Fatigue. Feelings of worthlessness. Loss of interest. We recognize these as classic signs of depression.
But according to Terry Real, MSW, LICSW, these symptoms aren’t always the way men experience depression.
So how do we help clients when their depression doesn’t necessarily look like depression?
In this short video, Terry shares a two-pronged approach to help his clients find relief.
Click here for full transcript
Please leave a comment below and tell us how you plan to use this in your work.
Don’t we all dream about the days when this is common knowledge and the shame around our inner world and/or our inner injuries have dissipated?
Thank you all at NICABM for your wonderful work!
I have talked to some men from whom I got a feeling they were not doing well, or even suicidal. It’s a gut feeling, still can’t put my finger on it. Maybe it’s something they said, like this fella who kept joking the whole time and talking about his love for stiff drinks.
I agree, I have asked clients “ if you weren’t drinking, what would you see inside or be left with?” And their affect changes quit noticeably.
I appreciate what is said about male ‘denial’ or ‘defense’ re; depression. Some of these same aspects do occur in women. Shame is huge. I am a 73yr. old female who has struggled with depression for decades. Meds. have never worked very well.
Margie Neugebauer, Counseling, Hermosa, SD, USA
says
Jan.
Thank you for acknowledging that depression many times is unresolved grief. This is exactly what the Grief Recovery Method states. As the Grief Recovery Institute states, much-unresolved grief leads to depression and PTSD. And you state correctly that grief is a natural and normal reaction to any significant emotional loss. The Grief Recovery Method is the only grief support group that is evidence-based.
Terrific job! Thanks.
An interesting synopsis.Men do not like to talk about their emotions, and rely on a false belief that they have to behave in the way that they have been conditioned in childhood and adolescence. Some of these specific traits are passed on on parenting and in adulthood and are acted out to suppress/ repress a deep sense of shame that they lack the coping skills to change such behaviour. Why do men apologise when they have had a violent outburst against their partners? Why to alcoholics say they will curb their drinking and not seek help? I have certainly seen differences in terms of very few men attending grief counselling( it tends to be more women who engage). I agree that the intense shame they feel is projected in some way as a defence mechanism. Yes it makes sense when these aspects are disarmed, the real elements of their depression emerge. I appreciated this viewpoint – makes one think !
I am grateful for this insight.
Admiring your work, I have found your comments quite interesting, Terry. My concern is when a client shows withdrawal with no sign of acting out or womanizing but more likely to satisfying pleasure through online porn, depression can be identified. Could it be also sign of grief due to past traumas or recent events in the client ‘s life, like lack of interest in activities, in people, in future, stuck in what is not present ? Thank you. Very grateful for your expertise that i will use to help my clients.
Being off from work has made me feel lonely because I love who I work for. Back next week, I feel lost already with fear. Been saying so much to everyone about my unhappiness no one care and think it will go away. So you think people understand about depression, bcs none could see I was going down the drain. Talked and forth to lose my dignity, I let myself go for a good start. So by this new decade I don’t see it much more different. Like the way it has been for my kids are so wonderful empathic and greatly loved. I am thankful and I can still nit snap out of it.
Just gotta hell of fun for the knew year friends mine and lots talk than drunk like am doing and gotta home alone in front of movie for two but got all done. Great night, thank-U. With muchhhh love then my app for tomorrow for mental care. Wish of luck see well my meds increased
i was told by my phychirtrist that i was living inthe past she signed me off yeh i cut my self i started drinking again ive lost my temper ive thrown alot of things that are worth alot too me and my family but being told i still live in the past well too be honest i bloody well dont ive told an asseser that dont look at me from the outside thinking ime all ok cos deep down inside i flippin well aint in the past was nt good for me no where near it nor my kids so how the heck can some one say ya living in the past paul deal with it ye years of abuse but soft towards any one yeh ive hidden my abuse pritty well but when ide came out and spoke about it well gonna sign ya of paul cant do nothing for you my answer hmm ok by
Hey yeap I live it when it flies and fast… din’t I go fwd no? It gonna always be in you lesser with time …just beat it bam bam Pam!!! Get it going I like it fast moving and gettin’ it done… you can talk to someone who can listen , me talk to everyone right pretty much hide years if abuse the only problem is not conscious about it… no blame only me . As opposed to you I avoid withdraw and shut down, terribly wrong and me being judging myself harshly. Tough and love
Seems right about withdrawing in men. Amazing sources. Thanks
How does the unbalanced of the hormones affect all the gender not considering the age factor?
