Health Issues
Here are particular areas of men's health that are now well identified as problematic for separated men. This page aims to provide an insight into the key areas, so men can reach out for timely support.
Depression
Depression is one of the most misunderstood health matters for the general community. This in large part flows out of the multifaceted use of the word in the English language:
- If a person is feeling a bit flat one day, they might describe their mood as depressed, or say they are “feeling depressed”.
- Clinical depression on the other hand is a serious state that has a known link to risk of suicide and increased risk of poor health outcomes generally.
It is very normal for most people to experience the former occasionally, where as the latter is a serious health issue that needs to be addressed promptly and appropriately. Whilst your general practitioner should be able to diagnose and point you at best-practice solutions for depression, in some cases, GPs reach for the prescription book and write a script for the latest anti-depressant medication being promoted by pharmaceutical companies, and that is the extent of their professional response.
One text we recommend on depression is Michael D. Yapko's Breaking the Patterns of Depression. Yapko is regarded as one of the world's foremost experts on the treatment of depression. Yapko says of depression:
“Through my experience, I have come to believe that the chief problem for most depressed people is that they think, feel and act out of a depressive perspective that is distorted and hurtful, and then make the mistake of actually believing this perspective is a God-given truth.”
Put another way, depression is like putting on a darker set of sunglasses every day you get out of bed, and believing that the blackness you perceive, is reality. Other people seeing the same “reality” see much more light, opportunity and hope. That is the danger of undiagnosed and untreated depression.
Symptoms of Depression
It is commonly believed that the presence of several of the following list of symptoms is a strong indication that a person may be experiencing depression:
- Psychological Symptoms:
- Sadness and despair
- Irritability
- Low self-esteem
- Apathy, no motivation
- Interpersonal problems
- Guilt feelings
- Negative thinking
- Suicidal thoughts
- Physical Symptoms:
- Sleep disturbances
- Appetite disturbances
- Loss of libido (sex-drive)
- Fatigue and decreased energy
- Inability to experience pleasure
- Family history of depression, suicide, eating disorders or alcoholism
- Additional Symptoms in Both Psychological and Physical Symptoms
- Poor concentration
- Poor recent memory
- Hypochondria: excessive concern with one's health
- Drug/Alcohol abuse
- Excessive emotional sensitivity (including anger and irritability)
- Pronounced mood swings
- Panic attacks.
Returning to Yapko, what is different about his approach, from a narrow pharmaceutical approach, is that he believes “depression is not a single problem with a single cause and a single treatment”. Hence our warning regarding a “cookie-cutter” approach to treatment.
Responses to Depression
Best practice response to depression these days typically involves a three or four pronged approach where medication might be replaced by exercise:
As depression is not simply a “disease”, its form can be very personal or individual in nature. For that reason it is not helpful to accept any professional opinion that takes a “cookie-cutter” approach to depression i.e. one solution fits all.
It is critical to accept the responsibility to determine what shape your depression takes, and then find an appropriate blend of elements in your response.
Medication is self explanatory, but it is worth noting that response to anti-depressant medication is very individual. What works well for one person, will not work for another. The currently popular SSRI family of drugs (Prozac etc) do not suit everyone, and some men have problems with increased anxiety symptoms frequently associated with SSRIs.
It is critical to be aware that a small percentage of people have an acute reaction to some SSRIs in the first few days after the commencement of medication. This complication is not well publicized, and not brought to the attention of patients by many doctors.
SHOULD YOU BE IN THAT SMALL PERCENTAGE OF PEOPLE THAT HAVE ANY SIGNIFICANT OR ALARMING REACTION TO MEDICATION, GET BACK TO YOUR DOCTOR URGENTLY. DO NOT FALL INTO THE TRAP OF THINKING THAT THIS IS WHAT HAPPENS WITH ALL ANTI-DEPRESSANTS AND CEASE MEDICATION WITHOUT REFERRAL TO A DOCTOR. IF YOU FEEL THAT YOUR DOCTOR DOES NOT SEEM TO BE TAKING YOU AND YOUR CONDITION SERIOUSLY, GET A SECOND OPINION AND CHANGE GP IF REQUIRED.
