depression

#WorldSuicidePreventionDay Male Suicide

DepresyonI know I’ve let this blog lie fallow for a while, other places tend to cover events and controversies before I can and I don’t have much extra to add.

Today is World Suicide Prevention Day though, and more attention has finally be drawn to the issue of male suicide, a topic which has long gone relatively unaddressed and only really began to come to any kind of serious prominence in this country after MP Jess Phillips mocked the issue last International Men’s Day.

The Huffington Post has a short article about this, bemoaning the fact, but also pointing out that we have no specific, real idea as to why men are committing suicide at four times the rate women are – even though women, reportedly, suffer depression more often and attempt suicide more often.

Some of these factors are known, or at least somewhat suggested. Women’s suicide attempts tend to involve less instantly deadly options and may be calls for help. Men’s attempts seem to be more serious and to more often involve things like car crashes, shootings and throwing themselves in front of trains or off buildings.

So why are men killing themselves more and why are they using deadlier methods when they do? Why are they doing it with such conviction when they do?

I suffer from moderate to severe depression and have done for some years now. I’ve been through the rigmarole of therapy, doctors, pills and all the rest and I have, indeed, tried to kill myself a handful of times with varying degrees of seriousness and effort.

My insights are, of course, only my own speculations and observations. Some from personal experience, some from what I’ve studied and learned talking to doctors, psychiatrists and therapists with reference to my treatment, and in general.

There are differences between the sexes, not just in terms of the obvious, but in terms of psychology. These are, of course, broad generalisations, but they are true. There’s arguments over the degree to which there are differences, but few other than the most extreme deny them. The effect of different hormones on behaviour alone are dramatic.

The bell curve regarding most male traits and behaviours tends to be flatter than womens. There are exceptional and unexceptional people of both genders, but more men fail hard or succeed well. More men are very stupid, or very intelligent. More men have autism and more women have borderline personality disorder.

It’s possible that this overall trend affects depression in men too. Perhaps more men suffer more severe forms of depression and more women suffer less severe forms. This seems possible given this overall trend.

It’s true that men seek help less often, but to use that to blame men for their high suicide rate is… unhelpful. It’s also true that the standard kinds of therapies made most readily available are less helpful for men. Talk therapy, for example, is less effective for men and it takes longer for men to unwind and open up. In national healthcare systems which are already stretched and operating on a form of triage, its a one-size fits all system offering one form of therapy less suited to half the population and offering an amount of time per appointment that isn’t long enough to be even minimally useful to men.

There’s a tendency, societally and medically, to try and treat men as though they are broken women. To blame them when things do not work for them, rather than to seek new solutions that might.

I’m far from a conventional masculine man. I work creatively. I’m not ‘handy’. I can’t fix a car and can barely wire a plug. I don’t drink casually. I have no interest in sport. I am far from typical, yet to one degree or another I struggled with all these aspects. If I have had trouble reaching out for help, admitting my diagnosis made sense, dealing with the therapy that was available and the disappointment that it wasn’t helping, looking for other help – each step tortuous and difficult.

How much more difficult for a more conventional man?

How much more difficult for a man who couldn’t afford a private therapist?

How much more difficult for one of the many men not doing so well? The failures without family or friends to support them to the same degree?

Societally I also see problems. The pressures and demands on men have not changed and progressed in the same way that women’s roles have. Men are still expected to provide, protect, to be the emotional rock. Men are still under a huge amount of pressure to succeed, to meet expectations and demands, to self-sacrifice. Men have lost many of the advantages that they once had, but have not lost the commensurate duties and demands that went along with it. Women’s expectations of men have not changed. They still want to partner with a societal equal – minimum – and the shifts in society have left a lot of men behind, with little sympathy and little effort to help them.

Again, I am far from conventional. I work from home, make less than my partner – and that’s fine. I am not particularly bothered by these expectations… yet they are still there. A constant nagging pressure. I should be able to make more money. I should be more successful. I should be able to create another hit concept or IP. I feel the judgement of people who have – miraculously – carved out some kind of ‘normal life’ from all this mess.

There’s a generational gap too. Men’s fathers and grandfathers don’t necessarily understand the problems men face today or the context that they take place in, or even that they are problems at all. Yet I have lost several peers or acquaintances to suicide or drugs and know many (many!) men struggling with varying degrees of depression. The things that were easier in the past – if not simple – such as owning a house, getting an education without crippling debt, job security, a family, all of these are much harder to achieve and, despite perhaps being outdated, are still expected of men.

Attention and awareness of the issue is the first step. Next will, hopefully, comes study that can turn some of these anecdotes and observations into hard facts. Once we have those, perhaps we can begin to make changes that will help reduce the male suicide rate. In the meantime though, encouraging men to seek help, providing help that actually works and trying to find new definitions of masculinity – from and for men and not from feminist theory or treating men as broken women – can’t hurt.

