Women in Croatia, Germany, Portugal, and Sweden have the highest rates of depression in Europe. Moreover, they have considerably higher rates of depression than men in these four countries. Depression and suicide are intimately connected. The debilitating mental disorder is the most common condition associated with suicide.
Which raises the question: Why are considerably more men in these countries killing themselves than women?
Contrary to popular, anti-biological belief, men and women are not the same. Male and female brains are, quite literally, wired differently; this difference in wiring contributes to differences in behavior and cognition. The difference in wiring also plays a significant role in the ways in which men and women experience and express symptoms of depression.
Unlike female depression, which tends to involve feeling unloved and of little value to the people they love, male depression involves feelings of helplessness and powerlessness. Women need to feel loved and appreciated. Men require a sense of purpose; they also require the ability to effectively impact their environment and create a meaningful, long-lasting impact. Males are far more interested in finding solutions to their problems than having their feelings validated. In plain English, men want answers, and they want them now. Asking a man to open up and reveal his deepest, darkest fears is of little help if immediate, practical solutions aren’t prescribed.
For men, feeling unable to positively affect their environment appears to be the precursor to deep depression. If depression is left undiagnosed and untreated, suicidal feelings may emerge. It is common enough to associate depression with feelings of sadness. Quite often, however, depressed males don’t present with classic symptoms of depression. Instead, they tend to be hostile, impulsive, and highly disagreeable. A depressed female is more likely to cry; a depressed male is more likely to raise his voice and lash out. For many readers, I’m sure, aggression and depression might seem like odd bedfellows, but that’s only because we, as a society, are viewing male depression through a female-oriented lens.
This is something that needs to change, and fast.
Sadly, modern day psychiatric textbooks fail to acknowledge the fact that the symptoms of depression in men and women manifest in different ways. The International Classification of Diseases (ICD), a diagnostic ‘bible’ used by doctors throughout Europe, also fails to acknowledge these facts. Doctors are using a female model of depression to treat (or not treat) the men of Europe. It’s not that the average man in Croatia or Portugal is experiencing depression less often than the average Croatian or Portuguese woman. It’s that they are experiencing and expressing it differently. In truth, many in the medical community don’t appear to be qualified to identify the symptoms of male depression—largely because they haven’t even been trained to identify its unique symptoms.
In 1996, Dr. Wolfgang Rutz, a pioneering psychiatrist who recognized the differences between mental illnesses in men and women, developed the first male depression scale. More recently, inspired by the work of Dr. Rutz, Dr. Simon Rice, an Australian clinical psychologist, developed his own scale, known as the Male Depression Risk Scale. In Rice’s own words, the scale was “designed to assess externalising depression symptoms (e.g., substance use, risk-taking, and aggression). These symptoms are theorised to reflect the behavioural manifestation of depression amongst men who rigidly conform to masculine norms.”
By “masculine norms,” Dr. Rice is referring to the average man’s tendency to suppress his emotions and stubbornly refuse to ask for help. Dr. Rice’s scale asks men to rate various statements, including how often they experience and express negative feelings, how often they have aggressive outbursts, and how often (if ever) they use substances like cannabis and alcohol to escape their psychic pain. For reasons that have already been discussed, the scale does not ask men to rate their feelings of sadness or hopelessness.
Why aren’t more psychologists and psychiatrists in Europe using the scale? In truth, many psychologists and doctors have never heard of it. This is something else that needs to change, and fast.
Another issue that needs to be addressed is the ratio of male to female psychologists in Europe. In a number of European countries, 70 percent of psychological professionals are female. If given the choice, males prefer speaking to a male therapist—and no, this has nothing to do with misogyny. Data confirms that males tend to respond better to male therapists than they do to female therapists. Regrettably, in many European countries, there just aren’t enough male therapists to choose from.
The men of Europe are suffering. Due to the lack of recognition of what male depression actually looks like, and the lack of male professionals equipped with the tools to help men, we should expect this suffering to continue unabated.
