Men(tal) Health Issues

Dean Heckscher

Hard to talk about, harder to live with. 

Have you ever had one of those days where you just weren’t feeling it? Where you’d rather just stay under the covers and watch the clock change? Where, even though your friends, family, work and football team were all doing well, you’d rather just spend some time by yourself, shut off from the world? You definitely wouldn’t be alone. But what if one of those days turned into one of those weeks? Or a month? What if you just couldn’t break out of this slump, just couldn’t find the same fire, the same drive, which pushed you to be the best mate, father, son, husband, man, you were before? What if, without you even knowing, you had developed Depression or Anxiety? For many of us, it’s not a ‘what if’, as nearly 50% of Australians develop a mental health disorder at some point in their lives, and it often strikes without warning or discrimination. For many of us, it changes our lives, even if we’re not the ones diagnosed with it. For all of us, it’s something that needs to be talked about more openly, with the taboos lifted and the ignorance lowered, so that those who feel alone don’t have to be. This article might be harsh, dark and in your face, but as Dr. Robert Schuller said, “Tough times never last, but tough people do”. 

Depression

Silent killer, silent sufferers. 

Depression. We all know of it, and yet it isn’t something that you’d be caught talking about at your weekly Sunday sesh. It shackles those who suffer from it, confining them to isolation because those around them simply don’t know how to deal with it or help lighten the load. We ignore the warning signs and we ignore those who can help. And this ignorance is making the situation worse. 

Depression has no singular cause, no singular treatment and no singular time frame for being cured. Its severity is as varied as the people it affects, and is often a build up of multiple factors, such as stressful family and work environments, or a sense of overwhelming loneliness. Even the term ‘Depression’ is quite broad, with the most common definition amongst global health organisations being “a mood disorder that causes a persistent feeling of sadness and loss of interest, affecting how you feel, think and behave.” It is the unseen killer of men, the silent tormentor of fathers, brothers and sons, and yet we simply do not want to talk about it. “Expectations of manhood are very rigid,” says Dr. Shira Tarrant, Professor of Gender Studies at California State University. “These include men don’t cry, they can’t back down and they shouldn’t feel. What this means is when men feel, that’s the equivalent of not being a man. Oftentimes, that gets in the way of men coming forward to say I’m depressed or struggling.” Men shun any attempt to talk about their issues and, as a result, we are dying from it. 

Depression can, and does, affect people in various forms of severity, and can sometimes be the forerunner for more serious conditions. Depression can be prioritised as mild, moderate, or severe, and further categorised as melancholic or psychotic depression depending on other factors, or even misdiagnosed as Bipolar Disorder. The most common symptom of Depression is a low mood or lack of interest in usual pastimes, hobbies and activities. Work and lifestyle habits are affected, and someone with Depression often becomes more withdrawn, irrational, or reliant on drugs or alcohol. Those who suffer often describe it as an emptiness that hangs in the background. Others describe it as seeing the world through a harsh, grey filter. All describe it as horrible. 

So if it’s something that everyone knows a bit about, why do men in particular find it difficult to talk about it openly, even in safe environments or with registered health experts? “Asking for help is seen as an affront to masculinity”, says journalist and author Laurie Penny. “It means when you’re taking the first step... reaching out for help is made doubly hard.” Statistics from the Australian Bureau of Statistics and multiple British health organisations such as Mind and Time to Change, back this up, relaying that while women are more likely to suffer from Depression, men are less likely to seek help. As a result, men are three times more likely to take their own lives. Jack Heath, CEO of non-profit organisation SANE, states that “There’s a belief that the very idea of being a man is that you deal with stuff and you don’t reach out or connect. Untreated, the problem snowballs. The combination of that and the notion of having to deal with it alone, is the reason behind high suicide rates.” Instead of seeking professional help, many men turn to drugs or alcohol, which can cause further problems. “[Men] start going to the pub, block feelings, hide feelings, drink, then do it more, and it becomes a cycle,” states Beth Murphy, Mind spokeswoman. “The drugs and alcohol end up as big a problem as the mental distress in the first place.” Research from the World Health Organisation has also shown that men are twice as likely as women to develop alcoholism, which in turn impacts the success of recovering from mental health disorders and illnesses. 

