In my past posts I have talked a lot about anxiety and stress, today I want to discuss depression and men.
So what do we mean by depression? Depression refers to both negative affect (low mood) and/or absence of positive affect (lost of interest and pleasure in most activities) and it is usually accompanied by an assortment of emotional, cognitive, physical and behavioural symptoms.
Depression is the most common mental health condition - and carries a significant burden in terms of treatment costs, effects on families/carers and workplace productivity. It is currently ranked the third most prevalent moderate and severe disabling condition globally by the World Health Organization (WHO). Whilst this figure is not a positive one, more than 80% of people with depression are treated within primary care services and recover. However, if untreated it may become a chronic disorder requiring secondary care treatment.
So how do we know if we are depressed? Everyone has at some time in their lives felt fed up, miserable and sad (me included). But these feelings tend not to last no longer than a week or two, and they don't interfere too much with our daily lives. Sometimes there is a reason, sometimes not. But these feelings do not dominate our lives and we usually cope - we may talk to a friend about it but otherwise we don't need any help.
However, in depression:
If you have been feeling depressed for weeks, months, or it becomes very bad you may find yourself stuck and unable to lift yourself out of it. It can start to affect every area of your life.
Men seem to suffer from depression just as often as women, but they are less likely to ask for help. I hope this post will provide some basic facts about depression, how it can affect men, and how to get help.
It is very important that we spread the message that depression is NOT a sign of weakness - it has affected many men - many of whom are famous and successful.
Why is it important?
Depression can be very unpleasant and is a major reason for people taking time off work. Many men who have killed themselves have been depressed - so it can be fatal.
It is important to realise that depression can be helped - and the sooner the better.
So what about bipolar (manic depression)?
Some people experience severe depression - but also times when they become over active or elated in their mood. These high periods can be just as harmful as the periods of depression.
So what are the signs?
In your mind, you:
feel unhappy, miserable, depressed. These feelings won't go away and can often be worse at certain times of the day, often first thing in the morning.
can't enjoy anything
find it difficult to concentrate
find it harder to make decisions
can't cope with things you used to
lose your self confidence
feel useless, inadequate and hopeless
avoid others - lose interest in seeing people and lose contact with friends
feel guilty about things that have nothing to do with you
feel restless and irritable
thinking of suicidal
You may find you:
can't get to sleep
wake early in the morning and/or throughout the night
lose interest in sex
can't eat and lose weight
'comfort' eat more and put on weight
feel utterly tired
Other people may notice that you:
make mistakes at work and can't focus
seem unusually quiet and withdrawn
worry about things more than usual
are more irritable than usual
complain about vague physical problems
stop looking after yourself properly - you don't shave, wash your hair, look after your clothes
stop looking after your home properly - you stop cooking, don't tidy, forget to change the sheets of your bed.
As we have discussed before, when depressed you may also feel anxious. You feel on edge all of the time, worried, fearful, and you may find it difficult to go out and face people. Anxiety is also the cause of many physical symptoms - sweating, dry mouth, palpitations, shakiness, stomach churning and diarrhoea.
Is depression really different in men?
Whilst there doesn't seem to be a complete separate type of 'male depression', some symptoms are more common in men than women. These include:
Men are also more likely to commit suicide.
Men are diagnosed with depression less than women, but also seem to drink and use illegal drugs more heavily than women. It may be that, instead of talking, men use drugs and alcohol as a means to 'self medicate' to cope with their depression.
Men's attitudes and behaviour
Some men, especially working in the City are particularly competitive and concerned about power and success. It therefore, may be harder to tell someone that you feel fragile or that you need help. You may feel strongly that you have to deal with it on your own.
You may also worry that if you do talk about it, you may be looked at differently, you may lose your job or you may lose your credibility.
You may also think that if you talk to say your partner - or anyone else- about how you feel, they will not be sympathetic.
These attitudes STOP you from talking about how you are feeling - so you don't get the help and support you need.
Shy men are more likely to become depressed.
However, depression can happen to anyone, even powerful personalities. Winston Churchill called it 'his black dog'.
Instead of talking about how you feel, you may use alcohol or drugs to feel better. This usually makes things worse, certainly in the long run. Your work will suffer and it often leads to irresponsible, unpleasant and dangerous behaviour.
You may also focus more on your work than your home life. This can cause conflict with your partner/wife.
You may function less at work and your performance may decline.
Talk to someone - don't bottle things up, try and tell someone how you feel. If you don't feel like telling someone, write it down.
Keep active - take some exercise, even if it's just a walk. Get outside during your lunch break. This will help you stay physically fit and help you to sleep.
Eat properly - you may not feel hungry but try to eat a balanced diet.
Avoid alcohol and drugs - they may make you feel better for a couple of hours, but it will make you more depressed in the long run. Street drugs can also cause psychosis.
Don't get upset if you can't sleep - do something restful that you enjoy, like watch the TV or listen to the radio. If you feel tense, try exercising, yoga or massage.
Do something you enjoy - take regular time out to do something you really enjoy - exercise, reading, a hobby.
Take a break - it can be really helpful to get out of your normal routine for a few days, even a few hours can be helpful.
Read about depression - it may help you to cope and also help friends or relatives understand what you're going through.
Tackle the cause - if you think you know what is behind the depression, it can help to write down the problem and then think of the things you could do to tackle it.
Keep hopeful - remind yourself that many other people have had depression, it may be hard to believe but you will eventually come out of it. It can at times be helpful, you may come out of it stronger and better able to cope. It can help you see situations and relationships more clearly.
How to get help?
Depression can be as much an illness as breaking your leg or pneumonia. Do not feel embarrassed or ashamed about it.
Visit you GP, he may suggest self help, talking interventions or anti depressants tablets.
How can you help someone who is depressed?
LISTEN - this can be harder than it sounds. You may even have to hear the same thing over and over again. It is usually best not to offer advice unless it is asked for, even if the answer appears to be perfectly clear to you.
It is helpful to spend some time with someone who is depressed. You can encourage them, help them talk, and help them to keep going with some of the things they normally do.
Someone who is depressed will find it hard to believe that they can ever get better. Reassure them that they will get better, but you may have to repeat this over and over.
Make sure that they are buying food and eating enough.
Help them to stay away from alcohol.
If they appear to be getting worse and begin to talk about not wanting to live or even hinting at harming themselves, take them seriously. Make sure they see and tell their doctor.
Encourage them to accept help. Don't discourage them from taking medication or seeking help from a therapist, coach or counsellor.
I offer 1:1 CBT coaching - many of us have habits of thinking which, quite apart from what is happening in life, are likely to make us depressed and keep us depressed. CBT helps to:
Identify any unrealistic and unhelpful ways of thinking
then develop new, more helpful ways of thinking and behaving
I also provide a safe and confidential space where you can talk about your feelings. I can help you problem solve in order for you to be clear about your key problems and how to break them down into manageable bits in order for you to move forward more positively.