Who me? Depressed? I am fine.
Every night, Tom comes home from work and has four or five drinks. Trevor gets so angry in traffic that he swears and punches his dash. Bill, who has recently retired, spends his day watching TV and rarely speaks to anyone.
These men have one thing in common – they are likely depressed.
The core features of depression that are common to both genders are: depressed mood, reduced energy, negative thoughts, and sleep disturbance. In males, however, irritability, aggressiveness, and a tendency to blame others are more common than in females. It has been suggested that in men you don’t see ‘depression’; rather, you see the ‘footprints’ of depression – or the defenses he is using to run from depression.
These footprints can be in the form of: abuse of alcohol/drugs; working or eating excessively; womanizing; watching too much TV; and, in some cases, becoming violent towards others and themselves.
Some of these activities are a form of self-medication and, as such, are often accepted and tolerated by others (and by themselves) so, as a consequence, it is difficult to convince them that they are just trying to stabilize or disguise a depressive state.
Men who are at risk for depression often feel they aren’t measuring up and they may believe that they are no longer meaningfully engaged in life. Personal losses can set the stage for depression in all individuals but a unique loss for men is a loss of physical strength. As well, some men who have lost a partner through death or divorce, or who have lost their father, may experience a more debilitating grief than expected, resulting in depression.
Men often deny they have a problem because they are taught to be strong and silent in suffering, and live up to the ‘Clint Eastwood’ image – strong like an oak, strong like a rock. Even when men experience sexual difficulties, they often do not understand the connection with depression. The little blue pill may solve a physical issue but it will not address the underlying problem, which may be depression.
Why worry about male depression? One of the features associated with depression is suicide and the rate of completed suicides for men is twice as high as in women. For those who don’t see suicide as an answer, they often present with a smile and an ‘everything is fine’ attitude but this is a mask for an emptiness that makes even the smallest tasks in life very difficult.
And asking for help is foreign to many men. Expression of feelings or sharing the human quality of being vulnerable is not something men are taught as young boys.
The cultural icon of men such as Clint Eastwood is linked to past and present role models; but many recent TV role models are now portraying men as goofy and incompetent. It seems that women are allowed to be mysterious or even complicated – they can be multi-dimensional. Men, however, can just be strong, goofy, or some other single-dimensional quality. Single-dimensional descriptors for men are both simplistic and ‘not real’. What is real is the fact that males are indeed complicated and that depression does happen to them. Depression may be perceived as being unmanly and shameful; as well, it carries a double stigma – the stigma of mental illness, as well as sharing traits that are commonly associated with a more feminine side.
Men are not generally well connected to the health system, which is central to the reason this is such a problem. This first contact with the health system is often through the family doctor but because men are often infrequent users of medical services, they may not feel comfortable in speaking with their doctor who has been a source of counsel for his wife and family for several years. In fact, his wife may have come to trust the family doctor with more than medical expertise – the doctor is seen as a source of support in the various parenting questions and other more general problems that life presents. The family doctor has also been an expert source for referral.
The first step for most men is to trust and confide in the family physician. This initial step may need the additional push from someone significant in the man’s life.
Men need to know that depression is a human condition that can be dealt with effectively.
Originally published in the ‘Tri-Cities News’ as a voluntary contribution to the community from Arthur Rathgeber.
The contents of this article are the property of Willow Grove Counselling, Inc. and further reproduction is given through written permission only. Copyright © 2012