Friday, August 27, 2010

Strong Silent Types: Seeing the Masculinity in Depressed Men

The blogger behind Strong Silent Types - Stuff About Men, ultimo167, is a therapist who works with men, which provides him with a useful perspective to review research on men and mental health, such as this post that looks at Men and Depression: Current Perspectives for Health Care Professionals.

Like most issues, depression in men is much more complicated than the simple "suck it up" assumption that most use to reason out why men do not seek help.

Fields, A., & Cochran, S. (2010). Men and Depression: Current Perspectives for Health Care Professionals American Journal of Lifestyle Medicine DOI: 10.1177/1559827610378347

There is a theory out there that depression in men is much more common than we can currently ascertain and that the personal, interpersonal, social and economic costs of this hidden epidemic are astronomical (Fields & Cochran, 2010, n.pag.). The massive gap between theory and fact is indeed largely occupied by the presumed reluctance of most men to seek help for any health-related problem, physical but more especially emotional, since to so cede to another person’s wisdom is an affront to masculine ideals. Further, fessing up to feeling a bit fagged out is what women and pewfs do, and so should be avoided at all costs. The script goes that ‘real men’ silently tough out their troubles with gall, gusto and a pint or two of Guinness, for good measure (2010).

Yes, we all know that ‘[m]en are expected to be stoic, independent, and capable of handling their own problems’ (2010). We also know that men are supposed to suck up any emotions that might make them appear ‘unmanly’ (2010), seemingly vulnerable emotions that include the textbook symptoms of depression: sadness, hopelessness, and worthlessness. Moreover, at an even more fundamental level, too many men are incapable of finding comfort in the arms of someone who can love and care for them when they most desperately need it. How many men I have counselled whose depression remained a closely guarded secret from the one person who might best respond to their suffering. That is, their partner…

Fields and Cochran (2010) concede here that yet another reason why men might be so reluctant to fess up to feeling depressed is that the standard, pharmacological treatment is so often much worse than the disease. After all, so-called ‘second generation’ anti-depressants come with some pretty hardcore baggage (weight gain, hair loss, impotence, etc.) (2010). Telling a man who is already feeling like total shite that he might soon be bald, fat and no longer able to get a stiffy is, I would suggest, hardly conducive to treatment uptake, let alone compliance…

…expectations on men to perform sexually raise serious considerations for the use of many antidepressant medications…which have side effects impairing sexual functioning’ (2010).

Where the authors (2010) flourish is in challenging health service providers to question their own practice orthodoxy when working with men who might be depressed…

Read the whole post.

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