#ManBrain – Survival Skills: Learning how to be a Pussy

mammoth_huntingThere’s no such thing as ‘man school’, but if there were one of the most important lessons it would teach you would be ‘not to be a pussy’ and, by and large, that’s pretty good advice as things go. The testosterone surging through our systems – amongst other things – affects our moods, our perception, makes us more prone to anger and so forth and so learning to control and suppress your feelings can actually be really important and useful.

Manning up is useful, but ‘girling down’ can also be useful. Sometimes you do have to let those feelings go and it goes against every male instinct and piece of social pressure to do so. For a guy to open up he pretty much has to be drunk, high or post coital and other than the last one that’s not especially healthy in the long term.

All the following advice is going to be bullshit, because I still have a hard time doing it all, but it’s worth trying and when you can do it, it does help.

  • Seek help: There’s nothing wrong with going for help and just because it’s a mental problem that doesn’t make it any bigger an issue than anything else you might need help with. You wouldn’t try to get a heavy sofa into a house without help and you don’t need to carry the weight of mental illness by yourself either. If you can’t confide in a friend there’s the Samaritans, doctors, therapists. They can’t judge you or expose your weakness by law or because they don’t know you. So that’s low risk too.
  • Join a Community: Self help groups sound stupid, but they really can help. Having people who genuinely understand what you’re going through is really helpful especially if you have trouble communicating it – as many of us do. If you can’t handle face to face there are forums and groups all over the internet where people help each other out and that has the added benefit of being anonymous.
  • Trust People: Your friends and family may have a hard time understanding, but they’ll try and odds are they’ll look after you and look out for you. Your instinct, as a gentlemanly dude, might be to protect them from your pain and not to want to be a downer. Here’s the shitty thing. Pretending to be OK can make conditions worse. Would you want your partner to keep their pain or illness secret from you? Would you want your friends to do it? Of course not. You’re a nice guy, you’d want to help in any way you could. Other people will do the same for you. If you keep it all to yourself nobody will know you need help. The sucky thing about mental illness is that it isn’t obvious like, say, being in a wheelchair. People won’t know you need help unless you tell them.
  • Take the Fucking Pills: Meds do work. There’s no giant pharmaceutical conspiracy. They take time to work though and you have to keep taking them. So take them. These particular pills may not work for you. If you feel worse, suffer bad side effects or they don’t help, go back to the doctor. I’ve been on four or five different medications now, many with quite severe side effects but eventually you find something that works and it’s great.

You’re not John McClane and you can’t tackle the big bad depression monster all by yourself as though it were a building full of terrorists. That Hollywood bullshit is entertaining and all but the real hunters from human history worked together. You think Krunk took down a mammoth all by himself? Bullshit. It took teamwork. A bunch of guys working together and helping each other to bring down a big beast nobody could handle by themselves. Mental illness is like that. Let your tribe take some of the strain for you. If they love you, they will.

Join the conversation on Twitter #ManBrain and if you want to submit an article or comment on your experience, please do.

My #ManBrain & Mental Health

broken-brain-fragmentedThis week at TDA we’re going to be talking about mental health, as it relates to men. I hope some of you will submit ideas and articles of your own this week and I’ll be reblogging and linking to things that look useful or helpful. To start with, however, I thought I’d tell my own story, since you can’t very well ask other people to share if you’re not willing to do so yourself.

I’m a 38 year old male and I suffer from moderate to severe depression and anxiety with suicidal episodes and mild dependency. I’ve been officially diagnosed for three-to-four years now and am on my fifth medication as well as taking up private therapy to try and help me find tools to deal with the problems. Despite the diagnosis being fairly recent I can look back and see I’ve been having episodes since I was in my late teens.

Some of these problems stem from, or are made worse by, my position as a man.

I was reluctant to seek help in the first place. I thought I had a form of chronic fatigue and sought every possible avenue for it to be something else that was wrong with me and not depression. Many, many blood tests, examinations and wasted days later I had to finally succumb to the inevitable and to begin treatment for depression, starting with my first lot of pills.

I was ashamed, as though it were my fault somehow and that mental illness was a weakness. As a nerdy and rather non-masculine boy I had been horrifically bullied at school and picked on. Something that teaches you never to show weakness and to hide the ways you are different from others lest you get beaten up for it. Stoicism is the only real male trait I could ever really claim as my own and so enduring became my way to be a man. Opening up was not only an invitation to violence and piss-taking but to give up the one thing that made one feel like a man.

That’s changed, obviously, but it was a hard thing to overcome. The pressure upon men, from men and women alike, is to be strong, solid and dependable. Not weak, unreliable and fragile.

