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

Recovery from depression involves active processes of taking back control and reclaiming the self. Antidepressant medication can play a critical role in recovery, yet these medications and their effects can also become associated with feelings of dependency and loss of self, whilst conflicting with social norms, including gender roles. Men may be vulnerable in particular ways to these conflicts because of a dominant masculinity that demands independence and self-control. High levels of non-adherence to prescribed antidepressant regimens in patient populations points to the importance of better navigating these socio-cultural and cognitive barriers in order to improve treatment outcomes. This study draws from one-on-one interviews with six men who speak about their experience of depression and antidepressants, and conducts a secondary thematic analysis of the data to explore the difficulties experienced around medication use, in particular in relation to these men’s redefinition of self, and exercise of agency. The analysis exposed three themes: feelings of altered embodiment and reality, concerns about dependency, and the ambivalent nature of masculine roles. It suggests that increased agency for men with regards to their therapeutic regimen, and consideration of masculine ideals of control and responsibility, could improve the experience of antidepressant use. However, the discussion also recommends the integration of medication use within treatment models that challenge less healthy aspects of male roles and identities, and allow for a diversity of masculinities. Public significance statement: Adherence to antidepressant regimens is frequently poor, and patients express reservations around their use. These include difficulties related to sense of self, and identities such as gender roles. Men’s conflicts around antidepressant use can be understood in the light of masculine norms, and treatment models designed to work with and around these norms could improve treatment outcomes for depression in male clients.