A friend of mine asked me a simple question not too long ago. “Dave, when is the last time that you were really happy?” I gave the question some thought, and the honest answer was somewhat alarming to me. The answer that I wanted to say was yesterday or maybe last week, but after some stomach churning self-assessment I realized that the real answer was about three and half years ago on a family vacation to San Antonio. Having been somewhat of an overachiever most of my life, coming to this type of conclusion was unacceptable to me. How could that be? Maybe I am just being too hard on myself, I thought.
The question plagued my mind for several days. The more I thought about it, the more I realized the answer that I came up with was dead on. Since that time in my life, I have navigated through a personal wasteland of death, divorce, and disappointments that have torn through my life like a tornado in the Midwest. While many of my friends and coworkers acknowledge that it makes sense that I am not brimming with happiness on a regular basis, this whole experience has caused me to dig a little deeper.
Could this be more than just a “rough patch”? Is it normal to feel down all the time? By many standards, I have a lot of things to look forward to in my life. I have two beautiful sons that I spend a lot of time with and enjoy seeing them grow up. I have a job that is challenging which has sent me all across the world to see places I wouldn’t get the opportunity to any other way. I have a handful of close friends and many other acquaintances. I live in a decent house, have a cool dog, and between video game consoles, a 50 inch plasma, surround sound home theatre, and enough computer equipment to run a small nation, I have more than enough things to entertain me and my friends. So with all of the aforementioned positives in my life, how could it be possible that I could be dealing with depression?
Depression. The word makes me cringe. I should know better. As a psychology major, I took all of the classes related to mental health. My ex-wife is a mental health professional and she suggested when we lived in upstate NY that it appeared like I had seasonal affect disorder at the very least. I have witnessed firsthand the negative effects of depression in my own family growing up and know that makes me over ten times more likely to experience depression related symptoms in my lifetime. The writing is on the wall, yet why I am resistant to that possibility? Perhaps at this point I have more questions than answers. But after reflecting on my own experiences, combined with recent discussions I have had with some of my peers, it would appear that depression in men is something that is far more prevalent than it would seem on the surface.
Depression in general is often misunderstood. There is no singular cause. While many people experience symptoms of depression tied to difficult life events, there are many other factors that can cause depression as well. Physiological factors such as high blood pressure and stress have been shown to contribute to depression. Some types of depression appear to run in families suggesting a genetic link. Also physical trauma such as a car accident or fall can cause depression. One thing that is clear is that there is a definite biological basis to depression and it isn’t “just in your head” Studies on depression have clearly shown using imaging techniques such as MRI’s or PET scans that the brain activity in someone with depression is much different in the areas of the brain that regulate mood, sleep, thinking, appetite, and behavior.
Additionally, there are several roadblocks that are unique to men when it comes to facing that depression might be a problem in their life. First, it goes against what most men think society expects from us. Many men feel the need to appear “tough” and “manly.” Men cascade through life with the innate desire to be superheroes to our wives, girlfriends, and children. How can a man with sights to be the Man of Steel end up more like Willy Loman in Death of a Salesman? Men with depression have a hard time reconciling these two conflicting viewpoints. Second, many people perceive depression to be a problem that mainly women deal with. This misconception is complicated by ad campaigns which are geared toward women. Commercials for drugs such as Prozac, Cymbalta, and Paxil are all narrated by women and feature women actors to men in a ratio of 3 to 1. Third, depression manifests itself differently in men than in women. A man with depression is far less likely to feel uncontrollable sadness which results in crying. Instead, many men with depression experience increased anger and agitation at small things. These differences and misconceptions about depression can inhibit men from seeking help when they need it and even many doctors fail to consider depression as a problem from men as well. Lastly, the issue of treating mental health issues such as depression with drugs is surrounded by a lot of stigma that is hard to overcome.
Despite these roadblocks, it is important to realize that depression in men is serious problem. It is estimated that about 6-10% of men will deal with a major depressive disorder during their lifetime. Major depression, according to the National Institute of Mental Health is experiencing five or more of the following symptoms for a period of more than two weeks.
