Irritable
Male
Syndrome
 

Jed Diamond is the internationally best-selling author of eight books including Male Menopause, now translated into 17 foreign languages and his latest book, The The Irritable Male Syndrome: Managing. The 4 Key Causes of Depression and Aggression and Mr. Mean: Saving Your Relationship from the Irritable Male Syndrome

For over 38 years he has been a leader in the field of men's health. He is a member of the International Scientific Board of the World Congress on Men’s Health and has been on the Board of Advisors of the Men’s Health Network since its founding in 1992. His work has been featured in major newspapers throughout the United States including the New York Times, Boston Globe, Wall Street Journal, The Los Angeles Times, and USA Today.

He has been featured on more than 1,000 radio and T.V. programs including The View with Barbara Walters, Good Morning America, Inside Edition, CBS, NBC, and Fox News, To Tell the Truth, Extra, Leeza, Geraldo, and Joan Rivers. He also did a nationally televised special on Male Menopause for PBS. He looks forward to your feedback. E-Mail You can visit his website at www.menalive.com Take The Irritable Male Syndrome quiz.

 

A couple wondering in the wilderness
Anger, Sex, Emotional Expression, and Irritable Male Syndrome (IMS)
Are Males Are Becoming the New Second Sex?
Are Men All That Bad or Are Our Small Gametes to Blame?
Are Men an Endangered Species?
Are You A Man With IMS? Are You Living with an IMS man?
Be Stress-Free Forever! 5 Simple Steps
Connecting and Networking
Depression Unmasked: His and Hers
The Differences Between Male and Female Depression
Don’t Scapegoat President Obama for the Failure of Our Sick, Addictive, Economy
Hard is Good and Not So Hard is Good Too: Discovering the Wisdom of the Penis
“Hell Hath No Fury like a Man Devalued”
Help Us Save The Males
A Gene’s Eye View of The Gender Dance. Making Babies: Will My Genes Be Carried On?
From Jekyll to Hyde: The Story of Barry and Sharon
The Irritable Male Syndrome: A Multi-Dimensional Problem in Life
The Irritable Male Syndrome: A Multi-Dimensional Problem in Life Part 2
The Irritable Male Syndrome and Domestic Violence
The Irritable Male Syndrome: Same problem, different View
The Irritable Male Syndrome: Take the Test The IMS Questionnaire
The Irritable Male Syndrome: Up Close and Personal
Irritable Out-of-Work Men and the Women Who Love Them
Is Becoming a Man Even Possible? The Evolution of Desire: Are There Two Human Natures?
Is It Healthy Love or “Love” Addiction?
It could be IMS not IBS that is the problem when nice men turn mean
Japanese Boys “Act Out” Their Anger and “Act In” Their Pain
The Legacy of Depression: My Father’s Story Part I
The Legacy of Depression: My Father’s Story Part II
Male Depression Rising due to Western Socioeconomic Changes
The Many Masks of Male Depression
Men’s Love and Hate for Women
My Own Story of Anger and Violence
The Real Reason Oprah, You, and I Keep Getting Fat and What We Must Do
7 Little Known Secrets For Making Money and Saving the World on SCRIBD
Sex, Love, and Intimacy: How Much is It Worth?
Suicide is a Predominantly Male Problem
Tapping Power: A Man’s Guide to Eliminating Pain, Stress, Anger, Depression and Other Ills Using the Revolutionary Tools of Energy Psychology
Ten Things You Must Do To Save Your Mid-Life Marriage and Live Happily Ever After, Part I
Ten Things You Must Do To Save Your Mid-Life Marriage and Live Happily Ever After, Part II
What Are Mid-Men Looking For When They Leave Their Partners?
What Do Mid-Life Men Really Want?
What Does It Mean to Be Male?
What Have We Done to Our Sons?
What is Depression and Why Is It Vital to Understand It?
What Is IMS?
What We Know About Depression and Teen-age Boys
When Depression Takes Over and Life Becomes Too Painful
Why Male Depression Is Hidden: My Personal Experience
Why Men Leave? What Every Woman (and Man) Needs to Know
Why Mid-Life Men Leave Perfectly Good Marriages
Women: Dealing with Mr. Mean
Y Am I Like This?

Why Mid-Life Men Leave Perfectly Good Marriages


“He says he loves me, but he’s not in love with me. He talks about leaving our marriage, but won’t tell me why. I’m devastated. Our children are hurt and confused. I love this man. What do I do? Help!” This is an excerpt of a letter, typical of many I am receiving every day, from a woman who is mystified about the behavior of her mid-life husband. Though, I hear most often from heterosexual couples, similar dynamics are present with gay and lesbian couples I’ve worked with. What’s going on here?

Certainly one possibility is that these aren’t good marriages at all. Many relationships deteriorate through time, yet one or both partners are oblivious to the unhappiness and pain that their spouse is experiencing. There are marriages that should have ended long ago, but the couple stays together because they are afraid to leave. However, there are other marriages that are really quite healthy, though all relationships of any length have their ups and downs, yet one spouse feels driven to leave.

There are, of course, many mid-life women who leave perfectly good marriages, but here I want to talk about the guys. Why do so many men leave their partners after 15, 20, or 30 years of marriage? The couple has often weathered many of the stresses of raising children, developing financial security, and seems to be ready to enjoy their later years. Yet, just when things seem to be going well, he becomes increasingly restless and wants to move out. His reasons are often vague and confusing. “I just need to find myself,” or “There’s nothing wrong with you. I just I feel like I’m missing something in our marriage", or “You’re making my life miserable. I can’t stand it anymore.”

It’s usually the woman who contacts me first. She’s emotionally distraught, hurt, angry, and afraid. “I don’t know what’s happened to my husband. He’s changed. We’ve had our good times and bad, but he’s always told me how much he loves me and how glad he is to be with me. All of a sudden it seems like I’m his worst enemy. I just don’t understand.”

When I talk to the guys, I find that they share similar experiences. Somewhere in midlife, often following some kind of loss—a parent dying, children moving out of the home, an illness, a sports injury, a bout of erectile dysfunction—he begins to become increasingly irritable. Rarely does he recognize the connection between the loss he’s experienced and his feelings of dis-ease. At first he is not aware that he is becoming unhappy. When he begins to recognize that something isn’t right, he looks for the cause.

Weeks, months, or even years can go by. All of a sudden things “click” for him. “It’s her.” Like a new born duckling who imprints on the first object he sees, these guys often associate their wives or partners with their unhappiness. Though they are rarely conscious of it, the undercurrent of their thought process goes like this. “God, I’m really feeling unhappy here. This is terrible. I have to find out what’s causing it. Martha just made one of those remarks that I hate. She’s always saying things to irritate me. Now, I see. It’s Martha, Martha, Martha!

He then begins to see her less as a source of joy in his life and more as a problem to be confronted or, more often, avoided. He becomes increasingly unhappy. He alternates between withdrawal and demands for more attention, love, and sex. He wants to be held, nurtured, and told that he is the best, but he can’t get past his perception that she is the source of his unhappiness. Even when she is loving and nurturing, he interprets it as a jab or attack.

She picks up on, usually unconsciously at first, his changed attitude. She becomes more irritable, defensive, and frustrated. Her negative attitude and behavior becomes additional validation that his perceptions were correct. “She really doesn’t like me,” he thinks to himself. “She doesn’t respect me. Nothing I ever do is enough for her. What’s the use?”

Over a period of months and sometimes years, these negative attitudes and “self-talk” cause the couple to become more and more estranged. At its most extreme, he becomes convinced that she is bad. “What kind of horrible woman treats her man with so little respect and care?” he thinks to himself in despair. She becomes convinced that he is mad. “He must be losing his mind. He’s acting totally irrationally.”

Enter, the other woman. Well, actually she’s been there all the time. She may be his trusted secretary who listens to his frustrations at work. It could be a co-worker with whom he shares dreams for the future. It may be his best friend’s wife who looks so nice and who gives him that certain look that says she thinks he’s someone special. It may just be the “feminine” in the world–All those anonymous, but lovely women that we see walking down the streets every day, or who gaze out at us from our television and computer screens. In the past she may have been someone he just noticed. Now he notices with ever more attention. “If only I had her,” he muses. “If she were in my corner, everything would be OK.” His fantasies may be sexual, but the need is for much more than sex.

If the wife comes to be seen as the problem, the other woman comes to be seen as the solution. Somehow she must have the key to his future happiness.

Since there are no secrets in the world of intimate relationships, the wife will “know” that there is another woman in the picture. She’ll know it even before she becomes aware of it. It will begin as an undercurrent of fear and anxiety. It the awareness finally bubbles to the surface, she may keep her concerns inside for awhile. When she finally voices them, he will most often tell her she is being ridiculous. “You’re imagining things,” he says. Or, “We’re just friends.” Or, “All men look at pretty women.” He may, in fact, believe what he says. She may accept his words and believe that her fears are ungrounded. He’s rarely aware of what’s going on until it’s too late. She rarely sees the underlying dynamic until he’s past the point of no return.

It may be months or years before he actually walks out the door, but in truth, he has left long ago. The couple may come to counseling and he may say he wants to work things out. He often is trying to “keep his marriage from falling apart.” However, too often his internal mind-set has solidified: “My wife can’t give me what I need. She’ll never change. There is some female out there who has the key to my happiness. I’m going to find her.”

Does this sound familiar to you? Have you been in the husbands shoes? How about the wife’s or the other woman’s? What did you do? How did it work out?

It’s one of the great tragedies I see in the world today. So many couples break up, just at the point when they could begin to heal old wounds and have the best relationship of their lives. What’s worse, neither really understands what’s going on. Like addicts hooked on heroin, they are pulled along a path that promises delight, but ends in destruction. Is there a way out? Tune in to my next post for some additional answers.

Y Am I Like This?


Genesis, chapter 5, tells us about "the generations of Adam": Adam begat Seth, Seth begat Enosh, Enosh begat Kenan... down to Noah of the flood. Translated into modern genetic terms, the account could read "Adam passed a copy of his Y chromosome to Seth, Seth passed a copy of his Y chromosome to Enosh, Enosh passed a copy of his Y chromosome to Kenan"... and so on until Noah was born carrying a copy of Adam's Y chromosome. The Y chromosome is paternally inherited; human males have one while females have none.

All human cells, other than mature red blood cells, possess a nucleus which contains the genetic material (DNA) arranged into 46 chromosomes, themselves grouped into 23 pairs. In 22 pairs, both members are essentially identical, one deriving from the individual's mother, the other from the father. The 23rd pair is different. While in females this pair has two like chromosomes called "X," in males it comprises one "X" and one "Y," two very dissimilar chromosomes. It is these chromosome differences which determine sex. That’s the good news about the Y chromosome. If we didn’t have it we would all be females.

However, the bad news is that the Y is very short compared to the X with which it is paired. Until quite recently it was believed that the Y chromosome was becoming ever shorter and some felt that it might lose function all together. However, a 40-strong team of researchers led by Dr. David Page of the Whitehead Institute at the Massachusetts Institute of Technology has found that the Y chromosome is much more important than scientists once believed.[i]

As well as having a previously unknown and elaborate back-up system for self-repair, the Y chromosome also carries 78 genes, almost double the previously known tally, the researchers reported. "The Y chromosome is a hall of mirrors," says Page, whose team has for the first time identified the full genetic sequence of a Y chromosome, from an anonymous donor.

The team believes the Y has developed an apparently unique way of pairing up with itself. They found that many of its 50 million DNA "letters" occur in sequences known as palindromes. Like their grammatical counterparts, these sequences of letters read the same forward as backward but are arranged in opposite directions - like a mirror image - on both strands of the DNA double helix. This means that a back-up copy of each of the genes they contain occurs at each end of the sequence. When the DNA divides during reproduction, the team believes, it opens an opportunity for genes to be shuffled or swapped and faulty copies to be deleted.

Cut this Other chromosomes typically have thousands of genes packed into their DNA. The Y-chromosome, to date, has been found to have only about 20 genes. The XX chromosome that women have helps insure that genetic errors on the X chromosome will be masked by the other X.

Although new discoveries show that the Y chromosome can repair itself better than was once thought, men with only one X and a very small matching chromosome, the Y,. are still more susceptible to problems than are females. As a result males suffer more genetic problems than females such as color blindness and muscular dystrophy.[ii]

From the moment of conception males are more fragile and vulnerable than females. Male fetuses die more often than female. So do male newborns. So do male infants. So do male adolescents. So do male adults. So do old men.[iii]

Part of the explanation is the biology of the male fetus, which is little understood and not widely known. At conception there are more male than female embryos. This may be because the spermatozoa carrying the Y chromosome swim faster than those carrying X. The advantage is, however, immediately challenged. External maternal stress around the time of conception is associated with a reduction in the male to female sex ratio, suggesting that the male embryo is more vulnerable than the female.[iv]

The male fetus is at greater risk of death or damage from almost all the obstetric catastrophes that can happen before birth.[v] Perinatal brain damage,[vi] cerebral palsy,[vii] congenital deformities of the genitalia and limbs, premature birth, and stillbirth are commoner in boys,[viii] and by the time a boy is born he is on average developmentally some weeks behind his sister: "A newborn girl is the physiological equivalent of a 4 to 6 week old boy."[ix] At term the excess has fallen from around 120 male conceptions to 105 boys per 100 girls.[x]

So we see that right from the moment when that sperm penetrates the egg, males begin to experience problems. Some of us don’t make it. We die off early. Others survive to make it into the world, but are at a greater handicap than our female counterparts.

One of the most respected scientists of our times, Ashley Montagu, wrote an entire book aptly titled The Natural Superiority of Women. Written in 1953 and updated a number of times since, he counters sexist claims of female inferiority and offers a host of data from many fields of science to demonstrate that women's biological, genetic, and physical makeup makes her not only man's equal, but his superior in many ways.

In looking at male disabilities we must remember that we are talking about averages. More males will suffer brain damage, for instance, than females. If you are one of those males, you probably find it easy to believe that males are at greater risk than females. However, if you’re the mother of a brain damaged daughter, you may feel outraged that we are saying that males are at a disadvantage.

As we go through the ways in which men feel endangered and insecure, remember that we aren’t speaking of all men. But we need to recognize the ways in which these underlying issues affect all men’s sense of security. We might think of these things as the foundation of manhood. There are many ways in which the foundation itself is weak beginning with weaknesses based on our genetic makeup and extending to our upbringing and socialization.

William S. Pollack, PhD and Ronald F. Levant, EdD have spent a great deal of their professional careers working with males. Dr. Pollack is the co-director of the Center for Men at McLean Hospital and assistant clinical professor of psychology in the Department of Psychiatry at Harvard Medical School. Dr. Levant is dean and professor of Psychology, Nova Southeastern University, Ft. Lauderdale, Florida and founder and former director of the Boston University Fatherhood Project.

In their excellent book, New Psychotherapy for Men they describe the behaviors that are often at the core of male susceptibility to later problems in life. Men suffer under a code of masculinity that requires them to be:

  • aggressive
  • dominant
  • achievement-oriented
  • competitive
  • rigidly self-sufficient
  • adventure-seeking
  • willing to take risks
  • emotionally restricted
  • and constituted to avoid all things, actions, and reactions that are potentially “feminine.”[xi]

Dr. Pollack also blames many of men's self-destructive ways on the persistent image of the dispassionate, resilient, action-oriented male -- the Marlboro Man who is self sufficient and self absorbed. Although there has been progress in the last 10 years in helping men expand our range of emotions, for most men the training we grew up with still restricts us. Men in our culture, Dr. Pollack says, are pretty much limited to a menu of three strong feelings: rage, triumph, lust. "Anything else and you risk being seen as a sissy," he tells us.[xii]

In a number of books, most recently Real Boys: Rescuing Our Sons From the Myths of Boyhood, he proposes that boys "lose their voice, a whole half of their emotional selves," beginning at age 4 or 5. "Their vulnerable, sad feelings and sense of need are suppressed or shamed out of them," he says -- by their peers, parents, the great wide televised fist in their face.[xiii] He added: "If you keep hammering it into a kid that he has to look tough and stop being a crybaby and a mama's boy, the boy will start creating a mask of bravado."[xiv]

In his book, The Hazards of Being Male: Surviving the Myth of Masculine Privilege, psychologist Herb Goldberg summarizes what many have come to believe about men. “The American an endangered species? he asks. “Absolutely! The male has paid a heavy price for his masculine ‘privilege’ and power. He is out of touch with his emotions and his body. He is playing by the rules of the male game plan and with lemming-like purpose he is destroying himself—emotionally, psychologically and physically.”[xv]

[i] Nature 423, 810 - 813 (19 June 2003)

[ii] Although it is true that the Y chromosome contributes to men’s genetically related problems, new evidence points to the fact that the Y chromosome is not as dysfunctional as once thought. For current information on these findings see Nature website at www.nature.com/nature/focus/ychromosome/ and Nature Genetics at www.nature.com/cgi-taf/DynaPage.taf?file=/ng/journal/v35/n3/full/ng1103-195.html

[iii] The World’s Women 2000: Trends and Statistics New York: United Nations, 2000.

[iv] D. Hanson D, H. Møller H, and J. Olsen. Severe peri-conceptional life events and the sex ratio in offspring: follow up study based on five national registers. BMJ 1999; 319: 548-549.

[v] R. Mizuno. The male/female ratio of fetal deaths and births in Japan. Lancet 2000; 356: 738-739.

[vi] M.E. Lavoie, P. Robaey, J.E.A. Stauder, J. Glorieux, F. Lefebvre. Extreme prematurity in healthy 5-year-old children: a re-analysis of sex effects on event-related brain activity. Psychophysiology 1998; 35: 679-689.

[vii] J.E. Singer, M. Westphal, K.R. Niswander. Sex differences in the incidence of neonatal abnormalities and abnormal performance in early childhood. Child Dev 1968; 39: 103-112.

[viii] D.C. Taylor DC. Mechanisms of sex differentiation: evidence from disease. In: Ghesquiere J, Martin RD, Newcombe F, eds. Human sexual dimorphism. London: Taylor & Francis, 1985:169-189.

[ix] T. Gualtieri, R. Hicks. An immunoreactive theory of selective male affliction. Behav Brain Sci 1985; 8: 427-441.

[x] L. B. Shettles LB. Conception and birth sex ratios. Obstet Gynecol 1961; 18: 122-130.

[xi] Ronald F. Levant and William S. Pollock (Eds.). A New Psychology of Men. New York: Basic Books, 1995.

