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An exploration of cultural, psychological and biological aspects of male depression.
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MEN & DEPRESSION
Andy Novinska, LCPC, CADC
Illinois Institute for Addiction Recovery
at Advocate BroMenn
Disclaimer
The following presentation contains some generalizations and stereotypes which may/may not offend/validate what you know/may know about men.
This information may lead you to pathologize your sons, brothers, boyfriends, husbands, grandparents, postman, waiter, and/or any other male figure in your life.
Consume with care.
Born in the U.S.A.
Masculine
Independent
Logical
Strong
Assertive
Adventurous
Feminine
Dependent
Emotional
Weak
Passive
Cautious
Patriarchy
American Heritage Dictionary
A social system in which the father is the head of the
family and men have authority over women and
children.
A family, community, or society based on this system or
governed by men.
Psychological Patriarchy
Defining relationships between two sets of human qualitiesHow Can I Get Through to You? Reconnecting Men and Women, by Terrance Real
Men and Women are both:
Independent and Dependent
Logical and Emotional
Strong and Weak
Assertive and Passive
Boys Learn
Hide or disconnect from feelings/emotions
Don’t ask for help (or admit you need help)
Stand up for yourself (be aggressive)
Don’t be a...
Sissy
Wimp
Sally
Punk
Etc…Real Boys : Rescuing Our Sons from the Myths of Boyhood by William Pollack and Mary Pipher
Be tough, big boys (real men) don’t cry
Emotional Life of the Male
In general…
Emotions live in the background of a man’s life and the foreground of a woman’s.
Men compartmentalize and intellectualize more.
Men experience a harder time interpreting unspoken messages in gestures, facial expressions and tone of voice
Men react less intensely to emotions — and forget them faster
The Lazy Husband by Josh Coleman, PhD
Societal norms/culture, politics, biases/prejudices, religion, temperament, etc., all influence our emotional lives
Stoic Man
Stoicism
1. indifference to pleasure and pain
2. (Philosophy) (capital) the philosophy of the Stoics
stoicism a form of conduct conforming to the precepts of the Stoics,
especially as characterized by indifference to pain and pleasure.
"Inside every man is a secret fear that he lacks competence and
courage, that he's not as manly as he should be. A man knows he is
supposed to take a bullet for his family. A man knows he is supposed
to fix whatever gets broken. When he's feeling powerless, when
everything he says seems to be the wrong thing, he shuts down and
withdraws. “Mark Goulston, MD, co-author of The 6 Secrets of a Lasting Relationship
Prefrontal Cortex The impulse control center of the brain, the part of the brain
that helps us consider the consequences of our actions . This
region is not fully developed until the early to mid 20’s in
males.
Assess for:
Drug and Alcohol
Head trauma Fighting
Sports
Accidents
Abuse
The Brain
The Male Brain
Men are hard-wired differently
The connection between the left brain (logic) and the right
(emotion), is much greater in women.
“Women have the equivalent of an interstate highway, so they
move readily between the right and left brains. For men the
connection is like a meandering country lane, so we don’t
have such ready access to feelings.”
David Powell, PhD, president of the International Center for Health Concerns
All things considered equal, vision trumps all senses with
men even more visual that women.
The Brain
Mirror Neurons
A neuron that fires when we act out a behavior OR when we observe a behavior in another
Social behaviors
Empathy
Language
In humans, brain activity consistent with that of mirror neurons has been found in the premotor cortex, supplementary motor area, primary somatosensory cortex and the inferior parietal cortex
"The mirror-neuron system“, 2004, Annual Review of Neuroscience
Depression Basics
Every year depression affects approximately 19 million Americans, or 9.5% of the U.S. population
Six million American men will be diagnosed with depression this year
At some point in their lives' 5-12% of men will become clinically depressed
National Institute of Mental Health (NIMH)
Abraham Lincoln
“I am now the most miserable
man living. If what I feel were
equally distributed to the whole
human family, there would not be
one cheerful face on the earth.
