Background
Three of every five deaths by suicide in Australia are men. The vast majority experience depression prior to death despite it being one of the most preventable mental illnesses: it is estimated that 22% of new cases per year can be prevented with evidence-based interventions.
There is a need to understand men’s adaptive responses to depression to inform public health programs that facilitate men’s uptake of such interventions.
While much research has focused on men’s use of unhelpful coping strategies to prevent and manage depression (e.g. self-medication with alcohol, risk-taking behaviour), there has been little emphasis on men’s use of positive strategies.
Aim
To examine 1) the positive strategies men use to prevent and manage depression, 2) whether strategy use varies according to demographic factors, and 3) whether strategy use predicts depression risk and symptoms.
Methods
An online survey was developed based on findings from previous qualitative investigation by the authors. Respondents selected options from a designated list of 26 positive prevention and management strategies; there was also additional space to record any strategies used that were not on this list.
For each strategy, they were asked whether they used it and how often they used it or their openness to using it. Standard demographic data were collected and participants were also asked whether they had experienced stressful life events in the previous year.
Depression risk was assessed using the Male Depression Risk Scale (MDRS) and depression symptoms by the Patient Health Questionnaire-9 (PHQ-9).
Men were eligible to participate if they were aged 18 years or older and were a resident in Australia. Participants were recruited through several strategies including advertisement on social media, a press release, and promotion via several radio stations.
Results
Of the 689 men who were eligible and consented for the study, 465 men completed the survey (response rate = 67%). Participants ranged in age from 18 to 74 years old (mean = 40.6 years).
Approximately half (56.8%) were in a relationship and (49.0%) held a bachelor degree. The majority (78.1%) lived in a metropolitan area.
The vast majority (93.5%) reported ever having experienced depression, with 54.6% reporting that they had received treatment for depression.
Additional management strategies listed by men included looking at photos or videos from happier moments, lots of rest and ‘quiet time’, avoiding people until feeling better, and making plans for the future.
Conclusion
Men use a variety of strategies to prevent and manage depression. The breadth of these strategies demonstrate that men view their mental health as being connected to their physical health, social connections, helping others, and recognising the need for ‘rewards’.
Health professionals should note that not all prevention strategies could be used for management purposes; once symptomatic, men reported that managing symptoms through cognitive strategies was important.
Public health programs for reducing depression may be more successful with the inclusion of positive strategies derived from men.
