Masculinities and College Men's Depression: Recursive Relationships
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Copyright © eContent Management Pty Ltd. Health Sociology Review (2010) 19(4): 465–477. Masculinities and college men’s depression: Recursive relationships JOHN L OLIFFE School of Nursing, University of British Columbia, Vancouver, BC, Canada MARY T KELLY School of Nursing, University of British Columbia, Vancouver, BC, Canada JOY L JOHNSON School of Nursing, University of British Columbia, Vancouver, BC, Canada JOAN L BOTTORFF Faculty of Health and Social Development, University of British Columbia, Okanagan, BC, Canada ROSS E GRAY Faculty of Medicine, University of Toronto, Toronto, ON, Canada JOHN S OGRODNICZUK Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada PAUL M GALDAS School of Nursing, University of British Columbia, Vancouver, BC, Canada ABSTRACT Depression is a signifi cant problem among college men. This qualitative study examines the interplay between masculinities and depression among Canadian-based college men who self-identifi ed or were formally diagnosed with depression. The resulting three themes – mind matters, stalled intimacy and lethargic discontent – reveal the recursive relationships between masculinities and depression whereby depression quashed men’s aspirations for embodying masculine ideals, with depression potentially trig- gered by self-doubt and concerns about harbouring a faulty masculinity. Key fi ndings include par- ticipants’ juxtaposing their private negative self-talk with attempts to pass as self-assured in public; anxieties about neediness and vulnerability negating their efforts to initiate or maintain an intimate relationship; and ruptured ideologies about a mind–body dualism whereby severe depression negatively impacted physical wellbeing. KEYWORDS: masculinities; college men; depression; sociology INTRODUCTION College Health Association [ACHA] 2007). epression ranks among the top fi ve health Many factors are cited as potential causes and/or Dconcerns that impede college students’ triggers for college men’s depression, including academic performance and, in North America, stresses around body image and identity (O’Dea depression among college men increased from and Abraham 2002), pressures to fulfi l academic 6.2% in 2000 to 10.9% in 2007 (American and career aspirations (Robotham 2008), and Volume 19, Issue 4, December 2010 HS 465 R H SR John L Oliffe et al. fi nancial strain (Hudd et al. 2000). College men constructed masculine ideals and men’s diverse are also known to engage in risky behaviours alignments to them infl uence their depression- (i.e., unprotected sex, drug use, weapon use related experiences. Specifi cally addressed in the and fi ghting, risk-taking when playing sports current study is the research question, ‘What are or driving) (Courtenay 2004), and these prac- the connections between masculinities and col- tices can be taken up as self-management strate- lege men’s depression?’ gies for depression (Blazina and Watkins 1996; Kilmartin 2005; Voelker 2004) and potentially Masculinities and men’s depression lead to violence and self-harm (Langhinrichsen- Courtenay (1998, 2004) suggests that college Rohling et al. 2004). The reported rates of male men’s aggression, stoicism and self-reliance, depression likely under-represent the actual along with their lack of interest in self-care, are incidence, for which men’s estrangement from informed by alignments to masculine ideals. professional medical services may be a contrib- Embedded here are gendered expectations that uting factor. For example, the US 2008 National the male body should be robust, competitive College Health Assessment study indicated that and deliver the promise of physical and sexual 53.2% of male college students reported feeling prowess (Potts 2000; Sabo 2005). Similarly, the very sad in the past year, 25% felt so depressed rational, decisive masculine mind is celebrated they found it diffi cult to function, with 6.1% and privileged as strategically focusing men’s indicating they had seriously considered suicide, efforts and energy (Kilmartin 2007). When signs yet only 6.3% of men surveyed reported being of illness or disability emerge men typically self- formally diagnosed or treated for depression manage and/or medicate rather than consult a (ACHA 2008). Generic depression screening health care professional to avoid being seen as tools have also been implicated in missed diag- weak (Galdas et al. 2005). noses and the underreporting of college men’s Such assertions are empirically supported by depression (Addis 2008). Downstream indica- studies linking masculinities to men’s depres- tors including men’s high rates of violence, sion-related practices. For example, Addis substance overuse and suicide support