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Suicide in Male Menopause

"All men are born distraught, and will not for the world be satisfied." Anon.

There is a sad statistic that eighty percent of all suicides are men. Among men in middle age, three percent of those are more likely to turn to suicide and in men over sixty the number climbs to seven percent. The rate of suicide is much higher for men than women throughout life. Women may attempt more suicides, but are less likely to die from the attempt.

Many symptoms of midlife crises are overwhelmingly those of depression. As the recognition of male menopause (midlife crisis or andropause) is a fairly new study, health care workers, including mental health care, are trying to get up to speed on the care of andropausal men. One of the biggest problems facing them is that the diagnostic criteria for depression are almost exclusively female.

This is because more women, by far, seek relief from depressive symptoms. Women are much more likely to reach out for help while men, taught or influenced to be strong and stoic, are reluctant to do so. In fact, denial is a pervasive problem in the diagnosis and care. Men are more apt to mask their symptoms with risk taking behaviors such as gambling, unprotected serial sex, or in acts of daring such as unsafe driving or "extreme" sports. 

Another factor is problems with sexuality. Many men deny their problems with impotence and do not understand the correlation to their depression. The loss of bodily and sexual vigor is viewed as a major loss, whether men realize that or not, and that can lead to a more profound depression.

Jed Diamond, author of "Male Menopause" has charted the differences of male and female depression and it makes for fascinating reading. Just a few of the examples of difference are these: Men are likely to act out, women turn inward. Women sleep too much; men sleep too little. Women use food, friends, and "love" to self medicate; men use alcohol, television, sports and sex to self medicate.

Another sad fact is that it can take ten years and three health professionals to arrive at the proper diagnosis of depression. Between denial and his need to be s"trong", a man can sabotage his own proper diagnosis without meaning to do so.

This is why proper diagnostic criteria is so valuable. Even though many parents strive to raise their sons and daughters equally, regardless of sex there is no getting around the societal pressures from friends, school and the media that exert their influence on boys. There are also our own ingrained impulses to take into account. We may tell our sons that it is OK to show emotion, to cry, to be afraid, but there is a whole world outside our door that tells him to be strong, stoic, and hard.

One more sad statistic is that sixty to eighty percent of adults never get help for their depression. A more hopeful statistic is that of those who get help for depression, eighty to ninety percent of those seeking help can get relief of their symptoms.