How do you know that behind a man’s smile lies a dark cloud that weighs down on his soul?
Recently, one of our mentors in medical school committed suicide. Everyone was shocked. He was the happiest lecturer we knew and he had international accolades for his clinical and scholarly contributions to medicine. He was a loving husband, a doting father and his career was heading for the stars. We thought he had achieved everything we all hope to accomplish as doctors. After his death, we learnt that he suffered from clinical depression. Behind his smile, lay a dark cloud that weighed down on his soul. The question that we all asked ourselves was, ‘how come we did not recognise that he was depressed?’
Depression is one of the most common mental health problems among men. Unfortunately, it goes undiagnosed because most people do not recognise the symptoms.
Depression affects men and women differently. However, there are some common features among both sexes.
There are some more predominant in men.
Signs, symptoms in men
The angry man
Although depression in men can manifest as sadness and moodiness, it can also come with extreme anger. Typically, everyone avoids an angry man because he is always irritable. In the office, he is the boss who is consistently critical of his team and colleagues — nothing seems to please him.
At home, his family recoils because he snaps at everyone. His children would rather interact with their mother as opposed to dealing with him. His wife cannot have a rational discussion with him without being put down. These men also suffer from frequent bouts of road rage.
Reckless, compulsive behaviour
Men with depression engage in inappropriate behaviour such as reckless driving, dangerous sports or past-times, and unsafe sex. Some gamble their wealth, ignoring the needs of their dependants.
The abusive man
Some men become physically, verbally and emotionally abusive. They also develop control issues and harass those close to them. They are hypersensitive and lose their sense of humour.
Most men look for something to immerse themselves in to try and cope with depression. For some, they opt to drown themselves in work. This man is always the first one to arrive in the office and the last one to leave. He always carries work home.
Even his supervisors often encourages him to go home and relax, he consistently brushes the unhealthy habit off. He would rather immerse his thoughts in work rather than deal with his mental and emotional problems. (But not all workaholics are depressed).
Alcohol and drug abuse is another common coping mechanism for depressed men. Unfortunately, drugs and alcohol have a downward spiralling effect in a depressed person. (You drink because you are depressed then the depression worsens because you realise that you are ruining your life. You then drink even more to drown out the feelings of hopelessness — it is a vicious cycle).
The sickly man
One may experience headaches, unexplained abdominal and chest pain, weight changes (more often, there is weight loss) and a racing heart (palpitations). Usually, medical tests do not reveal the cause of the problem and treatment by conventional means is often unsuccessful.
Sexual dysfunction, sleep issues
Most men with depression either sleep too little or too much. They may also lose interest in sex and develop erectile dysfunction. Usually, the decreased libido has nothing to do with their sexual partner, depression causes one to lose interest in things that were previously enjoyed.
Poor work performance
Depression significantly affects one’s mental capacity. Depressed men have low concentration levels and are consistently tired. In addition, they are always unhappy and unable to interact with colleagues. All these factors contribute to reduced work performance.
Some choose to isolate themselves from friends and family. The usual excuse when confronted about it is, ‘I’ve been very busy’. In addition, they neglect hobbies and social activities.
Why is depression in men not diagnosed early?
Most family members and colleagues do not recognise depression in men. Even doctors may fail to see the signs of depression in a man because they do not always present in the classic way. Most men are also reluctant to discuss mental and emotional problems. They have been brought up to believe that it is ‘unmanly’ and inappropriate. They fear that they will lose the respect of their family, friends and workmates. For this reason, they often downplay and mask any symptoms of depression rather than come out and ask for help coping with it. Most Kenyan families resist mental health treatment. They believe that one only visits a psychiatrist if he is ‘mad’.
In addition, most employers have a bias towards employees with mental health problems. This forces employees to hide their mental health issues from their employers because they risk damaging their careers. Stigma: there is a lot of stigma surrounding mental illness. No one wants to be labelled as ‘the man with depression’. Ignorance: there is little awareness on mental health issues. People do not realise that depression is no different from diabetes or hypertension and all need treatment.
Although it is important to be supportive of a spouse suffering from depression, do not tolerate abuse. Angry, abusive, depressed men have maimed and killed their partners. In addition, emotional abuse can leave one scarred for life.
Clinical depression can consume one’s mind and the dark thoughts and emotions become too overwhelming.
If a man around you exhibits suicidal tendencies or attempts suicide, do not put him down or ask him to ‘suck it up and deal with his emotions like a man’. His behaviour is a cry for help, do not ignore it. Look at the men around you. Could they be suffering from depression? If so, reach out and help them. It could save their lives.