Whether I shall ever be better I can
not tell; I awfully forebode I shall not.
To remain as I am is impossible; I must
die or be better, it appears to me.”
Adult Symptoms of Depression
Depressed mood most of the day, nearly every day
Markedly diminished interest or pleasure in all, or most activities, most of the day, nearly every day
Significant weight loss/gain or significant decrease/increase in appetite nearly every day
Insomnia or Hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive/inappropriate guilt
Diminished ability to think or concentrate, or indecisiveness, nearly every day
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
Feminizing Depression
“If modern psychologists were shown to understand how men's emotions affect their behaviors, it's only because their predecessors long ago decided that having a uterus was the main risk factor for mental illness. During the last two centuries, depression was largely viewed as a female problem, an outgrowth of hormonal fluctuations stemming from puberty, childbirth and menopause”
Julie Scelfo, Newsweek, Feb. 26, 2007
Feminizing Depression
“We tend not to recognize depression in men because the disorder itself is seen as unmanly. Depression carries, to many, a double stain-the stigma of mental illness and also the sigma of feminine emotionality”
Terrence Real
“Male” Symptoms of Depression
Frustration & Irritability
Anger & Aggression
Risky Behaviors (reckless driving, acting out sexually, gambling, etc.)
Alcohol or Substance abuse
Physical Ailments (pain, digestive issues, headaches)
Overworking (“workaholic”)
Excessive Television (sports)
Excessive Gaming or Internet Use
“As I reflect on over 30 years of clinical experience, I am appalled at the
realization that I have misdiagnosed male depression many times” Dr. Archibald Hart Psychologist and Author of Unmasking Male Depression
What's at Stake?
“Children of depressed parents have high rates of depression and anxiety disorders that are impairing and reoccur over the course of their lives"
Myrna Weissman, Ph.D.
Children with depressed parents have three times the rate of anxiety disorders, major depression, and substance use disorders
Adult children whose parents were depressed have about five times the rate of cardiovascular illness as children of non-depressed parents
Twice as many kids of depressed parents (19 percent) developed an addiction to drugs or alcohol, as did those of non-depressed parents (8 percent)
Offspring of Depressed Parents: 20 Years Later, 2006
Men & Depression: Facing Darkness, Newsweek, 02/2007
Men & Suicide
Although women attempt suicide more often than men, men are four times as likely to complete suicide
Men take an average of just 12 months to go from contemplating suicide to attempting suicide.
National Institute of Mental Health (NIMH)
Cause of Death?
Suicide
Covert Suicide (staged accidents)
Accidents (due to high risk behaviors)
Neglect of overall health
Violence/Homicide
Strokes
Heart Attack
____________________
Heart Disease and Depression
People with heart disease are more prone to develop
depression
People with depression are more likely to have heart
disease than otherwise healthy peopleNational Institute of Mental Health (NIMH)
Men with depression and heart disease are two to three
times more likely to die than men with heart disease who
are not depressed (3)
Men and Depression: New Treatments, Newsweek 02/2007
Working with Men
Assess for other disorders such as:
Anxiety, PTSD, sexual impulsivity, gambling issues
Be careful of jumping to axis II
Explore family history
Use a concrete tool such as the LEQ
Discuss male role models
Including athletes and media figures
Teach the language of emotions
Work with the left brain!
Working with Men
Talk “side-by-side”
Physically getting in a man’s face makes may trigger confrontation (watch personal space)
Coping skills
Exercise! Release stress and manages anger (cortisol goes down, dopamine and endorphins go up)
Diet
Hobbies/Interests
Painting, playing a musical instrument, woodworking, etc.) can tap into a man’s emotions
Explore parenting and partnering skills
Look for mentors (even surrogate ones!)
Thank You
Andy Novinska, LCPC, CADC
Illinois Institute for Addiction Recovery
at Advocate BroMenn