But all the statistics, warnings and professional opinions don’t mean much if we don’t take them onboard. Thankfully, male dominated cultures such as sport are changing through an increased awareness to mental health issues, with former AFL player Simon Hogan publicly opening up about his personal battles a prime example. “The most surprising thing, once I did open up, was the incredible support I got from everyone – from the blokiest of blokes and the people you wouldn’t expect... Everyone was so supportive.” Too many times we only realise the full extent of these types of issues when it’s too late, and while initiatives such as R U OK? are beginning to stem the tide, more needs to be done, and more awareness needs to be generated. Unfortunately, Depression isn’t the only mental health issue that needs to be discussed. There are many more, such as Anxiety, that are affecting, and controlling, us. 

Anxiety

The most common mental disorder, but one of the least discussed. 

“Imagine you are standing in a pitch-black room filled with dense air, and you feel like you are going to be attacked any second now, but the moment doesn’t pass right away”. What you’ve just read is a description from an anonymous sufferer of the feeling of Anxiety, the mental health issue that affects over 14% of adult Australians at some point in their lives. The same issue that has risen by 40% over the past six years, and the same issue that prompted health organisation Beyond Blue to take matters into their own hands with the advert I Am Anxiety, to combat this misunderstood disorder. 

Although similar to Depression, Anxiety is usually identified by feelings of panic or uneasiness, sleeping problems, excessive sweating, trembling and nausea, as well as the avoidance of certain situations, places or activities. It can prevent people from enjoying social situations, prevent them from leaving their own homes, limiting their day-to-day lives, and can often lead to other issues such as Panic Attacks (something that 35% of Australians will experience sometime in their life) and Depression. “People are talking about depression more and know it’s a condition you should seek treatment for”, says former Beyond Blue CEO Kate Carnell. “It’s not the same with anxiety. People think [anxiety is] a personality failure – they think ‘there’s something wrong with me’”. In fact, Anxiety is often mistaken or thought of as a simple personality trait such as shyness rather than a potentially crippling mental disorder. But Carnell elaborates. “Shyness might mean you’re not comfortable in front of people, social anxiety could have quite physical symptoms and would make you stay at home.” Anxiety is often mislabelled or misdiagnosed, both by the public and by medical practitioners. Surveys by mental health charities found that 40% of respondents thought Anxiety was simply stress, with many more not recognising the symptoms of Anxiety. Even one in five doctors were misdiagnosing Anxiety due to the physical attributions associated with the disorder, according to an article published in the Annals of Internal Medicine. So it’s not surprising that Anxiety isn’t as openly discussed, it’s simply just something we don’t understand well enough.  

Anxiety is the brain’s response to potentially threatening situations, putting your body in a heightened state of awareness, ready for fight or flight. The feeling of Anxiety is an increase in adrenalin and cortisol (hormones produced by the adrenal gland), which is why your heart pumps faster when suffering from an anxiety attack. But as we’ve developed as a society, most of the fight or flight sensation is replaced with daily stress, and as a result, the brain (which has subsequently learned that a certain amount of stimulation is required for a particular activity), associates an increase in stress to require more awareness. Instead of worrying about being hunted by prehistoric predators as our ancestors might have done, our adrenal glands are now associating danger with reports and deadlines. Our addiction to artificial stimulants such as caffeine doesn’t help either. 

But as science suggests, Anxiety is more to do with being a product of your environment than anything else, genetic or otherwise. So while you don’t have to necessarily worry about directly passing down your Anxiety to your children, you can still install the same apprehension in them by your actions. A study published in the American Journal of Psychiatry found that children often shared the anxieties of their parents. Co-author of the study Thalia Eley explains that “children might observe their parents’ fear or worries in their actions or overhearing their words, and then adopt those same worries.” She goes onto explain that “negative parenting behaviours”, where the child is unnecessarily shielded from something that the parent fears, are also a factor in how Anxiety is instilled within us from a young age. 

Regardless of what age they first appear, or how they form, mental health issues such as Depression and Anxiety cripple, and cripple severely. Man Therapy states that over 20% of men aged over sixteen will experience, and suffer from, an anxiety condition in their lifetime, with 10% of them suffering in the last year. And with the likelihood of men suffering further through other issues such as Depression or substance abuse, Anxiety, while a serious issue in itself, can be a very dangerous stepping stone. But now more avenues for assistance and support are opening up, allowing those who need help, or those who are simply wanting to understand, the chance to learn and develop. As Hogan states, “once diagnosed, mental health issues can be treated very effective[ly]”. 

Getting Help

Even Superman isn’t invincible.