asser- (2008) found that conformity to Western mas- tions that men’s depression is under-diagnosed culine norms in and of itself is a risk factor for (Beautrais 2002; McQueen and Henwood 2002; developing depression. A study of 14 US-based Statistics Canada 2007; White 2003). Most men, diagnosed and treated for major depres- prominent in terms of cause–effect relationships sion, indicated that expectations related to per- is depression-suicide, and clinicians, researchers formance, lack of connectedness with others, and policymakers agree that suicide is a pre- feeling out of control, elaborate secret-keeping ventable outcome of severe depression for many for fear of being seen as weak, and self-blame young men (Beaudet 1999; Beautrais 2002; for not being able to ‘overpower’ depression Government of Canada 2006; Health Canada were strongly represented (Heifner 1997). A 1994; Moller-Leimkuhler 2002). secondary analysis of 16 UK men’s interviews Connections between men’s depression derived from a study that focused on depres- and masculinities described in commentaries, sion-related issues indicated that longstanding reviews and empirical work reveal Connell and feelings of isolation and difference – in addition Messerschmidt’s (2005) gender framework as an to sadness, guilt, detachment, anger and fear – important and effective analytic lens. Courtenay’s were central to participants’ accounts of their (2000) commentary about masculinities and men’s depression (Emslie et al. 2006). An Australian health, which drew on Connell’s (1995) earlier grounded theory study of a non-clinical sample work, guides the current study whereby socially described how men reacted to emotional stress 466 HS Volume 19, Issue 4, December 2010 R H Recursive relationships in masculinities and college men’s depression SR and being ‘down in the dumps’ was connected on campus detailing our masculinity and depres- to traditional masculinity. Specifi cally, the avoid- sion study and inviting men to contact the project ance of problems and numbing with drugs and director. We described the study to prospective alcohol (‘acting in’) could lead to a build-up participants as being focused on their experi- of negative emotions and risk-taking (‘acting ences with depression, and including questions out’), culminating in self-harm and suicidal- about how being a man infl uenced their cop- ity (‘stepping over the line’) (Brownhill et al. ing and self-management strategies. Eligibility 2005). A grounded theory study of US men criteria included English-speaking men, 18 years who had received pharmacological or psy- and older who self-identifi ed or were formally chological therapy for depression confi rmed diagnosed with depression. Twenty-six men par- Brownhill et al. (2005) predictions. Specifi cally, ticipated in individual interviews and received the cyclic pattern of depression was detailed in a nominal honorarium (CAD$30) to acknowl- processes connecting triggers, early symptoms, edge the time spent and their contributions to external overfl ow and maladaptive coping to the study. Recruiting men to qualitative studies masculinity (Chuick et al. 2009). Galasin´ski can be challenging but, as Oliffe (2010) sug- (2008) employed a linguistic discourse analysis gests, some remuneration in the form of an to investigate men’s depression, and concluded honorarium can bolster the project feasibility by that men used distancing strategies to construct engaging men in an atypical dialogue without a self that was separate and outside of their infl uencing their talk and/or the study fi ndings. depression. Prior to being interviewed, participants com- Overall, consensus prevails that men’s depres- pleted a demographic questionnaire and the sion signals vulnerability, attracts signifi cant Beck Depression Inventory (BDI-II) (Beck et al. stigma, and threatens the strength and power 1996) (see Table 1 for participant characteris- synonymous with idealised masculinity (Link tics). The BDI details were collected to detail the et al. 1997; Real 1997). Moreover, in many range of severity of the men’s depression. Western countries depression is positioned as Participants were offered the choice of a male a feminine disorder requiring antidepressant or female interviewer; however, they indicated medications (Riska 2009). Experiencing, as well no preference. Interviewers followed a semi- as being treated for depression, are decidedly structured guide and used probe questions to unmasculine (Branney and White 2008; Oliffe solicit further details when needed (Oliffe and and Phillips 2008). This article focuses on college Mroz 2005). Specifi c questions included: How men to describe their experiences of depression, does depression impact your studies? How has and explore the connections between masculini- depression affected your relationships