{"id":46571,"date":"2015-03-24T16:30:50","date_gmt":"2015-03-24T21:30:50","guid":{"rendered":"http:\/\/www.artofmanliness.com\/?p=46571"},"modified":"2021-06-03T20:00:28","modified_gmt":"2021-06-04T01:00:28","slug":"leashing-the-black-dog-the-symptoms-of-depression","status":"publish","type":"post","link":"https:\/\/beta.artofmanliness.com\/health-fitness\/health\/leashing-the-black-dog-the-symptoms-of-depression\/","title":{"rendered":"Are You Depressed? The Symptoms of Male Melancholy"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-46351 size-full\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/blackdog.jpg\" alt=\"Vintage man leashing black dog male depression.\" width=\"550\" height=\"633\" srcset=\"https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/blackdog.jpg 550w, https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/blackdog-320x368.jpg 320w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/p>\n<p><em><strong>This article series is now available as a professionally formatted, distraction free&nbsp;ebook to read offline at your leisure.&nbsp;<a href=\"https:\/\/store.artofmanliness.com\/collections\/books\/products\/leashing-the-black-dog-a-guidebook-to-understanding-and-managing-male-depression\" target=\"_blank\" rel=\"external noopener noreferrer\" data-wpel-link=\"external\" data-amzn-asin=\"B01BKZQQG0\">Click here to buy.<\/a>&nbsp;<\/strong><\/em><\/p>\n<p>So far we\u2019ve discussed <a title=\"Leashing the Black Dog: The History of Depression\" href=\"https:\/\/www.artofmanliness.com\/articles\/the-history-of-depression\/\" target=\"_blank\" rel=\"noopener noreferrer\">the history of depression<\/a>, and <a title=\"Leashing the Black Dog: What Causes Depression?\" href=\"https:\/\/www.artofmanliness.com\/articles\/what-causes-depression\/\" target=\"_blank\" rel=\"noopener noreferrer\">explored its possible causes<\/a>. Before we conclude this series next week with a guidebook on managing your melancholy, we of course need to stop to examine what depression actually looks like. How is it different from run-of-the-mill sadness, and how does it manifest itself, especially in men?<\/p>\n<p>Today we\u2019ll tackle those two questions.<\/p>\n<h3>What\u2019s the difference between being sad and being depressed?<\/h3>\n<p>That\u2019s the million-dollar question and the source of a lot of debate. It\u2019s also a relatively modern query. As we discussed in our post on the history of the black dog, \u201cdepression\u201d as a clinical diagnosis only arose in the early&nbsp;20<sup>th<\/sup> century; before that you were just plain old melancholy &#8212; sometimes a little, and sometimes a lot. There wasn\u2019t a clear dividing line, because depression wasn\u2019t so much a disorder as a temperament.<\/p>\n<p>The <em>Diagnostic and Statistical Manual&nbsp;of Mental Disorders<\/em> (DSM) has attempted to establish a set of standardized criteria that distinguishes \u201cnormal\u201d sadness from clinical depression, but making the diagnosis remains an inexact science. This isn\u2019t a physical tumor you can measure in centimeters, but a measuring of mood.<\/p>\n<p>According to the DSM-V, for a spell of melancholy to be considered a Major Depressive Episode, it must persist for at least two weeks, and be accompanied by at least 5 of these symptoms:<\/p>\n<ul>\n<li>Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).<\/li>\n<li>Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).<\/li>\n<li>Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day.<\/li>\n<li>Insomnia or hypersomnia nearly every day.<\/li>\n<li>Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).<\/li>\n<li>Fatigue or loss of energy nearly every day.<\/li>\n<li>Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).<\/li>\n<li>Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).<\/li>\n<li>Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.