[xii] Quoted by Natalie Angier. Why Men Don’t Last: Self Destruction as a Way of Life. February 17, 1999 New York Times on Line http://www.nytimes.com/library/national/science/menshealth/17angi.html

[xiii] Ibid.

[xiv] Ibid.

[xv] Herb Goldberg. The Hazards of Being Male: Surviving the Myth of Masculine Privilege. New York: Nash Publishing, 1976, Dusk jacket quote.

Why Male Depression Is Hidden: My Personal Experience


In my marriage, I would often get irritable, angry, blaming, and judgmental. I was sure other people, particularly my wife, were doing things that caused me to become irritable and angry. I couldn’t see that the source of the problem was inside. Usually the irritability and anger that is characteristic of the “acting out” variety of the Irritable Male Syndrome (IMS) is obvious, though its cause may not be.

There’s another side of the problem that is usually hidden. I describe it as “acting in” IMS. Here our irritability may cover a more severe, yet concealed, problem. For many men, chronic irritability is a symptom of depression. Yet because the classic symptoms of depression don’t include components of irritability, it is often missed in men.

This was the case with me. One of the times I noticed it was after our son was born. Although I was ecstatic at his birth, I also felt irritable and edgy. I knew that some women suffered from post-natal depression, but I didn’t think it could occur in men. No one did 34 years ago when my son was born.

However, recent studies in England suggest that men also have problems after the birth of their children. Mary Alabaster, the manager of maternal mental health services has developed a program that includes men. Her own research suggests that male postnatal depression exists and is triggered by a wide variety of causes. "It really has to be taken seriously,” she says. "There has been lots of research that shows that fathers actually do suffer from postnatal depression, but people aren't actually doing anything about it.”[i]

There have been a number of times in my life I had been concerned that my irritability and anger might be related to depression. As a professional therapist I was well aware of the official symptom list, and periodically I would go over them to see how they applied to me.

Here is how it is determined if a person is suffering from depression using the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the main diagnostic reference of Mental Health professionals in the United States of America:[ii]

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

(1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.

(2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).

(3) Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.

(4) Insomnia or hypersomnia nearly every day.

(5) Psychomotor agitation or retardation nearly every day.

(6) Fatigue or loss of energy nearly every day.

(7) Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

(8) Diminished ability to think or concentrate, or indecisiveness, nearly every day.

(9) Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Every time I checked my own feelings and behavior against the criteria for depression listed here, I concluded I was not depressed. I rarely experienced depressed moods as the official manual defined them. I didn’t feel sad or empty or appear tearful. I didn’t feel a markedly diminished interest or pleasure in all, or almost all, activities. I noted that irritable mood is only an indication of depression in children and adolescents.

I always felt like a guy returning from the dentist. I was relieved that they didn’t find any cavities, but concerned that they hadn’t found a cause for my pain and discomfort. However, when the symptom was irritability, it seemed I knew the cause. The cause, I firmly believed, was my wife, or sometimes my children, friends, colleagues, the President of the United States (with his irrational policies), or “this messed up world we have to live in.” If there was a problem, it was clearly their problem. Getting my wife into treatment might help things, I thought. But, I was firmly convinced, my irritability and unhappiness didn’t have anything to do with me.

Whenever my wife, or occasionally a close friend, suggested I might want to “see someone,” I could easily brush them off. “Look, I’m a mental health professional. I’ve been in practice for more than 30 years. Don’t you think I would know if I had a problem? And listen, don’t take my word for it. Here, look at this.” I’d remind her that that I wasn’t depressed according to the professionally accepted official manual. I didn’t qualify. Case closed.

It took me a long time to believe that there might be something going on with me despite what the official manual said. It took even longer for me to wonder if the official manual might be wrong. As a psychotherapist I saw a lot of people who were depressed, primarily women. The criteria in the DSM-IV seemed to fit the majority of the depressed women I was seeing. However, though it fit some of the men, it seemed to miss a lot of those who I believed were depressed.

Furthermore, I couldn’t understand why the DSM-IV would recognize that irritability was a symptom in children and adolescence, but fail to recognize it in adults. For me irritability was one of the prime emotions that I was experiencing and my unhappiness generally expressed itself through worry, anxiety, and hypersensitivity.

I also remember my work over the years with people suffering from substance abuse problems. We used to believe that heroin addicts “got well” if they survived to be 40. That was because we didn’t see them showing up in treatment programs after that age. The problem was that they were showing up in alcohol treatment programs. Since the two types of programs didn’t communicate well with each other, we often didn’t notice that the spontaneous cures were anything but that. In fact, most of the addicts who had not fully recovered had simply switched to a different drug.

I wondered if a similar thing was happening with depressed men. In my work with men who used and abused alcohol and other drugs, I found a lot of them were depressed. However their depression was rarely recognized or treated because it was covered by their alcohol use. In some ways the men were “self medicating.” Using alcohol was a way many depressed men dealt with their painful feelings.

[i] Adam Lusher and Brian Welsh. Men To Get Counselling for “PostNatal Depression.” Accessed August 24, 2003 on the World Wide Web. www.telegraph.co.uk/news/exit.jhtml?exit=http://www.maledepression.com/links/links17.html

[ii] Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). American Psychiatric Association, Washington D.C., 1994

What We Know About Depression and Teen-age Boys


Teen-age boys are much more likely to express their sadness through anger than are girls.

Traditional school counseling and therapy are often not best suited for connecting with young males. Finding something to “do” together makes talking much easier.

Even though teen-agers, and boys in particular, often act hostile or indifferent to our offers to help, they are hungry to have someone who really wants to understand them.

Remember that what seem like “small” slights can seem “huge” when you’re a teenager. Our self-esteem and connection to others is very vulnerable. It doesn’t take much—a negative word, an indifferent stare, a lack of appreciation, a rebuff from a girl we like—to throw us into a tailspin.

Being laughed at, teased, or humiliated is one of the most crushing experiences young people go through, particularly males. The resulting experience of shame is at the core of much of the violence we see in young males. “I have yet to see a serious act of violence that was not provoked by the experience of feeling shamed and humiliated, disrespected and ridiculed, “says James Gilligan, M.D., author of Violence: Our Deadly Epidemic and It’s Causes.[i]

Sex, success, and self-esteem are very much intertwined for teen-age boys. We need to find ways to reach out to them and discuss these often taboo topics. One of the techniques I used with my teenage son (on separate occasions with my teenage daughter) was to get him in the car to take him somewhere. I would always take the long way around and use the time to talk to him about all the things I wished my father had said to me when I was his age. Usually he was silent or would make disgusted or disgusting sounds. But he couldn’t escape and later as an adult we joked about it and he told me they were even helpful at times.

While suggestions of suicide should always be taken seriously, we need to be particularly concerned about young males. They are much less likely to let us know that they are becoming increasingly depressed and much more likely to complete a suicide attempt than are young females.

There are a number of researchers and clinicians who work with boys that recognize the different ways boys express their unhappiness. “We see boys who, frightened or saddened by family discord,” say Dr. Dan Kindlon and Dr. Michael Thompson in their book Raising Can: Protecting The Emotional Life of Boys, “experience those feelings only as mounting anger or an irritable wish that everyone would ‘just leave me alone.’ Shamed by school problems or stung by criticism, they lash out or withdraw emotionally.”[ii]

“In so many cases, what in the teenage years may look like a bad boy is really a sad boy, whose underground pain may lead him to become extremely dangerous to others, or much more likely, to himself,” says Dr. William S. Pollack, author of Real Boys’ Voices. Tragically, boys rarely ‘attempt’ suicide; when they reach out for a knife, a rope, or a gun, generally they are not crying for help. Rather, they are very much trying to get the job done.”[iii]

[i] James Gilligan. Violence: Our Deadly Epidemic and Its Causes. New York: G.P. Putnam’s Sons, 1996, 119.

[ii] Dan Kindlon and Michael Thompson. Raising Cain: Protecting The Emotional Life of Boys. New York: Ballantine Publishing Group, 1999, 3.

[iii] William S. Pollack with Todd Shuster. Real Boys’ Voices. New York: Random House, 2000, 148.

When Depression Takes Over and Life Becomes Too Painful


Recognizing the close relationship between the irritability and anger that is “acted out” and what is “acted in” can be seen in the origin of the word suicide. The word is taken from Latin and means killing of the self. However, the German equivalent Selbstmord, which translates as self-murder speaks directly to the violence that occurs within. Although most people experience the milder forms of “acting in” IMS, it is useful to explore the outer fringes where death is a very real possibility. Seeing IMS in its extremes can better help us understand what most people experience. Suicide is still a fearful and taboo subject, one most people would rather ignore. Yet unless we confront the reality of suicide too many males will continue to die, too many will experience unremitting suffering, and too many families will be destroyed.

Kay Redfield Jamison is Professor of Psychiatry at the Johns Hopkins University School of Medicine and former director of the UCLA Affective Disorders Clinic. She has written more than a hundred scientific papers about mood disorders, psychotherapy, psychopharmacology, and suicide. It’s safe to say, she is one of the best in the field and knows what she is talking about.

But, unlike most other professionals who describe the problems of others, Dr. Jamison acknowledges her own battles with life-threatening mood disorders. “Within a month of signing my appointment papers to become an assistant professor of psychiatry at the University of California, Los Angeles, I was on my way to madness.” This is how she begins her book, An Unquiet Mind: Memoir of Moods and Madness. “It was 1974,” she says, “and I was twenty-eight years old. Within three months I was manic beyond recognition and just beginning a long, costly personal war against a medication that I would, in a few years’ time, be strongly encouraging others to take. My illness, and my struggles against the drug that ultimately saved my life and restored my sanity, had been years in the making.”[i]

Jamison, by her own admission, came very close to death many times in her life. “I was seventeen when, in the midst of my first depression, I became knowledgeable about suicide in something other than an existential, adolescent way. For much of each day during several months of my senior year in high school, I thought about when, whether, where, and how to kill myself. I learned to present to others a face at variance with my mind; ferreted out the location of two or three nearby tall buildings with unprotected stairwells; discovered the fastest flows of morning traffic; and learned how to load my father’s gun.”[ii]

Ten years later she found the desire to die overwhelming. “After a damaging and psychotic mania, followed by a particularly prolonged and violent siege of depression, I took a massive overdose of lithium [the most common medication used to treat manic depressive illness]. I unambivalently wanted to die and nearly did. Death from suicide had become a possibility, if not a probability in my life.”[iii]

From then on she was on a quest. “As a tiger learns about the minds and moves of his cats, and a pilot about the dynamics of the wind and air, I learned about the illness I had and its possible end point. I learned as best I could, and as much as I could, about the moods of death.”[iv] What she has learned can be a help to us all.

The underlying conditions that predispose an individual to kill himself include heredity, severe mental illness, and an impulsive or violent temperament.[v]

There are a number of events or circumstances in life that interact with these predisposing vulnerabilities: Romantic failures or upheavals; economic and job setbacks; confrontations with the law; situations that cause or are perceived as causing, great shame, and injudicious use of alcohol or drugs. [vi]

Suicide in our young has at least tripled over the past forty-five years.[vii]

One in ten college students seriously considered suicide and most had gone so far as to draw up a plan.[viii]

One in five high school students had seriously considered suicide and most had drawn up a suicide plan.[ix]

[i] Kay Redfield Jamison. An Unquiet Mind: Memoir of Moods and Madness. New York: Vintage books, 1996.

[ii] Jamison. Night Falls Fast: Understanding Suicide. New York: Vintage Books, 1999, 5-6.

[iii] Ibid., 6.

[iv] Ibid., 6-7.

[v] Ibid., 19.

[vi] Ibid., 19.

[vii] Ibid., 21.

[viii] Ibid., 21.

[ix] Ibid. 22.

What Have We Done to Our Sons?


If you are a parent, like me, who has a boy you know how difficult it is to raise him. I believe it does take a village to raise a child and most parents aren’t getting much help. In our tribal past everyone in the village celebrated the birth of a child and were responsible for his upbringing. Even when I was growing up most people in the neighborhood knew the kids. If I was doing something I shouldn’t, someone would usually notice and call me over for a little talk. My parents would hear about it before I even got home.

In many families there were grandparents, aunts, uncles, cousins who lived in the same house or nearby. Now extended families are a rarity. Nuclear families, with a Mom, Dad and kids, are the rule and even they are breaking down. Divorce results in many children being raised by a single parent, usually the mother. Even in “intact” families the economic demands of our modern life-style require both parents to work. Children rarely get the physical, emotional, and spiritual support they need.

This is having a devastating impact on children. In the last 10 years there has been a lot of attention paid to the stresses on girls growing up. We are only recently beginning to recognize what is happening to our boys. “Girls, our new myths tell us, have life much worse than boys,” says psychologist Michael Gurian, author of The Wonder of Boys. In-depth research shows that girls and boys each have their own equally painful sufferings. To say girls have it worse than boys is to put on blinders.”[i]

Boys who are having trouble now, grow into troubled teens, and become adults who are much more likely to suffer from IMS. “If there’s one thing we’ve learned,” says Dr. Dan Kindlon, of Harvard University and Dr. Michael Thompson, a preeminent child psychologist, “it’s that, unless we give him a viable alternative, today’s angry young man is destined to become tomorrow’s lonely and embittered middle-aged man.”[ii]

Understanding what our boys are experiencing can better help us deal with IMS in our teenagers. It can also make us aware of the kinds of stresses many adult males experienced growing up. Understanding our boys can also alert us to the kinds of stresses that will form the character of the men of the future.

Schools Are Leaving Our Boys Behind

In 1990, psychologist Carol Gilligan announced to the world that America’s adolescent girls were in crisis. “As the river of girl’s life flows into the sea of Western culture, she is in danger of drowning or disappearing.”[iii] A number of other popular books focused on the problems our daughters were experiencing in school. “Something dramatic happens to girls in early adolescence,” said Mary Pipher, author of Reviving Ophelia. “Just as planes and ships disappear mysteriously into the Bermuda Triangle, so do the selves of girls go down in droves. They crash and burn.”[iv]

These concerns were taken up by women’s groups and organizations concerned about the effect of society on the success of our daughters. As a result money was poured into the schools to make changes that would help the girls. Some researchers feel that the data supporting the view that girl’s are being shortchanged is suspect and that many of the changes that are meant to be “girl friendly” in fact discriminate against boys.

Interestingly, it is a woman who has become one of the strongest advocates for boys. Christina Hoff Sommers has a Ph.D. in philosophy from Brandeis University and was formerly a professor at Clark University in Worcester, Massachusetts. “The research commonly cited to support the claims of male privilege and sinfulness is riddled with errors,” she says. “Almost none of it has been published in professional peer-reviewed journals…A review of the facts shows boys, not girls, on the weak side of an educational gender gap.”[v]

I don’t find it helpful to get into a debate of whether females or males have a worse time of it. My experience raising both male and female children is that each sex has unique strengths and unique difficulties. Having worked in the classrooms when my son and daughter were growing up, it seems to me that both girls and boys are getting shortchanged. Here I want to focus on the boys since a great deal of attention is already being focused on girls and educational programs seem to be geared more to the success of our daughters.[vi]

Data from the U.S. Department of Education and from several recent university studies show that boys are falling behind in their education. Girls get better grades.[vii] They have higher educational aspirations.[viii] They follow a more rigorous academic program and participate more in the prestigious Advanced Placement (AP) program.[ix]

Christina Hoff Sommers notes that “A 1999 Congressional Quarterly Researcher article about male and female academic achievement takes note of a common parental experience; ‘Daughters want to please their teachers by spending extra time on projects, doing extra credit, making homework as neat as possible. Sons rush through homework assignments and run outside to play, unconcerned about how the teacher will regard the sloppy work.’ In the technical language of education experts, girls are academically more ‘engaged.’”[x] She also cites studies that have found that “engagement with school is perhaps the single most important predictor of academic success.”[xi]

It should not surprise us then that girls read more books.[xii] They outperform males on tests of artistic and musical ability.[xiii] More girls than boys study abroad.[xiv] Conversely, more boys than girls are suspended from school. More are held back and more drop out.[xv] Boys are three times as likely as girls to be enrolled in special education programs and four times as likely to be diagnosed with attention deficit/hyperactivity disorder (ADHD).[xvi] More boys than girls are involved in crime, alcohol, and drugs.[xvii]

We discussed in chapter 3 the huge difference in the suicide rate between males and females. Although the difference increases with age, it is significant during the school years. Between the ages of 5 and 24 males kill themselves nearly six times more often than females.[xviii]

The Horatio Alger Association is a fifty-year-old organization devoted to promoting and affirming individual initiative and “the American dream.” In 1998 they released a survey that contrasted two groups of students: the highly “successful” (approximately 18 percent of American students) and the “disillusioned” (approximately 15 percent of students.

They noted that the students in the successful group work hard, choose challenging classes, make schoolwork a top priority, get good grades, participate in extracurricular activities, and feel that their teachers and administrators care about them and listen to them. According to the report, the successful group is 63 percent female and 37 percent male.

At the other extreme, the disillusioned students are pessimistic about their own futures, get low grades, have minimal contact with their teachers, and believe that there is no one they can turn to for help. We would certainly say the disillusioned group has become demoralized. According to the report, “Nearly seven out of ten are male.”[xix] These are the young men who will suffer from the Irritable Male Syndrome. They will more likely become involved in violent or suicidal behavior, drop out of school, get involved with alcohol and drugs, have difficulty finding good employment opportunities, and have a very chaotic family life when they marry.

Although these statistics can just seem like numbers on the paper, they are very real to me. I work at a health clinic where I see the real people behind the statistics. Although we serve both males and females, I am always struck by the numbers of males that I see. I am rarely called to the school for problems with the girls. It is almost always with one of the boys. If you think about it I believe you will recognize real people you know behind many of these statistics.

Many of these boys are sinking below the surface and calling out for our help. Will we be there for them? If we pay attention to our young men, they will have a better chance to grow up to be responsible and loving adults. Whether or not we help them, they will grow up and the great majority will find a partner, start a family, and likely pass on their experiences to the next generation of young males.

[i] Michael Gurian. The Wonder of Boys. New York: G.P. Putnam’s Sons, 1996, p. xvii.

[ii] Dan Kindlon and Michael Thompson. Raising Cain: Protecting the Emotional Life of Boys. New York: Ballantine Books, 1999, p. vii.

[iii] Carol Gilligan, “Prologue,” in Making Connections: The Relational Worlds of Adolescent Girls at Emma Willard School, ed. Carol Gilligan, Nona Lyons, and Trudy Hammer. Cambridge, Mass: Harvard University Press, 1990, p. 4.

