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Depression manifests differently in men than in women

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(Vienna, 31 October 2022) Fewer men than women are diagnosed as having depression. One possible reason for this is that there is still a lack of awareness that this mental illness is characterised by different symptoms in men than in women. Johannes Wancata from MedUni Vienna's Department of Psychiatry and Psychotherapy is using the opportunity of International Men's Day to raise awareness that, among other symptoms, persistent irritability or conspicuous risk-taking behaviour in men could indicate depression and that professional help should be sought. International Men's Day is celebrated each year on 3 November as a day of action dedicated to men's health.

It is only in recent years that the concept of "male depression" has been developed among mental health experts. The assumption is that, in men, the known symptoms of depression are frequently masked by other male-specific symptoms. While a low mood, loss of interest and enjoyment, reduced drive and also feelings of guilt, lowered self-esteem, pessimism, reduced alertness, suicidal thoughts or actions, insomnia and loss of appetite can indicate depression in both sexes, men are also more likely to exhibit irritability, aggression and risk-taking or addictive behaviours.

Knowledge of these gender differences has not yet found its way into official diagnostics or public awareness. What is known, however, is that alcohol dependence is more common in men than in women. However, with our current scientific knowledge it is impossible to tell whether the drinking is masking underlying depression or is a clinical condition in its own right. "Beyond this academic discussion, the symptoms described in men should definitely be taken seriously and a doctor should be consulted," emphasises Johannes Wancata, Head of the Division of Social Psychiatry at MedUni Vienna's Department of Psychiatry and Psychotherapy.

The triggers are also different
In Austria, around 730,000 people are currently living with depression: 264,000 of them are male. Nowadays, the fact that depression is less frequently diagnosed in men is only partly attributed to the fact that men are more reluctant to seek medical help than women. According to research, hormones may also play a role. For example, another possible explanation is thought to be the different density of oestrogen and progesterone receptors.
Scientists also describe gender differences regarding potential triggers for depression: "Numerous studies report social risk factors for the onset of depression in women. These include the multiple burdens of household responsibilities, childcare and work. While interpersonal conflicts increase the risk of depression in women, the triggers in men are divorce, relationship breakups, and problems at work," Johannes Wancata reports from the research.

Symptoms lasting at least several weeks
According to a representative study conducted in 2017 at MedUni Vienna's Division of Social Psychiatry, over the course of the year 7.4% of men and 12.6% of women in Austria suffer from depression. Even though there are clear indications of a correlation between negative stress and the onset of depression in both sexes, Johannes Wancata explains that it is impossible to establish a direct link between the current crisis and the much-reported rise in the number of people suffering from depression: "It's perfectly healthy to respond to threats or crises with anxiety, worry or pessimism, for example. However, if symptoms persist for several weeks or more and are so pronounced that they restrict a person's ability to cope with their daily lives, mental illness should be considered."