<\/li>\n<\/ul>\n<p>Those symptoms can sound rather technical, so here\u2019s a list of common signs put in layman\u2019s terms by the Mayo Clinic:<\/p>\n<ul>\n<li>Feelings of sadness, emptiness, or unhappiness<\/li>\n<li>Angry outbursts, irritability or frustration, even over small matters<\/li>\n<li>Loss of interest or pleasure in normal activities, such as sex<\/li>\n<li>Sleep disturbances, including insomnia or sleeping too much<\/li>\n<li>Tiredness and lack of energy, so that even small tasks take extra effort<\/li>\n<li>Changes in appetite \u2014 often reduced appetite and weight loss, but increased cravings for food and weight gain in some people<\/li>\n<li>Anxiety, agitation, or restlessness \u2014 for example, excessive worrying, pacing, hand-wringing, or an inability to sit still<\/li>\n<li>Slowed thinking, speaking, or body movements<\/li>\n<li>Feelings of worthlessness or guilt, fixating on past failures, or blaming yourself for things that are not your responsibility<\/li>\n<li>Trouble thinking, concentrating, making decisions, and remembering things<\/li>\n<li>Frequent thoughts of death, suicidal thoughts, suicide attempts, or suicide<\/li>\n<li>Unexplained physical problems, such as back pain or headaches<\/li>\n<\/ul>\n<p>Besides Major Depressive Disorder, the other form of depression that\u2019s frequently diagnosed is \u201cPersistent Depressive Disorder.\u201d It\u2019s less severe from day to day than a bout of MDD, but it lasts longer. PDP manifests in adults as a low mood that lingers for most of the day, for more days than not, for at least 2 years. During this 2-year period, depression-free intervals last no longer than 2 months. One\u2019s low mood must also be accompanied by at least two of the DSM symptoms listed above.<\/p>\n<p>Other than experiencing a cluster of symptoms, the main crux of either of these diagnoses is whether one\u2019s mood creates \u201cclinically significant distress or impairment.\u201d In other words, does your disorder get in the way of your everyday life? Unfortunately, like the line between general sadness and depression itself, the standard here is somewhat hazy.<\/p>\n<p>The DSM does not provide objective criteria for what constitutes \u201cclinically significant distress or impairment,\u201d so individuals, doctors, and therapists are left with making subjective calls as to when a low mood reaches this benchmark. For some people, it might mean their depression is preventing them from going to work or taking care of their families; for others, it could mean that their low mood is getting in the way of achieving unrealistically high expectations for happiness. Some research suggests that it\u2019s largely the latter group that is going to their physician or psychiatrist for anti-depressants, while individuals with depression so severe they can\u2019t even take care of basic life functions are often not getting treated at all \u2014 they lack the motivation to even make an appointment with their doctor.<\/p>\n<p>All of this is to say that figuring out exactly when sadness becomes depression can be a fuzzy affair. While the DSM\u2019s symptoms-based approach to diagnosis has given depression a more medical, and less stigmatized slant, critics argue that it\u2019s also created such a broad net that it may cause some folks and doctors to view a bout of \u201cnormal\u201d sadness or low spirits as a disorder.<\/p>\n<h3>Symptoms of Depression in Men<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-46583 size-full\" src=\"https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/depressed.png\" alt=\"Man is sitting on chair and looking depressed.\" width=\"359\" height=\"456\" srcset=\"https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/depressed.png 359w, https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/depressed-320x406.png 320w\" sizes=\"auto, (max-width: 359px) 100vw, 359px\" \/><\/p>\n<p>Making things more difficult in diagnosing depression is that men often show different symptoms than women. Because women generally report feeling depressed more often than men, the symptoms and signs the DSM and other diagnostic outlines have aggregated tend to be female-oriented. Consequently, many men who may be struggling with depression aren\u2019t getting treated for it, and sadly, many of these men end up committing suicide; while women are more likely to get depressed, men are more likely to kill themselves, by a margin of more than 4:1.<\/p>\n<p>While many men experience the symptoms of low mood, lack of interest in normal activities, problems sleeping, etc. that the DSM lays out, it\u2019s also important for them to watch for the often uniquely male signs and symptoms of depression.<\/p>\n<p>One thing to keep in mind as you think through the symptoms below is that just because you display one or more of them doesn\u2019t necessarily mean you\u2019re depressed. It\u2019s important to put the signs in the context of the other criteria for depression such as the length you\u2019ve been manifesting the symptom and whether it causes significant distress or impairment to your life. It\u2019s also important to note that many of the symptoms below can actually be healthy responses to depression <em>if used in moderation<\/em>.