Aging Forward: Helping Men Recover from Depression

Patrick Arbore
By Patrick Arbore March 15, 2014 11:07

 Call for Help:  Click here for Central Sierra Suicide Prevention Hotlines and Resources

White men over 85 are at the greatest risk for suicide in the United States.

According to a 2010 American Association of Suicidology report, these older men not only killed themselves more often than people of any other age, gender or race, but were more likely to use highly lethal means, like firearms, to do so – thus leaving little time for intervention.

Among white working men in their 50s, suicide rates have jumped nearly 50 percent to about 30 per 100,000 population, according to sociologist Michael Kimmel, author of the new book “Angry White Men.” These men were most likely to have lost their jobs during the recession that began in 2008.

American men are about four times likelier than women to commit suicide, the Centers for Disease Control and Prevention reports. Sadly, researcher Dr. David Muzina found that some older men who die by suicide had seen their family doctor within the prior month.

The report on suicide in this issue of Friends and Neighbors shows that it is a significant public health problem in this tri-county region and that men are the most likely casualties. With this in mind, I’d like to discuss male risk factors – the most significant being depression.

Depression is a serious illness that negatively affects how we feel, think and act. According to Greek researcher Aphroditi Zartaloudi, it is the fourth most common cause of disability both in terms of physical and mental health worldwide. By 2020, depression will be the second most common cause of disability in the developed world and the most common illness in the developing world, according to the American Psychiatric Association.

While depression has been consistently and historically associated with women in mental health studies, growing evidence suggests these studies may not have adequately gauged rates of depression in men – and failed to recognize that men are just as vulnerable to depression as women.

In his book I Don’t Want To Talk About It, psychotherapist Terrence Real suggests that women are more likely to be diagnosed and treated for depression than men. One reason: Family, friends and mental health providers find it easier to talk with women about depression because it is seen as an emotional disorder and not as a “manly” disease.

Symptoms typical of female depression, such as crying and changes in appetite and weight, are less challenging to discuss than those of men. Depression symptoms for men often include suicidal thoughts, substance abuse and rage. If untreated, depression in men can be fatal, as suicide statistics show.

Commonly held beliefs about men have made it hard to recognize male depression. Examples: Masculine men only express feelings of anger, are independent, are competitive and resilient, and they do not cry. Men may learn early to deny or downplay feelings of helplessness, frailty, impotence, uncertainty, ambiguity, sensitivity and empathy. Many people view masculine men as invulnerable.

But hopeful changes are taking place, mental health experts say.

First, there is evidence that conditioning men to be tough, stoic and without emotion is being challenged in families, schools, churches and even politics.

Second, discussion by high-profile men of their own depression – the late Mike Wallace, Rod Steiger and William Styron, among them – has helped others acknowledge their own symptoms. Bruce Springsteen in 2012 revealed his battle with depression and suicidal thoughts. Awareness campaigns such as “Men Get Depression” (mengetdepression.com) have also prompted honest discussion.

One more positive point: Depression is very treatable.

Between 80 and 90 percent of those diagnosed with major depression can be treated and can return to their daily activities, according to the National Alliance on Mental Illness. It cites medication, psychotherapy and electroconvulsive treatment as effective therapies.

Research suggests that a combination of medications and counseling can be successful in managing men’s symptoms such as persistent sadness or irritable mood, changes in sleep or energy, feelings of guilt or worthlessness and recurrent thoughts of death.

In a 2011 report, University of Rochester’s Dr. Yeates Conwell concluded that older men who died by suicide could have been helped, but escaped detection because their depression was undiagnosed and thus untreated.

To address the problem of male depression, family members, friends and healthcare providers must acknowledge differences between the symptoms of the disease in men and in women.

While anyone can turn to mood-altering behaviors, men tend to use substances (including prescription medication), gambling, television, work or other addictive activities to temporarily numb feelings of distress. These behaviors may not only worsen depression, but each form of addiction may bring more problems.

What can we do? Some suggestions:

Support the men in our lives by helping them learn how to manage strong feelings without having to dull or numb them through addictive behaviors.

Let them know that it is OK to ask for help.

Finally, assure them that depression is a treatable illness.

Together we can remove the stigma associated with depression so that men can more easily ask for help and, ultimately, fully recover from this potentially lethal illness.

Dr. Patrick Arbore is the founder and director of the Center for Elderly Suicide Prevention and Grief Related Services at San Francisco’s Institute on Aging. He also founded and directs the Friendship Line, a 24-hour crisis line for those 60 and older: 800-971-0016.

Copyright © 2014 Friends and Neighbors Magazine
Patrick Arbore
By Patrick Arbore March 15, 2014 11:07
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