Is the man in your life depressed? Or is it something else?

by ih-mmd ih-mmd

Dr. Raymond Zakhari, NP

Before you run through the usual symptoms of a Major Depressive Disorder and immediately declare that the man in your life is not depressed, consider the symptoms of atypical depression which can also be called high functioning depression. 

In Major Depression, the symptoms are relatively easy to identify because it looks like what we may expect a depressed person to look like. We generally assume depressed people to have a depressed mood, anhedonia (loss of interest in once pleasurable activities), decreased appetite, feelings of worthlessness or excessive guilt, insomnia at night with fatigue during the day, difficulty concentrating, slowly moving (psychomotor retardation), and recurrent dark thoughts of suicide.

But there is another picture of depression which is more common in men. This type of depression is manifest by some of the symptoms of major depression but can be masked by some unusual symptoms. In someone with atypical depression, the person can remain reasonably high functioning. These guys may say something like I work very hard and I play even harder. They may be irritable especially around perceived wasting time, they may be very critical of themselves, and so they push themselves harder to “be the best.” They may overthink everything (even the most mundane things).  They may feel misunderstood. Because they don’t look and act typically depressed others assume that everything is Facebook fine.  This person may engage in an activity and perform well but takes no enjoyment in it and may feel numb during the process. Eventually, this person may consume excessive alcohol, gamble, try illicit drugs or misuse prescription drugs to feel something better or numb the bad feelings they may have. People with atypical depression may also find themselves eating more and becoming more fidgety. Finally, this person may engage in extreme escapist behavior like binge-watching or excessive gaming.  All of the symptoms of atypical depression are the body’s way of trying to make it feel better.

None of these individual symptoms is diagnostic of anything. However, when they are viewed in life’s context and consequence (and lasting at least 2 weeks), it may become clear that your man is suffering from depression.  While almost half of Major Depressive episodes may spontaneously resolve within a year even if you do nothing, 15% of people with depression commit suicide (more common in men)

How significant is 15%?

·         9% percent of the US population has Diabetes

·         20% of the US population has a sexually transmitted disease

·         7% of the population has depression

·         1% of the population has schizophrenia.  

Suffice it to say 15% is a very high percentage concerning health care statistics, and for this reason, if you suspect the man in your life has depression, or atypical depression despite being highly functional encourage them to get evaluated.

Could these symptoms be anything else besides depression?

These same symptoms can be associated with thyroid conditions, diabetes, low testosterone, and erectile dysfunction. A comprehensive physical exam with psychiatric evaluation can help you clearly identify and treat the condition of concern. A thorough physical examination and psychiatric mental health evaluation can be done in the privacy of your home with a house call.  

Dr. Raymond Zakhari is a triple board certified (Adult- Adolescent, Family Practice, Psychiatric Mental Health) Nurse Practitioner (NP). He provides Concierge Medical House Call services in Manhattan and outer boroughs. General #MedicalHouseCalls #PsychiatricHouseCalls (Therapy & Medication Management) #SkilledNursing House Calls Dr. Raymond Zakhari, NP does not take any insurance as he is out of network; provides concierge-style medical and psychiatric House call services. (If you have out of network benefits you may be reimbursed, check your plan for details).