MENDS' PAI research on separated men shows that elevated anxiety levels are frequently a co-existing problem, so an anxiety reaction to SSRI medication can create a significant problem. This might express itself in a variety of ways from general muscle tension, jaw tensioning, and even sleeplessness. If you find yourself increasingly anxious whilst on SSRI anti-depressant medication, speak with your GP about that, and consider a shift to either SNRIs or the older tri-cyclic medications. Note : sleep deprivation itself is very dangerous and can contribute to the onset of depression, so do not neglect that condition.
The subject of pharmaceutical anti-depressants cannot be raised without canvassing the latest research findings on duration of medication. Many people only take AD meds for 90 days and then cease. Recent research shows that the likelihood of relapse is greatly reduced by persisting with medication for 9 months. If you are uncomfortable or uncertain about side effects, check about what you are experiencing with your GP or specialist.
For those with a deep or strong resistance to pharmaceuticals, you might consider natural alternatives like SAMe. SAMe (pronounced Sammy) is an abbreviation for S-adensylmethionine, which is produced by the body naturally. SAMe has compared most favourably in large clinical trials in Europe with pharmaceutical ADs, and was approved in about 2002 in Australia by the Therapeutic Goods Association. The advantages are that it produces effect in 4-7 days, has no known side-effects, but its cost is its significant disadvantage. Dosage in the clinically tested range of 400-1200mg per day can cost $2 - 6(Aus) per day, which can be a significant financial impost for many separated men. Read & research more about SAMe on the internet.
WATCH OUT! - MENDS is developing a form that separated men can fill out before meeting with their doctor, to insure that all relevant information is presented. Watch here for that form when we have it completed.
Cognitive Therapy can best be described as a therapy that reviews a patient's self-talk, aiming to identify and weed out overly negative, and non-reality based self-talk. Stinkin' thinkin' aids in the process of creating and believing an overly pessimistic view of the world, but it can be contained and new habits of interpretation developed.
Therapy comes in various forms, but a separated man might look for someone who can help them talk and work through some of their more intense emotions and gather options for going forward.
Note : One-on-one therapy does have its place, but our MENDS experience is that it is no substitute for active participation in a good group setting like MENDS. The normalization and dissipation of some very intense emotions can progress well in a well facilitated group, provided the focus on separation issues is there.
Exercise plays an important role as an anti-depressant. Research has shown that regular exercise is as effective as medication in its anti-depressant effect, but that the exercising sample (of people) were less likely to have a recurrence of depression than the group using medication. Regular in this context means five (5) days a week or more. Interestingly the combination of medication and exercise did not enhance the outcomes over either in isolation.
Caution Advised
Some controversy is emerging around the world on the issue of addiction and withdrawal symptoms with the popular and highly prescribed SSRIs. Whilst warning separated men not to avoid addressing possible depression, we also advise being an informed consumer of products and services designed to treat depression.
We would encourage a web search on the work done by and professional opinions expressed by Dr David Healy, a British expert who has found some pharmaceutical companies hiding data that does not maintain an uncomplicated picture of SSRI medications.
Summary
In summary, depression is an extremely serious condition, because of the risk of progressive loss of a reality-checking for the depressed person.
In separated men this is doubly problematic because men typically withdraw socially, which further compounds the absence of some form of reality-checking. Normally, one of the qualities of a good friendship is that friends give us honest feedback, even if that feedback is a bit confronting on occasion. Good friends have the courage to stand their ground and express their deep love and concern for us by telling us the truth, as they see it.
This brings us to the question of whether friends and family should intervene when they see or are concerned that a loved one is slipping into more and more dangerous mental space. We can assure you that the short term anxiety of raising and persisting about the possibility of depression with a friend is infinitesimally smaller than dealing with the guilt of whether you should or could have done more, after the event of an attempted or successful suicide.
Resources
The American National Institute of Mental Health has an area on their website specifically on Men & Depression. It makes clear the seriousness of undiagnosed or ontreated depression and offers a user-friendly audio interface that goes a long way to demystify depression. Recommended.
Beyond Blue - the national depression initiative in Australia is backed by Government and is promoted by such public figures as Garry McDonald & Rachael Griffiths. Recommended.
