Tim O'Rahilly Life Coaching

Posts Tagged ‘Male depression’

Mindful Monday: Men and Depression #5

Getting help and helping yourself.

In this final part of my look at anxiety, depression and suicide in men, I intend to cover what you can do once you have recognised that there is a problem. In the first four parts I tried to give an evidence-based overview of the issues. While this final part is also based on my research of the subject, it is also a quite personal view based on my own experiences.

It will surprise many who know me to learn that I have been suffering from depression for the past two years. I spent most of that time trying to convince myself that as a life coach I should be able to talk myself out of it. I finally sought the help of my GP just two months ago and now wish that I had done it a lot sooner.

Men need UHT.

No, I don’t mean UHT milk. I have stolen the acronymbigstock-depressed-man-sitting-on-top-o-48751034 to explain the process which I believe all depressed men need to go through:

  • Understand
  • Help
  • Talk

First you need to understand what is happening. You are not weak or less manly. You have certainly not failed anyone. Your depression is most likely to be the result of chemical changes in your brain. It could also be the result of your efforts to cope with life in an increasingly demanding and stressful world or it could be a mix of both of these elements.

Once you understand the nature of your depression as an illness it should be easier to seek help. If you broke your leg or contracted some disease you would seek professional help. Depression should be seen in exactly the same way and it is nothing to be ashamed about.

Talking about your feelings is without doubt the single most important step on the road to recovery. I would say that the two most important people you need on your side will be your partner or a close friend and your GP. It is important to talk openly and honestly with both of them.

My partner had no idea that I was suffering with depression until I told him two months ago. Since then he has been an absolute star and way more supportive than I had expected. I do believe that even if they are not directly part of your recovery plan it is wise to have somebody who is at least aware of what is happening. When you are ready to ask for professional help, put some thought as to which doctor in your practice you can see most regularly and who you feel most comfortable with.

Be aware that doctors are often slow to diagnose depression in men simply because the patient is more likely to describe his physical symptoms and not his feelings or anxieties.

Self-help

There is quite a lot that most men can do to help themselves. None of the following things are a cure and they should not to replace medical help.

  1. Talk to someone. Tell somebody how you are feeling and what is happening. This is especially important if there has been any kind of trauma such as a bereavement or a relationship split which has caused a major upset in your life.
  2. Sleep. For many people with depression this can be a great cause of anxiety. You need to rest and get as much uninterrupted sleep as you can. If you can’t sleep don’t try to force it. Do something relaxing that you enjoy. Try reading, listening to music or the radio but avoid watching television if possible. You might also get some positive results from light exercise, massage or even some light yoga.
  3. Treat yourself. Try to build in some regular time in your daily life to do something which you really enjoy whether it be a hobby, exercising or simply reading a good book.
  4. Drinking is not the answer. Alcohol may make you feel better for a short while but in the long run it will increase your depression. Of course, the same applies to illegal drugs, particularly amphetamines, ecstasy or cocaine.
  5. Try to get out of doors and do something active when you can. This is not just for the sake of your fitness but it can help to distract you from depressing thoughts and feelings and will also help you to sleep better.
  6. You should try to eat a balanced diet with plenty of healthy nutritional foods even if you are not feeling particularly hungry. Depression can lead to not eating and therefore missing out on essential vitamins, or it can lead to binge eating or the consumption of junk food causing weight problems.
  7. Take a look at your work load. Can you set yourself more realistic targets? Can you structure your day or your week to be kinder to yourself? Are you the kind of perfectionist who tries to lose yourself in your work in order to avoid the real world?
  8. Get away. Taking time out for yourself can be hugely beneficial whether it’s getting away from your normal routine for a few hours or better still a few days. Check out those weekend breaks.
  9. There are many books and websites where you can read about depression. Sometimes researching medical conditions online can appear to make things worse than they really are, but in the case of anxiety and depression these sites and books can be very beneficial. Not only can they give you a variety of strategies to use, but they may also help friends, relatives or colleagues to understand what you are going through.
  10. Sometimes when you are depressed, self-help is not so easy. It may be beneficial for you to seek out a support group where you can talk to other men in similar situations. Your GP may be able to point you in the right direction or you may find local organisations who can help with this.

