Men and Depression

Are you tired and irritable all the time? Have you lost interest in your work, family, or hobbies? Are you having trouble sleeping and feeling angry or aggressive, sad, or worthless? Have you been feeling like this for weeks or months?

If so, you may have depression.

What is depression?

Everyone feels sad or irritable sometimes, or has trouble sleeping occasionally. But these feelings and troubles usually pass after a couple of days. When a man has depression, he has trouble with daily life and loses interest in anything for weeks at a time.

Both men and women get depression. But men can experience it differently than women. Men may be more likely to feel very tired and irritable, and lose interest in their work, family, or hobbies. They may be more likely to have difficulty sleeping than women who have depression. And although women with depression are more likely to attempt suicide, men are more likely to die by suicide.

Many men do not recognize, acknowledge, or seek help for their depression. They may be reluctant to talk about how they are feeling. But depression is a real and treatable illness. It can affect any man at any age. With the right treatment, most men with depression can get better and gain back their interest in work, family, and hobbies.

"My daily routine was shot. I didn't have the energy to do anything. I got up because the dog had to be walked and my wife needed to go to work. The day would go by and I didn't know where it went. I wanted to get back to normal. I just wanted to be myself again."
—Jimmy Brown, Firefighter

What are the different forms of depression?

The most common types of depression are:

Major depression—severe symptoms that interfere with a man's ability to work, sleep, study, eat, and enjoy most aspects of life. An episode of major depression may occur only once in a person's lifetime. But more often, a person can have several episodes.

Dysthymic disorder, or dysthymia—depressive symptoms that last a long time (2 years or longer) but are less severe than those of major depression.

Minor depression—similar to major depression and dysthymia, but symptoms are less severe and may not last as long.

What are the signs and symptoms of depression in men?

Different people have different symptoms. Some symptoms of depression include:

• Feeling sad or "empty"
• Feeling hopeless, irritable, anxious, or angry
• Loss of interest in work, family, or once-pleasurable activities, including sex
• Feeling very tired
• Not being able to concentrate or remember details
• Not being able to sleep, or sleeping too much
• Overeating, or not wanting to eat at all
• Thoughts of suicide, suicide attempts
• Aches or pains, headaches, cramps, or digestive problems
• Inability to meet the responsibilities of work, caring for family, or other important activities.

What causes depression in men?

Several factors may contribute to depression in men.

Genes—men with a family history of depression may be more likely to develop it than those whose family members do not have the illness.

Brain chemistry and hormones—the brains of people with depression look different on scans than those of people without the illness. Also, the hormones that control emotions and mood can affect brain chemistry.

Stress—loss of a loved one, a difficult relationship or any stressful situation may trigger depression in some men.

Most of the time, it is likely a combination of these factors.

How is depression treated?

The first step to getting the right treatment is to visit a doctor or mental health professional. He or she can do an exam or lab tests to rule out other conditions that may have the same symptoms as depression. He or she can also tell if certain medications you are taking may be affecting your mood.

The doctor needs to get a complete history of symptoms. Tell the doctor when the symptoms started, how long they have lasted, how bad they are, whether they have occurred before, and if so, how they were treated. Tell the doctor if there is a history of depression in your family.

Medication

Medications called antidepressants can work well to treat depression. But they can take several weeks to work. Antidepressants can have side effects including:

• Headache
• Nausea, feeling sick to your stomach
• Difficulty sleeping and nervousness
• Agitation or restlessness
• Sexual problems.

Most side effects lessen over time. Talk to your doctor about any side effects you may have.

It's important to know that although antidepressants can be safe and effective for many people, they may present serious risks to some, especially children, teens, and young adults. A "black box"—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts, especially those who become agitated when they first start taking the medication and before it begins to work. Anyone taking antidepressants should be monitored closely, especially when they first start taking them.

For most people, though, the risks of untreated depression far outweigh those of antidepressant medications when they are used under a doctor's supervision. Careful monitoring by a professional will also minimize any potential risks.

Therapy

Several types of therapy can help treat depression. Some therapies are just as effective as medications for certain types of depression. Therapy helps by teaching new ways of thinking and behaving, and changing habits that may be contributing to the depression. Therapy can also help men understand and work through difficult situations or relationships that may be causing their depression or making it worse.