[iv] Mary Pipher. Reviving Ophelia: Saving the Selves of Adolescent Girls. New York: Putnam, 1994, p. 9.

[v] Christina Hoff Sommers. The War Against Boys: How Misguided Feminism is Harming Our Young Men. New York: Simon & Schuster, 2000. p. 14.

[vi] I am indebted to Christina Hoff Sommers for gathering a great deal of the data on the educational system and our boys.

[vii] See Carol Dwyer and Linda Johnson. “Grades, Accomplishments, and Correlates,” in Gender and Fair Assessment, ed. Warren Willingham and Nancy Cole. Mahwah, N.J.: Erlbaum, 1997, 127-56.

[viii] Higher Education Research Institute. The American Freshman: National Norms for Fall 1998. Los Angeles: Higher Education Research Institute, University of California, Los Angeles, 1998, pp. 36, 54.

[ix] See Hoff Sommers. The War Against Boys., p. 24 and U.S. Department of Education National Center for Education Statistics. The Condition of Education, 1998, p. 90.

[x] Ibid., p. 28.

[xi] Ibid., p. 29.

[xii] Higher Education Research Institute. The American Freshman: National Norms for Fall 1998. Los Angeles: Higher Education Research Institute, University of California, Los Angeles, 1998, pp 39, 57.

[xiii] National Center for Education Statistics, NAEP 1997 Arts Report Card. Washington, D.C.: National Center for Education Statistics, 1998.

[xiv] Of students studying abroad, 65 percent are female, 35 percent male; see chart “Study Abroad by U.S. Students, 1996-1997.” Chronicle of Higher Education, December 11, 1998, p. A71.

[xv] For suspension rates, see U.S. Department of Education, Conditions of Education. Washington D.C.: U.S. Department of Education, 1997, p. 158. For data on repeating grades, see U.S. Department of Education, Conditions of Education, 1995, p. 13. For information on dropouts, see U.S. Department of Education, Digest of Educational Statistics 1995. Washington, D.C.: U.S. Department of Education, 1995, p. 409.

[xvi] For data on special education, see U.S. Department of Education, The Condition of Education. Washington D.C.: U.S. Department of Education, 1994, p. 304. For information on ADHD, see American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Vol. 4. Washington D.C.: American Psychiatric Association, 1994, p. 82. According to DSM-IV, the official diagnostic guide for all of us who work in the mental health professions, “The disorder is much more frequent in males than in females, with male-to-female ratio ranging from 4:1 to 9:1, depending on the setting.”

[xvii] For statistics on alcohol and drugs, see “National Survey Results on Drug Use,” in National Institute on Drug Abuse, Monitoring the Future Study, 1975-1995, vol. 1, Secondary School Students. Rockville, Md.: National Institute on Drug Abuse, 1996, p. 20. See also U.S. Department of Education. The Conditions of Education. Washington D.C.: U.S. Department of Education, 1997, p. 300, Table 47-3, “Supplementary Tables.” For crime statistics, see U.S. Department of Justice, Female Offenders in the Juvenile Justice System: Statistics Summary. Washington, D.C.: U.S. Department of Justice, 1996, pp. 28-29.

[xviii] The male rate is 47 per 100,000, while the female rate is 8.1 per 100,000. Summarized from R. Anderson, K. Kochanek & S. Murphy. Report of final mortality statistics. Monthly Vital Statistics Report, 45 (11), Hyattsville, MD: National Center for Health Statistics, 1997 and from G. Murphy. Why women are less likely than men to commit suicide. Comprehensive Psychiatry, 39, 1998, 165-175.

[xix] Horatio Alger Association. State of Our Nation’s Youth 1998-1999. The survey conducted by NFO Research, Inc., was based on two small but carefully selected samples of students (a cross section of 2,250 fourteen- to eighteen-year olds as well as a computer-generated sample of 1,041 students; see p. 4. The researchers are careful to note that this study is not definitive and provides only a “snapshot in time.”

What Does It Mean to Be Male?


Nothing is closer to our sense of self than our sense of “maleness” and “femaleness.” When our babies first emerge from the womb the mother (and increasingly the father who is in the delivery room) hears “congratulations, it’s a boy,” or “it’s a girl.” Many “parents to be” will say that they would be happy with either a boy or a girl, but none can ignore the fact that boys and girls are not alike.

Although we all recognize the differences, there is a great deal of controversy about what differences exist, whether they are inherent or a product of culture, and what these differences mean. In the past differences have often been used to restrict the freedom and opportunities of one group, most often women. Even the consummate scientist, Charles Darwin, believed that men were naturally smarter than women.

This superior male intelligence, he proposed, arose because of the unique tasks that men practiced. It was the men that fought to win mates, made tools to hunt, cooperated with other men, and fought wild animals to “bring home the mammoth.” He believed that the need of our male ancestors to compete with each other, created a superior level of intelligence. He assumed an aggressive, intelligent Adam and a gentle, nurturing Eve. This image conformed to what Darwin saw everywhere around him in Victorian England.[i]

This sexist view of gender differences was bitterly attacked after World War I. Margaret Mead was among the intellectual leaders of the period who believed that differences were not built in, but were a product of the particular culture in which a person lived. As Mead wrote in 1935, “We may say that many if not all of the personality traits which we have called masculine and feminine are as lightly linked to sex as are the clothing, the manners and the form of headdress that a society at a given period assigns to either sex.”[ii]

This view that what makes us male and female is largely determined by our environment has held sway since then. Certainly when I was doing my graduate training in the 1960s that was the view in most academic settings. To suggest that there were inherent differences between males and females was to open oneself to attack as being ignorant and sexist. For some women, and particularly for many academic feminists, there was a fear that acknowledging that there were inherent differences between males and females would lead back to a time when “different” was seen as “inferior.” It was an understandable fear.

However, there is an increasing body of evidence that has accumulated over the last 25 years that shows that males and females are different in many ways. Even many feminist academics now recognize these differences and realize that men and women can be different without one being superior to the other. According to Dr. Bobbi S. Low, Professor of Resource Ecology at the University of Michigan, “New research in evolutionary theory, combined with findings from anthropology, psychology, sociology, and economics, supports the perhaps unsettling view that men and women have indeed evolved to behave differently—that, although environmental conditions can exaggerate or minimize these differences in male and female behaviors, under most conditions each sex has been successful as a result of very different behaviors.”[iii]

This was certainly my experience raising a boy and a girl. No matter what my wife and I tried to do to raise our children in non-sexist ways, there were certain things that just seemed to be built in. Our boy turned everything into guns, even when we gave him dolls. Our daughter spent lots of time playing house even when we tried to interest her in baseball. “Some societies minimize the difference between the sexes; others—perhaps the majority—exaggerate them,” say David Barash and Judith Lipton authors of Making Sense of Sex: How Genes and Gender Influence Our Relationships. “But the differences are never reversed, and thus evidence mounts in favor of a biological common denominator.”[iv]

We will see that a good deal of what leads to the Irritable Male Syndrome can be understood in terms of the ways the biology of being male interacts with the environment we find ourselves in. It isn’t a question of nature versus nurture. Our biological nature influences our environment and our environment can have a profound impact on our biology.

In future columns we will take a look at some of these male attributes and see how they can help us understand why men are so vulnerable and subject to stresses and strains that lead to increased irritability.

[i] Helen Fisher. Anatomy of Love: The Mysteries of Mating, Marriage and Why We Stray. New York: Fawcett Columbine 1992, p. 190.

[ii] Margaret Mead, Sex and Temperament in Three Primitive Societies. New York: William Morrow, 1935, p. 180..

[iii] Bobbi S. Low. Why Sex Matters: A Darwinian Look at Human Behavior. Princeton, New Jersey: Princeton University Press, 2000, p. xiii.

[iv] David P. Barash and Judith Eve Lipton. Making Sense of Sex: How Genes and Gender Influence our Relationships. Washington, D.C.: Island Press, 1997, p. 5

Suicide is a Predominantly Male Problem


Randolph Nesse, M.D. and colleagues at the University of Michigan examined premature deaths among men in 20 countries. They suggest that as many as 375,000 lives could be saved in the US alone if male mortality rates were brought into line with those of women. Being male is now the single largest demographic factor for early death, the study concluded. "If you could make male mortality rates the same as female rates, you would do more good than curing cancer," Nesse says.[i]

Nowhere is this more evident than in looking at suicide rates. Each year, about 31,000 Americans commit suicide, making it the eighth leading cause of death in the United States. Almost every American has a relative, friend, or acquaintance who has killed himself. But what is often lost in the statistics and reports of suicide among “Americans,” or our “youth” or “high school” or “college” students is that the vast majority of these deaths occur in males.

Once thought to be primarily a white male problem, suicide is increasingly dramatically in the Black community. “The staggering growth in the number of black male suicides over the last 10 years is shocking,” says Susan Burks a writer for the Denver Post. “Suicide is now

the third-leading cause of death for African-American males ages 15 through 24. Suicide among black youth, once uncommon, showed a rate increase of 233 percent increase for boys between the ages of 10 and 14. Black teenagers in this country are killing themselves at a rate of 5 per day. Sixty-five percent of them are using firearms to do it.”[ii]

Whether Black, Caucasian, or any other racial or ethnic group, the number one risk factor for suicide is being male. In 1999, the suicide death rate was 18.2/100,000 among males, and 4.1 in females. This means that male suicides outnumbered female suicides by a ratio of more than 4 to 1.[iii] The imbalance between the number of males who kill themselves and the number of females who die by their own hand is evident throughout the life-cycle as the following table illustrates:

Estimated Annual Suicide Rate per 100,000 by Age and Gender[iv]
Age Range
Men
Women
Male:Female
5-14
1.3
0.4
3.25
15-19
18.5
3.7
6.08
20-24
27.2
4.0
7.35
25-64
25.6
6.1
4.20
65-85
49.4
5.1
9.68
85+
75.0
5.0
15.00

Points of Understanding

  • Even for children between 5 and 14 years of age when suicides are low, males are more than 3 times as likely to kill themselves as females.
  • For teens between 15 and 19 the ratio nearly doubles with males killing themselves 6 times as often as females.
  • During the young adult years, 20-24, the ratio jumps again to over 7 times.
  • In the adult years between 25 and 64, the male rate drops slightly and the female rate increases, but the ratio of male to female suicides is still more than 4 to 1.
  • However, in the retirement years after age between 65 and 85, the ratio more than doubles with more than 9 men killing themselves for every woman.
  • For the “old, old” over 85, the female rate drops slightly while the male rate increases dramatically. For those men who are fortunate to be alive after 85 fifteen times more men kill themselves than women.
  • There seem to be a number of factors that may account for the increased rate as men age. Being socially isolated, divorced, or widowed are important risk factors for men.[v]

The male suicide rate is also worrisome outside the United States. Worldwide, suicide claimed the lives of an estimated 815,000 people in 2000, the majority of which were males.[vi] The extent to which males outnumber females in suicide varies by country. For instance, in certain parts of China, where people most often kill themselves using chemical poisons found on rural farms, the numbers are nearly equal. However, in all other countries in the world males outnumber females. The sex disparity is especially high in countries of Eastern Europe and Latin America. Interestingly Puerto Rico has the highest ratio, with males killing themselves at rates more than 10 times that of females.[vii]

It is clear that men kill themselves at rates many times that of females in nearly all parts of the world. Yet females attempt suicide much more often. Most studies suggest that females experience depression at rates twice as high as males. Yet, we know that depression is highly associated with suicide. This raises some interesting and important questions. If the studies show that females tend to be more depressed than males, why do males have such high suicide rates? Are females really more depressed than males or are we failing to recognize depression in men? To answer these questions we need to delve more deeply into the world of depression.

[i] Being a man is bad for health. BBC News. July 24, 2002.

[ii] Susan Burks. Denver Post, January 3, 2003, Accessed on the internet January 12, 2003 at www.denverpost.com/Stories

[iii] National Center for Health Statistics: Health, United States, 2002. Hyattsville, MD, Table 30.

[iv] Summarized from R. Anderson, K. Kochanek & S. Murphy. Report of final mortality statistics. Monthly Vital Statistics Report, 45 (11), Hyattsville, MD: National Center for Health Statistics, 1997 and from G. Murphy. Why women are less likely than men to commit suicide. Comprehensive Psychiatry, 39, 1998, 165-175. Reported in Sam V. Cochran and Fredric E. Rabinowitz. Men and Depression: Clinical and Empirical Perspectives. San Diego, California: Academic Press, 2000, p. 141.

[v] Centers for Disease Control: Suicide among Older Persons, United States, 1980-1992. Morbidity and Mortality Weekly Report, January 12, 1996.

[vi] E.G. Krug, et al., eds. World report on violence and health. Geneva, World Health Organization, 2002, 185.

Is Becoming a Man Even Possible? The Evolution of Desire: Are There Two Human Natures?


Though the process is not always conscious, we never choose mates at random. We are all descended from a long and unbroken line of ancestors who competed successfully for desirable mates, attracted mates who were reproductively valuable, retained mates long enough to reproduce, and fended off interested rivals.

The way we carry out these vital functions is what evolutionary psychologists call our "reproductive strategy." It is our characteristic way of doing things, our standard operating procedure. It is what draws us to certain people, "the whisperings within," as Evolutionary Psychologist David P. Barash calls them. We don't always follow what we hear, but we must always listen.

When the anthropologist Napoleon Chagnon asked which females are the most sexually attractive to Yanomamo Indian men of the Amazon rain forest, his male informant replied without hesitation, "females who are moko dude." In referring to the life-giving fruits of the jungle, Chagnon was told, moko dude means that the fruit is perfectly ripe. When referring to a woman, it means that she is post pubescent but has not yet borne her first child, or about fifteen to eighteen years of age.

Since women's ability to conceive and bear children decreases with age, youth is a direct indicator of reproductive capacity. “Across all cultures,” say Barash and Lipton, “men consistently express a fondness for youthful women.” Another such indicator is beauty. Psychologist David Buss found that men throughout the world had a similar definition of beauty. "Full lips, clear and smooth skin, clear eyes, lustrous hair, and good muscle tone," he says," are universally sought after." Those who believe that beauty is arbitrarily defined in each culture are not aware of the increasingly convincing literature on the evolutionary basis of attraction between the sexes.

Attraction to beauty seems to be built into our biological makeup, according to psychologist Judith Langlois and her colleagues. In one study, adults evaluated color slides of white and black female faces for their attractiveness. Then infants of two or three months of age were shown pairs of these faces that differed in their degree of attractiveness. The infants looked longer at the more attractive faces. “This evidence,” says Buss, “challenges the common view that the idea of attractiveness is learned through gradual exposure to current cultural standards.”

Based on his research findings, Buss found a host of other differences between men and women and concluded that there are actually two human natures, one male the other female. He believed that both the similarities and the differences could be explained by understanding evolutionary pressures that our ancestors faced over the last five million years.

For instance, men's greater jealousy over his mate’s sexual infidelity can be traced, Buss believes, to the uncertainty men have over the paternity of their children. Every woman who gives birth is 100% certain that the child carries her genes. For men, on the other hand, there is always a degree of doubt. In evolutionary terms the consequence of raising a child that may not carry his genes, but those of another man, is the death of his line. Those men who took an easy-going approach to the possibility of his mate being sexual with other men left fewer genes than those men who were sexually jealous.

What makes Buss' findings so compelling is the breadth of his research. "If mating desires and other features of human psychology are products of our evolutionary history," says Buss, "they should be found universally, not just in the United States." To test his theories he conducted a five year study working with fifty collaborators from thirty-seven cultures located on six continents and five islands from Australia to Zambia. All major racial groups, religious groups, and ethnic groups were represented. In all, his research team surveyed 10,047 persons worldwide. His findings held up in every culture he surveyed.

Becoming a Man: The Big Impossible

It isn’t easy being a man today. We have the same evolutionary needs that we always had, but the world has changed in such a way that it is more difficult for many men to meet these needs. As always we must still compete with other males for access to females. If we come out on top in these contests we must then be chosen by the female.

Females are becoming choosier. As their power increases in the world, they are less willing to settle for men who don’t meet their standards.

In his book Manhood in the Making, anthropologist David Gilmore reports on his cross-cultural exploration of what it means to be a man. In cultures as diverse as hunter-gatherers, horticultural and pastoral tribes, peasants, postindustrial civilizations from the east and west, he found a similar vulnerability in all men. “Among most of the peoples that anthropologists are familiar with,” says Gilmore, “true manhood is a precious and elusive status beyond mere maleness.

Everywhere he looked at cultures Gilmore found that masculinity is a much more uncertain concept than that of femininity. As author Norman Mailer recognized “Nobody was born a man; you earned manhood provided you were good enough, bold enough.” He could be speaking about the universal man, not just men in contemporary western cultures. In aboriginal North America, among the Fox tribe for instance, manhood was seen as being “the Big Impossible,” an exclusive status that only the nimble few can achieve.

“A man must prove his manhood every day by standing up to challenges and insults,” says write Oscar Lewis, “even though he goes to his death ‘smiling.’”. How many young men do we see in our schools and neighborhoods today who would rather go to their deaths smiling than risk an insult to their manhood?

The case is different for females. Although women are pressured to live up to certain standards of femininity in all cultures and are sanctioned and punished if they deviate, they are not threatened with the loss of their womanhood to the degree that is true of men. “Rarely is their right to a gender identity questioned in the same public, dramatic way that it is for men,” says Gilmore. “The very paucity of linguistic labels for females echoing the epithets ‘effete,’ ‘unmanly’ ‘effeminate,’ ‘emasculated,’ and so on, attest to this archetypical difference between sex judgments worldwide.”

Who we are as men is shaped, in many ways, by what women find attractive. The reverse is also true. However, the feminine qualities are more solid and secure than are those for the men. There is no “big impossible” for women. Youth is a given for every female who is young. The parallel value for men to be strong and productive is not as easy to develop and maintain.

For women, beauty and youth may fade as they age, but there are huge industries whose main function is to make women appear young and attractive through the years. For men the skills and abilities to make a good enough living to attract and keep a woman are not always under a man’s control. There is no makeup or facelift that can create a job. Even if he does everything he can to get the education and develop the skills he needs for success, the economy may shift in ways that keep him from making the kind of living that would be most desirable.