Man-with-depressionEven if you engage in any or all of these self-help strategies you should at some point see your GP. Be completely transparent and honest since this will help the doctor to deliver the best help for you. Depending on the severity of your illness the GP may suggest one of three basic options, or a combination of these.

  • Self-help: this may be in the form of an exercise program, reading, or online therapy course.
  • Talking therapies, such as psychotherapist or counsellor.
  • Medication

Many men dislike the idea of psychotherapy or antidepressant medication but I have found both to be highly effective and neither has to be permanent.

Of course your GP is also best placed to know if your depression is linked to any physical condition which is often the case.

Self-harm and suicide are tragic consequences of untreated depression. As we have already seen, men are three times more likely to kill themselves than women. It is also more likely among men who are separated, widowed, or divorced. Suicide is much more likely among men who drink heavily too.

This is where the support of a friend, colleague, or partner may be vital. If you suspect that somebody is harbouring suicidal thoughts, then ask him. You will not be putting the idea into his head, but you may just save his life. If your depressed man talks, then listen and take what he says seriously. There is nothing more demoralising than a man plucking up the courage to talk to somebody only to find himself not being believed or not supported.

Finally, maintain hope. Things will get better and many men come out of depression much stronger than they were before. You may even have a better understanding of yourself, of relationships and of stressful situations. It is true that some people continue to suffer periods of depression but they become more resilient and learn to live with them. Remember that anxiety and depression are very common you are not alone and you can get help. Just ask for it.

As for me, counselling and medication are helping. I have to accept that some of the root causes of my depression will not go away overnight. What I am learning to do however is to manage the way I feel about them. For those of you who know me by the positive messages which I post on Facebook every morning, you should know that they are helping me as much as they are my readers. Yes, things are getting better.

Mindful Monday: When gay does not mean happy

Today I’m going to look at the very specific issues5562 of mental health in the gay community. First, let me say that when looking at anxiety, depression and suicide in men I could have chosen any one of the number of sub-groups. These days it would be easy to single out black men, Asian men, Muslim men, military men, transgender men, young men, old men, married men or fathers etc. Each of these groups has specific issues and needs, and all do need attention. I chose gay men because that is the area that I feel most qualified to address. I will include bisexual men in this, although I am in no way endorsing the notion that they are really undecided gay men.

Of course for women, read all of the above too!

Recent victories in equality can lead many people both gay and straight to think that the gay cause is winning. That may be true in some areas but there is no room for complacency yet. Several recent studies confirm that LGBT people are much more likely to suffer from issues of anxiety, depression, self-harm and suicide. Some studies show as many as half of all gay men having at some point contemplated suicide and almost half of those have actually attempted to kill themselves.

We have already examined the mental health issues encountered by men in general. We’ve also looked at many of the factors preventing men from admitting to the problems or seeking help for them. Our health services are failing to meet the needs of the population in general with regards to mental health issues. With gay people already feeling that their needs go unmet, those with mental health issues just have their worries amplified.

Surveys and studies carried out over the last five years or so have shown many results in common. Lists of the causes of depression in gay and bisexual men are very similar both in content and in the rankings of the issues. Many of the factors are not unique to gay men but some of them definitely are.

Very few people would list only one causal factor and as mentioned last time, there is more likely to be a toxic cycle of factors all feeding into the problem. The top scorer from most studies seems to be that of low self-esteem, closely followed by relationship issues and feelings of isolation. Low self-esteem can take many forms but in young gay men it is often related to concerns about body image and ‘fitting in’.