"I lost interest with the kids and doing things that we used to do. . . they'd ask their mother, ‘Why is Daddy not getting up and not wanting to do anything with us?' ‘Did we do anything?' They didn't do anything to me. I just didn't want to do anything."
—Rene Ruballo, Police Officer

How can I help a loved one who is depressed?

If you know someone who has depression, first help him find a doctor or mental health professional and make an appointment.

• Offer him support, understanding, patience, and encouragement.
• Talk to him, and listen carefully.
• Never ignore comments about suicide, and report them to his therapist or doctor.
• Invite him out for walks, outings and other activities. If he says no, keep trying, but don't push him to take on too much too soon.
• Encourage him to report any concerns about medications to his health care provider.
• Ensure that he gets to his doctor's appointments.
• Remind him that with time and treatment, the depression will lift.

How can I help myself if I am depressed?

As you continue treatment, gradually you will start to feel better. Remember that if you are taking an antidepressant, it may take several weeks for it to start working. Try to do things that you used to enjoy before you had depression. Go easy on yourself. Other things that may help include:

• See a professional as soon as possible. Research shows that getting treatment sooner rather than later can relieve symptoms quicker and reduce the length of time treatment is needed.
• Break up large tasks into small ones, and do what you can as you can. Don't try to do too many things at once.
• Spend time with other people and talk to a friend or relative about your feelings.
• Do not make important decisions until you feel better. Discuss decisions with others who know you well.

Where can I go for help?

If you are unsure where to go for help, ask your family doctor. You can also check the phone book for mental health professionals or check with your insurance carrier to find someone who participates in your plan. Hospital doctors can help in an emergency.

What if I or someone I know is in crisis?

Men with depression are at risk for suicide. If you or someone you know is in crisis, get help quickly.

• Call your doctor.
• Call 911 for emergency services.
• Go to the nearest hospital emergency room.
• Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (1-800-799-4889).

"It starts slowly and the only person you're talking to is yourself. You're lost. It's dark, the pain is twenty-four seven... you just want it to end... I'd drink and... I tried to numb my head... but you have to deal with it. It doesn't just go away."
—Patrick McCathern, First Sergeant, U.S. Air Force, Retired

"It affects the way you think. It affects the way you feel. It affects the way you love... It's just a blanket that covers everything... and it's one that's just so asphyxiating. And at times you just say it's enough already. It just feels like enough."
—Steve Lappen, Writer

NIMH publications are in the public domain and may be reproduced or copied without the permission from the National Institute of Mental Health (NIMH)

The Good, The Bad, and The Ugly

I have been med-free for about a month now and thought I would list out the good, the bad, and the ugly:

The Good:

-My moods have been manageable. The first week after the wean I had a lot of depression, but I forced myself to do some exercise every time I felt myself seeping down lower, and each time the physical activity helped to boost my mood back into a safe range. Sometimes that "exercise" was just jogging in place for a few minutes, and sometimes I managed to dance to a few songs. Either way, it definitely helped!  Mania is a little harder to tame without meds, but so far my little manic spurts have been brief and reasonable. No major episodes of rage like I had on the Paxil.

-In addition to discarding psychiatric medication from my system, I have also cleaned up my diet. I have removed sodas and other sugary substances, and have greatly reduced the amount of unhealthy fats. I drink 1-2 cups unsweetened tea a day and the rest of the time I drink water. My meals now consist of less bread and more fresh fruits and vegetables.  I have done away with foods that have suspicious ingredients. While we can't afford to buy all organic food, I am trying to prepare meals with as little processing and chemicals as possible. I won't lie; the first week of eating this way I felt like crap. But since then, I have felt so much better, mentally and physically! This is more than trying to lose weight; this is a new lifestyle, and I really feel good about it.

The Bad:

-Major, major trouble sleeping!  Even though I wasn't on anything specifically for sleep, my meds must have played a part in easier slumber, because going to bed is such a struggle now!  It's usually 2-4 a.m. before I can finally get some rest.  My goal this week is to learn of some natural ways to induce a more restful sleep at night; feel free to comment with your own tried and true antidotes.

