Depression: The Hidden Psychological Face of Men-Identifying Mental Wastelands, Nine Diagnostic Criteria, and Suicide Crisis Intervention

The word "depression" is derived from the Latin word for "repression." Depression is not only a visible outward manifestation but also an inner mental state; it is also a physical pathology. In Austria, approximately 800,000 people suffer from depression. Although fewer men suffer from depression than women, suicidal behavior is frequently seen in men with depression. This seemingly contradictory phenomenon can be attributed to the fact that depression in men is often difficult to detect and therefore goes untreated. Symptoms of depression include: depressed mood, decreased interest in daily activities, weight loss, insomnia, difficulty concentrating, a tendency to withdraw into oneself, loss of energy, and feelings of inferiority. Many male patients believe that seeking help or seeing a doctor is detrimental to their masculinity or are simply unaware that they have an illness. Bound by guilt and a misinterpretation of their own condition, patients with depression often fail to recognize their illness. Psychological medicine is not a one-way street; physical illness can also lead to a depressed state of mind. For this kind of difficult-to-identify, interacting depression, the concepts of "reactive depression" or "comorbid depression" are used. The main symptoms of depression are as follows: At least five of the following symptoms must be present, and at least one of the main symptoms (1 and 2) must have persisted for more than two weeks: 1. Depressed mood for most of the day; 2. Loss of interest in all or almost all activities; 3. Unnatural weight loss or gain, or significant changes in appetite; 4. Insomnia or excessive sleep; 5. Irritability or slowed behavior and reactions; 6. Fatigue or lack of energy; 7. Feelings of worthlessness or inappropriate guilt; 8. Impaired ability to concentrate or make decisions; 9. Frequent thoughts of death, or suicidal ideation, suicidal behavior, or suicide plans. Former British Prime Minister Winston Churchill described his depression as "a black dog that cast a shadow over my life." He wrote, "I felt like I was sitting in an empty swimming pool that had been drained, and I wanted to get out, but I couldn't get out..." Depression arises from the interaction of a complex set of biological, psychological, and social factors. Depression originates in the brain. Research has found that serotonin and norepinephrine both play a role in transmitting information from one nerve cell to another. Once a nerve cell is excited by an electrical impulse, it produces and releases a biochemical signaling substance, such as serotonin. The brains of patients with depression produce too little serotonin. SSRIs (Selective Serotonin Receptor Inhibitors) were developed. SSRIs prevent released serotonin from being re-recepted to the cell that originally released it, thereby increasing the amount of serotonin needed at the receptor site. This drug's mechanism of action is very specific; it does not affect other signaling substances in our brain, so it rarely produces side effects. In the late 1980s, fluoxetine hydrochloride was marketed as a remarkable drug because it not only greatly helped patients with depression but also had positive effects on many other diseases.