In this Healthed lecture, Prof David Castle, Psychiatrist; Inaugural Scientific Director, Centre for Complex Interventions (CCI) at the Centre for Addictions and Mental Health (CAMH), Toronto, Canada;  Professor, Department of Psychiatry, The University of Toronto explains why mood disorders in men are less common than in women, but keep this diagnosis in mind if behaviour is becoming violent. Allowing men to express their emotional pain and marshalling support, offering helplines, support groups all help. Pay attention to longitudinal history when differentiating depression from bipolar disorder, and if you suspect this, avoid prescribing SNRIs and tricyclics. When the patient cannot see the pain they will cause when they die by suicide, we may have to take active measures even against the patient's will.

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