The Ugly:

-I haven't written in nearly a month. This part doesn't really have much to do with my reprieve from medication. I was having trouble focusing before, so it's more of a constant problem that I have yet to find a solution for. It also has more to do with time limitations than anything else. I am preparing a pre-K lesson plan for my son to begin his first year of homeschooling this fall, so between that, spending time with him now and my other obligations, there is not a lot of free time to write these days.  I have a lot of ideas, just no time for follow through. Maybe I will reach a more balanced existence soon :)

So, there ya have it. Overall, I am feeling wonderful. As I have said in previous posts, going med-free isn't for everybody! Talk to your doctor before making any changes to your own regimen.

The Glass

A psychologist walked around the room while teaching stress management to an audience. As she raised a glass of water, everyone expected they’d be asked the “half empty or half full” question. Instead, with a smile on her face, she inquired:

“How heavy is this glass of water?”

Answers called out ranged from 8 oz. to 20 oz.

She replied, “The absolute weight doesn’t matter. It depends on how long I hold it. If I hold it for a minute, it’s not a problem. If I hold it for an hour, I’ll have an ache in my arm. If I hold it for a day, my arm will feel numb and paralyzed. In each case, the weight of the glass doesn’t change, but the longer I hold it, the heavier it becomes.”

She continued, “The stresses and worries in life are like that glass of water. Think about them for a while and nothing happens. Think about them a bit longer and they begin to hurt. And if you think about them all day long, you will feel paralyzed – incapable of doing anything.”

It’s important to remember to let go of your stresses. As early in the evening as you can, put all your burdens down. Don’t carry them through the evening and into the night. Remember to put the glass down!

~Author Unknown

*Pub on YCN*Awakening the Endorphins

I recently let my exercise regime slide (again!) while battling a nasty case of bronchitis, but now that I can breathe normally I am easing ever so slowly back into a more active lifestyle. My own struggles with maintaining a fitness program due to bouts of depression, physical injuries, and lack of motivation are not uncommon. I could do the research and spout out statistics on how many people exercise on a regular basis and how many don't, but you know as well as I do those numbers don't really help you in bettering your own health. And chances are, you already know all the reasons why exercise is good for you. The hard part is actually doing it.

Those first steps toward the seemingly unattainable goal of good health seem only suited for mammoth godzilla strides, but it's much easier to go about it with baby steps. Start where you are. If you've been spending most of your time under the covers as many of us do during an extended depression, make your first effort to get out of the bed and walk over to the window for some sunshine for a few minutes. Tell yourself you can go back to bed afterwards if you want, but make yourself take that little trip to the window. If you have been on the couch watching TV, decide to do some stretches or march in place during the commercials. Even if it's just during one commercial. Keep taking those baby steps until you can go for a walk, a swim, or visit the gym - whatever suits you the best. For me right now, it's dancing along with my toddler to Dance 4. Let me be honest with you: I am no dancer! I barely get any of the moves in sync with what is happening on the screen, and I make sure the curtains are drawn to avoid traumatizing the neighbors. But I sure do make my son laugh while I'm trying, and that makes me want to exaggerate my moves to make him laugh even harder. My eleven year old daughter joins in the fun a lot of times too, while my thirteen year old tells us how stupid we all look! Whatever it takes to get those endorphins pumping, people. Whatever it takes.

And you can do it, I know you can! The problem a lot of times is we have it in our heads that we have to start right off with an actual "workout", like there's a special code of conduct we have to go about to consider it real exercise, but there's not! Do what makes you happy, energized and pumped for the rest of the day. Don't fixate your fitness efforts on what you will look like in the mirror, because those results will likely take weeks, months, maybe even longer depending on what your ideal body looks like. Instead, focus on how it makes you feel. Apart from some sore muscles, perhaps, you will most likely feel a spark of energy as your blood gets flowing due to movement, followed by a sense of confidence and wellbeing.  That's the endorphins talking, so listen in and keep doing what they like.  And don't forget to drink some water!

It is a cruel shame that many of the health issues that are improved by exercise (like depression, obesity, and fibromyalgia, for instance) are the very same ones that make it so hard to get up and get started in the first place! When you see no point in living, you see no point in taking care of yourself. When every joint in your body aches, you don't feel like moving any more than you have to. When regular daily activities cause you to be short of breath, it seems impossible and even scary to push yourself to do more. It's situations like this where you need to be upfront with your doctor. Express your concerns and ask for practical approaches to better health. Certain activities may cause you more harm than good, so please get a medical okay before doing anything strenuous!

Even small steps may be difficult at first, but it is worth it! Now, excuse me while I go exercise my two left feet...

