their work and personal portfolios," Dr. Rochlen told Medscape Medical News.

In their commentary, Dr. Dunlop and Ms. Mletzko also note that women are increasingly becoming the primary household breadwinners, with 22% of wives earning more than their husbands in 2007 vs only 4% in 1970. Compared with women, men attach greater importance to their roles as providers and protectors of their families, and men’s failure to fulfill the role of breadwinner may contribute to depression and marital conflict.

Men who suddenly find themselves in the homemaker/childrearing role may need help adjusting, Dr. Dunlop said. "There could be increased rates of life dissatisfaction and substance abuse. Some men who do better in this role are the older siblings in a family who already have had the experience when younger of taking care of younger siblings, but the youngest men in the family, or last born, may have the hardest time with this," he noted.

To get the conversation going, Dr. Dunlop encourages clinicians to ask "simple, nonthreatening general questions, for example, How is work going? How is life at home? How are you guys getting by with how the economy is doing?"

Growing Pains

In shifting economic times, said Dr. Rochlen, it is important that men consider how to "redefine themselves and their conceptualizations of masculinity.

"There's at least some evidence," he said, "that men are expanding the ways they think of themselves. And I'd say, in many ways, this is a good thing."

"For example," he said, "we are seeing more active and involved fathers, including men as primary care providers for their children. I do think the idea of male as 'provider' is expanding. And while there are some growing pains with this, I'd argue that it's needed and a positive thing in the long run." Dr. Rochlen's research interests include men’s gender role socialization, help-seeking behaviors, and the lives of men in nontraditional work/family roles.

Dr. Dunlop receives research support from the National Institutes of Health and various pharmaceutical companies, including AstraZeneca, Evotec, Forest, GlaxoSmithKline, Novartis, Pfizer, and Wyeth, and has served as a consultant to Imedex, MedAvante, and Pfizer. Dr. Rochlen has disclosed no relevant financial relationships.

Br J Psychiatry. 2011;198;167-168.