Depression is incredibly common and we all know someone (or several people) who has suffered from this problem, even if they have never shared this with us. As a GP, I see patients every day of my working week suffering from symptoms of low mood, depression and anxiety, either as the main issue they have come to discuss, or discovered by chance when looking into other more physical symptoms. It has a huge impact on the sufferer, but also on their friends, families and work colleagues.

Jon Rees

So what is depression? Many people describe themselves as ‘depressed’ when they really mean they are feeling a bit low or down. Medical experts describe depression with strict criteria to allow a formal diagnosis of ‘clinical depression’ – the reality, however, is that in many ways the label is unimportant, and there is a continuous spectrum from mild and short lived low mood to severe depression – we will often move around on this spectrum from day to day, week to week or month to month. What really matters is that if you have these symptoms and they are making your life difficult, you must feel able to seek help, both from your friends and family, and from medical professionals, particularly your GP.

A recent survey on depression by talkhealth ( looked at some common issues around this condition. The finding that stood out for me was that 9 out of 10 respondents were female and this illustrates a common problem. Both men and women are affected by depression and other mental health issues, but women tend to be far better at coming forward to seek help than men. There are a number of reasons for this, from being unable to accept that they have a problem, to being unable to take time off work to seek help, or the feeling of shame or embarrassment of admitting to this condition. Whatever the reasons, this means that men are half as likely as women to have received any treatment for depression, but tragically, over 3 times more likely than women to commit suicide.

Women have a vital role therefore – men need you to spot the signs of depression and be brave enough to discuss it with them and encourage them to seek help. So, how can you recognise that the man in your life, be it your husband / partner, father, son, or even just a friend or work colleague, is suffering from depression?

  1. Common symptoms of low mood, loss of pleasure or interest in life, poor sleep, lack of energy or difficulty concentrating.
  2. Anger and irritability – this is a common feature of depression in men – it can range from simple irritability and oversensitivity to criticism, through to outright aggression and even verbal or physical abuse.
  3. Risk taking – men with depression can start to behave in a reckless manner, possibly to avoid confronting their mental health issues – this can include drinking too much alcohol, drug taking, gambling, risky sexual behaviour or dangerous driving.
  4. Physical symptoms – men with depression will often complain of symptoms such as headache.  Remember too that loss of interest in sex, or difficulty getting or keeping an erection are also common problems in men who are depressed.

The talkhealth survey showed a very worrying feature – many patients with depression wait a very long time before seeking help – in the survey, almost ½ the respondents said they had waited over a year before coming forward, and over a ¼ had waited more than 5 years. Why did people wait so long? Many said that they just felt it was a ‘phase’ that they would recover from, others just felt embarrassed or that their lives had been too hectic to spare the time. Many of my patients worry that all I am going to offer is medication such as anti-depressants – but there are many other options, from lifestyle changes (such as increasing exercise), counselling through to more complex therapies such as ‘cognitive behavioural therapy’ or CBT.

I have lost count of the number of times a man has come to see me with the opening line of “I’m only here because my wife sent me” – sadly, men still need you to spot the signs of their ill health and help them to seek professional advice – the suicide rates in men, if nothing else, illustrate why this is so vital.


Dr Jonathan Rees

Jon Rees trained in Urology in Taunton and became a Member of the Royal College of Surgeons in 1999. He then spent 3 years completing research into the quality of life of prostate cancer patients and their partners, and was awarded his MD thesis in 2003. In 2004 he switched to General Practice and is now a partner at Backwell & Nailsea Medical Group in North Somerset. He continues to work in Urology, providing a primary care diagnostic urology service to 3 CCG's, including a community based LUTS, Haematuria and raised PSA one-stop service. He was a member of the Guideline Development Group for the NICE 'Lower Urinary Tract Symptoms in men' Clinical Guideline, published in 2010. He is deputy editor of ‘Trends in Urology and Men’s Health’ ( and involved extensively in educating his fellow GP’s about Urology, particularly through the Prostate Cancer UK Masterclasses. He is currently chair of the educational advisory group for Prostate Cancer UK and a member of the Global Committee on prostate cancer survivorship for the International Movember Foundation.

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