Working our way down the list the next group of issues include sexuality, finances, employment and homophobic bullying. Although it is usually young gay or bisexual men or teens who suffer directly from bullying, its effects can linger into much later life. There may in fact be lifelong anxieties which often lead to poor relationships, addictions and in far too many men, to suicide.

A third group of factors include sex, difficulties with coming out, other forms of bullying, family rejection and living with HIV/AIDS. Some of these are clearly related to each other and there are for example, still far too many homeless young LGBT people who have been rejected and turned out by their own parents.

The final group covers a wide range of factors12011233_831151810317550_6546850233210408206_n from the death of loved ones to prejudice and even rejection by the gay community itself. This group also includes alcohol and drug addictions, fear of HIV infection and religious reasons.

Rejection by the gay community may seem a surprising factor, but ageism, racism and the prejudice against bisexual men all feature in this and the victims often describe feelings of invisibility in gay settings or groups.

I have already talked about the cultural pressure which leads to perceptions of weakness or of diminished masculinity in depressed men. This is a much greater issue for gay men. It’s not particularly to do with any overtly anti-gay behaviour, but comments like ‘man up’ or ‘grow a pair’ cut much deeper for gay men. Many are already struggling to have their masculinity accepted and feel that any admission of mental illness will be seen as simply stereotypical.

Many men already feel that seeking help with their problems will be seen as an affront to their masculinity. For gay men it may form a solid barrier to treatment.

For young men in particular, gay culture can put a lot of pressure on them to conform. This can be the peer pressures of fashion, body type, socialising, alcohol consumption, drug taking, hobbies and sexual behaviour. Any of these areas can lead to problems, but together they can add up to a very destructive cocktail.

The toxic cycle of peer pressure can also lead to money problems, eating disorders, feelings of inadequacy and stress. If unchecked and untreated, any of the factors mentioned so far can precipitate problems in the daily lives of anxious gay men just as it does in the heterosexual world.

Social anxiety and isolation, self-isolation, panic attacks, mood swings, inadequacy in the workplace and at home, insomnia, promiscuity and addictions are all signs of trouble. The toxic cycle means that these manifestations will all deepen the depression over time and become self-fulfilling, possibly to the point of self-destruction.

Having laid out a lot of background detail to the challenges of anxiety depression and suicide in men it’s time now to move on. Next time I will take a look at some options for help, support and treatment. I will also include some insights into my own battle with depression in the hope that all others may benefit from my recent experiences.

Mindful Monday: The Toxic Cycle of Depression

Having talked about some of the typical ways that depression can manifest itself in men, it’s time now to assess some of the causes of anxiety, depression and suicide.

11923193_1079074222104390_1798667778734272587_nThere are many factors which can lead to depression and a lot of research has been done to prioritise these. In truth, however, it is clear that because men hide the problem for so long they end up with a whole cocktail of issues contributing to the illness. There may indeed be one major factor or one may rise to the top of the whole depressing mess. Of course it may be that after a long slow build-up of issues, one will reach the tipping point, leading to either a cry for help, a breakdown, or even attempted suicide.

Most surveys come to the same conclusion with the same two factors at the top of all their lists: relationships and economic factors consistently get blamed for depression. Of course, either one of these can also feed into the other and they often go hand-in-hand.

A recent study by academics from the universities of Bristol, Oxford and Manchester show a link between the economic dip of 2008 – 2013 and an increase in mental illnesses and suicide rates.

Another study by the Samaritans shows that people in the lowest socio-economic circumstances are ten times more likely to commit suicide than those in the most affluent. Poverty has no gender boundaries, but it seems that it is men who are more likely to kill themselves if they are poor.

Naturally, wealth is often linked with employment. In the 1990’s those most at risk were men in their 20’s. These days it seems that it is men in their 40’s who are most at risk of suicide. There has been work done to examine the long-term consequences of unemployment in the younger age group. Some say that this may lead to economic ‘scarring’ with lingering problems such as higher rates of unemployment, long-term unemployment and reduced earning opportunities later on.

