According to the National Institute of Mental Health, over 17 million adults in the United States have experienced at least one major depressive episode over the past year. While it's known to be more prevalent in women, the NIMH says depression still affects over six million men each year. Treatment options for depression are generally the same for everyone — therapy, medication, or certain lifestyle changes. But some forms of treatment have been found to be more effective for men than women.
"Generally, the treatments for depression have not been developed with sex in mind," Dr. Catherine Burnette, an assistant professor in the School of Social Work at Tulane University, tells Bustle. "However, we know that depression presents differently in men and women."
Due to social pressures to fit "traditional male roles," Dr. Burnette says that some men may feel less comfortable expressing their emotions and vulnerability. Because of this, research suggests that men are more likely to exhibit depressive symptoms such as anger, irritability, and social isolation. They're also more likely to report having physical symptoms of depression, such as fatigue, pain, headaches and digestive problems.
There are so many different forms of treatment for depression, and everyone has different needs. It should be noted that rates of depression for transgender, non-binary, or gender nonconforming people are higher than for cisgender people in general. For instance, depression within the transgender community is higher than the general population. In fact, a 2013 study by the Journal of Consulting and Clinical Psychology found that nearly 49 percent of transgender men have depressive symptoms. While the same therapy options are available to them, research has found gender-affirming mental health services can be really effective. Still, medical bias means that research looking at depression treatment effectiveness in non-cisgender people is less robust than it is for cis-gender men and women.
According to current research, there may be subtle differences between how men and women experience depression. So according to Dr. Burnette, treatments should account for these differences. Unfortunately, "most treatments have not focused on this level of specificity," she says. Research may be limited, but here are some things that may be more helpful in reducing depressive symptoms in men than in women.
A Harvard Medical School study found that exercise can be a form of treatment for depression. In less severe cases, exercise can be just as effective as antidepressants for some people. Previous research also found that exercise can help both men and women, if they're able to maintain an exercise program long-term. But as a recent study published in the Journal of American College Health found that exercise can affect men and women differently. While researchers found a link between moderate or vigorous exercise and a decrease in depressive symptoms in men, they didn't find the same results in women. In fact this study found that exercise wasn't as effective in reducing depressive symptoms in women. It is important to note, though, that some research suggests women can benefit from exercise for depression too.
More work needs to be done to figure out why this happens. Researchers theorize that men are less likely to report having depression in the first place, even if they show similar symptoms as women. So they may be more motivated to exercise — as opposed to seeking out a diagnosis and therapy — and get the benefits from that.
2. Certain Medications
Some medications that work well for women, may not for men. As Traci Parramore-Chambers, director of outpatient services at Discovery Mood and Anxiety Program, tells Bustle, this happens because of hormonal and biological differences, as well as differences in our neurological responses. "Research conducted by Dr. J. Douglas Bremner revealed a different outcome for men and women when injected with chemicals blocking serotonin," Parramore-Chambers says. For instance, men attempted to escape their increased stress levels by engaging in behavior to avoid the symptoms, while women cried, talked, and ruminated on past losses and other past painful events. Men and women's brains may work differently. Since medications to treat depression causes chemical changes in the brain, Parramore-Chambers says it will have a different effect on men and women due to certain biological differences.
3. Anger Management Therapy
Psychotherapy can be really effective for anyone. But according to Parramore-Chambers, "interventions are provided based on individual preferences." Since research has found that men tend to experience more anger and irritability when dealing with depression, they may benefit more from types of therapy, like anger management, that will help them manage anger and develop a tolerance for distress.
4. Testosterone Therapy
A 2018 study published in Jama Psychiatry, found that testosterone therapy could help to reduce depression in men. Researchers found a greater reduction in depressive symptoms for men who received a dosage of testosterone a week in comparison to those in the placebo group. However, more research needs to be done in order to say this is truly an effective and safe treatment for depression in men.
Research has also found links between lower levels of testosterone and depression in women. But there is an overall lack of research on the treatment of low testosterone in women. In fact, a task force appointed by the Endocrine Society and others recommended against routinely measuring testosterone levels in women. In the 2014 report published in The Journal of Clinical Endocrinology & Metabolism, the task force also recommended against the therapeutic use of androgens, like testosterone, in women due to a lack of research.
5. Evidence-Based Treatment
"Men are scientifically proven to underreport about depressive symptoms due to the idea that it is associated with being perceived as a 'weakness,'" Ryan Steinberg, clinical director at Banyan Treatment Center, tells Bustle. "Therefore, a suggestion for treatment among males would be to incorporate evidence-based treatments that are alternatives to the traditional talk therapy." An example of this type of treatment would be incorporating mindfulness-based techniques into their daily routine, along with physical exercise and pharmacotherapy. A 2018 study published in the American Journal of Men’s Health also found the treatment styles most engaging and beneficial for men are those that are collaborative, transparent, action-oriented, and goal-focused. An example of this would be interpersonal-and-social rhythm therapy, which helps patients learn how to manage their depression by creating positive daily routines.
Many people experience depression, and it shows up in different ways. Unfortunately, there's limited research on how treatment options affect certain people differently. There's still so much to learn. But for now, these are just some things that may help reduce depression in men more than women.
Note: If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.