"Social support is, generally speaking, a good thing. In many ways, it buffers against depression in the first place. You have a confidant — someone to reach out and talk to is really helpful for all different aspects of your health, depression or otherwise," said study author Alan Teo, an assistant psychiatry professor at Oregon Health and Science University and researcher at the VA Portland Health Care System.
"What's suggested in this study is there might be areas where social support inadvertently works against treatment for those who have clinical depression," Teo said.
Researchers analyzed data from 1,379 adults with depression symptoms who participated in the National Health and Nutrition Examination Survey.
They found that good social support for moderately and severely depressed men meant they were less likely to use any professional mental health services. On the flip side, depressed men who said they had inadequate social support were more likely to get that professional help.
For example, 26 percent of depressed men who felt supported by family or friends used some mental health service, while 47 percent of depressed men lacking social support did the same.
But moderately to severely depressed women in the study, regardless of how much social support they had, more or less sought out professional mental health services at similar rates.
"One of the key conclusions here is gender seems to be a driving factor in whether these patients ... actually seek treatment from a mental health professional," Teo said. "Men seem to be on the losing end of that stick."
Now, it's not that men with moderate and severe depression aren't going to the doctor or seeking any professional help. They actually saw non-mental health providers, such as primary-care doctors, at much higher rates than women. And when it comes to non-mental health services, the dynamic between friends and seeking help reversed for men: Depressed men with good social support were more likely to go to such doctors than those without good support.
That means primary-care doctors have "a big window of opportunity to reach many of these folks who have untreated depression," Teo said.
There's also a gender difference when it comes to general use of health care. The study shows that overall, women more consistently use mental health services than men, regardless of how much social support they had.
But why is it that having adequate bonds with friends and family means it's less likely depressed men will get mental-health help? Social support can mean a lot of things, including an emotional confidant. Sometimes that's the person who can encourage you to seek professional help — or the person you turn to in place of a professional.
Some men may view such support as a substitute for professional help, or maybe men have a more "unfavorable attitude toward using mental health services if they feel like they have social support in their lives," Teo said.
The study focused on adults over 40.
"A lot of them are going to be partnered or married men," Teo said. Such men may believe, "Oh, I have support from my wife. I talk to her about things. I might have this depression going on, but I still have my wife."
He added: "They end up not seeking treatment, thinking, 'I don't need help.' "
Now, all of this doesn't mean people with depression shouldn't seek out the company of good friends and family. Teo said he encourages his patients, especially those with mild depression symptoms, to seek that out in their lives.
"But if it gets past that point to moderate or severe, it just doesn't cut it," he said. "Those folks need to be getting professional treatment."
And that's where the friends and family of men with severe depression can really step in. "One of the best ways to support your family or friend with depression is to encourage seeking out a mental health care professional," Teo said.