What Women Want, Men Are Finding Hard to Provide

In Buss' world-wide study, he found that the top three qualities that women look for in men are exactly the same as those things that men look for in women: Intelligence, kindness, and love. Once again we see that, at their core, men and women are the same. But then, what women want diverges from what men want.

“Nothing agreeth worse than a lady’s heart and a beggar’s purse,” wrote the English satirist John Heywood in the sixteenth century. Whether in tribal societies like the Aleut Eskimos or the !Kung San of the Kalahari desert, women want to marry “big men,” individuals with rank and status. American women polled in both the 1930s and the 1980s considered a potential mate’s financial prospects about twice as important as men did. This is true world-wide and doesn't seem to depend on whether the women, themselves, are well off. I have found that women doctors, for instance, are drawn to even higher paid male doctors, rather than to male nurses who might share their interests.

“Power is the great aphrodisiac,” said Henry Kissinger. Looks are much less important for women than they are for men. From an evolutionary perspective, women wanted men who would provide resources for her and the children. Those who mated with socially powerful men reaped the benefits of her mate’s intelligence and charisma, as well as his ability to protect and provide. In Buss's study, he concluded that the reason women were less concerned about a man's sexual fidelity and more concerned about their mates emotional fidelity was the fear that an emotional attachment was more likely to lead to abandonment and the loss of the man's resources.

We see this evolutionary proclivity showing up in the modern dating and mating game. When interviewing the women contestants on the Joe Millionaire program, Time magazine found that the subject the women were most likely to lie about was their age. Male contestants for the show The Bachelorette were most likely to lie about their income. Even in T.V. land men know that women are drawn to men who are well off and men are drawn to female youth and beauty.

These desires are often not conscious. Women usually don't say to themselves, "I like that guy because he is willing to commit his resources to me and my children, if I decide to have children." She just says, "I like that guy. I can count on him." She doesn't say, "I want a tall strong man who can protect me from wild animals." She just says, "He turns me on. The chemistry feels right."

In the modern world, men are falling farther and farther behind. We begin with many biological disadvantages and are increasingly experiencing social stressors as well. At all stages of life our boys, teens, and adult men are losing out. This is most apparent in the two critical areas of life—production and reproduction. Without good jobs men are having trouble being productive in the world. Men who are not good producers and providers are not chosen by women to develop long-term relationships.

A Gene’s Eye View of The Gender Dance. Making Babies: Will My Genes Be Carried On?


None of your direct ancestors died childless. Think about that for a moment. It’s obvious that your parents had at least one child. Your mother’s parents and your father’s parents had children. If we could look backward and trace our ancestors as far back as we could go, we would find an unbroken chain of reproductive success.

We all know people today who don’t have children. However, that was not the case with any of our direct ancestors. Over a period of 5 million years, not one of our family members dropped the ball. We are a product of their reproductive success and you can bet that what it takes to pass on our genes to the next generation is built into our attitudes, desires, and behaviors. From an evolutionary perspective, whatever contributes to our genetic success makes us feel good. Whatever stands in the way of our evolutionary success makes us feel irritable, angry, and depressed.

Although our current research on the genome gives the impression that humans are increasingly in charge of our evolutionary future, it is a valuable exercise to look at humans “through the eyes of the gene.” Richard Dawkins was the first to make this view explicit. In his book The Selfish Gene, he says “No matter how much knowledge and wisdom you acquire during your life, not one jot will be passed on to your children by genetic means. Each new generation starts from scratch. A body is the gene’s way of preserving the genes unaltered.”

From a gene's perspective, it is less important whether we survive to a ripe old age, than whether we reproduce. Charles Darwin, the father of modern evolutionary theory, called this process "sexual selection." The idea that reproduction was the key to understanding why we do what we do was ignored for many years after Darwin's death and has only recently come back into vogue. "Its principal insight," says Matt Ridley, author of The Red Queen: Sex and the Evolution of Human Nature, "is that the goal of an animal is not just to survive but to breed. Indeed, where breeding and survival come into conflict, it is breeding that takes precedence; for example, salmon starve to death while breeding. And breeding, in sexual species, consists of finding an appropriate partner and persuading it to part with a package of genes."

The basic reality of sexual selection helps us understand a good deal about men and the Irritable Male Syndrome. We often wonder why it is young men, more often than young women, who take risks that put their lives in danger. An important reality is that during these key reproductive years it is the males who must compete against other males for access to the females. Whether he is a bull moose or a bull headed 20 year-old, he is willing to fight other males or take risks in order to have the best chance of having sex with the most attractive female he can find.

At the other end of the age spectrum it helps us understand why older men more often leave their partners or have affairs than do older women. Rarely do these older men hook up with a woman the same age as their wives. It’s almost always with a younger woman. Why? From an evolutionary perspective a person’s success is measured, not by their bank account or the value of their car, but by the number of children they are able to bring into the world and who grow up enough to have children of their own.

Have you ever watched Dr. Phil, the psychologist who became famous on Oprah Winfrey’s show? One of his favorite answers to women who ask “why does he do that?” (Usually the “that” has to do with some way in which the man is treating the woman badly.) Dr. Phil’s answer is often an in-her-face “Because he can.” What he usually means is that he does it because she lets him get away with it.

In the world of evolution “because he can” means “because he can produce children.” There is a reality that most 50-something couples don’t deal with directly. She is post-menopausal and cannot produce more children. He, on the other hand, has the biological potential to have more kids. If he continues to be stay with his 50 year-old wife, his genetic potential is limited. If, on the other hand, he finds a 35 year-old or a 25 year-old to have sex with him, his genetic success can be increased.

Remember, this does not occur on a conscious level. Few men say to themselves, “I’d like to increase the success of my genes, so I think I will leave my 50 year-old wife and date two 25 year-olds with the chance that I might have more children to carry my genes.” More often it expresses itself as “I love my wife, but we just don’t have the old spark we used to. We fight all the time and she just doesn’t like to do the things that I like to do. And, well, there’s this woman who I work with….”

Let me be very clear here. I’m not saying that because men have a genetic urge to leave their wives or have affairs with younger women that this is a good thing. I’m not saying that we are prisoners of our genes and that we have no power to decide what is right or wrong. I am saying that our biological urgings to reproduce and pass on the most genes to the next generation is powerful. If we are not aware of the strength of these desires we will have less success controlling them.

Remember, too, that for every older man who hooks up with a younger woman, there is a younger woman who wants to connect with an older man. As we will discuss later in the chapter, men have a biological attraction to young, attractive females because they have the best chance of producing children. Women have a biological attraction to successful men with resources available to share with them and their children (These are often older men who have had a chance to become successful in the world).

Yet, biology is not destiny. Older men don’t have to leave their wives and have affairs. Younger women don’t have to go after the husbands of those older wives. We all can choose, but the choices aren’t always easy.

Are you one of the people like me who has a hard time keeping your weight under control? I do well until I see the candy, cake, pies, or pudding. I can’t resist. Why is it so difficult for us? Evolutionary biology can help us understand our desire for sweets and other strong urges. It tells us that for most of our 5 million year ancestral history, sweets and fats were scarce. Those who learned to find the most and eat what they found were the most successful and passed on their genes to the next generation.

The problem today is that we still have the same biology, but now sweets and fats are everywhere. If we followed our biological urgings all of us would be 400 pounds and unable to walk. My point is that we can and do control our evolutionary desires, but it isn’t easy.

The knowledge of how difficult it is can help us be more successful. Whether we want to understand why we overeat, why young men take such high risks, why Viagra is the most successful drug of our times, why men stray, or why we are so irritable, we need to understand our evolutionary history and how our genes act on our minds, bodies, and actions.

We may not like the ways our genes influence us, but we better pay attention to their pull. “Genes never sleep,” say Drs Terry Burnham and Jay Phelan, two experts on genetic influences and authors of Mean Genes: From Sex to Money to Food—Taming Our Primal Instincts. “Instead of a blissful ‘they got married and lived happily ever after,’ gene fairy tales end with offspring and more offspring—any way the genes can get them.”

“Hell Hath No Fury like a Man Devalued”


These are the opening words of the book Eve’s Seed: Biology, the Sexes, and the Course of History by Robert S. McElvaine. They could also be the words of the millions of men today experiencing the Irritable Male Syndrome

In our computer economy, the blue-collar labor that was usually the province of men is being supplanted by what Peter Drucker calls “knowledge workers.” Drucker believes that those who are smart, educated, and computer literate, the “gold-collar workers, will be able to write their own career tickets. Career advancement has always been a part of men’s feeling of self respect. In the world of the future more and more men will lack the education to compete for the best jobs. Demographers predict that by 2007, 9.2 million American women and only 6.9 million American men will be enrolled in college.” says Fisher. “The contrast is even greater among part-time, adult, and minority students. Women are also gradually closing the education gap in much of the rest of the world.”

Women have always been better than men at “people skills.” They tune in to others’ feelings and are more empathic. These skills have enabled women to be good mothers and increasingly in the work place, excellent employees. Surprisingly, it was John D. Rockefeller who said, “The ability to deal with people is as purchasable a commodity as sugar or coffee. And I pay more for that ability than for any other under the sun.”

Neuroscientists currently believe that interpersonal sensitivity, a conglomerate of aptitudes they call “executive social skills” or “social cognition,” resides in the prefrontal cortex, the area of the brain behind the brow. Those with a well-functioning prefrontal cortex are aware of the feelings of others, pick up on emotional expressions and body language, and are adept at maintaining good social relationships with friends, family and co-workers.

Neuroscientist David Skuse believes that women are more likely than men to acquire the genetic endowment for developing these vital social skills. The reason, he believes, is that there is a specific gene or cluster of genes on the X chromosome that influences the formation of the prefrontal cortex. He found that this gene or gene cluster is silenced in 100% of men but active in about 50% of women. Hence about half of all women and no men have the brain architecture to excel at perceiving the nuances of social interplay. This doesn’t mean that the other 50% of women and all us men can’t learn these skills. It just means we have to work harder at it.

Dr. Simon Baron-Cohen is professor of psychology and psychiatry at Cambridge University. He has been researching sex differences for over twenty years. In his recent book, The Essential Difference: The Truth About the Male & Female Brain, he details the latest research in the field. His conclusions are both startling and clear-cut. “The subject of essential sex differences in the mind is clearly very delicate,” he cautions us. But the findings substantiate the fact that males and females are different, in large measure because of the different ways our brains are structured. “The female brain is predominantly hard-wired for empathy,” he tells us. “The male brain is predominantly hard-wired for understanding and building systems.”

Emotions Guide Our Direction in Life and Men Have Difficulty Expressing Their Feelings

The various mental states we call emotions have evolved through eons of time to help us meet life’s challenges. It is our emotions that let us know when we are on the right path in life. “Negative emotions—fear, sadness, and anger, says psychologist Martin Seligman, “are our first line of defense against external threats, calling us to battle stations. Fear is a signal that danger is lurking, sadness is a signal that loss is impending, and anger signals someone trespassing against us.”

Until recently the possible purpose of positive emotions for our survival was not considered. In 1998 psychologist Barbara Fredrickson published a paper titled “What Good Are Positive Emotions. Seligman who is the primary founder of the field of Positive Psychology said, “Fredrickson claims that positive emotions have a grand purpose in evolution. They broaden our abiding intellectual, physical, and social resources, building up reserves we can draw upon when a threat or opportunity presents itself.” It is our emotions that give color to our lives. Feeling our feelings and sharing what is inside us with others creates the bond that is the foundation of love.

Yet most men I know are very limited in our ability to experience a range of feelings let alone to put those feelings into words. One of the most common questions a woman will ask a man when she wants to get closer to him is “what are you feeling?” For most men the response is “I don’t know.” Women, on average, are more aware of their emotions, show more empathy, and are more adept interpersonally.

Alexithymia is a condition where a person is unable to describe emotion in words.

Frequently, alexithymic individuals are unaware of what their feelings are. Dr. Ron Levant, a professor at Harvard University, coined the technical term "normative male alexithymia" to describe the general emotional restriction most men experience. His own research and that of many others indicates that most North American males suffer to some degree from the conditioning of our culture which causes men to be underdeveloped emotionally.

His research shows that men have developed two primary responses to emotional issues. For vulnerable feelings including fear, hurt and shame, he sees men using anger as the "manly" response. For nurturing feelings, including caring, warmth, connectedness and intimacy, he sees men channeling these feelings through sex. It is called normative because his research shows that this limited dual response of anger or sex is the norm for men.

For most of us we are playing on an instrument with only two strings. Women have a whole orchestra to choose from. For many of us we alternate playing the note, “I’m pissed,” or “Let’s have sex.” It can be a pretty limiting repertoire, made even worse when men are going through IMS. However, psychotherapist Tom Golden, who works extensively with men suggests that men may feel as strongly as women, but have difficulty expressing themselves. Asking a man to tell you how he feels may not be the best way to find out what’s really going on inside him.

“When a man had suffered a loss, I started asking them not what he was feeling, but what he was doing about it. I was delighted at that point to see that when I asked the right questions, in the right manner, I started seeing things in a very different light. The men started talking to me about what they were doing. This was familiar territory. As the men talked of their endeavors, the emotions flowed in a comfortable manner feelings differently.”

What do you think? How do you feel? What’s your experience with feelings? Do men feel less, express feelings differently than women, or have different feelings? I’d like to hear your thoughts. You can e-mail me.

The Differences Between Male and Female Depression


Just as there are two life forces in the natural world, the outer-directed dynamic and the inner directed magnetic, I believe there are dynamic depressions which are expressed by “acting out” our inner turmoil and magnetic depressions which are expressed by “acting in” our pain. Men are more likely to experience dynamic depressions and women are more likely to experience magnetic depressions.

Women often express their depression by blaming themselves. Men often express their depression by blaming others—their wives, bosses, the economy, the government—Anyone or anything, but themselves. [i]

I have developed a chart to describe the main differences in the ways males and females experience depression. I want to emphasize that this is a short-hand summary of thousands of people I have seen. Most depressed people will find they identify with some things on both sides of the chart. Some men will find themselves predominantly on the magnetic side and some women will find themselves predominantly on the dynamic side. However, most depressed men, I believe, will identify more with the dynamic depressions and most women will identify more with the magnetic depressions.

Magnetic depression (Female)
Dynamic depression (Male)

Blame themselves for problems

Feel sad and tearful

Sleeps more than usual

Vulnerable and easily hurt

Tries to be nice

Withdraws when feeling hurt

Often suffers in silence

Feels they were set up to fail

Slowed down and nervous

Maintains control of anger/ May have anxiety attacks

Overwhelmed by feelings

Lets others violate boundaries

Feels guilty for what they do

Uncomfortable receiving praise

Accepts weaknesses and doubts

Strong fear of success

Needs to "blend in" to feel safe

Uses food, friends, and "love" to self-medicate

Believe their problems could be solved if only they could be a better… (spouse, co-worker, parent, friend)

Wonders, "Am I loveable enough?"

Blame others for problems

Feel irritable and unforgiving

Has trouble sleeping or staying asleep

Suspicious and guarded

Overtly or covertly hostile

Attacks when feeling hurt

Over-reacts, often sorry later

Feels the world is set up to fail them

Restless and agitated

Loses control of anger/ May have sudden attacks of rage

Feelings blunted, often numb

Rigid boundaries; pushes others away

Feels ashamed for who they are

Frustrated if not praised enough

Denies weaknesses and doubts

Strong fear of failure

Needs to be "top dog" to feel safe

Uses alcohol, TV, sports, and “sex” to self medicate

Believe their problems could be solved if only their… (spouse, co-worker, parent, friend) would treat them better

Wonders, "Am I being loved enough?"

Tom Golden, an expert on male emotions and author of Swallowed by a Snake: The Gift of the Masculine Side of Healing recognizes that the ways men and women deal with their emotions, particularly those of loss, may be quite different. Women often express their emotions through talk and tears. Men often express them through action and reflection. The kinds of actions men engage are often related to creativity, thinking, and practicality Golden believes.

“Eric Clapton used creativity in writing a song about his four-year-old son who died in a tragic accident,” says Golden. “C. S. Lewis wrote A Grief Observed which to this day is a classic in the grief literature. Mr. Lewis used his strength in writing and in thinking to do something that honored his wife and helped others.”

“Michael Jordan used his experience as an athlete when he dedicated his season on the Chicago Bulls in memory of his murdered father. Remember the championship where Jordan fell to the floor after the Bulls won the game and was tearful and holding the basketball at mid-court? It turns out that this was the season he had dedicated to his father and they won the championship. Additionally, the game was won on Father's Day, which sharpened and amplified the emotion surrounding his efforts to honor his father.”

Men and women often do not understand the ways each expresses loss and grief. Many men see women as dwelling on the past since they continue to talk and sometimes cry when they remember a loss. Women often feel that men are denying their emotions when the men say little and throw themselves into action. We all need to understand and be more accepting of male/female differences in emotional expression. Of course these differences don’t apply to all men or all women.

I tend to think of these kinds of male/female differences the same way I think of height. What do we mean when we say, “Men are taller than women?” We mean most men are taller than most women. We do not mean all men are taller than all women. As a man who is 5 feet 5 inches tall, I am constantly reminded of that fact. There are a lot of women who are taller than I am. So think of the above chart as a guide to help us explore the general differences between male and female depression.

Depression Unmasked: His and Hers


I think of male depression as being masked. Those of us who live with depression wear a mask that hides what we are really feeling from others and even from ourselves. People don’t know we are depressed because what they see doesn’t look like the kind of depression they are familiar with. We also mask our depression with other things like anger, alcohol, and chronic withdrawal.

As a result, the common view is that depression is predominantly a female problem. We think of teenage girls who are sullen and sobbing. We picture young women who become depressed after the birth of a child. We hear about mothers who are overwhelmed by the stresses of keeping a house and raising children (and now increasingly having to work). We read about the “empty nest” syndrome and know of women whose lives lose meaning after their children leave home.

