Hello Darkness, My Old Friend - On Depression

It's been many years since last I felt the darkness descend. But I know it's taste, it's feel, the heaviness in my limbs, my heart. My old friend, my old companion . . . depression.

The tell-tale signs (my collection, yours may vary):

• No motivation to work out
• Loss of sex drive
• Excessive or absent hunger (varies)
  
• Wanting to sleep all the time
• Inability to concentrate
• Moodiness
• Physical heaviness

But I have learned some lessons over the years - so I talked to Jami and let her know what was going on with me so that she didn't feel that somehow it was an issue between us. Letting her in on what I have been feeling also gave me the freedom to stop trying to pretend nothing is happening. It also allows her to help me, which generates intimacy and trust for both of us.

In that freedom, the symptoms have gotten worse. But I also know that they have to work themselves out and that burying them prevents this natural process.

I have been trying to understand what may have triggered it, and I can't identify a single thing - there are many.

• We lost Maggie (our Great Dane) a while back
• I am overworked
• I am wiped out with school after 2 years
• The shooting this weekend in Tucson (where I live)
• A darker colder winter than usual here

The list could probably go on with home repairs and other minor stresses. And until the events of this weekend, I was holding it together. Not so much now, although until this post there was no one else who knew besides Jami.

But why should I have to hide it? Or better, why I do I feel that I should hide it? Why is it wrong for men to say they hurt, they feel vulnerable, they experience emotional pain? Why do we teach our boys, and increasingly our girls, that having feelings is bad or wrong.

Fuck that.

In the US, six million men suffer from depression each year. To make it worse, men are less likely than women "to recognize, acknowledge, and seek treatment for their depression. In addition, their loved ones and even their physicians may not always detect depressive symptoms in men."

The NIH offers some resources for men, their families, and health care providers:

• Publications about men and depression (fact sheets and brochures)
• Public Service Announcements (PSAs) for television, radio, and print
• Public Service Announcements (PSAs) in Spanish for television, radio, and print
• Real stories of men with depression, how they got help and got better.
• For More Information about depression in men
• Download the PDF for the Web (36 page(s)

Here is some more information from the NIH on depression in men:

Research and clinical evidence reveal that while both women and men can develop the standard symptoms of depression, they often experience depression differently and may have different ways of coping with the symptoms. Men may be more willing to acknowledge fatigue, irritability, loss of interest in work or hobbies, and sleep disturbances rather than feelings of sadness, worthlessness, and excessive guilt.^12,13 Some researchers question whether the standard definition of depression and the diagnostic tests based upon it adequately capture the condition as it occurs in men.¹³

“I’d drink and I’d just get numb. I’d get numb to try to numb my head. I mean, we’re talking many, many beers to get to that state where you could shut your head off, but then you wake up the next day and it’s still there. Because you have to deal with it, it doesn’t just go away. It isn’t a two hour movie and then at the end it goes ‘The End’ and you press off. I mean it’s a twenty four hour a day movie and you’re thinking there is no end. It’s horrible.”

-Patrick McCathern, First Sergeant, U.S. Air Force, Retired

Men are more likely than women to report alcohol and drug abuse or dependence in their lifetime;¹⁴ however, there is debate among researchers as to whether substance use is a “symptom” of underlying depression in men or a co occurring condition that more commonly develops in men. Nevertheless, substance use can mask depression, making it harder to recognize depression as a separate illness that needs treatment.

Instead of acknowledging their feelings, asking for help, or seeking appropriate treatment, men may turn to alcohol or drugs when they are depressed, or become frustrated, discouraged, angry, irritable, and, sometimes, violently abusive. Some men deal with depression by throwing themselves compulsively into their work, attempting to hide their depression from themselves, family, and friends. Other men may respond to depression by engaging in reckless behavior, taking risks, and putting themselves in harm’s way.

“When I was feeling depressed I was very reckless with my life. I didn’t care about how I drove. I didn’t care about walking across the street carefully. I didn’t care about dangerous parts of the city. I wouldn’t be affected by any kinds of warnings on travel or places to go. I didn’t care. I didn’t care whether I lived or died and so I was going to do whatever I wanted whenever I wanted. And when you take those kinds of chances, you have a greater likelihood of dying.”

-Bill Maruyama, Lawyer

More than four times as many men as women die by suicide in the United States, even though women make more suicide attempts during their lives.^15,16 In addition to the fact that men attempt suicide using methods that are generally more lethal than those used by women, there may be other factors that protect women against suicide death. In light of research indicating that suicide is often associated with depression,¹⁷ the alarming suicide rate among men may reflect the fact that men are less likely to seek treatment for depression. Many men with depression do not obtain adequate diagnosis and treatment that may be life saving.

More research is needed to understand all aspects of depression in men, including how men respond to stress and feelings associated with depression, how to make men more comfortable acknowledging these feelings and getting the help they need, and how to train physicians to better recognize and treat depression in men. Family members, friends, and employee assistance professionals in the workplace also can play important roles in recognizing depressive symptoms in men and helping them get treatment.

Some depressions are mild and situational - these things feel bad but they will pass. Other depressions feel like the dark night of the soul. And there are others that feel like being enveloped in irrevocable blackness.

There are lots of things we do not know about men and depression, and this will not change unless men learn how to talk about it rather than hiding in the shadows.

I will not hide in the shadows.

I am depressed, but it does not make me any less masculine, any less of a man. If you are depressed, find someone to talk with about it, preferably your partner and then a professional if you need help.

If you have had any thoughts of suicide, PLEASE SEEK HELP:

Call the toll free, 24 hour hotline of the National Suicide Prevention Lifeline at 1 800 273 TALK (1 800 273 8255) to be connected to a trained counselor at the suicide crisis center nearest you.

Tags: men, depression, mental health, suicide, masculinity, NIH, symptoms, sex drive, motivation, sleep, appetite, get help, alcohol