My On Again-Off Again Relationship with Medication

Yesterday I asked at my Facebook page "What is the worst side effect you have ever had from a medication?" There were numerous responses, many of which I have also experienced from medications at one point or another. It's more than a little unfair that the drugs we are given to help us overcome an ailment of some sort can so often produce another ailment, sometimes much worse than the initial problem we were having!

My last post on this site admitted my recent self-wean off of one of my medications. I vowed to keep taking the drug, despite its inconvenient side effects, at least until I spoke with my doctor. But, since that post I have slowly weaned myself off all of my medications.

I'm not sure how I feel just yet. I have been a little weepier at times, and I *may or may not* be hallucinating (I am convinced the house I am living in is haunted, and I really don't think it's just a mental health issue).

I am also convinced the meds are only stifling me at this point. Rather than making day-to-day functioning easier, I feel like the drugs are creating more issues than they erase. It's a personal decision, and I am an adult, albeit a little unreasonable and delusional at times. I am certainly not suggesting anyone reading this follow in my footsteps and discontinue your medications. I am not endorsing that at all! I will repeat, this is a personal choice. Not a recommendation!

Having said that, I know my own personal history with mental illness. My bipolar symptoms tend to take a hiatus every now and then, and flair up at other times. The schedule seems to usually run as two years on, two years off. I have always been a strong believer in only taking medication when it is truly needed. Many might disagree with me, and they may very well have right to do so. But for me, I take the drugs to decrease debilitating symptoms, because at those times I really can't function without them. The side effects are a drawback, but they are better than the alternative...but then the tables flip and as my symptoms decrease so does my patience for those side effects.

But how do you know when you will be safe to wean off your medication when it may actually be the drugs' effectiveness giving you a false security of wellness?  It's a valid question, and that is why it's so important to speak with your doctor before making any drastic changes like this. Personally, I don't really know, but at the same time I do. I just get this feeling, the stifled feeling, and it prompts me to reevaluate my mental health status. This is not medically sound advice, because often when we "just know" that we are alright without treatment that is when we are the most unwell. It's easier to tell if a drug is working for, say, high blood pressure or a cold. You are certain of the symptoms present, and you are certain of what your recovery should feel like. With mental illness it's a lot trickier. Your mind is the ill piece, and this affects emotions and thought processing. It's hard to know exactly what the outcome should feel like. "Better", you say, and we all know what that means: a lack of the symptoms that produced this sense of misery in the first place. But would you trade a limp for an amputation? That's often what it can seem like, mentally speaking, when side effects rob you of even more of your abilities than the illness. It all comes down to input/output. How is what you are putting in your body affecting what is coming out? Of course, I don't mean bodily fluids, though the drugs can definitely make those a bit kooky at times too! But coming out as in meaning, how are you feeling? How do the people around you, the ones who know you the best, rate your behavior? How are you handling daily stressors? Do you feel like "yourself" or like the real you has been medicated away?

Most importantly, could something besides medication have the same or better success at controlling your most troublesome symptoms? Just like healthy lifestyle choices can help stabilize blood sugar in diabetes, it can make a huge difference in mental illness as well. Sometimes medication will still be needed to tame the worst of the illness, and sometimes it won't. But I think our biggest problem is that we seek an easy solution, a magic pill, that is going to make everything fine and dandy without much effort on our part. But medicine is more like a crutch than a new leg. It can be the support that helps you stay stable, but by itself pills are not a cure-all. I was going to type out a list of things that contribute to the wellness factor, but then a friend forwarded me 6 Steps Toward Resilience & Greater Happiness and it points out all the things (and a few more) that I would have mentioned, so that saved me some time :)  I highly recommend you read this useful material. And don't just read it; apply it to your life. Make an honest effort to get enough sleep, eat well, exercise, nurture relationships, seek out your purpose, and practice gratitude. See if it makes a difference. Then, if you begin questioning the need for medication, it's time to discuss things with your doctor and determine whether a med-free life is achievable for you. There is no shame in taking medication if you need it. Just because someone tells you how wonderful they feel without the meds, it doesn't mean that you will have the same results. But if you are struggling with side effects, even after your doctor has changed your medications several times, then it may be something to research.

I don't know how long I will go med-free this time around. It may be a couple of years, or I may have to resume them next week. Time will tell. It's been a rocky relationship, and I think it always will be.