This study reports on the experiences of 45 male focus group participants with a history of depression. Men responded to questions addressing the interaction between the male role, masculinity, depression, and experiences with treatment for depression. Using a qualitative, thematic-based coding strategy, three primary themes emerged. First, participants described aspects of the male gender as being in conflict or incongruent with their experiences of depression and beliefs about appropriate help-seeking behaviors. Second, men outlined alternative symptom profiles that could interfere with the recognition of depression and willingness to seek help. Finally, men expressed a range of positive and negative reactions toward depression treatment and treatment providers. Implications for health care providers are provided.
Addis, M.E. ( 2008). Gender and depression in men. Clinical Psychology: Science and Practice, 15, 153-168.
2.
Addis, M.E., & Mahalik, J.R. ( 2003). Men, masculinity, and the contexts of help seeking. American Psychologist, 58, 5-14.
3.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
4.
Bair, M.J., Robinson, R.L., Katon, W., & Kroenke, K. ( 2003). Depression and pain comorbidity: A literature review . Archives of Internal Medicine, 163, 2433-2445.
5.
Brownhill, S., Wilhelm, K., Barclay, L., & Parker, G. ( 2002). Detecting depression in men: A matter of guesswork. International Journal of Men’s Health, 1, 259-280.
6.
Cochran, S.V., & Rabinowitz, F.E. (2000). Men and depression: Clinical and empirical perspectives. San Diego, CA: American Press.
7.
Cochran, S.V., & Rabinowitz, F.E. (2003). Gender-sensitive recommendations for assessment and treatment of depression in men. Professional Psychology, 34, 132-140.
Emslie, C., Ridge, D., Zeibland, S., & Hunt, K. ( 2006). Men’s accounts of depression: Reconstructing or resisting hegemonic masculinity? Social Sciences and Medicine , 62, 2246-2257.
10.
Good, G.E., & Mintz, L.B. ( 1990). Gender role conflict and depression in college men: Evidence for compounded risk. Journal of Counseling and Development , 69, 17-21.
11.
Good, G.E., & Wood, P.K. ( 1995). Male gender role conflict, depression, and help-seeking: Do college men face double jeopardy?Journal of Counseling and Development, 74, 70-75.
12.
Hart, A.D. ( 2001). Unmasking male depression. Nashville, TN: Word Publishing.
13.
Heim, D., Smallwood, J., & Davies, J.B. ( 2005). Variability in lay perceptions of depression: A vignette study. Psychology and Psychotherapy, 78, 315-325.
14.
Kessler, R.C., McGonagle, K.A., Nelson, C.B., Hughes, M., Swartz, M., & Blazer, D.G. ( 1994). Sex and depression in the National Comorbidity Survey II: Cohort effects. Journal of Affective Disorders, 30, 15-26.
15.
Kilmartin, C.T. ( 2005). Depression in men: Communication, diagnosis and therapy . Journal of Men’s Health and Gender, 2, 95-99.
16.
Kornstein, S.G., Schatzberg, A.F., Thase, M.E., Yonkers, K.A., McCullough, J.P., Keitner, G.I., et al. (2000). Gender differences in chronic major and double depression. Journal of Affective Disorders, 60, 1-11.
17.
Lowe, B., Spitzer, R.L., Williams, J.B., Mussell, M., Schellberg, D., & Kroenke, K. ( 2008). Depression, anxiety and somatization in primary care: Syndrome overlap and functional impairment. General Hospital Psychiatry, 30, 191-199.
18.
Lynch, J., & Kilmartin, C.T. (1999). The pain behind the mask: Overcoming masculine depression. Binghamton, NY: Haworth.
19.
Magovcevic, M., & Addis, M.E. ( 2008). The masculine depression scale: Development and psychometric evaluation. Psychology of Men and Masculinity, 9, 117-132.
20.
Mahalik, J.R., Good, G.E., & Englar-Carlson, M. (2003). Masculinity scripts, presenting concerns, and help seeking: Implications for practice and training . Professional Psychology: Research & Practice, 34, 123-131.
21.
