A new issue of Newsweek is out today, but we can't let this one go: Last week's cover story on depression in men turned on the central point that men were less likely than women to seek treatment for depression — yet the story did not actually present any hard evidence to support this.
Here's what editor Jon Meacham said in his editor's letter: "Our reporting shows that men are still much less likely than women to seek help." Here's the money paragraph:
Six million American men will be diagnosed with depression this year. But millions more suffer silently, unaware that their problem has a name or unwilling to seek treatment. In a confessional culture in which Americans are increasingly obsessed with their health, it may seem clichéd — men are from Mars, women from Venus, and all that — to say that men tend not to take care of themselves and are reluctant to own up to mental illness. But the facts suggest that, well, men tend not to take care of themselves and are reluctant to own up to mental illness. Although depression is emotionally crippling and has numerous medical implications — some of them deadly — many men fail to recognize the symptoms. Instead of talking about their feelings, men may mask them with alcohol, drug abuse, gambling, anger or by becoming workaholics. And even when they do realize they have a problem, men often view asking for help as an admission of weakness, a betrayal of their male identities. (emphases added)
This may be correct but the language is staggeringly vague — "many" "often" and "the facts suggest" are not enough to back up a Newsweek cover story, nor are they enough to justify focusing on men to the exclusion of women. The "manliness" theory of depression — causally linked to suicide above — is also not supported by any specific data. The examples cited in the story focus on classic symptoms of depression (not being able to get out of bed, feeling overwhelmed and hopeless, weeping) but, as told, seemed to have had more to do with misdiagnosis than a male-specific source.
The data, too, does not break out along gender lines; on the contrary, the information on new treatments, screening tests and brain chemistry were completely gender-neutral. The only specific information given on incidence relates to suicide: Men are four or more times as likely to commit suicide than women (though Newsweek does not additionally report that women are more likely to attempt it, according to the National Institute of Mental Health.) The NIMH website fleshes out the numbers: While it's true that six million men suffer from depression every year, it reports that women experience it "about twice as often" as men, though the statistic on total number of sufferers suggests even more: 20.9 million total, which means approximately 14.9 million women in America suffer from depression annually.
Those are the stats which were left out; here's one that's just plain wrong: "Depression has been linked to heart disease, heart attacks and strokes, problems that affect men at a higher rate and an earlier age than women." Actually, no. Women have greater lifetime risk of stroke and are more likely to die in the first 30 days following; middle aged-women are more than twice as likely to have a stroke than their male counterparts; women have a higher incidence of stroke across three separate age ranges from 35 - 64; women are at least 40% more likely to inherit the risk of stroke; and women and/or their doctors are 33% less likely to recognize stroke symptoms, and are less likely to receive a "crucial" drug.*
I wish I could stop there, truly I do. But then there's this statement: "The nation's largest depression-treatment study, STAR*D, a three-year NIMH-funded project, found that 67 percent of patients who complete from one to four treatment steps, such as trying a different medication or seeking counseling, can reach remission. The process can be onerous and frustrating, and the potential side effects, including a low libido, can be hard to take — especially for men." Again, we are presented with a blanket statement without anything to back it up. So we went back to the NIMH and its detailed STAR*D Q&A page, which did not differentiate according to gender. We dug a little deeper, and learned that "[w]omen (62.8% of the sample) had a younger age at onset of the first major depressive episode."** From there, we found the abstract for a 2002 study on gender differences in depression re: symptoms, causal attribution, help-seeking, coping, and consequences; while it didn't say either way that side effects were "especially" hard on men, it did actually, finally, provide us with the statistical support that Newsweek left out: "Even after stratification by clinically significant impairment and paid employment status, men reported fewer symptoms than women; as a consequence, men reached the diagnostic threshold less often."
So yes, after all that, "the facts suggest" that Newsweek's premise is correct. Make no mistake, there's no vested interest here in the outcome, just in complete reporting that doesn't force a reader to go digging for the proof that was left out, or fact-checking assertions that are flat-out wrong. After all that, though, you'd expect that Newsweek would be pretty careful to send the right message: That is, that men should be encouraged to take their symptoms seriously and seek treatment. So that's why we almost choked at this near-end sum-up quote:
Fading social stigmas are already making it easier for young men to come forward. Recently, Zach Braff, filmmaker and star of TV's "Scrubs," told a reporter from Parade magazine that he thinks he suffers from "mild depression."
So, wait: The guy self-diagnoses off the cuff and that's that — no concern about the condition, no talk of having sought medical attention, no effort to understand the feeling beyond making Zeitgeist-tapping movies, which sends the distinct message that being angsty and depressed is COOL, and by the way, why aren't YOU channeling YOUR depression into Zeitgeist-tapping movies?*** We'd think it unlikely that such an example would provide much assistance to depressed men who "view asking for help as an admission of weakness, a betrayal of their male identities."
Newsweek, you had good intentions: Depression is a serious, crippling illness, debilitating in its effects on men, and women. If this article makes even one person seek medical attention — even Zach Braff — then it's worth it. But where 14.9 million women are suffering, too, your coverage ought to be more balanced (I was surprised by the absence of at least a women-related sidebar; even the cover on menopause a few weeks back included a piece on male menopause). Beyond that, it ought to be based on measurable facts rather than anecdotes, vague assertions and easily fact-checked misstatements. We applaud the intention, Newsweek; we just wish we could also applaud the execution.
*This tweaked in me because I actually knew that women were more likely to suffer from stroke (from my research for this), but in order to find current information, I put the following incredibly specialized search term into Google: "women stroke men."
**This was from an abstract of a journal article called "Gender differences in depression: findings from the STAR*D study," which we found by Googling "STAR D depression men women."
***The relevant quote is as follows: "I think I suffer from some mild depression," Braff says. "So to have millions of people go, 'I watched your movie and related' was the ultimate affirmation that I'm not a freak." The article is not online but ETP receives PDFs from Parade, and uploaded the spread here (quote closeup here).
