More threads by HA


More awareness means help for depressed men
Improved therapies and medications ease disruptive symptoms

By Terri Yablonsky Stat
August 14, 2007

While many women don't hesitate to confide their troubles to a hairdresser, friend or even complete stranger, men shoulder the reputation of being more reluctant to share their blues. Their depression may be manifested in obvious ways, such as being suicidal, but they also hide their pain, letting it escape through irritability, anger or lethargy.

This reluctance to seek help has been borne out for years in health surveys showing that men prefer to tough it out, whether medically or emotionally, even to their detriment.

But that seems to be changing as more men seek help for depression.

"There's been a recent focus on mood disorders in men in the popular media in the last five years," said Sam Cochran, a clinical professor of counseling psychology at the University of Iowa in Iowa City. Cochran credits a new candor in men's magazines and by public figures such as journalist Mike Wallace and baseball player Mark McGwire, who have come forward to say they got help for depression.

Lack of recognition

There also has been an increasing awareness by health professionals that depression in men has gone unrecognized for a long time, Cochran said, adding, "Men don't come in and say in so many words, 'I am depressed.'"

In the last 10 to 20 years, much better treatments for depression and proven psychotherapies have been developed, Cochran said. All in all, "our culture is a little more friendly to men seeking help."

Evanston Northwestern Healthcare has seen a dramatic increase in the number of men seeking therapy, rising to 46 new male patients in July this year from 29 in July last year.

"Thirty years ago, most patients seeking help for depression were women, while now over half are men," said Robert Farra, coordinator of the ENH Mood and Anxiety Disorders Program.

Farra has started a cognitive-behavioral therapy group for depression, composed mostly of men.

Different signs

Men show depression differently than women, Farra said. Men may have little energy, are irritable and angry and lose interest in work and hobbies. Some turn to alcohol and other drugs, others work overtime or overeat. "The children know dad is very cranky, and the spouse knows something's wrong," Farra said.

"Many men don't know they are suffering from depression," Farra added. "It's usually not until they visit their primary-care physician that they learn they are experiencing depression."

David Maltenfort, 40, a network administrator who lives in Evanston, sought help for depression after feeling irritable, withdrawn and lethargic. "One of the real problems with depression is it's like this entity that doesn't want to be found out," he said. "Its purpose is to make somebody miserable and to propagate itself."

After seeking help through therapy and the ManKind Project, an international support organization for men, Maltenfort has noticed a big improvement, he said. "Men are taught to take care of their own problems, but that doesn't work," he said. "We can't do this by ourselves, and that's not being weak. It's stronger to ask for help than to try to do it by yourself."

The ENH support group helps people see how thoughts influence their feelings and behaviors. "We teach people to analyze their thinking and to identify the habitual and problematic way of thinking that keeps symptoms going," Farra explained. "We help them change ways of thinking."

Men in the group can make significant changes. Antidepressants also help reduce anger and upset, but they're not always enough.

"In this group we talk about the present," Farra said. "Dwelling on the past doesn't help much. We look at thinking patterns that lead to depression. For example, someone may have the core belief that he must win the approval of others or he doesn't feel good. There's no end to that. It ends up being frustrating because we know it's impossible."

Participants learn to affirm themselves. "We change the focus of control from outside the person so you're the one who evaluates how you're doing," Farra said. "If there is something you do that upsets the boss, you don't have to take that as a major blow but put it in perspective. You can say, 'I did my best, yes I made a mistake, but the problem isn't me; [it's] the intervening variables that caused the problem.'"

Men will blame their partner, the boss, the kids for how they feel. "None of that is true," Farra said. "If the lens through which we see the world is colored by depression, then everything we do is going to be influenced by that."

Women seek help for depression a lot sooner than men and are not afraid to admit they feel miserable and don't know why, Farra said. "Men have no forum for sharing, to air these things and realize that others think and feel the same way they do. There's real comfort in that, and then they can make changes in the way they think."

Expressing feelings

A movement centered on helping men get in touch with their feelings has emerged, allowing them to be vulnerable. "Sometimes men recognize that instead of being isolated, it's good to have men friends to be open and honest about thoughts and feelings," said Richard Reid, a counselor who leads the Oakton Community College men's support group.

"Men have been enculturated to feel competitive and the breadwinner and appear like we have all the answers and know what we're doing," Reid said.

For more information about the ENH support group, call 847-425-6400, or the Oakton group, phone 847-869-2983. The Chicago branch of ManKind Project is at 312-243-6743. And another program offering retreats and support groups for men is Victories of the Heart at 312-604-5013.
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