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MEN’S
HEALTH
Treating Depression
Disorders in Men
By Malathi V. Koli, M.D. F.A.P.A
Depression is a leading cause of disability and a major health ideation is the most serious one. Many depressed patients experience
problem in the U.S. and throughout the world. It is estimated that thoughts of death, ranging from transient feelings that others would
5 percent to 8 percent of the general population is affected by major be better off without them, to actual planning, and implementing
depression in their lifetime. to commit suicide.
As of 2013, there were 40,000 deaths by suicide in the U.S., mak- Major depression accounts for 50 percent of suicides. Hence early
ing it the 8th leading cause of death. There is evidence of serious detection of depression and effective treatment interventions are
somatic symptoms and physical illness linked to depression. Recent imperative. For each 8-10 deaths by suicide, 18-20 suicide attempts
studies have found depression in elderly patients is a predictor of are made.
negative cardiovascular events, including myocardial infarction
stroke and death. Factors associated with elevated risk for suicide:
1. Males — older than 45 especially over 65 age group
When depression is detected early and well treated, it can reduce 2. Caucasian males
the risk of suicide, adverse physical health and will increase produc- 3. Protestant
tivity. 4. Divorced or widowed
5. Recent severe loss
The estimated economic loss due to depression ranged from 6. Poor prognosis with serious physical illness
$83.1 billion in 2000 to $210.5 billion in 2010. 7. Prior suicide attempts
8. Family history of suicide
Symptoms and factors 9. Unwillingness to accept help
Now let us examine the symptoms of major depressive disorder. 10. Lack of support system
11. Alcohol or drug abuse
Five or more of the following symptoms are needed to be present 12. Depression with psychotic symptoms
for at least two weeks:
Compared to males, more female patients attempt to commit sui-
1. Feeling sad, blue cide, however male patients are higher in completing suicide.
2. Loss of interest in things one usually enjoys
3. Changes in appetite — up or down with weight loss Depression comes in a variety of forms due to different etiology.
Other medical illnesses can present with depression simultaneously.
or weight gain
4. Trouble sleeping — too little or too much Differential diagnosis, to mention a few
5. Loss of energy or feeling tired all the time
6. Feeling sluggish, psycho-motor retardation Hypothyroidism Secondary to cardiovascular disease, MI
7. Difficulty concentrating or making decisions.
8. Feeling worthless and guilty Multiple sclerosis Secondary to stroke:
9. Thoughts of death or suicide
Pancreatic Cancer Dementia
Not all patients display all symptoms. Symptoms can be catego-
rized as emotional and physical. Among these symptoms suicidal Lyme disease Parkinson disease
16 San Antonio Medicine • December 2015 Chronic Fatigue Syndrome
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