- Persistent sad, anxious, or “empty” feelings
- Feelings of hopelessness and/or pessimism
- Feelings of guilt, worthlessness and/or helplessness
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Fatigue and decreased energy
- Difficulty concentrating, remembering details, and making decisions
- Insomnia, early–morning wakefulness, or excessive sleeping
- Overeating or appetite loss
- Thoughts of suicide, suicide attempts
- Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment
One or more of these symptoms in relation to an isolated incident or on occasion is not a cause for alarm. However, it’s the multiple symptoms over an extended period that is a cause for concern. For me, the biggest factor has been a loss of interest in activities that were once pleasurable. I really like to write, however I haven’t written an article for three months, and I have a folder full of a dozen or more incomplete stories. In addition, I am normally excessively patient with my sons, and over the last month or two I have noticed increased irritability. My sleep habits have been irregular, too. The problem always is that there are life stressors for me that I can use to rationalize these warning signs away. I have had enormous amount of work. I spent over a month away from home in the last two and a half months, and while I have been home I have had huge projects to do that have required 10 hours a day or more of work. International travel contributes to jet lag.
Most significantly, the biggest personal challenge in accepting the possibility in dealing with my depression is my own pride. I have always had the will to overcome just about anything. I came from a very poor family and grew up in a home that by many would be considered uninhabitable. Yet I graduated near the top of my class, and went to college on combined music, academic, and sports scholarships. After my mom passed away almost three years ago, I decided that I would take up running. I have since completed three marathons and have my eyes set on an ironman triathlon before I hit 35.
I allowed myself to believe that the type of willpower necessary to complete a marathon or get through college in spite of the odds should be able to carry me through anything. The reality I have had to face is that willpower alone isn’t always enough. I know that I shouldn’t feel this way, but sometimes I still do. I am fortunate that I have a handful of male friends that I trust that I can be real with and share my hurts and hang-ups. Many of the other men I know do not have the depth of friendships where they can share feelings of depression, hurt, guilt, or anxiety. As a result, men that face depression often turn to destructive behavior to find answers. Men are more likely to abuse drugs or alcohol, engage in affairs, and successfully complete suicide. Although women are more likely to attempt suicide while battling depression, men complete the act of suicide four times more than women do. To put that in perspective, out of the 33,300 suicides reported in 2006 (the most recent year from which statistics have been compiled by the Center for Disease Control) nearly 27,000 of those were men.
If you or someone you know is dealing with these types of feelings there are steps that you can take to help. To help others, keep in mind some of the following possibilities:
- Offer emotional support, understanding, patience, and encouragement.
- Engage your friend or relative in conversation, and listen carefully.
- Never disparage feelings your friend or relative expresses, but point out realities and offer hope.
- Never ignore comments about suicide, and report them to your friend’s or relative’s therapist or doctor.
- Invite your friend or relative out for walks, outings, and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon. Although diversions and company are needed, too many demands may increase feelings of failure.
- Remind your friend or relative that with time and treatment, the depression will lift.
If you are experiencing depression yourself, here are some steps to take to feeling well:
- Engage in mild activity or exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social, or other activities.
- Set realistic goals for yourself.
- Break up large tasks into small ones, set some priorities, and do what you can as you can.
- Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.
- Expect your mood to improve gradually, not immediately. Do not expect to suddenly “snap out of” your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
- Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
- Remember that positive thinking will replace negative thoughts as your depression responds to treatment.
There are also some great blogs that I have come across that chronicle struggles of other men in dealing with depression. Many of them offer articles, encouragement, and other resources that can provide a way to get out of the rut that many of us find ourselves in from time to time. Storied Mind (http://www.storiedmind.com/), chiphur (http://chipur.com/), Knowledge Is Necessity (http://knowledgeisnecessity.blogspot.com/) and A Splintered Mind (http://thesplinteredmind.blogspot.com/) are all a good place to check out to read about other men’s experiences with depression.
I hope that by sharing my some of my own personal struggles, the issue of depression in men will gain a bit of awareness. In addition to my own struggle of trying to walk this path alone, I have witnessed too many friends and family do the same thing. At this time I don’t intend to take any medication, but I am committed to being accountable and acknowledge that depression is an issue that I must deal with in my life. So as I put one foot in front of the other, share my struggles with my friends, and dust off the pile of writing that has sat on my desk for the last couple of months, I encourage anyone else out there that might be dealing with same things to take action as well. Remember that you aren’t alone. I welcome any feedback or comments regarding this issue. While I am by no means a doctor or clinician of any type, I am available to offer any assistance I can.
Image credit: Dave Gingrich
Dave Baldwin is a businessman, musician, and divorced father of two boys. They live together in El Paso, TX.