Men & Clinical Depression: Even the Toughest Hit Tough Times Greg runs a successful high tech company in one of the most upscale, safest suburbs of Los Angeles. His journalist wife and three cheerful children are involved in lots of activities. They have warm family dinners and vacations together with extended family. And yet, anymore when Greg’s kayak or poker friends call to get together, he declines. The effort just doesn’t seem worth it. He’d rather have a drink or two and stay home watching one inane sitcom after another. Some days, he feels the boredom will kill him. If Greg finally took his wife’s advice and went to the doctor, he would most likely tell the doctor he had “an energy problem.” Even though both men and women, rich and poor, rural and urban, blue collar and white can experience depression, men resist that diagnosis. Conscious that society can antiquated notions of “weakness” with depression, Many men feel ashamed to admit they’re plagued by sadness and a lack of motivation. A man is supposed to be a striver and a provider, after all. Feelings of depression threaten a man’s identity. Women, accustomed to feeling (and being perceived as) more emotional, don’t find depressive feelings so surprising or disappointing. Women are far more likely to get help. Societal factors aren’t they only culprits underlying male depression, however. Possibly due to biological predilections, men tend to keep feelings to themselves. Typically less verbal than women, they’re not accustomed to sharing much more than functional facts (and sports scores) with other men. When no outlets for sadness or anger exist, mood darkens. UC Irvine sophomore Paul feels it takes all of his energy just to get to class and back to his dorm again. When other guys on the hall drop by his dorm room to see if he can go to a sorority party or pizza social, Paul finds himself choosing to stay in and study or sleep so he get his mind clear enough to study. “Geez!” his friends say. “You’re turning into a real drone!” Paul shrugs as they close his door behind them. That night, instead of doing the reading he’d planned, Paul finds himself staring out of his dorm window listening to music. When the CD ends, changing it feels like too much effort, so he stares out his dorm window from his dark room. Men tend to cope with dreary, sad, or irritable feelings in unproductive, ineffective ways. To escape from unbearable moods, they resort to excessive use of alcohol or drugs, engage in reckless behavior such as picking fights, driving irresponsibly and taking unwise risks. The man who buries himself in work hopes that the papers piled up around him will keep the sadness at bay. These coping strategies never work. Jason had been counting on things getting better once he retired. But now, even with plenty of time to play and watch golf, his wife still complains that he’s a hothead. He does blow up when other drivers cut in front of him or when his wife leaves a tool in the yard or when a waitress messes up his order. While he tells his wife these incidents are no big deal, he feels embarrassed and angry at himself after they happen. He always resolves to be better, but the rage just takes over . . All three men above have symptoms of clinical depression. In the United States every year, six million men endure depression so severe it interferes with their work and relationships. Specifically, depression impacts your ability to: 1. communicate 2. concentrate 3. sleep 4. have sex That’s right . . . all the wonderful, connecting, comforting parts of life! Why live with depression when you can so easily live without it? And no . . . life does not have to be inherently sad (see our Blog: “Does Life HAVE to Be So Hard?”). Even if your parents and some of those around you struggle, months and years marred by sadness and anger are not inevitable. Even people who lose everything in bankruptcy, divorce, lose children to leukemia find ways to cop and create fulfilling lives. How Do I Know If My Sadness Is Really Depression? Everyone has blue moods once in a while. They result from life changing events. Losses must be grieved. Disappointments endured. No one escapes this kind of sorrow. If your underlying mood and self-esteem are at optimal levels, however, these feelings dissipate in a reasonable time. When sadness and fatigue or extreme irritability last longer than two weeks, become intense (enough even to prompt suicidal thoughts) and/or prevent you from going to work, school or social events, you may be experiencing biochemically based depression. You will need medical help and possibly psychotherapy to elevate your mood. Those who try to wait it out or ignore it generally fail. This mood disorder manifests in different ways in different people. While you may not have all of these symptoms, if four or more resonate with you, a doctor visit is in order. The following are symptoms of depression: • lack of interest in activities you once enjoyed • feeling a sadness you feel will never lift • intense feelings of emptiness, worthlessness or guilt • restlessness • exhaustion, fatigue • sleep changes: either too much or too little • loss of focus or concentration • persistent thoughts of death or suicide • unexplained aches and pains • excessive use of alcohol or drugs If you or a loved one