I find another covert defense in men is aggressiveness and lived out aggression. It combats the feelings of helplessness and fear of being vulnerable. I’ve also noticed that this often coincides with unacknowledged, unresolved grief, and usually goes back to childhood losses and hurts, paving the way for dysthymia and covert recurring episodes of depression.
immeasurable …i’ve Seen this in men in their thirties who while denying there is possibility of depression or OD, they will argue and turn the blame to others and would turn to drinking as a mean of socializing and getting it out. Sadly this decision bring usually pleasures and reinforce their grief. What do you use to confront them to face the issue(s)! Thanks for sharing such findings.
I recently learned that older men often show signs of depression when they have low testosterone. I think this is an important idea to keep in mind so that treating depression doesn’t mask the underlying physiological issue.
It seems typical for men to carry on and Lloyd’s of lots and why? We ve no choice. It is how love we express in action and burn out. Stick to stone we like this the way it is , . Cool look in T’s Jeans and sandals BUT overwhelmed always by a to do list . Not only find this depressing. Just sayin’
I am an intern and just finished my program. This description of overt and covert behaviors.!Explained the open and hidden of what is consciously or unconsciously said. Intentionally or not. Very amazing Usually my anonymous clients hold me for caring more than keeping their confidentiality in file, they want to feel they can trust so to say the therapist. So, my sessions are only 30mins and I trust them to start early. Most women have no problem with this while men gets nervous and can not go straight on. Has anyone have this issue?
Discussion is always good. Sharing information, experiences etc. Intent is good. That is healing and living a life that is worthwhile, functional, meaningful and connected. Even having written this just now, I realise that my “definition” of a life is a modern one. I struggle with symptoms of depression daily, multiple times daily. I wonder if my expectations were not so profound, calculated, established, fixed – if my symptoms would be so felt? Or if it is just being a human being? We are simple yet complex. Our modern world of achieving success, setting and ticking off goals, “finding ourselves”, being heard, and so many other things – is what underlines some of our depression. If only we could “switch off”. Just be. This almost sounds regressive but just allow ourselves to be in the moment, be human, fail, make mistakes, regroup, redirect, sometimes go no where. Just some food for thought. Everything is ok. Everything will be ok. Easier said than done I know. We can just keep trying. Moment by moment. Hug ourselves.
Good day to you! Why so much rambling and not going for a midnight swim …in hot Season …it happened to me as I tend to overthink because I don’t want to be wrong . I wouldn’t feel alright at night. My chest ‘ll beats faster and wouln’t Keep my eyes shut. Then overthink has its unexpected planning that awaits nothing comes with a lifetime guarantee. Unfortunately that’s where depression arises. I can truly relate. Sometimes in fact our anxiety is unjustified because the other person could have the same feeling shame/guilt/fear of you seeing her as such. For me, I can’t think of the same reason, but my depression happens when I gets on the avoidance path rather front face life …
Andrea, you’re right on target in my opinion. This idea helps but takes practice and consistency to positively effect outcome. I can see this helping more so with anxiety. Depression can be triggered by many different situations. Support groups may help in certain situations where people don’t have someone to turn to for non-judgmental acceptance. Thank you for sharing.