<\/p>\n<p>Prudence and wisdom should thus be used when checking yourself against this criteria; when in doubt, talk to a mental health professional.<\/p>\n<p><strong>Increased use of alcohol and other substances.<\/strong> There\u2019s a common saying when it comes to gender and melancholy: women get depressed; men drink. And indeed, a typical response for men going through a prolonged low mood is to turn to alcohol and other mood-altering substances to blunt their despondent feelings. If you find yourself using these sorts of substances more than you usually do, it could be a sign that you\u2019re depressed.<\/p>\n<p><strong>Distraction and escapist behavior.<\/strong> While there\u2019s certainly nothing wrong with taking part in activities that distract you from your low mood (in fact, we\u2019ll recommend it as a method for managing your depression), it can become a problem when those distractions are of a type that can make your depression worse or prevent you from living a thriving life. Common distractions men resort to when feeling depressed include TV watching, video game playing, and web surfing. There\u2019s nothing wrong with these activities in moderation, but if done too much, they may actually make you feel <em>more <\/em>depressed \u2014 or at least no better than before. In a study in which participants were paged at random times during the day and asked to report on how they were feeling, people were found to experience their lowest mood when watching TV or surfing the web, especially late at night.<\/p>\n<p>Another distraction men commonly turn to when depressed is pornography. While the good feelings that come with masturbating to porn can alleviate a low mood in the short-term, this habit can do more harm than good in the long-term. Repeatedly stimulating your dopamine production in an artificial way, whether through excessive porn use or substance abuse, leads to dopamine desensitization. And recent research has shown that dopamine desensitization can cause depression. Which makes sense. One symptom of depression is the lack of motivation to do things that once brought you joy. Dopamine is the neurotransmitter of motivation, so if your brain becomes deadened to it, your drive decreases, and you get into a funk.<\/p>\n<p><strong>Workaholism.<\/strong> Related to distractions and escapist behavior is workaholism. Instead of lying around the house in apathy, some men respond to their low mood by putting in extra time at the office. Again, this isn\u2019t <em>necessarily <\/em>a bad response to depression. Focusing on your work can be a healthy way of harnessing your black dog. It can become a problem, however, when putting your nose to the grindstone causes \u201csignificant distress and impairment\u201d to the other facets of your life like family and community responsibilities.<\/p>\n<p><strong>Irritability and uncontrolled anger.<\/strong> For men, anger and depression often go hand-in-hand. Melancholy for men might be best described not as an entirely gray existence, but rather a dark landscape occasionally punctuated with flashes of red. It may not be acute anger you experience either, but rather a constant low level of irritability and peevishness.<\/p>\n<p><strong>Sulking and aloofness.<\/strong> Many depressed men will become socially aloof, and when they are around people, they\u2019ll sulk \u2014 just silently sitting there while the low mood and irritable emotions radiate from them.<\/p>\n<p><strong>Decreased sex drive.<\/strong> Depressed men will often have a depressed libido. This could be the direct result of blunted dopamine sensitivity, or be rooted in decreased testosterone levels, which in turn decrease dopamine production \u2014 the neurotransmitter that gives you your sex drive.<\/p>\n<p><strong>Increase in risky behavior.<\/strong> If you\u2019re generally not a risk-seeking kind of guy, but suddenly find yourself doing things like gambling, drinking while driving, riding your motorcycle recklessly, etc., you may be depressed. Though you may not be, too. Again, it\u2019s important to take a big picture approach when you\u2019re reviewing these symptoms.<\/p>\n<h3>Conclusion<\/h3>\n<p>So are you depressed or just feeling low? As you can see, the line between the two just isn\u2019t very clear.