There’s also a tendency in men to self-sacrifice. I delayed applying for any additional help for the longest time because I believed that I could cope without it. When I did apply I discovered that mental health services are backlogged and severely underfunded and that the only NHS available therapy was CBT (Cognitive Behaviour Therapy) which didn’t really work for me and which, I think, might not be the best choice for many other men (being based on ‘woo’ like positive thinking that doesn’t work well for cynics or skeptics who tend to be more represented in male ranks. I soon dropped out, not only because it wasn’t working for me but because I felt that the other people needed the help more than I did – having met many of them at the community mental health centre. More self sacrifice.

Spending money on myself for therapy was hard to reconcile too, but given I wasn’t taking attention away from anyone I felt able to do so. I’m very cognisant of the fact that I am incredibly lucky to (with help) be able to afford the therapy I am getting, humanistic therapy with a therapist who specialises in men. Most people will not have this option.

This is what it has taken to get me into a relatively stable condition, where I can cope day to day rather than having long and protracted periods of helpless depression. Eighteen months of therapy, three years of medication and a lot of help from others.

While there are some dangers in pathologising everything and there are benefits to toughing things out and learning how to endure harm. Being strong is a good survival skill, but not to the point it begins to hurt you.

  • Men are less likely to ask for help.
  • Men are more likely to follow through on threats of suicide and to kill themselves.
  • Existing health structures as a whole favour women and there are resources available for post-natal depression that are not available for men. There is nothing inherently wrong with this, but similar effort needs to be made for men and boys.
  • Mental health stigma is bad for everyone, but appears to be worse for men.
  • Men are more likely to self-medicate with alcohol, illegal drugs and other self-destructive habits.

What can we do about this?

  • Highlight the need for extra mental healthcare funding in general.
  • Highlight the need for tailored mental health services for men.
  • Destigmatise and raise awareness of mental health issues.
  • Advocate for a plurality of approaches to mental health issues.
  • Educate teachers, school nurses, college counselors and others who are on the front line with young men to recognise signs of depression and to take the initiative in approaching them to see if they need help.

Most important of all we need to get to the root of why both men and women are depressed and why men kill themselves so much more often (3.5 times as often as women). What is the root of their pain and how we might address it.

Let’s try and make a start here.

Men & Mental Health – Call for Content

i_BlueBrainI’ve added some reblogs from The Athefist on appropriate topics to get us started, but the first thing I really want to do with The Dude’s Abode is to tackle one of the most difficult subjects there is, whether you’re a man or not.

Mental health.

Suicide rates for men in the UK should be a national disgrace and the rest of the world isn’t much better.

According to a report in The Guardian earlier this year, the figures are shocking:

In 1981, 4,129 men in the UK took their own lives. Three decades later, despite improvements in psychiatric and emergency care medicine, a range of suicide prevention barriers and policies and, arguably, some degree of social, political and personal empowerment, the number in 2012 had risen to 4,590.

All is not hopeless however. We have, as a society, managed to greatly reduce the number of women committing suicide and that holds out hope that we can do the same for men by addressing the problem with similar effort.

In 1981, 2,466 women in the UK took their own lives. Three decades later, thanks to improvements in psychiatric and emergency care medicine, to a range of suicide prevention barriers and policies and, perhaps, to gradual social, political and personal empowerment, the number in 2012 had almost halved to 1,391.

This information from the Office for National Statistics shows the greatest gender-gulf in suicides ever recorded and research suggests that it is the 40+ and the lower income part of the demographic which has been most affected. Men’s expectations in life, the roles they are traditionally supposed to adopt have all been eroded or wiped out by societal, economic and technological developments and while women have been able to make their causes heard to government and industry men have not. There has been no commensurate and complimentary change in the pressures, expectations and duties required of men and no adjustment to their expectations and options.

Mental health is also, sadly, intimately linked with homelessness. 84% of the homeless and 9/10 rough sleepers are male.

There are differences in the effects, incidence and severity of mental conditions as well. Schizophrenia tends to express more strongly in men than women. Men are nine times more likely than women to be on the autism spectrum.

These issues are compounded by men’s reluctance to seek help, to be a burden, to impose their needs upon others and even to talk about how they’re feeling. While this may actually be useful in some cases, toughing it out isn’t always the best answer.

I would like to present some articles on this topic next week and I’d like your help. I intend to talk about my own mental health experiences but if you’re a man who has experienced mental illness, or if you’re someone that has had to care for a man with a mental illness, let me known. Have you been homeless or had to sleep rough? What was your experience as a man with that? If there are any psychiatrists, psychologists or sociologists out there I’d like to hear their opinion on the reasons for the high male suicide rates and what we might do in order to reduce it.

If you want to talk anonymously, that’s fine too.

Volunteers can reach me at: [email protected]