Depression In Men
“The son wishes to remember what the father wishes to forget”
– Yiddish Proverb
I Don’t Want to Talk About it: Overcoming the Secret Legacy of Male Depression by Terrance Real has been one of our books of the month in the past and is one I am utilizing for part of this blog. There are a number of pieces I would love to share from this book and from personal experience, and yet I will limit this to only a few and we may need to have a follow-up to dig a little deeper on this.
Let’s first take a look at what depression is diagnostic. In clinical depression, there are multiple symptoms that have been present for the individual for at least two weeks with this being a change from previous functioning. These symptoms can include depressed mood, loss of interest or pleasure, a shift in weight by about 5% either up or down in a month, insomnia or hypersomnia, feeling of worthlessness or inappropriate guilt, diminished ability to think or concentrate nearly daily, recurrent thoughts of death unrelated to the fear of dying. There are a number of different experiences and conditions that can elicit depressive symptoms and in experiencing these symptoms it is also important to know that they can exist at different levels of intensity. The symptoms listed above are from the DSM-5 which contains diagnostic criteria for mental health conditions.
Depression is a state and experience that every human may be impacted by at some point in their life. It is important to be aware of the different familial and social messages we may have received as men about depression and about talking about our internal and emotional experiences. Some of the messages I recall hearing and overhearing while growing up were that “it’s not that bad, this too shall pass, that’s not real pain, I’ll give you something to cry about, real men don’t cry, don’t be a sissy, and so many more”. Terrance Real states there is a “Tendency to not recognize depression in men because the disorder is seen as un-manly”, that men aren’t supposed to be vulnerable, and that pain is something to rise above. This focus on the gendering of emotions and avoidance of vulnerability and pain can limit what a male allows themselves to be aware of and if they are aware of it, who and how they share this knowledge with. This creates a double shame bind of depression being both shame-filled and shameful and is difficult for individuals, families, and health providers to navigate appropriately and effectively. Depression “goes largely unrecognized by both the men who suffer and by those who surround them” and “the impact of this hidden condition is enormous”. With this being a hidden condition this also brings me back to the quote at the beginning of this blog and how as young men we are eager to learn and connect but may be faced with an emotional wall that has been in place to avoid acknowledging or feeling pain and thus seeking to understand what the other has worked to actively forget or omit.
“When we minimize man’s depression, for fear of shaming him, we collude with the cultural expectations of masculinity in a terrible way. We send a message that the man who is struggling should not expect help”. And thus we perpetuate damaging social norms and patterns that encourage men to “walk it off”, “suck it up”, and resolve the issue on their own while reinforcing that asking for help is not an option. In that pattern, there is also reinforcing of it being acceptable to be a workaholic or to turn to other means of “escapes” to avoid or disconnect from the symptoms and reality of pain and depression. “One of the ironies about men’s depression is that the very forces that help create it, keep us from seeing it”. Terrance Real speaks to how depression can be overt or covert and when we limit the ability for men to connect authentically to their own pain and sadness and name it, that keeps it in a covert state (hidden). When depression is covert it can be like a block of ice, frozen and unmovable. As we are able to name the pain, and identify the “troubles” realistically then we are able to move depression from covert to overt and thus thaw those frozen feelings and allow sadness to flow and release that pain in a way that fosters healing, growth, and awareness.
You have a right to all your feelings. You have a right to know that no emotional state or level of vulnerability causes you to be less than others or better than others, we are all human. As friends, family, and providers this is an opportunity to see beyond the symptoms. This is an opportunity to help treat the underlying cause of the symptoms. You have a right to heal.