Fear of Feelings! Treating Male Suicide & Depression

New Content Added: To update the content we have added Depression information found at the end of the Table of Contents.

On this track, we will discuss the difference between masculine depression and feminine depression, Dissociation or Disconnection, and the Lynch and Kilmartin concept of direct expression, indirect expression, and physical expression.

Far more women suffer from depression that men do, so it seems odd that women would commit suicide at only one-fourth the rate of men. The key difference between the two sexes may be that women talk out their problems. George E. Murphy, an emeritus professor of psychiatry at Washington University School of Medicine in St. Louis, says that women may be protected because they are more likely to consider the consequences of suicide on family members or others. Women also approach personal problems differently than men and more often seek help long before they reach the point of considering suicide. As a result, women get better treatment for their depressions.

As you know, we typically recognize people as being depressed if they exhibit feelings of sadness and hopelessness, a low of self-esteem, changes in diet and sleeping patterns, and tendencies toward isolation. What my colleagues and I have found, though, is that these characteristics describe a typical depressed female. Do you agree that you are more likely to diagnose women with depression because you see these symptoms as classic signs of depression?

Masculine Depression vs. Feminine Depression
According Dr. Caroline Dott, when women are depressed, they often avoid conflict, blame themselves, and feel as though they were born to fail. Men, on the other hand, will often create conflict, place the blame on others, and feel as though the world set them up to fail. Do you agree that what we sometimes fail to see is that these criteria for depression are partial to our cultural and social expectations of how men and women should behave? Women are more likely than men to worry, cry, and mope when they are depressed, while men will more often act out aggressively.

You may be asking yourself then, "How is masculine depression different from feminine depression?" Masculine depression involves emotional pain similar to that of feminine depression, but I have found that the pain is manifested in different ways. For instance, as mentioned earlier, instead of crying or talking about his emotions, a man might demonstrate anger and self-destructiveness in response to painful feelings. He might distract himself by drinking, gambling, womanizing, or working. According to Overcoming Masculine Depression, males complete suicide four times more often than females in the United States.

Lynch and Kilmartin Concept
Lynch and Kilmartin have come up with a different viewpoint regarding distinctions between feminine and masculine depression. Feminine depression is characterized by direct expression of feelings, like telling others about their pain. It is also characterized by "acting in" behaviors, which could be crying, moping, loss of pleasure, and insomnia. Masculine depression, on the other hand, features dissociation from feelings.

Dissociation or Disconnection
You already know men and women are conditioned in our society to behave in certain ways according to their sex, referred to as gender socialization. Women, of course, are raised to be feeling oriented and self-reflective, and they often look within themselves first when they feel depressed. Men, on the other hand, learn to look for answers to their depression outside of themselves. They seek to control their emotions rather than express them. Such reactions are common because our society expects men to be powerful at all times, extremely independent, and virtually numb to their emotions.

Think of a male client you are currently treating in which emotional dissociation occurs when he detaches himself from his emotions and cuts off any awareness of what he is feeling. Would it be helpful to share with your client the following information as outlined by Lynch and Kilmartin? I found it helpful to discuss with Foster, a 42-year-old warehouse worker, Lynch and Kilmartin's concept that feelings can be expressed in three ways.

Technique: Three Ways Feelings can be Expressed
Foster hated his job, and his wife Laura had left him for an old high school boyfriend. I explained to Foster:
-- Step 1 - "One way to express feelings is direct expression. An example of direct expression is when you would tell Laura you are feeling worried or angry.
-- Step 2 - The second way to express feelings is an indirect response. An example of an indirect response is when you yell at your children because you are angry with Laura.
-- Step 3 - The third way an emotion can be expressed is in physical body symptoms. A physical body symptom of expressing feelings could be when you feel that pain in your back."

Do you have a client who might benefit from the Lynch and Kilmartin concept of direct expression, indirect expression, and physical expression? You might consider replaying this track prior to your next session.

On the next track I will discuss perceived pervasive power.

Online Continuing Education QUESTION 1
According to George E. Murphy, a professor of psychiatry at Washington University School of Medicine, what are two reasons women commit suicide at a rate of one fourth less than men? To select and enter your answer go to CEU Answer Booklet.