Have more compassion for myself (woman) and also my husband. I don’t think this is unique to men. I am a woman who is acting out most of these things. I carry enormous shame about my depression. It is seen as a weakness. It is a weakness. It weakens me. I know you are not saying only men here. Men do need to be acknowledged and possibly exhibit different signs / behaviours, but it is no means easier for women. We have so much responsibility and must carry on. Juggling all the balls and just carry on. For men I think yes they feel burdened by the depression and want to avoid or not acknowledge or deal with it, but I just have to carry on. With my heavy load.
Thamnk uyo to commet forward. Men are terrifried to dread say ferociously the shaming feelings and stay konventional not saying in modern like uyo r i like that uyo let us know tank uyo
I hope this practitioner’s intent was to say that people of all gender identities deserve personalized, respectful, and effective care.
Because every client’s experience of depression is their unique, present, and profoundly personal experience of depression. Stereotyping that experience by gender – even with caveats – only reinforces stereotyping.
Every client – regardless of their gender – deserves to be recognized as an individual, no matter what combination of traits and experiences they may have.
Every client also deserves to be treated without prejudice, without bias, and without scorn.
Assumptions aren’t a shortcut for real listening. So listen. Listen, and listen more, and maybe, no matter what else they’ve heard, all of your clients will finally hear the song of their spirit, too.
I have lwritten about this subject and presented a papoer at the AATA conference 5 years ago. Yes, it is an important subject, and the more we talk about it and recognize the simptoms the sooner man will be able to be treated correctly. As an Art Therapist, I like to team up with a psychiatrist who recognises the specific medication which is appropriate, and I manage the art Psuchotherapy.
It might be that often men , and I speak here on behalf of my husband and brother , and from what I have noticed, hold themselves strongly as responsible for their action and are able to show vulnerability. As women, righteousness have more meaning since it leads to equality and that’s where their “strength” is ??
There are many paths that lead to depression and this is one of them. Certainly, the symptoms described are not exclusively male in nature and can be seen across genders, culturally, family, etc.
I do appreciate, however, the acknowledgment of tending to the needs of men’s psychological health and the idea that men might express symptoms differently.
Thank you. I recognize that method of masking depression in my ex-partner.
I logically thought he may need to feel good about himself and if I gave him confidence boosts it would help, but I realised after some time, those lightweight tactics we’re not significant enough for the level of help he needed.
I can see it is a real problem for many and I do wonder whether ego is mostly behind the vicious cycle as a main obstacle.
This is massive generalisation. I am female but come from a family that ignored all feelings for fear of collapse. Any negative feelings were simply not allowed and we were instead encouraged to self medicate. Also, at play was the dysfunctional family we lived in within the dysfunctional society of Northern Ireland and the “troubles”. Depression would have been seen as a luxury or a cop out. Something others get to have. This didn’t just apply to the men in the family.
It’s tough to fight through the depression after ending substance use. Often depression leads to relapse & so I like to use hypnotherapy early in recovery to start working with feelings.
I have found ,working as an addiction therapist ,that the depression in recovery is many times repressed grief. And to their disappointment, working a recovery program did not take it away. Since grief is normal and natural and not an addiction or a “character defect” , recovery steps don’t usually work. I found that addressing the losses with a time proven and evidenced based method has done wonders.
Jan.
Thank you for acknowledging that depression many times is unresolved grief. This is exactly what the Grief Recovery Method states. As the Grief Recovery Institute states, much unresolved grief leads to depression and PTSD. And you state correctly that grief is a natural and normal reaction to any significant emotional loss. The Grief Recovery Method is the only grief support group that is evidence based.
This resonates with me very much. I do similarly.. and it works
Awesome @ Terry REAL is the man of the year!
Very helpful.
Using the appropriate hypnotherapy technique for each individual (whether man or woman) to get to the root cause of all behaviors and symptoms, as well as resolving them on that level speeds up the healing process and brings about positive change. Often symptoms are the subconscious expressing symbolically the underlying issue.
I will share video with clients as way starting conversation about possible signs of depressiom