Depressed older men are much less likely than depressed older women to recognize their depression and seek treatment for it, according to a study conducted in California.
According to the team led by Dr. Ladson Hinton of the University of California-Davis School of Medicine, men tend to experience and express their depression differently than women. Men less often express common symptoms of depression, such as depressed mood or sadness, they report in the American Journal of Geriatric Psychiatry, and may actively try to conceal or mask their depression, whereas women tend to be more open about their depressed mood.
Men are also more apt to express their depression through anger, rage and risky behavior.
"Old school" or "John Wayne type" older men are difficult to diagnose and treat because they perceive depression to conflict with their masculinity, Hinton and colleagues have observed. For this subgroup, depression connotes vulnerability or weakness and is in direct conflict with an image of men as self-sufficient, tough and stoic.
Consistent with prior studies, Hinton's group has found that the stigma of depression is an important barrier to care in men, particularly its association with severe mental illness.
The team's observations are based on an analysis of data from 1,800 depressed adults age 60 years or older participating in a study of depression, as well as interviews with 30 trial physicians, depression care managers and study recruiters.
