According to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR), major depressive disorder (MDD), also known as clinical depression or major depression, is characterized by a recurrent low mood along with low self-esteem and loss of interest or pleasure in every day activities.  Many disorders have related symptoms to and are usually comorbid (or paired) with MDD.

According to Branny and White (2008), the prevalence rate for this disorder is much higher for women than it is for men, making men a minority in this area.  This means that more women than men are self-diagnosing themselves and entering themselves into treatment.  For this reason, effective interventions are lower for men than for women.  This makes sense because there won’t be a high push for treating men with depression effectively (and differently than women) if there isn’t a high rate of them seeking treatment.  There may also be an overdiagnosis of women with depression because women are known to be more in tune with how they feel and more open with expressing their emotions.  They may enter themselves into therapy, displaying signs of depression when the cause of their low mood could be temporary, thus relieving their symptoms and them returning to a "normal" state of mind.

According to Branny and White (2008), as far as symptoms in the DSM go for diagnosing depression, they are usually aimed towards women.  Depressed women show symptoms of worry, crying spells, helplessness, loneliness, suicidal idea, augmented appetite and weight gain, which are all recorded in the DSM as symptoms of depression.  Some symptoms that are not common to diagnostic criteria for (adult) depression are slow movements, scarcity of gestures and slow speech, non-verbal hostility, trait hostility, and alcohol dependence in difficult times.  These are all symptoms shown by men but are not under the criteria for being diagnosed with depression.  Here is an outlined list found in “Big boys don’t cry: depression in men” of non-diagnostic symptoms of depression:

Diagnostic criteria and non-diagnostic symptoms for depression

ICD–10 F32 Depressive episode (World Health Organization, 1992)

·       Depressed mood

·       Loss of interest or enjoyment

·       Reduced energy, leading to increased fatiguability and diminished activity

·       Marked tiredness after slight effort

·       Reduced concentration and attention

·       Reduced self-esteem and self-confidence¹

·       Ideas of guilt and unworthiness

·       Bleak and pessimistic views of the future

·       Ideas or acts of self-harm or suicide¹

·       Disturbed sleep

·       Diminished appetite¹

DSM–IV Major depressive episode (American Psychiatric Association, 1994)

·       Depressed mood

·       Loss of interest or enjoyment

·       Weight loss

·       Insomnia or hypersomnia

·       Psychomotor agitation

·       Fatigue

·       Feelings of unworthiness¹

·       Reduced concentration

·       Slow movements²

·       Slow speech²

Non-diagnostic symptoms

·       Alcohol dependence during difficult times²

·       Bodily pains¹

·       Hostility (non-verbal)²

·       Hostility (trait)²

·       Scarcity of guestures²

·       Stooping posture¹

            According to Li, Guiseppe, and Froh (2006), “in gender role theory, the feminine style of coping is to deal with the emotion associated with the stressor (emotion focused), whereas the masculine style is to deal directly with the stressor (problem focused).”  According to Branny and White (2008), this causes some to question whether or not we are addressing depression in the right way.  Some have suggested that ‘male depressive syndrome’ (characterized by periodic irritability, anger attacks, and aggressive behavior) needs to be addressed as a symptom or branch of depression so that men can be diagnosed correctly instead of overlooked based on the non-feminine symptoms they may exhibit.

So as you can see, this disorder is typically seen in females rather than males.  I believe, however, that this is because of the pressure society puts on men to be strong and unemotional in a sense as well as the stigma that is put on women that they are weak and emotional.  There is also no real reason for men to think there is something wrong with them because they do not display the written symptoms of depression, which are targeted towards females.  For this reason, men are likely underreported because they do not want to seem weak in the eyes of others for feeling the way that they do, or because they are exhibiting symptoms that are not classified in the DSM.

-Emily

References:

American Psychiatric Association.. Diagnostic and statistical
manual of mental disorders (4th ed., text rev.). 2000. web. 25 April 2012
doi:10.1176/appi.books.9780890423349.

Li, C., DiGiuseppe, R. and Froh, J. "The roles of sex, gender, and coping in adolescent depression." Adolescence. 2006. web. 25 April 2012 409–415.
 

Peter Branney and Alan White. "Big boys don't cry: depression and men." Advances in PsychiatricTreatment. 2008. web. 25 April 2012. 256-252.