Conflict in Men’s Experiences With Antidepressants

Abstract

While men’s experiences of depression and help seeking are known to be shaped by gender, there is little research which examines their experience of using antidepressants to treat this. This study is based on in-depth, narrative-style interviews with 20 New Zealand men who had used antidepressants. The analysis identified a number of areas of conflict in the men’s accounts of using this medication. Conflict centered on the way taking antidepressants was seen as undermining personal control while also allowing users to take charge of their problems; facilitating general functioning while undermining sexual functioning; relieving emotional distress while undermining emotional vitality; and the tension participants felt between making autonomous judgments about the value of antidepressants and relying on the “expertise” of others. Participants negotiated these conflicts in a variety of ways. In some cases, antidepressants were positioned as being able to affirm aspects of traditional masculinity, while a smaller number of participants managed these conflicts by redefining aspects of their own masculinity in ways that contrasted with dominant constructions. This research is limited by the sample of older, more privileged men in the context of New Zealand culture which favors macho forms of masculinity. In similar contexts, mental health practitioners should be mindful of the conflicts that men might experience in relation to their antidepressant use. Facilitating men’s exploration of these issues may enable them to make better decisions about treatment options or to provide more effective support to those who have opted for antidepressant treatment.

Exploring difficulties in men’s experience of self and agency during antidepressant use.

“…Perceived distortions in sense of self and exercise of agency, associated with a sense of altered reality and dissociated embodiment, attributed by users as a side effect of the antidepressant medication, are well reported in existing research (Read et al, 2014;Gibson et al, 2018), and our participants also voiced these concerns. For Tom, one of the most pronounced negative effects attributed to the medication was a sense of unreality and disembodiment: This concern is consistent with the findings from the Gibson et al (2018) study, in which the men reported being particularly concerned with loss of vitality and sensory engagement, rather than loss of empathy or concern for others, which research has suggested may be more often reported as a concern for women (Fullagar and O'Brien, 2012). Harry reports a numb "dream like state" when he first started taking the medications, whilst George reports "feeling constantly flat", which impacts on his ability to write music, an identity defining occupation linked with enjoyment:…”

“…"you feel like a sort of porn star, you can go for hours you know [laughs]" (Samuel) Yet despite trying to reframe the situation, participants were unable to fully normalize this new form of embodiment, and it removed enjoyment of sexual activity, which previous research has suggested may become a source of distress in itself and further increase feelings of depression (Gibson et al, 2018).…”

Men's views of antidepressant treatment for depression, and their implications for community pharmacy practice

“…There is limited knowledge about men's views of taking antidepressants. Studies suggest findings are similar to non-gender specific studies, although hegemonic masculinity is influential for some aspects 20,54 . Some men felt taking antidepressants compromised hegemonic masculine traits such as control and autonomy 54 .…”

“…Studies suggest findings are similar to non-gender specific studies, although hegemonic masculinity is influential for some aspects 20,54 . Some men felt taking antidepressants compromised hegemonic masculine traits such as control and autonomy 54 . These traits are especially valued by men 55,56 .…”

Masculinity and Help-Seeking Among Men With Depression: A Qualitative Study

“…In addition to the impact of expectations regarding male roles on help-seeking behavior, studies revealed positive as well as negative experiences of (mental) health service use among men with depression. A recent qualitative study referred to conflicts that men experienced in relation to antidepressant use (9). On the one hand, medication was perceived as a way in which men asserted their control over difficulties; on the other hand, antidepressants were seen as an obstacle to emotional and physical vitality, for example by undermining sexual function.…”