We don’t usually associate the idea of “male” with the idea of “depression.” Male and aggression, yes. Male and depression, no. This view that depression is more common in women is borne out by a number of major research studies. Susan Nolen-Hoeksema, author of Sex Differences in Depression, found that depression is about twice as common in women as in men.[i] “One of the most consistent findings in the epidemiological study of mood disorders over the past 50 years in the United States,” say Drs. Sam V. Cochran and Fredric E. Rabinowitz, authors of Men and Depression: Clinical and Empirical Perspectives, “is that women suffer from depression at approximately twice the rate of men.”[ii]

Similar results were found in two large-scale studies, the Epidemiological Catchment Area study (ECAS) and the National Comorbidity Survey (NCS). Both these studies are noteworthy in that they interviewed people in the general population rather than surveying people who are already in treatment. The ECAS was sponsored in part by the National Institute of Mental Health and used trained interviewers to survey samples from five population centers (New Haven, Connecticut; Baltimore, Maryland, Raleigh-Durham, North Carolina; St. Louis, Missouri, and Los Angeles, California. A total of 19,182 persons were interviewed).[iii]

The study reported lifetime prevalence estimates of psychiatric disorders by gender. For the affective disorders as a whole (Depression, bipolar disorders, dysthymia) women outnumbered men two to one. Interestingly though, men outnumbered women five to one in alcohol abuse and dependence and antisocial personality disorders. I will return to this point shortly.

The NCS was designed, in part, to minimize gender bias in the reporting of symptoms of mental disorders, including depression. This study sampled a total of 8,098 men and women between the ages of 15 and 54. Although considerably more females than males reported symptoms of depression, the ratio was 1.6 to 1 rather than 2 to 1.[iv] It was believed that more men reported symptoms of depression because the interviews were done in such a way to counteract the male tendency to forget or underreport symptoms. However, neither study looked at the possibility that the symptoms of male depression may be quite different than those for women.

Although the generally accepted view is that women are much more likely to be depressed than men, these findings may be biased in the following ways:

  • Different behavior of reporting symptoms. Men tend to be less in touch with feelings than women and less likely to discuss feelings when asked. In addition we often view being “down” as being “unmanly” and hence less likely to discuss these kinds of feelings.
  • Since men don’t seek professional help as often as women, there tends to be a bias that women are more likely to be depressed.
  • Problems that are more common in men such as alcohol dependence, personality disorders, or acting out may mask depression.
  • When depressed, women often ruminate and re-play situations and feelings in their minds. Hence they are more likely to remember and be able to report them. Men tend to project their feelings on to others and avoid or deny problems. They are, therefore, much less likely to describe themselves as depressed.
  • Male role conditioning is such that we see ourselves as independent. If there are problems we are action oriented and solve them ourselves. We don’t focus on our feelings or share them with others. Women are conditioned more towards sharing what is going on inside them whether or not there is a solution.
  • Finally, symptoms that characterize female depression may be quite different from symptoms of male depression.

[i] Susan Nolen-Hoeksema. Sex Differences in Depression. Stanford, Ca: Stanford University Press, 1990.

[ii] Cochran and Rabinowitz, 2000, p. 11.

[iii] Lee Robins and Darrel Regier. Psychiatric Disorders in America. New York: Free Press, 1990.

[iv] R. Kessler, K. McGonagle, C. Nelson, M. Mughes, M. Swartz, & D. Blazer. Sex and Depression in the National Comorbidity Survey. II. Cohort effects. Journal of Affective Disorders, 30, 1994, 15-26.

Connecting and Networking


I’ve been working in the field of men’s health since my son, Jemal, was born in 1969. I wanted to be a different kind of father than my father had been able to be with me and I wanted to help bring about a new kind of world where males were valued and had joyful relationships with women, children, and other men.

When Gordon asked me to do a column, I wondered whether I could keep up with a weekly assignment. I thought it would be a good excuse for me to communicate regularly with people who might share some of my ideas on men and health. These columns have enabled me to reach out to people and share some of my ideas about what works in life and what doesn’t.

I’ve been working on a new book, The Irritable Male Syndrome: Managing the 4 Key Causes of Depression and Aggression for the last 2 or 3 years. I had gotten so many requests to get information out to people I have tried to put some of the information in these columns. I get lots of e-mails from people who have given me feedback on what they have gotten from the feelings and ideas that I’ve shared.

When I began writing on-line back in the early 90s, there wasn’t a lot out there on men and men’s health. Gordon Clay was the first person to bring information to people, both through his traveling book mobile and through his wonderful on-line site Menstuff. Now, the problem isn’t lack of information, but it can be too much information or information that isn’t exactly what we want when we want it.

With this my 30th column, I’d like to take stock. I’d like to know who has been reading these columns. I’d like to know what has been helpful or valuable to you. I’d like to know who you are, male/female, age, background—anything you’d like to share.

I know we are all so busy that it isn’t easy to find the time to send another e-mail out. To encourage some interchange and networking between us, I would like to offer you copies of my most asked about “White Papers” on men’s health, just by writing back and letting me know what you’d like to see in these columns. The value of these special reports is well over $200. Here’s a brief summary:

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Are Men an Endangered Species?


A new program opened in the United Kingdom in 2002 called Man Not Included.

Their logo shows a figure of a man surrounded by a red circle with a line running through it. The meaning is quite clear and, for me, the feeling was chilling. Man Not Included helps women who want to have children without the involvement of men. They help them to get the necessary sperm and teach them how to use it. And of course they have their own website at www.ManNotIncluded.com . Clearly there are those who feel that men are useful only as sperm donors.

The idea that men are in decline and may face extinction would have seemed ludicrous even a few years ago. Now more and more people are taking it seriously. In November, 2001, the prestigious British Journal of Medicine published an editorial written by Siegfried Meryn, M.D. titled “The future of men and their health: Are men in danger of extinction?”

The British Journal of Medicine is not a publication to make wild claims. They are one of the most scientifically grounded professional journals in the world. Dr. Siegfried Meryn is not a “pop-psychologist.” He is a medical doctor with a world-wide reputation in the field of men’s health. He is professor of medicine at the University of Vienna and chairman and president of the World Congress on Men's Health.

“Although there is still a long way to go in most societies around the world, it is clear that women can perform (and on most occasions outperform) pretty much all the tasks traditionally reserved for men,” says Dr. Meryn in his editorial. “In most of the developed world women are starting to outnumber men in medical schools and making rapid gains in terms of equality in compensation and opportunities in the workforce.”

“Will we see the gap in life expectancy between men and women widen as the gaps in social determinants of health become narrower? The answer is probably yes, unless women continue to adopt the same negative behaviors that characterize men today. With the advent of sperm banks, in vitro fertilization, sex sorting techniques, sperm independent fertilization of eggs with somatic cells, human cloning, and same sex marriages, it is also reasonable to wonder about the future role of men in society.”[i]

Devra Davis is one of the top health researchers in the world. Her specialty has been the relationship between health and the environment. She is now Visiting Professor of Public Policy at Carnegie Mellon University’s Heinz School and Senior Advisor to the World Health Organization. In her recent book, When Smoke Ran Like Water: Tales of Environmental Deception and the Battle Against Pollution she devotes an entire chapter to the serious decline in male reproductive viability that seems to be caused by our destruction of the environment.[ii]

In the chapter “Save the Males” she notes that men are having increasing difficulty fathering children and males are actually in decline. “Now it looks like something is wrong with baby boys,” she cautions. “Fewer boys are being born today than three decades ago, and more of them have undescended testes and effects in their penis. More young men are getting testicular cancer than as recently as the early 1990s, and they are developing it at younger ages. Some trendy magazines have even suggested that male health is an oxymoron.[iii]

So what do I mean when I say I think that men are in danger of extinction? First, I think the whole human race is in danger of destroying ourselves either through wars or environmental destruction. Obviously if we kill off humanity, the men go as well. Second, I believe that sometime in the not too distant future, society might decide that there are too many males and limit the number of males that are born. Some even suggest that we could eliminate males completely. “Man himself may in the end become redundant,” says Steve Jones, Professor of Genetics at University College London. “for his sperm can be grown in animal testes, and in mice at least an egg can be fertilized with a body cell from another female, which cuts out the second sex altogether.”[iv]

Third, we have seen in earlier chapters that men are killing themselves through suicide, through homicide and wars. This could lead to a severe reduction in the male population. Finally, males could continue losing significant roles in the society and might become psychologically extinct, if not physically so.

Whether these possible losses ever come to pass, they still influence our psyches. If you ask the average guy why he is so irritable he is unlikely to say because I’m afraid we’re going to blow ourselves up, or because environmental pollution is destroying the quality of my sperm, or because I’m losing my role in society and might be eliminated from meaningful involvement in work and relationships, or because I’m feeling depressed and want to hurt myself or someone else. Most men will blame their bad feelings, if they allow themselves to feel at all, on such things as the way their wives treat them, job stresses, traffic jams, terrorists, the economy, the government, or general worry about the future.

Certainly things like family conflict, job stress, and the state of the economy can cause any of us, including men, to become irritable, but there is more going on than meets the eye. If we are going to help ourselves and each other prevent and treat IMS, we have to have a better understanding of the causes of our male insecurities. To do that we have to get at the core of what it means to be male.

[i] Siegfried Meryn. Editorials, The future of men and their health: Are men in danger of extinction? BMJ 2001;323:1013-1014 ( 3 November )

[ii] Devra Davis. When Smoke Ran Like Water: Tales of Environmental Deception and the Battle Against Pollution. New York: Basic Books, 2002.

[iii] Ibid., p. 193.

[iv] Steve Jones. Y: The Descent of Men. London: Little, Brown, 2002, p. 7.

Are Men All That Bad or Are Our Small Gametes to Blame?


Do you remember the Mother Goose nursery rhyme about little boys and girls? There are a number of variations. The one I grew up with went: “Little girls are made of sugar and spice and everything nice. Little boys are made of snips and snails and puppy dog tails.” Even as a child I always remember being uncomfortable with that rhyme. First, I was uncomfortable with “snip.” What is a snip anyway? I suspect that any boy who has been circumcised shivers a bit when he hears the word snip. I wondered why I couldn’t be sugar and spice and everything nice. It seemed a much nicer option.

And what am I supposed to be made of? I’m made of snips and snails and puppy dog tails. It sounded yucky to me. And what happened to the cute puppy dogs? All I get are the snips and the tails. There seemed to be an implication that I had something to do with the lost tails. Did I snip them off?

Even as we’ve eliminated a good deal of sexist language in our society, those old memories remain. Sugar and spice still sounds pretty nice. In fact, there’s a website called Sugar and Spice that describes the sweet meeting of Kati, a Finish girl, and Hans, a Dutch boy.

The “sugar and spice” nursery rhyme was written by Robert Southey around 1800 and has survived through the centuries in defining the difference between boys (icky things) and girls (nice things). Over the course of time and in order to accommodate other countries, different nasties were used in place of snips. Some use snakes, others used frogs.

Whatever the language, the meaning was clear. There was something inherently good about girls and something nasty and destructive about boys. The feminist movement helped women break out of the constraints of having to be “nice.” Males still suffer from the belief that there is something wrong with being male.

A five-year-old boy is prosecuted for sexual harassment in grade school for kissing a female playmate. Older boys are mistakenly diagnosed as having ADD because they don’t want to sit still in a classroom that does not allow for their natural male exuberance. Recess and school sports are being dropped in many schools because they don’t provide any “real” educational value.

Some feminists believe that being male is itself some kind of disease. Natalie Angier, an influential voice in the public discourse on gender, wrote a piece in the New York Times called “The Debilitating Malady Called Boyhood: Is There A Cure?” Can you imagine what kind of an uproar would be created if the New York Times published an article titled “The Debilitating Malady Called Girlhood: Is There A Cure?.”

Well, if being a male is a disease, guess what the cure would be. Marilyn French is another prominent American writer, celebrated for her novel The Women’s Room.” In a New York Times interview she said, “I think men would be much happier if they behaved like women. I think they would get much more out of life and would have much more easier selves if they were like women.” Could anyone in the world today get away with suggesting that women would be happier if they were like men, or that Muslims would be happier if they behaved more like Jews, or Blacks happier if they behaved more like Whites?

There are some who believe that if men are going to be alive we should pay the price. June Stephenson wrote a book called Men Are Not Cost Effective in which she details the cost of crime to society and points out that most crime is committed by men. She proposes a gender tax that all males would pay to make up for what men cost the society. Her philosophy seems to be “if you play, you pay.” She doesn’t seem to recognize that crime is not just a gender issue, it results from many factors. For instance, we know that crime goes up when the unemployment rate increases and goes down when it drops. Boys who grow up in homes with single mothers are more likely to be involved in delinquent activities and crime as they get older than boys who grow up with both a father and mother at home.

The Dating and Mating Game: Small Sperm, Large Egg, Look Out.

Biologists have a very simple and useful definition of what is male and what is female, whether we are fish, ferns, or human beings. An individual can either make many small gametes (sex cells) or fewer but larger gametes. The individuals that produce smaller gametes are called "males" and the ones that produce larger gametes are called "females." Although the human egg is microscopic, it is large enough to house 250,000 sperm.

The small gametes are designed to fuse with a large one, and the large ones are designed to fuse with a small one. The female strategy produces gametes that are large, and have a high rate of survival and fertilization. The male strategy is to produce as many as possible, to increase the chances of finding a large one. About 400 eggs are ovulated in a woman's lifetime. A healthy male produces 500 million sperm per day.

An individual must either invest in a few large eggs or in millions of sperm. Thus, there will always be many times more sperm than there are eggs. Consequently, sperm must compete for access to those rare eggs. Although these basic facts of life may be obvious, the importance and implications may not be.

In fact, this difference in the size of our sex cells makes a huge difference in how we act as males. As we will see, it helps explain why men can become so irritable, why we die sooner than women, why we are involved in more violent arguments, and why we become more depressed. “The cellular imbalance is at the center of maleness,” says geneticist Dr. Steve Jones. “It confers on males a simpler sex life than their partners, together with a host of incidental idiosyncrasies, from more suicide, cancer and billionaires to rather less hair on the top of the head.”

Generally it is easier to move the smaller sperm to the larger egg than vice versa, and so it is the male that seeks out the female and the female who makes the selection from those males that come courting. “Males are in flux in almost every way: in how they look and how they behave, of course,” says Jones, “but, more important, in how they are made. From the greenest of algae to the most blue-blooded of aristocrats their restless state hints at an endless race in which males pursue but females escape.”

This is one of the reasons that there will always be more irritable and insecure men than women. Because they carry the larger, scarcer, and valuable eggs, women will always be more sought after than men. Men will always have to take the initiative and women will always get to choose the most attractive male from those who present themselves and reject the others. In the game of life, women hold more of the evolutionary valuable cards.

Are Males Becoming the New Second Sex?


In 1949 Simone de Beauvoir wrote the book, The Second Sex, she described a period when women’s lives were restricted. Women were seen as mothers and homemakers and those who wanted to work outside the home were often seen as “less than” a complete woman. Males ruled the workplace, government, and academia. Since bringing home the bacon was seen as much more important than raising children, they were top dog at home. It was a time when “father knows best” and “what is good for General Motors is good for the nation.”

But times have changed, I believe for the better. Our daughters can grow up to have many more choices than their grandmothers. Our sons don’t have to carry the full load of supporting the family. Bacon is no longer seen as a health food and men are valued for more than our status as wage earners. However, in some ways things have gotten worse.

We still live in a culture that Riane Eisler, author of The Chalice and the Blade, calls a dominator society. She says that the dominator model, which is popularly known either as patriarchy or matriarchy, ranks one half of humanity over the other. She contrasts this with a partnership model in which the differences between men and women are not equated with either superiority or inferiority.

Dominator societies are like teeter-totters. When one side goes up, the other side goes down. The rich get richer while the poor get poorer. If women are on the rise, men are in decline. One respected researcher who has recognized this shift is anthropologist Helen Fisher. After studying men and women around the world she concluded that the balance has shifted significantly in the 50 years since de Beauvoir wrote her book. She reports these findings in her book The First Sex: The Natural Talents of Women and How They Are Changing the World. She quotes historian Gerda Lerner who said, “We stand at the doorway of what may become an age of women.”[i]

Fisher uses her considerable talents to survey the world of the 21st century and concludes that women will increasingly find their talents and skills being useful while men, unless there is considerable change, will find themselves to be falling farther and farther behind. For instance, she finds that the differences in the way males and females think will favor women. She says that women more regularly think contextually. They take a more “holistic” view of issues. Men, on the other hand, tend to compartmentalize their attention. Their thinking is more channeled.[ii] In a world that is becoming increasingly complex, where context is everything, men are at a considerable disadvantage.

Power in the world is shifting and will continue to do so in the 21st century. Countries like the Soviet Union have come apart. Huge corporations like Enron have folded. The power of the United States government is being challenged from within and without. Centralized, top-down kind of power is shifting everywhere towards a more egalitarian shared power.

This way of being is familiar to women and is often foreign to men. “Men regularly associate power with rank and status,” says Fisher. “Women more often see power as a network of vital human connections.” We can see it with children on the playground. Boys play war games and sort themselves into hierarchies. We compete to see who will be the leader, the quarter-back, the top dog. Girls are more interested in the relationships that form in play. They care about each others feelings more than boys do. “If girls want to be liked,” says Fisher, “boys want to be respected.” [iii] This need for respect is a significant male need that is becoming increasingly difficult to get in our modern world.

We see that women’s way is increasingly becoming the business model of the future according to Edie Weiner, a futurist and co-author of Insider’s Guide to the Future: The Powerful Forces Shaping Our Future…and how to profit from them. “These trends toward decentralization, a flatter business structure, team playing, lateral connections, and flexibility favor women’s way of doing business.”[JD1] [iv]

[i] Helen Fisher. The First Sex: The Natural Talents of Women and How They Are Changing the World. New York: Random House, 1999, p. xix

[ii] Ibid., p. 5.

[iii] Ibid., p. 31.

[iv] Ibid., p. 32.

Anger, Sex, Emotional Expression, and Irritable Male Syndrome (IMS)


Many men combine their anger with their desire for sex which also limits their expression and likelihood of getting a positive response. This often makes us more irritable, angry, and negative. “When we are in a positive mood, people like us better, and friendship, love, and coalitions are more likely to cement,” says Seligman. Men suffering from IMS find that their negative mood undermines their friendships and love relationships. But even men who are not suffering from IMS are often emotionally inept. We know that social connection is one of the key factors that determine health and longevity. Men’s failure to express ourselves emotionally may account for the fact that we die nearly 7 years sooner than women.

Thinking back on the way I was raised helps me understand why so many of us guys are limited emotionally. I learned early that “big boys don’t cry.” Later playing highschool basketball I learned to “play hurt and not complain.” I also learned that feelings were for females and boys learned to express themselves intellectually rather than emotionally. Figuring things out was what males did; sniveling over every little thing is what girls did—or at least that’s what I thought growing up.

Emotions are what we experience during gaps in our thinking. If there are no gaps, there is no emotion. Men often mistake emotions for thoughts. I recently had a man in my office who was obviously feeling a mixture of emotions: anger, hurt, fear, confusion, worry, sadness.

