Understanding major depressive disorder among middle-aged African American men.

AIM This paper is a report of a study of how a cohort of African American men recognized and expressed symptoms of depression, and how depression affected their lives. BACKGROUND Major depressive disorder has had global financial consequences in the form of healthcare visits, lost work hours, and disruption of family lives. Early recognition of depression and engagement of depressed individuals to promote management and treatment of this disorder is crucial in controlling its impact. African American men are often not included in research exploring factors that limit their engagement in mental health care. METHOD A descriptive qualitative study using semi-structured interviews was conducted in 2008 with ten African American men between the ages of 40 and 59 years. All participants self-reported a history of depression. FINDINGS Three central themes were identified: life events, the funk, and the breakdown. Life events were identified as stressors which led the men to experience what they described as the funk, which was later identified as depression. Due to lack of resolution of the funk, a breakdown was experienced. Over time study participants became informed about their condition, and their responses to managing depression varied depending on individual and contextual factors. CONCLUSION It is important to approach depression diagnoses from a broad perspective rather than as a limited list of symptoms. Healthcare providers would benefit from taking into account cultural factors, gender and age, examining them carefully in relation to the development of depressive symptoms.