There are many ways to help reduce and reverse the effects of mental health issues such as Anxiety and Depression, some of which are tailor made for men. There are multiple websites and 24 hour phone services available, with organisations such as Beyond Blue, Black Dog Institute, HeadSpace, Anxiety Australia, Open Minds and ManTherapy.org all providing services, information, online forums and story sharing that allow any and all to learn, share and experience. Online services also provide anonymity, which allows men to open up without fear of ridicule. A 2014 study found that, with anonymity, participation and risk taking increased exponentially, due to what is known as the Online Disinhibition Effect. 

There are multiple options to address mental health disorders, and are primarily broken into self-treatments, psychological and medicinal. Self-treatments include stress management and relaxation techniques such as meditation and yoga, and while they might not fit into your current gym routine of chest and arms, they have proven effective in reducing Anxiety without the need for further help. They primarily work by simply ‘resetting’ the brain through the slowing of breathes, allowing a regulation and recalculation of hormones and other chemicals. 

Another form of help is through the use of a psychologist, psychiatrist or counsellor. Psychological interventions are preferred and recommended by medical professionals as they are generally more effective than a supportive counselling session, as they emphasise addressing current issues to prevent future mental episodes. One technique, known as Cognitive Behaviour Therapy, is structured around recognising how a person reacts and feels about certain aspects of themselves or their lives in an attempt to locate and reverse the negatively-impacting areas. By altering a line of thinking, or pattern, a person can then implement a more focused mindset, rather than worrying about ‘what-ifs’. Essentially, this therapy aims to balance out the negative thoughts and behaviours with activities that are enjoyable and give off a sense of achievement. That is why exercise is often recommended, as chemicals such as Endorphins and Serotonin are released during a workout, which have been found to decrease stress and enhance moods. As CEO of Inspire Foundation Jonathon Nicholas simplifies, “Moving straight to the practical steps they can take to help while learning about their illness, such as eating well, exercising and getting into a regular sleep pattern, is something many guys feel engaged with and empowered by.”  Other psychological treatments include Psychodynamic Therapy and Interpersonal psychotherapy, with the latter looking at relationships in an attempt to nurture and develop positive relations, resolve conflicts, improve communication techniques and social support networks. By recognising traits or patterns within certain relationships, one can make alterations and improvements to limit the possibility of further Depressive episodes. 

Unfortunately, not all cases can be solved through psychological means, with some requiring medical assistance, primarily through the use of antidepressant medication or mood stabilisers. Antidepressants are usually only used if the case of Depression or Anxiety is more severe, or if other means to treat the disorder have proven unsuccessful. Antidepressants work by balancing the neurotransmitters in the brain that affect emotions, which often improve mood, sleeping patterns, as well as other areas such as anxiety management and eating habits. Due to their effects on the brain, they are only available through doctor consultation, as individual cases and dosages will vary. There are primarily six different types of antidepressants recommended and used within Australia, each addressing particular severities and symptoms of mental health disorders. Organisations such as Beyond Blue provide information about these antidepressants on their website, allowing you to research and make up your own mind about this type of treatment. 

Of course, some men don’t want to be treated, psychologically or medically. In fact, they’d be in the majority. Sometimes, even the mere act of heading to a footy match with a mate can do enough. “For guys, quite often it’s about being connected, without actually talking,” says Nicholas. “For a lot of men, the process of talking puts them off.” Psychologist, and author of the book, I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression, Terrance Real, states that “Men are just as feeling, just as relational, just as connected, just as dependent, just as needy, as women are. Men have been coerced since childhood to forego these relational qualities and skills and squeeze their sense of membership and self-esteem through performance. Girls are taught to filter their sense of self-worth through connection to others, and boys are taught to filter their sense of self-worth through performance. That’s a vulnerable foundation for one’s self-worth.” 

But while choosing whether or not you’re up to talking to someone about your problems is a choice, having Depression or Anxiety is not. At the end of the day, mental health disorders affect too many, and due to the lifestyles that we lead, it’s not surprising. That isn’t to say that you should change your habits or quit your job, but by simply taking a step back every once in a while, you can reduce the likelihood and severity of potential episodes. Anxiety and Depression are complex and personal issues, but simply understanding the issues for what they are is something that those who suffer from it will be grateful for. Because no matter how well others might know you or the problems that you’re facing, everyone knows the struggle of mental health issues, and everyone is on your side.

Please note any views or opinions presented in this piece are solely those of the author and do not represent the views of the Rotaract Club of Brisbane Rivercity or Rotary International and its subsidiaries.