He had been injured on the job and had been referred to me by his wife because he was becoming increasingly depressed. He hadn’t been able to work for the last six months and the medical procedures he had undergone weren’t working. After getting some history I asked him how he was feeling. “I feel like I want to get back to work.”

“I know you want to get back to work, but how are you feeling?” I asked.

He thought for a moment and replied. “I feel like I need to do something, but I don’t know what to do.”

When I kept pressing for his feelings, he just looked at me and was obviously mystified. It took many sessions to begin to help him tune into to the sensations going on in his body, to recognize the feelings that went with the sensations, and to put a word on the feeling. He finally exploded with feelings and said, “I’m really, really pissed off.” I cheered and we both laughed.

“Both men and women feel an incredible variety of emotions,” says Dr. Helen Fisher. “Both feel them with piercing intensity and dogged regularity. Yet the ability to express these emotions is the special trait of women.” This is not to say that all men are unable to express their emotions or that all women are emotionally literate. I know many men that are much more expressive than many women. But generally there is a significant difference between males and females.

I suspect that this difference is built into our genetic heritage. For millions of years of human history, it was women who took the major responsibility for nurturing young children. An ability to read and respond to a baby’s emotions would have been a great advantage. Men, on the other hand, were the ones who had to leave their wives and children and go out for days on end hunting for wild animals. An ability to suppress their feelings would have made it easier for them to leave and easier for them to kill.

The men who allowed their feelings for their wife and children to come to the surface, the men who broke down when their children called, “Daddy, daddy, don’t leave,” the men who couldn’t make themselves “be strong”, were the men who didn’t hunt and didn’t bring home food for the family. In the long run, the children of these men were not as successful. These men didn’t pass on a whole lot of their genes to the next generation. We are descended from the men who submerged their feelings and went off with the other men.

As men become more nurturing and are required to be away from their families less, we are learning to allow our feelings to be expressed more easily. But millions of years of evolutionary history continue to have an impact on the differences in emotional expression between men and women. This seems to be true everywhere in the world. After Gallup pollsters asked people in twenty-two societies which sex was more emotional, they concluded “More than any other trait, this one elicits the greatest consensus around the world as more applicable to women than men. Eighty-eight percent of Americans think women are more emotional, as do 79 percent of the French, 74 percent of the Japanese, and 72 percent of the Chinese.

This evolutionary difference may have a hormonal basis. Prior to puberty both sexes express their emotions fairly equally. However, as boys mature and their testosterone levels increase, they become skilled at masking feelings of vulnerability, weakness, fear. It usually is during adolescence that teen-age boys refuse to discuss their feelings. “They become fluent at ‘joke-speak,’” says Helen Fisher, “all of the quips and gags and seemingly offhand remarks that boys and men employ to mask their emotions.”

When men do tap into their feelings, especially into powerful ones such as fear, anger, sadness, or anxiety, they are more likely than women to be swamped by these emotions, a condition that psychologist John Gottman calls “emotional flooding.” The fact that guys often close down and refuse to talk to their partner isn’t because we are being stubborn or emotionally stingy, it may be that we are overwhelmed by our emotions.

A couple wondering in the wilderness


This is a couple who came to me because Irritable Male Syndrome was causing problems in their lives. Here’s how the woman experienced the problem:

Five years ago my husband turned 50 and since then our lives have been turned upside down. I feel I have been wandering in the wilderness trying to understand what is going on. We’ve had our ups and downs during the 24 years we have been married, but I’d say, on the whole, we’ve been happy. I’m three years younger than him and my own menopause was stressful on him and the rest of the family, but it wasn’t as bad as most women I know.

He owns his own retail business and I’ve been a part-time bookkeeper while the kids were growing up. We have all the things we’ve been striving for. We have a nice house, drive new cars, and have good friends. Our 22 year-old son is away at college and our daughter is getting ready to go next year.

But just when I thought we could really enjoy our time together my husband has totally changed. At first little things bothered him. If I didn’t have dinner prepared at the exact time I had promised, he’d snap at me. When I got in a slight car accident, he nearly went ballistic. He accused me of not knowing how to drive.

Work has always been stressful. Owning your own business means you have to be “on” all the time. We always worried about whether the business would make it, then wondered if it would survive. But now that it’s successful, he seems even more uptight and indecisive. One minute he says he wants to sell it and retire. The next he tells me the thing to do is to expand. It’s been driving me nuts.

I guess I could take all that, but now he’s been taking things out on me. The irritability now is nearly constant. It seems that nothing makes him happy. Frequently he is on the verge of rage. He’s never hit me, but the way he looks at me is frightening. He gets a certain look in his eye that makes me shiver. What’s so confusing is he used to be patient and laid back. For most of our marriage he was the gentlest and kindest man you’d ever want to meet. Now he’s become so angry and hurtful I hardly know him.

When I’d ask him what’s wrong, he’d either ignore me or snap at me. When I reach out to touch him, he pulls away like my touch is poisonous. “I feel like all the passion has drained out of me,” he says. A year ago he started counseling and a lot of issues from his childhood began to surface. I thought this would help him get rid of some of the anger and bring us closer together. But now he’s decided to move out.

He tells me, “I love you, but I’m not in love with you.” That cuts me to the bone. How can the man who so recently told me he was more in love with me than when we got married, all of a sudden decide that he is no longer in love? It’s like waking up one morning and finding out your husband has decided he’s your brother now, not your lover.

It’s been the worst nightmare of my life. I’m beginning to see that he is experiencing a great deal of anxiety and depression. At times he is angry and blaming and at other times he acts almost like a zombie. He seems so cold and heartless; I wonder where his humanity has gone.

Now he’s got one foot in the relationship and one foot out. He says he still wants to be married, but doesn’t want to live together. He says, “I need to find myself.” I wonder if it’s that or if he just wants to run away from any marital or family responsibilities. The kids are devastated. They don’t understand what’s happened. There didn’t seem to be any serious problems, but all of a sudden their Dad is gone. I might be able to understand why he would distance himself from me, but why is he withdrawing from his own children?

It’s not knowing what I can count on that is driving me nuts. I ask him if he wants a divorce and he says “no.” I ask him if there’s anything I can do to make things better, he says, “no.” I ask if he’ll go to counseling, he says, “no.” Everything is negative and there’s no room for dialogue. It’s like talking to a post.

Now he’s having a serious flirtation with a woman he has met. He tells me it’s not sexual, she’s just someone he can talk to about what’s going on with him. I want to tear my hair out. “Why can’t you talk to me,” I scream to myself. “I love this man. I don’t want our relationship to end. I know he’s going through something and I want to help him heal.”

There is help available. However, a couple must first recognize that something is wrong. Have you or anyone you care about experienced these kinds of problems? Let me hear from you.

The Irritable Male Syndrome and Domestic Violence


They are an interesting group of men. They range in age from 25 to 40. They come from all over the area and they are engaged in a variety of jobs. Most are married with children. The weather has been nice and we have been meeting around picnic tables behind the old firehouse. People walking by might conclude that this was a group of fire-fighters or perhaps Dads’ planning the little-league schedule for the coming year.

In fact the men have all been arrested on domestic violence charges and are part of a year-long program I direct that is set up to teach the men better ways of dealing with their anger. When you talk with these men you wouldn’t suspect that anger was a problem in their lives. They are generally soft spoken. They care about their families and say they wouldn’t do anything to hurt them. Nevertheless, they were each involved in “blow-ups” that were serious enough to draw the attention of the police.

Marks’ Story

Mark is a twenty-seven year-old man who has been married for four years. He and his wife have a 3 year-old son. He is good-looking, full of energy, and talks easily. When asked what brought him to the program, like most of the men, he describes the incident as though it were quite minor:

“We’d been partying pretty good and Cary kept bugging me about my drinking. I told her I was fine. Later in the evening she started in again. She also said I was flirting with her girlfriend at the party. You’re imagining things, I told her. She kept on in a loud whisper that I was afraid someone would hear.

“I’ve learned to go along with what she says when she’s like this. Yes, uh huh, sure, I will, whatever you say dear. You’re right. I won’t drink any more tonight. I love you. I nod and smile. Her words go in one ear and out the other. I had a few more drinks. What the hell. I work hard and deserve to have fun on the weekends.

“The first thing that got me really pissed was that she wanted to drive us home. At first I wouldn’t give her the keys. It’s my car and I don’t want her to mess it up. I wasn’t drunk. I’ve driven home safely a hundred times like this. She kept bugging me and I finally tossed her the keys. Later when the police came, she said I threw them at her, but she’s lying.

“As soon as we got in the door she checked on our son then started ragging on me again. “You’re always doing this, you’re never doing that…on and on,” Mark does his imitation of his wife in a disparaging sing-song voice.

“I just wanted to go to sleep and I started for the bedroom. She said something to me that pushed me over the edge. I turned around and told her to shut. She made a smart remark and we got into it. A neighbor heard us yelling and called the police. That’s about it.”

When I pressed him about what he meant when he said, “we got into it,” he was pretty vague at first. “I just blew up.” When pinned down, he acknowledged that “I pushed her.” What else, I wanted to know.

“She started hitting me and I just held on to her arms to defend myself. I pushed her away to keep her from hitting me more and she fell into the wall. Really, it was no big deal. By the time the police got there, things were settled down and would have been fine if they’d have just left us alone.

Points of Understanding

  • Those involved in domestic violence are not out of the ordinary. They are, in many ways, just like us.
  • Domestic violence is universal. According to the World Report on Violence and Health, “Violence against intimate partners occurs in all countries, all cultures and at every level of society without exception.”[i]
  • Men tend to minimize the extent or the affect of violent behavior. Although, not always obvious, they usually are quite ashamed of their behavior and want to deny that it happened.
  • Domestic disputes often occur when one or both parties are intoxicated.
  • Around the world, the events that trigger male violence in abusive relationships are remarkably consistent. According to the World Report on Violence and Health, they include disobeying or arguing with the man, questioning him about money or girlfriends, not having food ready on time, not caring adequately for the children or the home, refusing to have sex, and the man suspecting the woman of infidelity.[ii]
  • The currently popular “feminist” approach to domestic violence which posits women as the victim and men as the aggressor may be misguided and actually be making the problem worse. According to Linda G. Wells, Professor at the New York University, and herself a feminist scholar, “Women are not merely passive prisoners of violent intimate dynamics. Like men, women are frequently aggressive in intimate settings.”[iii]
  • More than twenty years ago, Murray Straus, Richard Gelles, and Susan Steinmetz published their first landmark study and Erin Pizzey wrote Prone to Violence, both documenting the dreadful truth that women and men commit violence against their spouses with roughly equal frequency at all levels of severity. Yet, nearly all Americans still believe that domestic violence nearly always involves men as the aggressor and women as the victim and rarely or never involves women as the aggressor and men as the victim.
  • Men are much less likely to report abuse. It is not seen as manly to be abused by a woman. Our social perceptions that women are “good” and men are “bad,” often blinds us to these realities.

What’s been your experience? Do you think domestic violence affects women and men equally? I’d like to hear from you.

[i] Ibid., p. 15.
[ii] Ibid., p.15.
[iii] Linda G. Mills. Insult to Injury: Rethinking Our Responses to Intimate Abuse. Princeton: Princeton University Press, 2003, p. 8.

My Own Story of Anger and Violence


My father had been gone since I was six and my mother did various jobs in order to support us. One of her jobs was watching other people’s children. One of the kids she watched was a little girl who was four or five years younger than me. Occasionally when my Mom was busy, she’d ask me to keep an eye on the girl. I dreaded those times because that little girl terrorized me.

Whenever we were alone she would pinch me so hard I’d nearly cry. At other times she would punch or kick me. She would laugh at my tears. I didn’t know what to do. I was taught never to hit a girl, never to hit anyone smaller than you, and resolve all disputes with words. I was immobilized. She’d hurt me and I would take it, holding my feelings inside and praying that my mother would come back soon. Even by then I had learned that big boys don’t cry, if you run away from trouble you are a coward, and no one likes a tattletale. I would get through those times by acting like I was made of stone.

As I got older I would generally keep my feelings buried as deeply as I could and spent very little time around other kids. But school being what it was and kids being what they were and me being short and slightly built, I was picked on often. Usually I would joke and talk my way out of danger or walk away from those situations I couldn’t talk my way out of. But if I felt cornered and the taunting, teasing, or attacks didn’t stop I would come unglued. I would launch myself like a mad-man and the other kid would usually end up bleeding.

When I grew up I was always attracted to feisty, fiery women. There was an excitement and passion that would spark when we were together. But the same thrills that made our relationship interesting also created a lot of conflict. I remember an incident during my first marriage when I flew into a rage and broke a glass on the floor at the feet of my barefoot wife. I blamed her for causing me to lose my temper and demanded that she walk over to me and make up.

She looked at me, looked at the glass all over the floor, and refused. Her refusal felt like an attack and I wanted to strangle her. I held my feelings inside and later we made up. I apologized, swore it would never happen again. And it never did…until the next time. It seemed our relationship was on a rollercoaster.

There were wonderful highs and plunging lows. I alternated between out-of-control anger and being the most loving, responsive husband a woman could ever want. Our friends, even those who were the closest to us, never knew about the anger. All they saw was the “perfect” couple whose lives they admired. But like an addiction, the anger got worse and the love was overshadowed. We stayed married for ten years.

It didn’t take long until I met another woman who generated even more sparks than the first. I should have been forewarned when she told me about her recent experience in Mexico. It seemed she was walking back to her hotel late at night when a car full of young men drove by. They ran through a puddle and splashed some water on her. She became enraged. She screamed a curse, and as they say, extended to them the finger. The effect was instantaneous. They swung their truck around, floored the accelerator and ran her over. Only the fact that she’d been smashed into the side of a parked car saved her life. She was in the hospital for three months.

Our relationship was not nearly as violent. Neither of us ever spent time in the hospital, but we both nearly killed each other. She slept with a gun under her pillow, to protect herself from men, she told me. Not surprisingly, it didn’t make me feel safe. I hated guns. During a period when I was very depressed I was afraid I might use the gun on myself. She agreed to get rid of it. I felt relieved not to be with a woman who carried lethal weapons, until she began to carry knives.

During one of our fights, which lasted many hours, I was exhausted and wanted to rest. I knew she was still angry, but there didn’t seem to be any reason to keep trying to resolve the problem. Clearly we weren’t getting anywhere. When I went off to bed, she smiled slightly and said, “You better not fall asleep.” The threat was chilling. It was very real, yet it was vague enough to make it difficult to talk about.

I really understood how frustrated women become when they try and tell someone about their terror. I pictured myself telling a judge about my situation. Did she ever hit you or harm you in any physical way?” he might ask. I would have to say “no.” “Did she ever threaten your?” I’d have to say, “Well, not exactly.” By then, I would feel like a fool. I might even believe that it was not as serious as I was making it out to be. But it was serious and violence, even cover violence, can easily explode.

The last big fight could easily have killed one of us and put the other one on trial for murder. We had been in one of our long-running arguments. I kept trying to stop things before they got even worse. “Let’s give it a rest. I’m tired of fighting,” I screamed.

She wouldn’t turn it lose. She wanted to keep talking. “You always want to avoid getting down to what’s really going on” she screamed back. I had prided myself on never having hit a woman and this woman had pushed me to my limits on more than one occasion. One of the things that kept us from going over the edge was an agreement that if either of us felt like we were going to become violent, we could call a “time out” and we would go into separate rooms for a cooling off period.

I knew I badly needed to cool down. I could feel the heat coming up into my face, the volcanic activity beginning to shake my insides. I called a time-out and walked into my room and shut the door. The violent panic began to recede. I wasn’t in the room three seconds when the door flew open and my wife was standing in the doorway yelling.

“You’re always running away, you coward. Why don’t you stay and work things out?” I was instantly on high alert. I could feel the adrenaline rushing through my body. I tried to breathe slowly and talk calmly. “Get out of here. We have an agreement about taking our own space. Leave now, we can talk about this later.” I felt the panic rising inside me.

She turned to leave, but wheeled on her feet, and came back at me. She came right up in my face and started to poke me in the chest with her index finger. Once, twice, three times she poked me. I lost all sense of control. The red rage took me over. I grabbed her by the hair, pushed her up against the wall and brought my fist back. I knew when I hit her I wouldn’t stop, I couldn’t stop. I didn’t care. Nothing mattered but making the rage and terror I felt inside go away. My fist came forward and it truly was like in slow motion. I could see the hair and blood and bone. At that moment I had another sight. It was of my fist going through the wall and coming out the other side of the house.

When I hit the stud in the wall my fist stopped cold. I could hear bones break and I felt I was about to pass out. We were on our way to the emergency room before the red rage drained out of me and the pain enveloped me. I felt very grateful that I hadn’t killed my wife, happy I was going to the hospital instead of to prison, and determined to rid myself of violence in my life.

What’s been your experience with violence?

From Jekyll to Hyde: The Story of Barry and Sharon


The book Dr. Jekyll and Mr. Hyde was written by Robert Louis Stevenson in 1886 and has become a mainstay of stage and screen throughout the world. It seems to speak to something in the human psyche, particularly the male mind. The story is about Dr. Henry Jekyll who is pursuing his life-long quest to separate the two natures of man to get at the essence of good and evil.

Refused help by his peers and superiors, he begins experiments on himself with his formula. He meets with success, and shocking results. The evil nature of Dr. Jekyll surfaces as a separate identity: Edward Hyde. Hyde begins murdering the members of the Board of Governors who previously refused assistance to Jekyll's cause. Throughout the story Jekyll fights in vain to keep his darker half under control.

I have increasingly met with women who feel their mates have undergone some kind of transformation from loving to mean, sensitive to uncaring, involved to absent. One of these was Sharon, a 38 year-old woman who came to see me because he was at her wits end and didn’t know what to do. “I have been trying to tell my husband that he has changed into a Jekyll/Hyde personality overnight but he wouldn't believe me and blamed all his frustration on me.”

Her husband, Barry is a 42 year-old attorney who she describes as “very successful, good looking, and very physically fit.” Things seemed to be pretty good for most of their married life. “He pursued me in college and we got married after graduation. We have been married 19 years, with 18 1/2 of those being wonderful and blissful. He even said just 7 months ago, ‘You still turn me on after all these years" and "you don't need to wear makeup, you're beautiful just the way you are’. We have 2 great kids, a 15 year old daughter and a 10 year old son. He has been the IDEAL husband and father for all these years until now.”