<\/p>\n<p>The good news is that when it comes to light-to-moderate cases of depression, knowing if you\u2019re technically, clinically depressed or not isn\u2019t that important. And that\u2019s because the methods you\u2019ll use to remedy the situation are pretty much the same whether you\u2019re actually depressed or just going through a gloomy spell. In fact, the best methods for tackling depression are things you should be doing even during the times when you\u2019re <em>not <\/em>feeling melancholy.<\/p>\n<p>And, if you have severe depression, well, you won\u2019t have much doubt as to whether you\u2019re struggling with the black dog or not. It will be quite evident. If you\u2019re having trouble summoning up the motivation to even get out of bed, if your whole world\u2019s gone gray and you don\u2019t feel anything at all, and\/or you\u2019re experiencing suicidal thoughts, you\u2019re almost assuredly clinically depressed. In this case, in addition to taking up the best practices we\u2019ll lay out at the end of this series, you may need to talk to a mental health professional. If you won\u2019t do that, at least talk to a friend, loved one, or clergyman; don\u2019t keep how you\u2019re feeling to yourself.<\/p>\n<p>Ultimately, while it\u2019s helpful to give something you\u2019re experiencing a concrete name, depression is so complex, and manifests itself so individually, that I don\u2019t recommend obsessing over clinical checklists in order to give yourself a label. Only you know for sure whether what you\u2019re experiencing is normal and bearable, or is something that is getting in the way of the life you want to live. If it is, then you need to take action. How to take the bull by the horns, and the black dog by the leash, is what we\u2019ll lay out next week in the final installment of this series.<\/p>\n<p><strong>Read the Entire Series<\/strong><\/p>\n<p><a title=\"Leashing the Black Dog: My Struggle With Depression\" href=\"https:\/\/www.artofmanliness.com\/articles\/leashing-the-black-dog-my-struggle-with-depression\/\" target=\"_blank\" rel=\"noopener noreferrer\">My Struggle With Depression <\/a><br \/>\n<a title=\"Leashing the Black Dog: The History of Depression\" href=\"https:\/\/www.artofmanliness.com\/articles\/the-history-of-depression\/\" target=\"_blank\" rel=\"noopener noreferrer\">The History of Depression<\/a><br \/>\n<a title=\"Leashing the Black Dog: What Causes Depression?\" href=\"https:\/\/www.artofmanliness.com\/articles\/what-causes-depression\/\" target=\"_blank\" rel=\"noopener noreferrer\">What Causes Depression?<\/a><br \/>\n<a title=\"A Realistic, Encouraging, Compassionate, No-Nonsense, Research-Backed, Action-Oriented Guidebook to Managing Your Depression\" href=\"https:\/\/www.artofmanliness.com\/articles\/managing-depression\/\" target=\"_blank\" rel=\"noopener noreferrer\">How to Manage Depression<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This article series is now available as a professionally formatted, distraction free&nbsp;ebook to read offline at your leisure.&nbsp;Click here to buy.&nbsp; So far we\u2019ve discussed the history of depression, and explored its possible causes. Before we conclude this series next week with a guidebook on managing your melancholy, we of course need to stop to [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":46583,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[42265,7],"tags":[],"yst_prominent_words":[],"class_list":["post-46571","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","category-health-fitness"],"featured_image_urls":{"large":"https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/depressed-359x280.png","reactor-320":"https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/depressed-320x406.png","rpwe-thumbnail":"https:\/\/content.artofmanliness.com\/uploads\/2015\/03\/depressed-45x45.png"},"_links":{"self":[{"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/posts\/46571","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/comments?post=46571"}],"version-history":[{"count":20,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/posts\/46571\/revisions"}],"predecessor-version":[{"id":135125,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/posts\/46571\/revisions\/135125"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/media\/46583"}],"wp:attachment":[{"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/media?parent=46571"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/categories?post=46571"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/tags?post=46571"},{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/beta.artofmanliness.com\/app-json\/wp\/v2\/yst_prominent_words?post=46571"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}} 