It strikes me that the men who were at risk in their 20’s are now the same cohort who are killing themselves in their 40’s. At the time of writing I could find no research on this point but I cannot help thinking that it may be relevant.

Unemployment is regarded as the second most likely cause of tipping men into serious depression. Research shows that one out of every seven men experiencing unemployment will develop some kind of depression illness within six months of leaving work. Loss of a job may of course be aggravated by a whole list of attendant issues. For a man, his job may be a source of power, giving him the means to be in control of his life. If the period of unemployment lasts for a while, that feeling of control will slip away along with the income, the company car and the camaraderie of the workplace. Of course as depression deepens the job prospects may also diminish and you are now in a toxic cycle of unemployment and depression feeding on each other.

Relationship issues come top of every study into causes of depression. Collapse of a marriage or other significant relationship, even close family relationships, are the single most likely cause of anxiety, depression and even suicide. This is a huge and complex topic which I can only skim the surface of here.

Traditionally, men have considered themselvese6291399b63a7fdbeb05e08b06ff17ee head of their family, not just as the breadwinner but in the way that they control the lives of their family. Maybe it’s not surprising that is often the woman who instigates separation and even divorce. This undermines the perceived status of the man and so depression is more common in men who are separated or divorced. Of course just as with the side effects of unemployment, divorce has its own additional problems to. The need to relocate, loss of contact with children and shortage of money will also create their own toxic cycle.

Of course there are many other challenges which can lead to depression. Retirement carries with it many similar feelings to unemployment. Having a job can also be just as depressing as losing one. This can very quickly become a toxic cycle of not coping leading to depression, which leads to coping even less and so on.

We should not ignore pregnancy or childbirth either. Postnatal depression is well documented in women but it is also a recognisable trigger of depressive illness for one in ten new fathers. Of course becoming a father is generally a good thing and celebrated but it is also one of the biggest lifestyle changes that you will ever experience. Some of the side issues here include lack of sex in the first few months due simply to tiredness, but also the young husband may feel that for the first time he is taking second place in his partner’s affections.

A serious cause of anxiety for many men is living with illness. Having a serious illness, waiting for treatment, living with chronic ailments (cancer, arthritic pain, HIV/Aids, dementia etc.) can all cause stress and depression. Living with the illness of a partner, family member or friend can have the same result.

These days we cannot ignore the issue of post-traumatic stress disorder being suffered by a growing number of young soldiers returning from war, but also by the survivors of civilian terrorist attacks. To this modern phenomenon we should now also consider the many millions of refugees displaced by conflict, losing homes, work and even family in the process.

Sexual problems can of course also contribute to male depression or can become a side effect of it.

This final comment segues into the next part in this series where I intend to look in some detail at the specific problems of depression in gay men.

Mindful Monday: Men and Depression Pt. 2

Signs of Depression.depression-symptoms-men-400x400

Welcome to this second part of my look at the serious issue of anxiety, depression and suicide in men. In the first part we looked at some shocking statistics and some vague reasons why there is a specific male problem. Before delving too deeply into reasons and solutions I thought it might be useful to consider just what depression is and how it particularly manifests itself in men.

Most of us have experienced periods of time when we have felt down, miserable, or depressed. This can often be attributed to a known event, cause or trigger but it does not really dominate our lives, seldom lasts long and is soon forgotten.

For some however, the feelings do not go away. The depression may continue for weeks or months or the feelings may become deeper. This can leave the victim feeling very much stuck in a rut or in a downward spiral and unable to lift themselves out of it. By this time they will feel it’s beginning to affect every area of their life and even before others recognise that there is a problem, they may have feelings of guilt about it which simply fuel the deepening depression.

What is going on in your mind will start to have physical consequences and also lead to behavioural changes. Where the mind and body are concerned the problem may remain purely personal, but once behavioural changes begin it will only be a matter of time before others notice that you have a problem.

