Many Angry Men
Psychotherapist Jed Diamond says excessive moodiness can be caused by something called irritable male syndrome. Now he’s trying to convince skeptics that the condition is real–and treatable.

By Jennifer Barrett
Updated: 8:13 a.m. ET Aug. 16, 2005

Aug. 16, 2005 – Millions of lines have been written about how women’s hormonal changes can cause mood swings. But what about when men get irritable and withdrawn? Psychotherapist Jed Diamond believes they could be suffering from irritable male syndrome, a condition he says is affecting a growing number of men. No, it’s not a joke. The IMS term was coined by a Scottish researcher who found that rams became irritable, withdrawn and irrational when their testosterone levels plummeted. After visiting Scotland and reviewing the research, Diamond, author of the best-selling 1997 book “Male Menopause” (Sourcebooks), thought the syndrome might apply to humans as well. He analyzed data collected from more than 6,000 men and found that about half said they were stressed, gloomy or negative most or all of the time.

A total of 40 percent of the overal survey said they were often or always irritable. Many of those who reported feeling the negative emotions, he discovered, were also experiencing certain hormonal fluctuations–namely, a drop in testosterone–as well as changes in brain chemistry, increased stress and a loss of male identity. Diamond’s research developed into a quiz and a book, “The Irritable Male Syndrome,” which Rodale Press will release in paperback next month. NEWSWEEK’s Jennifer Barrett spoke with Diamond about the causes, treatment, and skepticism of the condition. Excerpts:

NEWSWEEK: I have to admit that when I first saw the book’s title, I thought it was a joke.  How did the book come about?
After I finished my book on male menopause in 1997, I got hundreds of letters from all over the world … Many people were asking about symptoms in men that were not yet identified with male menopause like irritability, and men changing from Jekyll to Hyde … Then someone sent me article from an obscure Scottish journal about irritable male syndrome. Dr. Gerald Lincoln [of the Medical Research Council’s Human Reproductive Sciences Unit in Edinburgh, Scotland] had coined the term after studying rams. He’d been working on male contraceptives and was moderating the hormone levels of rams. He found, inadvertently, that as their testosterone levels dropped, they became more irritable.

But those were rams.
We wondered if it might also be true in human males. So I went to Scotland and interviewed him and visited his research lab, and I decided that IMS really captured the biological, hormonally based shift that happens in men during age ranges where hormonal changes are most likely to occur.

How does a man know if he has IMS?
We adapted a [test] of 50 different symptoms. You can see the degree to which these symptoms can cause problems.

I’ve heard this described as both male PMS and another term for a midlife crisis. Why is that?
When we did this research–and it’s probably the largest of its kind in the world–we used samples of males from 10 to 75 years old. We were then able to see which ages are most likely to have extreme forms of IMS. There were two age groups where it’s most common: young men between 15 and 28 years old and those in midlife [between 40 and 55 years old]. What they have in common are hormonal changes and changes in their male identity and sexuality and relationships. Those seem to be times when males are more vulnerable to this.

So can IMS happen from normal changes in testosterone?
We found triggers can be internal and or external. If someone has a serious drop in testosterone, he can become more irritable and frustrated and angry. In the real world, it is often triggered by a traumatic loss. It could be the loss of a job or a relationship, a physical illness or injury. But rather than ask, “What is going on inside me?” men tend to think the problem is being caused by someone else. He’ll say, “Of course I am irritable–who wouldn’t be when treated this way?” He complains that his wife is not there for him or his boss is always doing this or that. He assumes the anger is justified–if he recognizes it at all. Part of the difficulty is getting men to recognize that [IMS] is something triggered by something that is going on in them, too. So they are looking out at the world through distorted lenses.

Do all men get IMS at some point?
No. Four factors come together to produce IMS. All males go through adolescence and have brain and physical and hormonal changes, and they will get irritable–same with midlife and male menopause. But some go through it relatively easily while others have major changes. What determines that is a mixture of hormonal changes–some have more than others–changes in brain chemistry, stress levels and loss of male identity.

Are we seeing more cases of IMS as men’s roles in society change?
There is a disconnect as more women ascend [in the workplace] and more men don’t know their role … Men are economically becoming displaced and the result is emotional. And in relationships, women are less likely to want to be with men who aren’t successful or don’t seem to have the ability to be successful. So they are marrying later, and they are not willing to settle for men not as adept as they are. So more males feel they can’t attract and keep a woman. That increases irritability on an individual and a national and international scale.

How do you treat IMS?
It can be helpful to have counseling. Those men with low testosterone levels may need testosterone restoration. We know that exercise and diet also figure into this pretty significantly. I keep harping on this with people because low-carb diets are the rage. People don’t realize that if you have extremely low levels of carbohydrates, you’ll lower your serotonin levels and get irritable. And we know when you exercise vigorously, your testosterone level goes up and your feeling of well-being increases.

Do you think we’re jumping the gun a bit by labeling these symptoms as a disorder?
We don’t want to label everybody who is angry and irritable with IMS. It’s important that people take the test [that Diamond has devised]. Sometimes it is just normal-life irritability. But the test is very helpful, especially with guys who insist “There’s nothing wrong with me.” They take the test and get a 124 [out of 150], which is very high, and they recognize it is something they need to deal with. My message to men is that this is something that is real and treatable–and not treating it is putting your own health at risk and running  the risk of destroying relationships at home and at work.

© 2005 Newsweek, Inc.

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