expresses thoughts of suicide, contact a medical professional, clergy member, family member or friend immediately or call 1-800-273-TALK. Suicidal thoughts result from biochemical imbalances that can be rectified. What Causes Depression? Some Insights for Men Decades of strict research have confirmed that depression results from a chemical imbalance in the brain. Often, this imbalance can be treated and rectified. It has nothing to do with character weakness or inability to cope. The brain’s chemicals become imbalanced for a number of reasons. Some individuals are genetically predisposed to depressive illness. Just as a diabetic’s body does not make enough insulin, the bodies and brains of some depressed people do not create an ideal balance of neurotransmitters. In many cases, serious illness such as heart disease, diabetes or cancer sends some into depression. Beyond the fear and stress these diseases can cause, the very medications that treat them can initiate, mimic or intensify depression. Events can send individuals into depression as well. When someone loses a loved one, of course mood will plummet. If the brain cannot revive from this lower mood on its own, medication and/or therapy often does the trick, returning the neurotransmitters to optimal levels. After a significant period, the individual can withdraw from the medication to monitor whether the better mood can be sustained. Many people need only be on anti-depressant medication for a year or less. Blog #19: Steeler Quarterback Terry Bradshaw: Anxious and Depressed? As quarterback, Terry Bradshaw helped the Pittsburgh Steelers win four Super Bowls in the 1970s. The personality he revealed in his post-game interviews and his announcing career that followed led most of us to believe he had a jocular approach to life. Why wouldn’t he? For heavens sakes, sports journalists lauded him as one of the all time greatest quarterbacks. He was handsome and popular with women. After his NFL career ended, however, Bradshaw admitted that after games panic and anxiety often overwhelmed him in the locker room. The problem worsened after his third divorce in the late 1990s. He explained that he "could not bounce back" as he had before. He lost weight, experienced crying spells and insomnia. Meanwhile, his anxiety hadn’t improved. Once he was diagnosed with clinical depression, he began taking the antidepressant Paxil CR. Since then he has become a champion for removing the stigma of depression and urging people to get the help they need. In fact, during 2004 he travelled around the U.S. speaking about the prevalence of depression. It’s a shame when people compare themselves to the public image of celebrities and athletes and find them selves coming up short. Almost every star’s on-screen persona has been airbrushed, coached and manipulated by a team of public relations experts, makeup artists and advisors. I applaud Terry Bradshaw for coming clean with what really went on in the locker room after the film crew went home. The stress involved in football games must be unbearable even for the very toughest of men. I wonder how many more football players struggle to this extent and try to keep it quiet. That would be a terrible shame. Life can become unbearable for anyone, no matter their strength of character. When it does, the strongest go out to get help so that the problem can be rectified as quickly and efficiently as possible. Terry Bradshaw found a medication and other therapies that enabled him to continue a life in the public sphere. Now that he no longer hides his struggles with mood, he is a free man. Blog #20: More Tough Men with Depression While football builds a lot of fierce facades, the toughest figure in the literary field had to be Ernest Hemingway. A medic in World War I, he witnessed many atrocities and gory aftermaths of gassings and massacres. An avid hunter and aficionado of bullfights, Hemingway’s stories featured stoical, emotionally controlled men who strived for “grace under pressure.” After losing a portion of his memory following electroconvulsive therapy and unable to stop drinking, Hemingway shot himself with a double barrel shotgun in the hallway of his home when he was just 62 years old. While Hemingway wanted men to be courageous and struggled to achieve that power himself, probably the most truly courageous man America has ever seen was most Abraham Lincoln. A brilliant man who thought and felt deeply about all kinds of subjects, Lincoln struggled with many dark periods. Despite these setbacks, he faced down powerful forces and knowingly sent boys into battle to their deaths in order to turn the United States away from its abominable dependence on slavery. The guilt and isolation nearly devastated him. To read an excellent account of Lincoln’s life and what he accomplished despite depressive his illness, visit: www.abilitymagazine.com/abe_story.html. Check out these names of other men who’ve suffered depression: Ozzie Osbourne, Jean Claude Van Damme, former Oakland Raiders offensive lineman Barret Robbins, Axl Rose of Guns 'N Roses, football players Barry Sims and Ricky Williams, Sir Isaac Newton, Johnny Depp and more. These men have been brave enough to get the help they need, share their struggles with friends and even the media. A man doesn’t get stronger than that.