Depressed people will recognise some, most, or all of the following feelings. It becomes increasingly difficult to find joy in anything. For much of the time you may feel down, unhappy, miserable, sad or depressed and those feelings just will not go away. For some the feelings are worse at particular times of the day, especially first thing in the morning when you are facing the day ahead. You may find it difficult to concentrate on anything and you may lack motivation. There may also be feelings of guilt, even about things which have nothing to do with you. You may lose interest in social activities and start to lose touch with friends. As you become more pessimistic you may start to feel hopeless, overwhelmed and even suicidal.

These problems of the mind will often manifest themselves in physical conditions. Most depressed people have difficulty sleeping, either in getting to sleep or staying asleep. Often this results in a broken sleep pattern or the habit of waking up very early which of course leads to physical tiredness. Depression can also affect your weight in one of two ways. Some people ‘comfort eat’ and gain weight while others cannot eat and start to lose weight. Many depressed people also experience a loss of interest in sex.

Of course as these physical symptoms become more noticeable they are added to the growing list of anxieties so increasing the bad feelings.

As things either get worse or just go on for longer, the depression will start to affect your behaviour. This is when it is possible that others will notice a problem even if they don’t recognise what it is. Your poor concentration may lead to mistakes at home or at work as you lose focus. If you start to worry about more things you may also become quieter than usual or even withdrawn. You may become more irritable than usual and you may even begin to complain about vague physical ailments such as headaches etc.

Man-with-depressionAfter a time, your personal hygiene, appearance and tidiness may fall victim to the depression. You may begin skipping showers, not shaving, not washing your hair or brushing your teeth. Shirts may go unironed or even unwashed. At home you may lose interest in cooking, cleaning, or changing the bed sheets.

Where anxiety features in the depression there are additional symptoms such as feeling ‘on the edge’ or constantly worried that things will go wrong. You may become fearful of unknown problems occurring and will find it increasingly hard to go out or to face people. Anxiety also causes its own set of physical problems which may include sweating, palpitations, breathlessness, shakiness, dry mouth, stomach churning or even diarrhoea.

So far the symptoms I have described a fairly general and although there is no specific diagnosis of ‘male depression’, it is quite clear that some symptoms are more common in men than in women. These include increased irritability or temper. There is often a feeling of losing control or you may increase risk-taking. There may be aggression and men are three times more likely than women to commit suicide.

In many ways it is not the symptoms of depression which are different for men so much as their attitude towards it and their coping mechanisms. These often in the long term lead to not coping at all. For many men drugs and/or alcohol become a means of self-medication rather than admitting to any problems or talking about them. Personality does not seem to be a great indicator for depression since, although shy men may be more likely to become depressed, it can also affect the strongest of men. Depression has affected many famous and successful men, even some who have famously spent all their time making the rest of us laugh. Sir Winston Churchill could hardly be called a shy man and yet he suffered deep depression which he called his ‘black dog’.

It is often the classic male attitudes which exacerbate the illness. These attitudes prevent us from talking to loved ones or to health professionals and so we do not get the help which is needed. Many men feel that if they tell their partners, family members or colleagues, that these will be unsympathetic.

For too many men it is their very masculinity which gets called into question. Men can be competitive, ambitious or concerned with power, control or success. This of course makes it much harder to admit to feeling in any way fragile or in need of help. Whatever the perceived reason most men will feel that they must sort the problem out for themselves.

For some men work itself can become the coping strategy, but focusing on that can cause conflict in other areas, especially relationships.

The drug or alcohol route of course becomes destructive itself in the long run. This path can lead to addiction which can then result in unpleasant, irresponsible, reckless, dangerous, or even self-destructive behaviour.

Hopefully this delivers some understanding as to what depression is. Next time I will take a look at some of the causes of anxiety, depression and suicide in far too many men.