Monday, October 31, 2005

Melancholy Monday: Masculinity is a Health Risk

While there is plenty to be melancholy about today on this day of bad, bad, dastardly SCOTUS appointments, I am going to write about something less obviously political.

I want to write about male depression. I happen to be around a lot of depressed men lately and what really saddens me about them is their inability to reach out for help. For example, the other day, I had a long conversation with a close male friend about why I thought he might value some therapy. He has serious stuff to deal with: what career route to take, how to meet child support obligations, how to deal with an ex-wife who is still really vindicative and willing to render him penniless as payback, and poor working conditions. He is in the shit. When I proposed he considered therapy, his response, rather hostile:

"No, no, no. Therapy is bullshit. I have been in therapy before and it didn't work."

I respond: "Well, you have been in relationships before that didn't work and you didn't give up on the possibility of a fulfilling partnership. You have had bad teachers, but you didn't give up on education did you?"

The conversation died just there. This is a man, mind you, who is perfectly willing to take medication. But, talk therapy, no. It won't do any good to talk about his problems. He doesn' t want to think about them.

What is his strategy for coping? Further isolation. He doesn't want to get too close to others because he thinks that he should devote all of his free time to his career. He told me once that if he is failing in his career, then he has nothing. His entire identity is bound up with his ability to succeed.

In his mind, this is how he can best be a parent to his children after a divorce. If he gives up at his career to move closer to them, and takes a less prestigious job, he thinks he is not a good role model for them. There are other reasons at work there (not wanting to further cave into a demanding and manipulative ex-wife), but the job thing is pretty huge. He also thinks that supporting his children financially is his most important responsibility as a father.

The fact is, he is missing out on their lives. He sees them 6 times a year and has intermittent conversations on the phone, that only reinforces his pain.

What do I think would be the value of therapy? Well, I don't think that therapy will cure the pain and resolve the regret of divorce. What I do think will be valuable is that he can talk to someone who is not mired in the stress and pain that he is in, can look at the decisions he has to make unburdened by that weight, and give him some helpful advice with prioritizing and solving problems.

Men are 4 to 6 times more likely (depending on the study you read) to commit suicide than women are. While women are far more likely to be diagnosed as depressed and treated in both talk therapy and with medication, men's depression ends far more tragically.

Men are not supposed to show weaknesses, be slowed down by their emotional lives in ways that affects work. Men are also not encouraged very often to talk to others (besides, their sisters or girlfriends) about what is weighing them down.

Women, however, are quite good at sharing their frustrations, stresses, hurts, anxieties and fears. Women friendships are often built around these sorts of discussions. In fact, it is likely that women have an easier time just living with their depression, accepting it, because they have support systems.

Men are in danger of isolating themselves to the point of no return. They spiral further and further into self-doubt, anger, violence, sometimes addiction until they look for some permanent (although rash) way out.

This is a real tragedy and a serious way in which men are penalized and made ill by the cultural expectations of masculinity.

When I fail in my efforts to encourage my depressed male friends and relatives to get help, I just feel hopeless. I know that some men will seek out help; some will realize when they need others to help them make better decisions and cope with stress. But, lately I am constantly reminded of the men who do not and it is rather sad.

Depression in men often looks a lot like aggression. It strains, or breaks their ties to the nurturing compassionate relationships they desperately need with others.

We do not function well outside of supportive relationships and when we break those ties we put ourselves at great risk.