“Most of this seemed to have started after he visited a close friend in Minnesota. Barry came back a day early "freaked out" because his friend Warren seemed so depressed. He told me Warren and Susan haven't made love in 9 months and asked me if I was still attracted to him. I told him of course I was, that he didn’t have anything to worry about.

“I thought that would settle things, but over the next few weeks things got worse. He went from being one of the most gentle and kind men I know to being aggressive and hostile. He’d alternate between yelling and screaming at me and withdrawing into silence. At first he wouldn’t tell me what was wrong. Finally we had a heated discussion that lasted well into the night and early morning. Through the hours that we talked he told me he ‘wanted his space,’ ‘I'm not sure if I want to continue to be a married family man’, ‘I can't decide if I should stay or leave’, ‘I've always been someone's son, husband, father and now I want to put myself first’”.

Sharon was in tears as she tried to sort out her confused feelings. “How can someone who has been such a dedicated husband and father make such a strong statement that he is not sure he wants to continue to be a family man? He doesn't have the other symptoms like tiredness and weight gain; but he has a hard time kissing me and being touched. When I try to kiss him he turns his head away. It’s devastating.”

Points of Understanding

  • Men experiencing IMS can change, seemingly overnight, from “peaceful” to “agitated,” from “loving to mean,” from “content” to “discontented.”
  • Although not always the case, there may be some triggering event such as a crisis with a close friend or relative.
  • Often the man describes his roles as a son, a father, a husband, a friend. He may feel trapped and believe he has lost his sense of self, his own sense of identity. “When will it be time for me?” he may want to scream.
  • In his fear and confusion he may feel he has to pull away, destroy the old in order to move on to something new.

There is another way. Men at this time of life often want to be free. We want to shed the old ways and find a new self that we can relate to as we age. We often don’t know how to bring that about without destroying what we have. However, with guidance and support we can be free and also keep the closeness we crave as well. What have you experienced? I’d like to hear from you.

Japanese Boys “Act Out” Their Anger and “Act In” Their Pain


He was known only as the boy in the kitchen. His mother, Yoshiko, wouldn't say his name, fearful that neighbors in the Tokyo suburb where they lived might discover her secret. Her son is 17 years old. Three years ago he was unhappy in school and began to play truant. Then a classmate taunted him with anonymous hate letters and scrawled abusive graffiti about him in the schoolyard.

One day, he walked into the family's kitchen, shut the door and refused to leave. Since then, he hasn't left the room or allowed anyone in. The phenomenon of social withdrawal, or hikikomori was first drawn to the attention of the Japanese public following a series of highly publicized crimes. In 2000, a 17 year old hikikomori sufferer left his isolation and hijacked a bus, killing a passenger. Another kidnapped a girl and held her captive in his bedroom for nine years. A fear of hikikomori dominated newspaper headlines. Though most of these young men are not violent, the frustration that many sufferers experience--the desire to live a normal life but the inability to do so--often expresses itself in anger and aggression towards those around them. The trigger is usually an event such as bullying, an exam failure or a broken romance.

These seem to be the same kinds of issues that young males face all over the world. When these pressures become too much to handle, as increasingly they are, some kind of breakdown occurs. For some it is acted out violently. Others withdraw and turn their aggression on themselves. It’s interesting that the Japanese have become aware of these kinds of social phenomena. In the 1970s they identified deaths that occurred as a result of overwork. They called it karoshi.

With our networked society, what occurs in one part of the world usually reflects issues that are going on elsewhere. It’s important that we ask ourselves about the hidden pain that so many young males experience in our own society. Boys are unlikely to talk directly about these issues. We need to spend time with them, do things together, look for clues in behavior. It’s important to listen to the words that are not spoken.

There are no easy answers. One thing we do know is that there is a strong relationship between the “acting out” that males do as we express our anger towards others and the “acting in” that we do as we focus our unhappiness on ourselves. As was true of the Japanese young males who are suffering from hikikomori, we may alternate between outward and inward focus. Outward focused irritability and anger is often a sign of male type depression.

The Legacy of Depression: My Father’s Story Part I


Every father’s day I think about my children and grandchildren, but most of all I think of my father. He was a wonderful man who suffered most of his life from depression and manic depressive illness. As a therapist I thought I was immune from the family inheritance. Many of us have to deal with a family legacy of depression.

My father was born in Jacksonville, Florida December 17, 1906. He was one of eight children whose parents had been born in Eastern Europe and had come to the United States in the late 1800s. From what I heard growing up, he was emotionally sensitive, artistic and talented. He wrote stories, poetry, and put on little plays for the family.

Unlike most of his brothers and sisters who either went into business or married business men, when he was 18 my father went to New York to become an actor. At first things looked bright. New York in the 1920s was full of glitter and glitz, a great place to be for a young man seeking fame and fortune. But that ended in 1929 with the stock market crash and the beginning of the Great Depression.

It was in New York that he met my mother and they married on her birthday, October 5, 1934 after a somewhat stormy courtship. Economically things were difficult, but they were together and ready to weather the storm. When all money ran out they would invite friends and acquaintances to their small apartment and my father would put on a show—readings from Shakespeare, his own poetry, or short stories. The price of admission was a can of food.

But as the economic situation worsened so did his mood. He would snap at my mother. Small things irritated him. How she cooked, cleaned their apartment, or made the bed became points of discord. Recalling the times, my mother told me, “He was always on edge. I couldn’t seem to do anything right. No matter how much I tried to support him and let him know I cared, he still got mad at me.”

There were increasingly heated arguments and fights. He would accuse her of being interested in other men and “sleeping around.” She would proclaim her innocence and feel hurt. They would make up, make love, and everything would seem all right. And they would be all right, until the next time. There was always a next time.

My mother was always able to find work as a secretary. She had excellent skills and even in bad times people needed her talents and experience. However, there weren’t a lot of people looking for my father’s skills and talents. Not feeling comfortable at home, my father spent more and more time away. “He’d stay away for hours at a time,” my mother said. “Sometimes he wouldn’t come home until early the next morning.”

His brothers tried to convince them to come home to Florida and sell insurance like they were doing. My father laughed. “I’d rather die first.” It was a prophetic outburst. He nearly did die. Most of what I know about his life I learned from my mother and the journals that he kept in the last three years before he tried to kill himself. A lot of my own life has been spent in fear that I might suffer from the same illness as father. As is true in so many other areas, until we confront and deal with legacy of our parents, both good and bad, we are trapped by truth we are afraid to acknowledge.

The Legacy of Depression: My Father’s Story Part II


In the preface to his book, Depression Decade, author Broadus Mitchell describes the historical period this way. “The years of our national economic life here described were crowded with emotion and event. They registered the crash from 1929 super-confidence and the descent into the depression—at first dismaying, then disheartening, then desperate.” These last words would be an accurate description of my father’s slide into the deep depression. Kay Redfield Jamison, an expert on mood disorders, uses an analogy from the animal kingdom to describe the difference ways men and women react to the stresses of life that leads to the Irritable Male Syndrome (IMS) and depression. "Young male elephants go out and they are quite solitary," she observed. "The only times males get together is during the breeding period in an adversarial role. They're not talking about anything, they're competing.

“Conversely, the female elephants are drawn together and are constantly communicating with each other. Female elephants have a system set up if one is in distress," she continues, "and they are more likely to be there to serve and help one another. Like male elephants in an adversarial role, human men have an ‘irritability’ that is ‘part and parcel’ of depression,” she says. “It's one of the diagnostic criteria for depression and mania, more common than not," she explained. "Emotions get so ratcheted up, it's often we see men with short-tempered fuses. It makes depression difficult for others to be around."

Here is a note from my father’s first journal, written when he was his old self, full of confidence and joy for life:

“A traveling troupe is putting on a show not far from us. I know them from earlier times when I first came to New York. They are gay and exciting and have an enchanting flavor of holiday. I look at Kath and marvel at her sweetness and beauty. You often forget how lovely feminine youth is. The cream-like texture of skin, a verve and a buoyancy. Henry is a perfect type of company manager. He has great big floppy ears, that inevitable cigar, and a certain softness. Charm is not the exclusive province of youth. Henry has it as well as Kath.

“Kath has that wonderful spirit of newness about her, that same wide-eyed wonder that a child has when he is seeing the circus for the first time. She sits at the feet of the elders who have been around the block and have makeup rubbed into their soles. She reminds me of my little boy [I was five at the time]. He has a wonderful impishness, a beautiful delightful growth about him. He has a suppleness of mind and body, a rapt attention as he looks for animals and calls to them.

“I feel full of confidence in my writing ability. I know for certain that someone will buy one of my radio shows. I know for certain that I will get a good part in a play. Last night I dreamt about candy. There was more candy than I could eat. Does it mean I’ll be rewarded for all my efforts? Has it anything to do with sex?”

Journal number ten was written three years later. The economic depression of the time and the depression going on within his mind had come together. His entries are more terse, staccato, and disheartening. I still get tears when I feel how much was lost in such a short time.

“June 4th:

Your flesh crawls, your scalp wrinkles when you look around and see good writers, established writers, writers with credits a block long, unable to sell, unable to find work, Yes, it's enough to make anyone, blanch, turn pale and sicken.

August 15th:

Faster, faster, faster, I walk. I plug away looking for work, anything to support my family. I try, try, try, try, try. I always try and never stop.

November 8th:

A hundred failures, an endless number of failures, until now, my confidence, my hope, my belief in myself, has run completely out. Middle aged, I stand and gaze ahead, numb, confused, and desperately worried. All around me I see the young in spirit, the young in heart, with ten times my confidence, twice my youth, ten times my fervor, twice my education.

I see them all, a whole army of them, battering at the same doors I'm battering, trying in the same field I'm trying. Yes, on a Sunday morning in early November, my hope and my life stream are both running desperately low, so low, so stagnant, that I hold my breath in fear, believing that the dark, blank curtain is about to descend.

Six days after his November 8th entry, my father tried to kill himself. Though he survived physically, emotionally he was never again the same. For nearly 40 years I've treated more and more men who are facing similar stresses to those my father experienced. The economic conditions and social dislocations that contributed to his feelings of shame and hopelessness continue to weigh heavily on men today.

The Many Masks of Male Depression


There are millions of men who are depressed, but don’t know it and millions more who know it, but are afraid to show it. It isn’t manly to be depressed. There is a double stigma for men. We can accept physical disability, but mental disability makes us feel helpless and out of control. Emotional problems are also seen by many of us as “feminine.” We cover our unhappiness with drink, drugs, excessive exercise, overwork, and angry moods.

Psychotherapist Terrence Real, author of I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression says: “Hidden depression drives several of the problems we think of as typically male: physical illness, alcohol and drug abuse, domestic violence, failures in intimacy, self-sabotage in careers.”[i]

Not only is it difficult for the men to recognize their depression, those around them tend to see the men as “bad” rather than “sad.” It isn’t surprising because men’s behavior seems more aggressive than passive, more wounding than wounded. “Because men are raised to be independent, active, task oriented, and successful,” say Drs. John Lynch and Christopher Kilmartin, authors of The Pain Behind the Mask: Overcoming Masculine Depression. “They tend to express painful feelings by blaming others, denying their feelings, and finding solutions for their problems in places outside of themselves.”[ii]

One of the largest studies of its kind in the world, the Epidemiological Catchment Area study, sponsored by the National Institute of Mental Health, sought to find out the percent of the population suffering from various kinds of mental illnesses. A total of 19,182 persons were interviewed. Although many believe that psychiatric disorders affect women more than men, the data showed that 36% of men suffer from some kind of psychiatric disorder, compared to 30% of women. It was found that 5.2% of men and 10.2% of women suffered from some kind of affective disorder such as depression. 23.8% of the men and 4.6% of women suffered from alcohol dependence. 7.7% of men and 4.8% of women suffered from drug dependence. 4.5% of men and .80% of women suffer from antisocial personality disorder.[iii]

“Interestingly, men outnumber women in alcohol-related disorders, drug-related use and disorders, antisocial personality, and any psychiatric conditions,” say Drs. Sam V. Cochran and Fredric E. Rabinowitz. “Additionally, the sex imbalance in these male-dominated disorders raises the question of how many men who might be ‘depressed’ are manifesting their depression in these categories or through other undocumented syndromes.”[iv]

I suggest that Irritable Male Syndrome is one of the categories where male depression is manifested. This idea was given additional credibility by two studies done in Denmark indicating that males and females show equal levels of depression when an irritability and aggressive component was added.[v]

[i] Terrence Real. I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression. New York: Scribner, 1997, p. 22.

[ii] John Lynch and Christopher Kilmartin. The Pain Behind the Mask: Overcoming Masculine Depression. New York: The Haworth Press, 1999, p. 7.

[iii] L. Robins & D. Reiger. Psychiatric Disorders in America. New York: Press Press, 1991. Summarized in Sam V. Cochran and Fredric E. Rabinowitz. Men and Depression: Clinical and Empirical Perspectives. San Diego, California: Academic Press, 2000, p, 13.

[iv] Sam V. Cochran and Fredric E. Rabinowitz. Men and Depression: Clinical and Empirical Perspectives. San Diego, California: Academic Press, 2000, p. 13-14.

[v] See Finn Zierau, Anne Bille, Wolfgang Rutz, Per Bech. The Gotland Male Depression Scale: A validity study in patients with alcohol use disorder. Nordic Journal of Psychiatry. Vol. 56, No 4., p. 265-271, 2002.

See also Rutz, W., et. al. Prevention of male suicides: lessons from Gotland study. Lancet. 345:524, 1995.

What is Depression and Why Is It Vital to Understand It?


“Depression is the flaw in love,” says Andrew Solomon, author of The Noonday Demon: An Atlas of Depression. “To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair.” When we are depressed we are unable to feel the love coming from others or to give love. Like my father and many other relatives in my family I have experienced depression in my own life. For me, depression is like being trapped within a dark cloud that allows no light or heat. When I’m in it, I feel like I’ve always been there and I will never come out of it.

Depression can be roughly divided into small (mild) and large (major) depression.

“Mild depression,” says Solomon, who is a journalist and has personally wrestled with depression throughout his life, “is a gradual and sometimes permanent thing that undermines people the way rust weakens iron. It is too much grief at too slight a cause, pain that takes over from the other emotions and crowds them out.”

It is mild, only by comparison. For those who have it, this kind of depression can slowly sap all the life energy out of a person. “On the face of it, ‘mild’ depression sounds like a quiet problem,” say John J. Ratey, M.D., and Catherine Johnson, Ph.D. We think of the slightly depressed person as an unassuming soul: melancholic, perhaps shy, a meek and retiring figure standing on the sidelines of life’s parade. A person who is more trouble to himself than to anyone else.”

I believe that this describes the kind of depression that is more common in women. There is another kind of depression that is more common in men. Ratey and Johnson describe it this way. They are “often stressed, frazzled, angry. They feel overwhelmed and fed-up; they are the people who have ‘hit the wall.’ They bark at their children; they snap at their mates. They are chronically irritable, and they are having no fun.”

As we know if we’ve ever experienced this kind of depression or lived with someone who has, it is far from mild. Andrew Solomon offers a useful contrast. “Large depression is the stuff of breakdowns,” he says, “If one imagines a soul of iron that weathers with grief and rusts with mild depression, then major depression is the startling collapse of a whole structure.” Many men suffer from depression in silence. Many of us don’t know we are depressed. Others of us, suspect we are depressed, but feel we can and should handle it ourselves.

Many of us don’t feel much hope that the talk therapy or drugs can really solve what is eating away at us. From my own experience, I know we need not suffer alone. There is help that will work for each of us. We just need to be willing to look for it. Of course, when we’re depressed, it can feel impossible to seek out the help we need. Often it is someone close to us who pushes or pulls us toward recovery.

The Irritable Male Syndrome: Take the Test The IMS Questionnaire


The Irritable Male Syndrome manifests itself through a number of feelings that can help us recognize where it is present in us or in someone we care about. The following questionnaire will help you assess IMS and the degree of seriousness. Everyone is irritable from time to time. Life is inherently stressful and there are inevitably things that bother us. What we want to know, though, is how irritable are we? Is our irritability excessive? Has it become entrenched? Does it seem to be getting worse? Is it causing problems for me or in my relationship with my family, friends, or community?

We don’t have a precise instrument to measure IMS. We can’t read your level of irritability like we can your blood pressure (though excessive irritability can lead to high blood pressure and other stress-related illnesses). Like so much in the psychological sciences we can only understand IMS by asking you questions and helping you reflect on what the answers mean in your own life. Let the score be a guide, not an absolute indicator that there is a problem or not a problem.

The IMS Questionnaire

In the last month reflect on how often you feel the following:

Not at All
Sometimes
Frequently
Most of the Time

Angry

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Impatient

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Blaming

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Dissatisfied

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Moody

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Fearful

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Discontented

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Hypersensitive

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Exhausted

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Grumpy

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Easily Upset

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Bored

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Aggressive

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Unloved

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Unappreciated

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Tense

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Touchy

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Tired

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Unloving

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Lonely

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Hostile

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Overwhelmed

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Destructive

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Demanding

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Depressed

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Frustrated

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.

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Withdrawn

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Mean

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Sad

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Scared

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Numb

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Explosive

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Defensive

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Denies problems

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Critical

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Troubled

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A desire to overeat

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A desire to drink or use drugs

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A need to withdraw behind T.V. Newspapers, or Computer

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A desire for increased time at work

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A need to sleep more or have trouble with sleep

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Impulsive

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Worried

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Less intimacy

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A pull to argue and fight

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Sarcastic

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Jealous

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Stressed

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Uncompassionate

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Uncommunicative

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Please don’t use the questionnaire to prove to someone that you don’t have a problem. Even if you don’t score in the range, if your behavior is a causing stress in your family, take it seriously. On the other hand, don’t use the questionnaire to prove someone else has a problem because they scored “high” on the test. For each feeling noted, check whether it is true of you (or the person you are rating) not at all or rarely (score 0), sometime (score 1), frequently (score 2), or most of the time (score 3). Thus the score can range from 0 to 150.

With that in mind, I have found the following scores to be worth considering. They are based on my own clinical experience with people I rated and who then took the questionnaire. The scores are also based on the 9,453 people who took the Irritable Male Syndrome and Male Depression Questionnaires on the Men’s Health Website:

0-25: None or few signs of IMS.
26-49: Some indications of IMS. May need help or watchful waiting to see if things improve or get worse.
50-75: IMS is likely and it is advisable to seek help.
76 and higher: IMS is definitely present and getting help is most important.

