Truth time! I wrote the book, Irritable Male Syndrome: Understanding and Managing the 4 Key Causes of Depression and Aggression to make sense of my own life and how it was impacting my family. Seeing a doctor and getting medications to treat my own depression and bipolar disorder helped a lot. But there were still many things about the causes of Irritable Male Syndrome (IMS) that weren’t clear. Researching and writing the book was very helpful to me personally, but I was surprised at the world-wide response.
In the book I describe IMS as follows: A state of hypersensitivity, anxiety, frustration, and anger that occurs in males and is associated with biochemical changes, hormonal fluctuations, stress, and loss of male identity.
The 4 Key Causes of Irritable Male Syndrome
1. Hormonal fluctuations
In order to understand the way in which hormonal fluctuations cause IMS in men, we need to know something about testosterone. Theresa L. Crenshaw, M.D., author of The Alchemy of Love and Lust, describes testosterone this way: “Testosterone is the young Marlon Brando—sexual, sensual, alluring, dark, with a dangerous undertone.” She goes on to say that “it is also our ‘warmone,’ triggering aggression, competitiveness, and even violence. Testy is a fitting term.” We know that men with testosterone levels that are too high, can become angry and aggressive. But recent research shows that most hormonal problems in men are caused by testosterone levels that are too low.
Dr. Gerald Lincoln, who coined the term “Irritable Male Syndrome,” found in his research that lowering levels of testosterone animals caused them to become more irritable, biting their cages as well as the researchers who were testing them. We know that testosterone fluctuations can occur in men caused by stress, conflict, and aging.
2. Biochemical changes in brain chemistry
Most people have heard of the brain neurotransmitter, serotonin. When we have enough flowing through our brains, we feel good. According to Siegfried Meryn, M.D., author of Men’s Health and the Hormone Revolution, “The more serotonin the body produces, the happier, more positive and more euphoric we are. Low serotonin can contribute to a man’s irritability and aggression.”
One of the most common causes of low serotonin levels is our eating and drinking habits. Judith Wurtman, Ph.D., and her colleagues at the Massachusetts Institute of Technology found that a high protein, low carbohydrate diet can cause increased irritability in men. They found that men often mistake their cravings for healthy carbohydrates, such as those found in vegetables like potatoes, rice, corn, squash, etc., with cravings for protein found in meat. “Eating protein when we need carbohydrates,” says Wurtman, “will make us grumpy, irritable, or restless.”
Wurtman’s team also found that alcohol consumption increases serotonin levels initially. However, chronic use dramatically lowers serotonin, resulting in depression, carbohydrate cravings, sleep disturbances, and proneness to argumentativeness and irritability.
3. Increasing levels of stress
For most of us, stress is synonymous with worry– if it is something that makes us worry, then it is stressful. However, our bodies have a much broader definition of stress. To our body, stress is synonymous with change. It doesn’t matter if it is a “good” change, or a “bad” change, they are both stressful. When you find you find your dream home and get ready to move, that is stressful. If you get a divorce, that also is stressful. Good or bad, if it is a change in your life, it is stress as far as your body is concerned.
We can’t eliminate stress, but we can deal with it differently. For most of human history we spend a lot of time moving about. We had to walk every day to obtain our food and when we were being chased by wild animals, we ran. Our sedentary lifestyle increases the changes that our stress will turn into distress and cause us to become more irritable and angry.
4. Changes in male roles and identity
For most of human history, the male role was clear: our main job was to bring home the bacon. We hunted for our food and shared what we killed with family and tribe. Everyone had a role to play. Some were good at tracking animals. Others were good making bows and arrows or spears. Some men were strong and could shoot an arrow with enough strength to kill a buffalo. Others were skilled at singing songs and doing dances that invoked the spirit of the animal and made the hunt more effective.
When we weren’t hunting we spent time with family and friends. We played with our children and had plenty of leisure time to teach them what we knew. In modern times our roles have become confused– many of us don’t have jobs or are working at jobs we don’t like. Divorce separates us from our children and we often lose connection with a community of supportive friends and relatives.
The 5th Cause No One Talks About: The Flaw in Love
My first clue that there was a fifth cause for IMS came when I read Andrew Solomon’s encyclopedic, but very engaging book, The Noonday Demon: An Atlas of Depression. I thought I knew all there was to know about depression having dealt with my father’s depression growing up, my own depression as an adult, and the many clients whose depression I treated.
I was not prepared for the way Solomon begins his book: “Depression is the flaw in love,” he says. “To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair.” These words gave me a new understanding of my own depression and that of many other people I had seen.
My doctors focused on neurotransmitters and what was going on inside me. Solomon was telling me that my anger, irritability, and depression also had something to do with my love life. Reflecting specifically on my irritability and anger I realized they were often triggered when I felt disconnected from my wife.
I would feel slighted or criticized and would react with anger. She would often clam up and withdraw. The more she withdrew the more alone and unloved I felt and the more irritable and angry I became. Over time, this downward cycle caused us to become more cut off from each other, more reactive, protective, and distant. We became like two porcupines in the snow, longing for the warmth of contact, but hurting each other every time we got close.
Luckily, we never gave up on each other or on our love. It took me a long time to realize how destructive my anger was to the relationship. Carlin couldn’t give me the love I needed because I was constantly bombarding her with angry works, hostile looks, and resentful thoughts. Getting therapy helped me to break the cycle. As I became less irritable and angry, Carlin withdrew less, and we began to slowly rebuild the bonds of trust that had been broken. We could talk about our need for love and support and how we could give and receive it more fully.
The New Science of Love
Once I understood the fifth cause of IMS was a flaw in the way I was loving, I began to learn about the “new science of love” and the work of John Gottman and Sue Johnson. Dr. Gottman is world renowned for his work on marital stability and divorce prediction and has conducted 40 years of breakthrough research with thousands of couples. His recent book, What Makes Love Last? How to Build Trust and Avoid Betrayal, focuses on love and how we can learn to love more wisely and well.
Dr. Johnson is the author of Love Sense: The Revolutionary New Science of Romantic Relationships. “Today, we have a revolutionary new perspective on romantic love,” she says, “one that is optimistic and practical. Grounded in science, it reveals that love is vital to our existence. And far from being unfathomable, love is exquisitely logical and understandable.”
We’ve all got a lot to learn about love and fortunately that’s a course of study that everyone can enjoy.
Jed Diamond, Ph.D., L.C.S.W., is Founder and Director of MenAlive, a health program that helps men, and the people who love them, to live well throughout their lives. He is a pioneer in the field of male-gender medicine, integrative mental health, and complementary medicine. Since its inception in 1992, Jed has been on the Board of Advisors of the Men’s Health Network. He is also a member of the International Society of Men’s Health and a founding member of the American Society of Men’s Health.
His work has been featured in major newspapers throughout the United States including the New York Times, Boston Globe,Wall Street Journal, The Los Angeles Times, and USA Today. He also did a nationally televised special on Male Menopause for PBS.
Diamond has been a licensed psychotherapist for over 40 years and is the author of ten books including the international best-selling Male Menopause that has thus far been translated into 17 foreign languages.