Mahalik, J., Locke, B.D., Ludlow, H., Diemer, M.A., Scott, R.P.J., Gottfried, M., et al. (2003). Development of the conformity to masculine norms inventory. Psychology of Men and Masculinity, 4, 3-25.
22.
Mahalik, J., & Rochlen, A.B. ( 2006). Men’s likely responses to clinical depression: What are they and do masculinity norms predict them? Sex Roles , 55, 659-667.
23.
Mansfield, A.K., Addis, M.E., & Courtenay, W. ( 2005). Measurement of men’s help-seeking: Development and evaluation of the barriers to help seeking scale. Psychology of Men and Masculinity, 6, 95-108.
24.
Moller-Leimkuhler, A.M., Bottlender, R., Straub, A., & Rutz, W. ( 2004). Is there evidence for a male depressive syndrome in patients with major depression? Journal of Affective Disorders, 80, 87-93.
25.
Moller-Leimkuhler, A.M., Heller, J., & Paulus, N.C. ( 2007). Subjective well-being and "male depression" in male adolescents . Journal of Affective Disorders, 98, 65-72.
26.
Moscicki, E. ( 1997). Identification of suicide risk factors using epidemiologic studies. Psychiatric Clinics of North American, 20, 499-517.
27.
National Institute of Mental Health. (2004 ). Suicide in the U.S.: Statistics and prevention. Retrieved January 21, 2009, from http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention.shtml
28.
Pederson, E.L., & Vogel, D.L. ( 2007). Male gender role conflict and willingness to seek counseling: Testing a mediation model in college-aged men. Journal of Counseling Psychology, 54, 373-384.
29.
Penick, E.C., Powell, B.J., Nickel, E.J., Bingham, S.F., Riesnmy, K.R., Read, M.R., et al. (1994). Co-morbidity of lifetime psychiatric disorder among male alcoholic patients. Alcoholism: Clinical and Experimental Research, 18, 1289-1293.
30.
Pollack, W.S. ( 1998). Mourning, melancholia, and masculinity: Recognizing and treating depression in men. In W. S. Pollack & R. F. Levant (Eds.), New psychotherapy for men (pp. 147-166). Hoboken, NJ: Wiley.
31.
Rabinowitz, F.E., & Cochran, S.V. ( 2008). Men and therapy: A case of masked male depression. Clinical Case Studies, 7, 575-591.
32.
Real, T. ( 1997). I don’t want to talk about it: Overcoming the legacy of male depression. New York: Fireside .
33.
Rochlen, A.B. ( 2005). Introduction: Men in (and out) of therapy: New directions and remaining challenges. Journal of Clinical Psychology, 61, 627-631.
34.
Rochlen, A.B., Blazina, C., & Raghunathan, R. (2002). Gender role conflict, attitudes toward career counseling, career decision-making and perceptions of career counseling advertising brochures. Psychology of Men and Masculinity , 3, 127-137.
35.
Rochlen, A.B., Whilde, M.R., & Hoyer, W.D. ( 2005). Real men. Real depression: Overview, theoretical implications, and research considerations. Psychology of Men and Masculinity , 6, 186-194.
36.
Seal, D.W., Bogart, L.M., & Ehrhardt, A.A. (1998). Small group dynamics: The utility of focus group discussions as a research method. Group Dynamics: Theory, Research, and Practice, 2, 253-266.
37.
Shepard, D.S. ( 2002). A negative state of mind: Patterns of depressive symptoms among men with high gender role conflict. Psychology of Men & Masculinity, 3, 3-8.
38.
Warren, L. ( 1983). Male tolerance of depression: A review with implications for psychotherapy. Clinical Psychology Review, 3, 147-156.
39.
Wexler, D.B. ( 2005). What to do when the man you love is irritable, moody, and withdrawn. Oakland, CA: New Harbinger.
40.
Winkler, D., Pjrek, E., Heiden, A., Wiesegger, G., Klein, N., Konstantinidis, A., et al. (2004). Gender differences in the psychopathology of depressed inpatients. European Archives of Psychiatry and Clinical Neuroscience, 254, 209-214.