Men’s Love and Hate for Women


In his book, Misogyny: The Male Malady, anthropology professor David D. Gilmore, says, “That men love and hate women simultaneously and in equal measure, that most men need women desperately, and that most men reject this driving need as both unworthy and dangerous.”

Gilmore explores cultures from Western Europe to the Middle East, from the jungles of South America to the remote uplands of New Guinea, from preliterate tribal peoples to modern Americans. He looks at ancient and modern cultures and all those in between. He finds that in all places and in all times, there has been a tendency for men to fear and hate women.

Obviously this isn’t the case of all men. Though this ambivalence is played out in all societies, individual men differ in the degree to which it affects them. For some of us the fear and rage are extreme. For others, we control it well and it seeps out only at times of change and stress. The fear and hatred can be expressed in thoughts and actions as well as through art, writing, poetry, and fantasy. We can see it in the works of many famous writers including Swift, Schopenhauer, Nietzsche, Strindberg, Tolstoy, Pound, D.H. Lawrence, and Norman Mailer.

After offering hundred’s of pages of quite interesting and compelling evidence to lend credence to his thesis Gilmore concludes that this “love/hate” dynamic is rooted in men’s unique dependency on women. He points out that in most cultures men depend upon their mothers and later their wives for food preparation, domestic care, emotional support and nurturing.

He also reminds us that in all cultures and in all times, men are dependent on women to mate with them, carry a child within her body, give birth to the baby, and feed and care for him until he is able to live on his own. Men depend on their wives, he tells us for procreation and continuity. “To bear the sons who will assure them a measure of immortality, protect them in war, care for them in their dotage, validate their masculinity, and assist them in their god-given task of continuing their line.”

We love them for what they can give us, but are also frightened at the degree of our dependency. “So man must cling helplessly to woman as a shipwrecked sailor to a lifeboat in choppy seas,” says Gilmore. “He desperately needs her as his salvation from all want and from oblivion; his dependency is total and desperate. But, and here’s the rub, man must also separate from woman to achieve anything at all. He must overcome his desire to regress to infantile symbiosis with her if he is to be accountable as a man.”

I’ve found this dynamic has played out in most of my intimate relationships. Understanding it has helped me be less demanding on my mate and less hard on myself. What’s your experience been like? Drop me a note and let me know. I’d like to hear your thoughts and reactions.

The Irritable Male Syndrome: Same problem, different View


For the Woman

You may feel you are losing the person you most love and care about. Your sex life is probably not good. There is often tension in your love-making and even when there is passion and excitement, something is missing. What you miss even more than the enjoyment and comfort of lovemaking is the feeling of safety and intimacy you once felt. The gentle touches and warm smiles are distant memories. Where he used to feel warm and cuddly, he now seems cold and prickly. You may feel you are on an emotional roller-coaster, whipped up and down and side to side. There are times you’d just like to get out and walk away, but you remember how things used to be and long for what you hope can still be in the future. You probably feel hurt and you likely feel lonely. You long to get the man back who you loved and used to know.

For The Man:

If you’re a man you may be aware that life is more stressful than it should be. At times you may feel that the hassles of life are more than you can take. You think you should be able to handle things, but you sometimes think how nice it would be to get away from it all. You can’t understand why all your efforts to make things better seem to have the opposite effect. You’re tired of feeling that nothing you do is right.

It seems that the people you most rely on are no longer on your side. People at work seem more adversarial than supportive. Old friends may have dropped away or are no longer as close. Your children treat you differently and you may have lost connection and contact. Your wife seems to withdraw from you sexually. Where she used to feel warm and cuddly, she now seems cold and prickly. She seems to nitpick at the smallest thing you do or forget to do. It’s increasingly difficult to relax around her. You feel guarded and protective, but also lonely and misunderstood. You too long to have the kind of relationship where you can relax and enjoy the ease of intimacy you seem to have lost.

Does this sound familiar? If it does, drop me a note. I’d like to hear about your experiences.

Are You A Man With IMS? Are You Living with an IMS man?


If you’re a man you may be aware that life is more stressful than it should be. At times you may feel that the hassles of life are more than you can take. You think you should be able to handle things, but you sometimes think how nice it would be to get away from it all. You can’t understand why all your efforts to make things better seem to have the opposite effect. You’re tired of feeling that nothing you do is right.

It seems that the people you most rely on are no longer on your side. People at work seem more adversarial than supportive. Old friends may have dropped away or are no longer as close. Your children treat you differently and you may have lost connection and contact. Your wife seems to withdraw from you sexually. Where she used to feel warm and cuddly, she now seems cold and prickly. She seems to nitpick at the smallest thing you do or forget to do. It’s increasingly difficult to relax around her. You feel guarded and protective, but also lonely and misunderstood. You too long to have the kind of relationship where you can relax and enjoy the ease of intimacy you seem to have lost.

If you are living with an IMS man you may feel you are losing the person you most love and care about. Your sex life is probably not good. There is often tension in your love-making and even when there is passion and excitement, something is missing. What you miss even more than the enjoyment and comfort of lovemaking is the feeling of safety and intimacy you once felt. The gentle touches and warm smiles are distant memories. Where he used to feel warm and cuddly, he now seems cold and prickly. You may feel you are on an emotional roller-coaster, whipped up and down and side to side. There are times you’d just like to get out and walk away, but you remember how things used to be and long for what you hope can still be in the future. You probably feel hurt and you likely feel lonely. You long to get the man back who you loved and used to know. Does this sound familiar? Let me know what you have experienced.

The Irritable Male Syndrome: Up Close and Personal


Last week I talked about Irritable Male Syndrome and said I’d share how it had impacted my own life. It became most difficult at a time when stresses were building up in our lives. We were dealing with aging parents, I had changed jobs, we were spending less time together and were less intimate. Things became more and more unbalanced, out of kilter, and uncomfortable. Despite the changes in my own life, I continued to maintain that I was just fine. It was Carlin that had changed and needed to come back in balance, I felt.

Despite all evidence to the contrary I was convinced that things would be right again if only she would….Depending on the day, the hour, or the minute, I had different things I was convinced she should do. Many of the things contradicted each other, but at the moment they each seemed perfectly reasonable: Work more, stay home more, be nicer and more attentive, leave me alone, be sexier, be nurturing, want sex more often, not be too aggressive sexually, make nice dinners, not feed me so much good food that I got fat, be home when I want her, let me be free to be by myself.

When she wouldn’t do these few simple things (and this was just my short list), I was convinced that she didn’t really care about me. I was sure I was being perfectly reasonable and she was withholding her affections to make me suffer. It never occurred that I was making so many demands they could never be met. I was totally blind to the fact that, even if she tried to meet them, they were so contradictory to make success quite impossible.

The irritability that I had kept in check began to seep out. At first it was indirect. I wouldn’t be overtly aggressive, but passive aggressive. I would forget to put things away after I had used them. I would spill things on the floor and not quite get them cleaned up completely. Something would break and I would pretend that I didn’t notice.

Later, the feelings began to blow up. I became more argumentative, demanding, and uptight. I started becoming more critical of Carlin, though I would have insisted I wasn’t criticizing I was just pointing out ways she could improve things. Carlin tried to point out the changes she was seeing in me but I would immediately become angry and defensive.

Irritable Male Syndrome sounds so benign. We might think it’s like Premenstrual Syndrome. If we’re living with a woman going through a normal PMS, we understand she feels irritable, uncomfortable, and out of sorts, but we know it won’t last long and balance will be restored. Irritable Male Syndrome, may start out like that. But at it’s worst the man is totally out of touch with reality, is literally out of his mind, and yet he is convinced he is the only sane one about and everyone else has gone mad.

I finally decided to see a doctor. I had to make it clear that I wasn’t going because she wanted me to go. I was going because I wanted to see how things were with me. Inside, of course, I was convinced that the doctor would tell me I was fine and I could come back and tell Carlin, “See even the doctor says I’m fine, so if there’s a problem it must be you.”

Fortunately for me, for her, and for our marriage, the doctor said I did have problems and suggested medications, therapy, and marriage counseling. I thanked him and said I’d think about it. As I was going out the door, he gave me a zinger. He told me that one of the main symptoms of this kind of problem is that men don’t think they have a problem.

I waited two weeks and made an appointment with another doctor. This doctor was more sympathetic, more empathic, and did a much more complete evaluation. I was convinced she would see if there were any problem, it was minor and nothing I need be concerned about. Instead, she validated what the first doctor had told me, nearly word for word. I had finally run out of excuses and began getting help.

In addition to starting medications, doing therapy, and couples counseling, I began reading everything I could find on depression, attention deficit disorder, anger, aggression, worry, irritability. One of the most insightful things I read was written by Kay Redfield Jamison, herself a well-known researcher and therapist. In her exceptionally fine book, An Unquiet Mind, she talked openly about her own struggles with mental illness and her road to recovery.

Hers were the first words that captured what I had been experiencing over the last 5 years.

“You’re irritable and paranoid and humorless and lifeless and critical and demanding and no reassurance is ever enough. You’re frightened, and you’re frightening, and ‘you’re not at all like yourself but will be soon,’ but you know you won’t.”

Have you had similar experiences? Do you know someone who has? I’d be interested in your response.

The Irritable Male Syndrome: A Multi-Dimensional Problem in Life Part 2


Definition of the Irritable Male Syndrome (IMS): A state of hypersensitivity, anxiety, frustration, and anger that occurs in males and is associated with biochemical changes, hormonal fluctuations, stress, and loss of male identity.

Let me share with you what went into this particular definition. Working with males (and those who live with them) that are experiencing IMS I have found there are four core symptoms that underlie many others.

The first is hypersensitivity.

The women who live these men say things like:

  • I feel like I have to walk on egg-shells when I’m around him.
  • I never know when I’m going to say something that will set him off.
  • He’s like time bomb ready to explode but I never know when.
  • Nothing I do pleases him.
  • When I try and do nice things, he pushes me away.
  • He’ll change in an eye-blink. One minute he’s warm and friendly. The next he’s cold and mean.

The men don’t often recognize their own hypersensitivity. Rather their perception is that they are fine but everyone else is going out of their way to irritate them. The guys say things like:

  • Quit bothering me.
  • You know I don’t like that. Why do you keep doing it?
  • Leave me alone.
  • No, nothing’s wrong. I’m fine. Quit asking me questions.
  • The kids always….(it’s always negative). The kids never….(do the right things).
  • Why don’t you ever…. Fill in the blank. …want sex, do what I want to do, do something with your life, think before you open your mouth, do things the right way.
  • You damn….Fill in the blank….fool, bitch, etc. As IMS progresses the words get more hurtful.
  • They don’t say anything. They increasingly withdraw into a numbing silence.

One concept I have found helpful is the notion that many of us are “emotionally sunburned,” but others don’t know it. We might think of a man who is extremely sunburned and gets a loving hug from his wife. He cries out in anger and pain. He assumes she knows he’s sunburned so if she “grabs” him she must be trying to hurt him. She has no idea he is sunburned and can’t understand why he reacts angrily to her loving touch. You can see how this can lead a couple down a road of escalating confusion.

The second core emotion is anxiety.

Anxiety is a state of apprehension, uncertainty, and fear resulting from the anticipation of a realistic or fantasized threatening event or situation. As you will see as you delve more deeply into the book, IMS men live in constant worry and fear. There are many real threats that they are dealing with in their lives—sexual changes, job insecurities, relationship problems. There are also many uncertainties that lead men to ruminate and fantasize about future problems.

These kind of worries usually take the form of “what ifs.” What if I lose my job? What if I can’t find a job? What if she leaves me? What if I can’t find someone to love me? What if I have to go to war? What if something happens to my wife or children? What if my parents die? What if I get sick and can’t take care of things? The list goes on and on.

The third core emotion is frustration.

Princeton University’s WordNet offers two definitions that can help us understand this aspect of IMS.

1: the feeling that accompanies an experience of being thwarted in attaining your goals. Synonym is defeat.

2: a feeling of annoyance at being hindered or criticized; The dictionary offers an enlightening example to illustrate the use of the word…"her constant complaints were the main source of his frustration."

IMS men feel blocked in attaining what they want and need in life. They often don’t even know what they need. When they do know, they often feel there’s no way they can get it. They often feel defeated in the things they try and do to improve their lives. The men feel frustrated in their relationships with family, friends, and on the job. The world is changing and they don’t know where, how, or if they fit in.

Author Susan Faludi captures this frustration in her book Stiffed: The Betrayal of the American Man. The frustration is expressed in the question that is at the center of her study of American males. “If, as men are so often told, they are the dominant sex, why do so many of them feel dominated, done in by the world?”[1] The frustration, that is often hidden and unrecognized, is a key element of IMS.

The forth core emotion is anger.

Anger can be simply defined as a strong feeling of displeasure or hostility. Yet anger is a complex emotion. Outwardly expressed it can lead to aggression and violence. When it is turned inward it can lead to depression and suicide. Anger can be direct and obvious or it can be subtle and covert. Anger can be loud or quiet. It can be expressed as hateful words, hurtful actions, or in stony silence.

For many men, anger is the only emotion they have learned to express. Growing up male we are taught to avoid anything that is seen as the least bit feminine. We are taught that men “do” while women “feel.” As a result men are taught to keep all emotions under wrap. We cannot show we are hurt, afraid, worried, or panicked. The only feeling that is sometimes allowed many men is anger. When men begin going through IMS, it is often anger that is the primary emotion.

As we explore IMS in more depth, be aware that we are talking about a problem that isn’t easily categorized or circumscribed. It is slippery and illusive. It can wreak havoc in the lives of men and those who love them and remain hidden from scrutiny. I know. IMS nearly destroyed me and my family. Next week I’ll share my own experiences with IMS.

The Irritable Male Syndrome: A Multi-Dimensional Problem in Life


IMS is a multi-dimensional problem that affects and is affected by hormonal, physical, psychological, emotional, interpersonal, economic, social, sexual, and spiritual changes. One of the reasons it is so difficult to understand and deal with is its complexity. In our 21st century world of high technology and specialization we tend to see problems in either or terms.

It’s either physical or psychological; biological or social; personal or interpersonal. The result is we go to one specialist to treat our heart, a different one to take care of our psyches, and still a third to deal with physical pain. No one deals with the whole person, much less the person in the context of his family, community, and social environment. We are learning about the very nature of life, how the genes lay the foundation for who and what we are. But we seem to be losing the larger picture of what it means to be a healthy human being.

Who do we go to see about the increasing stress in our lives? Where do we learn about andropause (male menopause) and the changes in men as we age? How do we find out about the hormonal tides that affect males at all ages? What do we do when our problems are larger than can be understood by looking at our own lives? We are social beings and can’t be understood apart from our mates, our parents, our children, our friends, our communities, the world we live in, and our view of the spiritual world beyond.

In trying to describe something that is new, it is difficult to come up with a short, accurate, and useful definition. In some sense this whole book is my attempt to define what I mean by Irritable Male Syndrome. What follows is my current definition. I expect it will change through time as we gather more information and conduct further research:

Definition of the Irritable Male Syndrome (IMS): A state of hypersensitivity, anxiety, frustration, and anger that occurs in males and is associated with biochemical changes, hormonal fluctuations, stress, and loss of male identity.

Whereas feelings like anger, anxiety, and frustration can occur quickly and end quickly, irritability can develop into a mood state that can last over a long period of time and can trigger these feelings over and over again. It can have a major impact on our whole lives. “When we’re in a mood it biases and restricts how we think,” says Paul Ekman, who is professor of psychology and director of the Human Interaction Laboratory at the University of California Medical School in San Francisco. Dr. Ekman is one of the world’s experts on emotional expression.

In describing these kinds of negative moods, Ekman continues. “It makes us vulnerable in ways that we are normally not. So the negative moods create a lot of problems for us, because they change how we think. If I wake up in an irritable mood, I’m looking for a chance to be angry. Things that ordinarily would not frustrate me, do. The danger of a mood is not only that it biases thinking but that it increases emotions. When I’m in an irritable mood, my anger comes stronger and faster, lasts longer, and is harder to control than usual. It’s a terrible state…one I would be glad never to have.”

Does this sound familiar? Do you see yourself, others you know and care about? If you have experiences to share, please drop me a note.

It could be IMS not IBS that is the problem when nice men turn mean


Q: What do you call a man who is always tired, miserable and irritable?

A: Normal.

Q: How can you tell if a man has irritable male syndrome?

A: You ask him to pass the salt and he yells: “Take, take, take—that’s all you ever do!”[i]

These little zingers which appeared recently in the London Daily Mirror illustrate some important aspects of what many men, and those who must live with them, are experiencing these days. First it seems that stress has become a normal part of modern life and more and more men are taking our frustrations out on those closest to us. Second, men’s irritability, blame, and anger seem excessive and more explosive. You ask an innocent question and he jumps down your throat. What’s going on here?

We've all known a grumpy old man or two. Maybe he was the guy down the street who chased you off his lawn when you were a kid. Hollywood turned grumpy old men into comic icons in movies starring Jack Lemmon and Walter Matthau. While we sometimes laugh off the chronic crabbiness of an older friend, we're just as likely to dismiss it as an unfortunate, but inevitable, part of getting old. But as we will see, there is more to this kind of behavior than what we see on the surface and it is no joking matter for those who are experiencing it or those who must live with a chronically irritable man.

For some, this kind of irritability has come on slowly over a period of months and years. For others, it seems like someone has flipped a switch and Mr. Nice has turned into Mr. Mean. “God, it’s like he’s hormonal,” one woman told me. When I told her she wasn’t too far from the truth, she snapped back “I knew it.”

There was a time when we laughed at and ridiculed women who said they had emotional changes associated with hormonal fluctuations. Most now accept that PMS is real and can be treated. Columnist Liz Langley writing for the Orlando Weekly feels this same understanding will soon be extended to men.

“Just as men have had to concede that there’s a real, scientific reason for our moody silences and sharp behavior and it’s PMS, not RBS (raving bitch syndrome), we might be able to take comfort in the fact that they have to confront this crap, too. It might just be IMS rather than IBS (insensitive butt-hole syndrome) that makes them as dumbfounding as they can be.

Since I began my study of this subject five years ago, I have received thousands of letters from men and women describing their experiences. Over the next weeks, I will tell you more about this interesting and baffling change that so many men experience, particularly as we get older. Have you heard of the Irritable Male Syndrome? Do you know someone who is going through it? Drop me a note and let me know.

©2009 Jed Diamond

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