Relationships Between Masculinity, Externalizing Depression, and Suicidality in College Men

Women are diagnosed with Major Depressive Disorder (MDD) at a much higher rate than men (Martin et. al., 2013), yet men commit suicide at significantly higher rates than women (CDC, 2012). While the suicide rate in men is significantly influenced by men’s higher likelihood to engage in violent methods of suicide (CDC, 2012), the possibility also exists that some men may also be at risk for suicide because they do not appear typically depressed. A rapidly building body of research on depression suggests that the diagnostic criteria listed in the DSM-5 (American Psychiatric Association, 2013) may not include the full range of depressive symptoms experienced by men who adhere to hegemonic masculine gender role norms. Men who more strongly adhere to hegemonic masculine gender role norms instead appear to be more likely to present with externalizing depressive symptoms (e.g., anger and hostility) which are more consistent with hegemonic masculine gender role norms (Fields & Cochran, 2011). Therefore, depression in men is likely underdiagnosed and undertreated because clinicians may not necessarily consider externalizing symptoms when they examine male patients (Fields & Cochran, 2011). Based on this knowledge, that some men exhibit atypical depressive symptoms a primary focus of research has shifted to how an understanding of atypical depressive symptomatology informs the highly concerning public health issue of suicide in men