Seven Things You Should Know About Men and Depression
By Joanne Laucius, Ottawa Citizen
July 23, 2011
Men think that clinical depression is something that doesn't happen to them.
Except that it does, says Todd Patkin, author of Finding Happiness: One Man's Quest to Beat Depression and Anxiety and-Finally-Let the Sunshine In.
"Men need to feel like they're taking care of the family. When you feel depressed and stressed, you feel weak. A lot of it has to do with ego," Patkin says.
Depression is more prevalent in women than men. In Canada, women are twice as likely as men to experience depression and are 1.5 times more likely to be hospitalized, according to the Mood Disorders Association of Canada.
But men also experience depression differently from women. Their symptoms are different and they can be more resistant to seeking treatment.
"Men and women are socialized differently," says Karen Poole, chief of social work at the Royal Ottawa Health Care Group. "We are better at talking about feelings. Women see their family doctor more often. Men have less experience in reaching out for help."
Even more disturbing, suicidal thoughts are often - although not necessarily - present for depressed people. And while attempted suicide is higher among women, men are four times more likely to complete suicide, according to the Centre for Addiction and Mental Health in Toronto.
If you think a family member is having thoughts of suicide, ask them directly, says Poole. The question will not introduce suicidal ideas to a person who is not thinking about suicide. And it gives a suicidal person the opportunity to express their feelings and seek help.
"Suicidal thoughts are closely related to feelings of hopelessness," says Dr. Georg Northoff, who holds the Michael Smith Chair in Neuroscience and Mental Health at the Royal Ottawa. "If you speak about it, you have the feeling of relief."
Being around a family member who is in real pain and resistant to help creates a tendency to constantly ask them how they are feeling, says Poole. Look for more than verbal cues. "Every conversation can't be an intervention," she says.
Patkin, now 46, spent 18 years building his family's Boston-area auto-parts business, which the family sold in 2005 for $100 million. He had a thriving business, a happy marriage and a son he adored when his life spiralled out of control in 2001.
His wife had a miscarriage and he fractured both feet when he jumped off a chair during a motivational meeting with this staff.
Then things started to crumble. "I had made my own life a living hell," says Patkin. "Eventually, I short-circuited."
Exercise had been the way Patkin powered his way through 70-and 80-hour work weeks. During his breakdown, he spent his days in bed, sinking deeper into apathy and fearful that he would never get back on his feet. At one point, he couldn't even decide between potato salad and coleslaw. "You might as well have been asking for the cure for cancer."
But the breakdown was also Patkin's breakthrough.
"I realized that I had been pushing myself too hard and looking for fulfilment in the wrong places. I got the medical help I now realized I had needed for quite some time, and I revised my outlook on my life in general and on my mental health in particular."
People can have debilitating depression for months or years, but most can get back their lives through a combination of medication and counselling. However, it's important to realize that it might take time to find the right medication and dosage.
Patkin, for example, points out that one of the side effects of the first medication he was prescribed was feelings of paranoia - he began to worry, irrationally, that his wife was plotting to leave him. Another physician prescribed a combination of two medications, and he continues to take both.
Depression is the most treatable of all mental illnesses, according to the Canadian Mental Health Association. But patients are often hesitant to take prescribed medications.
The Mood Disorders Association of Canada reports that 72 per cent of depression patients say they take their medications as prescribed, but only three per cent of physicians agree with that statement.
Of those who don't take their medications, almost two-thirds say it's because they forget. The physicians had another explanation. They said it's because patients don't think they need medication, or because they don't like the side effects.
Patkin estimates that he has gained four or five pounds as a result and has to be checked for liver and kidney function twice a year. But it's worth it, he says. And he plans to remain on medication for life.
"People say, 'Are you really you?' And I just say, 'Yeah, this is me without having another breakdown.' "
Northoff, who is also Canada Research Chair for Mind, Brain Imaging and Neuroethics at the University of Ottawa Institute of Mental Health Research, says continuing to support a depressed person, even if they appear to be rejecting help, is crucial. "Always keep the relationship," he says. "It's important, as difficult as it is."
Poole adds the key is to maintain support while not being confrontational.
"Offer support. Do you want to see a doctor, a crisis worker? What's the time frame? Should we make the appointment today? It gives a sense of empowerment and makes them accountable."
You may also want to go to see the doctor with the depressed person, she says. While the doctor can't give you any information about the patient, you may be able to offer useful information.
And get some support for yourself, like joining a family support group, advises Poole. "It can be a long haul."
Patkin says he lucky because his family has always believed in therapy. But he admits that persuading a man to get help for depression may take a different sort of approach.
"You have to make the man feel like a hero. You have to kind of flip it around and say: 'You're putting your family first.' Men are all about ego."
7 IMPORTANT THINGS TO KNOW ABOUT MEN AND DEPRESSION:
- While some people have a genetic tendency to depression, life circumstances can also prompt an episode of depression. Patkin points to stress, overwork and concerns of jobs and vanished savings and job security due to the recent economic downturn as conditions that have contributed to the increase in the prevalence of depression.
- While the classic symptoms of depression are sadness, apathy and lethargy, these are more common among women. Men are more likely to get irritated, hostile or show flashes of anger or risk- taking behaviour, like gambling.
- There is a close relationship between stress and depression, which appears to be on the increase in western societies, although it is debatable whether this is caused by environment or because depression is more likely to be recognized and diagnosed. "Stress can trigger depression," says Northoff. But the levels of stress that pull that trigger are different from person to person, and are often related to that individual's genetic predisposition.
- While depression starts in the brain, it can damage physical health. Depression can cause muscle pain, joint pain, digestive problems, weight loss, headaches and sexual dysfunction, among other symptoms. Many people with depression are diagnosed with another illness or condition because of these other symptoms, says Northoff.
- Depression and the accompanying anger, irritability and lethargy can affect the entire family. You don't want your wife to feel like she's walking on eggshells and you don't want your children thinking that unhappiness is the norm, says Patkin.
The most difficult thing for children to understand is why a parent withdraws, says Northoff. Studies show that the children of depressed parents are more likely to suffer from depression themselves as adults.
Children of depressed parents often have to compensate or take on new roles. Still, depressed parents can be good parents, says Poole. "If someone is overwhelmed, hopeless and not looking forward to things, it affects everyone."
- There's no need to feel stigmatized by depression. No one chooses to suffer from depression, and no one can "power through" a depression without help, says Patkin. Untreated, depression can be just as devastating as any other major illness. The Mood Disorders Association of Canada points out that depression is on par with smoking as a predictor of early death.
- Treatment works, but drugs are not one-size-fits-all, and they need to be combined with psychotherapy. "The main thing is to develop a relationship of trust," says Northoff. Finding the right solution can take time, and may require a combination of therapies, he says. "We don't have markers or predictors of what drugs work in which patients." Relapse is always a risk, but it does not mean that a person who has suffered from depression must remain on medication for life.
Mental Health Crisis Line: 1-866-996-0991
© Copyright The Ottawa Citizen