The tragic death of Mark Wylie, Security Professional, Former Police Officer and Recipient of the Medal of Valour, has once again turned the spotlight onto the issue of mental health and depression. Mark’s unfortunate passing serves as a reminder that it is often hard to see depression in others, and that many men suffer in silence, mistakenly believing that seeking help is either weak, something other people do, or not necessary in their case.
Depression is a serious issue amongst men in Australia. On average, one in eight men will have depression at some stage of their lives and one in five men will experience anxiety.
While women are more likely to experience depression and anxiety, men are less likely to talk about it. This increases the risk of their depression or anxiety going unrecognised and untreated.
Depression is a high risk factor for suicide and, in Australia, there are approximately 2,200 suicides each year. 80 per cent are by men – with an average of five men taking their lives every single day. Suicide is the leading cause of death for men under the age of 44, significantly exceeding the national road toll.
It is important to remember that depression and anxiety are illnesses, not weaknesses, and effective treatments are available. Taking action may not be as hard as you think.
In general, men tend to put off getting any kind of help because they think they are supposed to be tough, self-reliant, able to manage pain and take charge of situations – especially those people in the security industry with military or law enforcement backgrounds. This can make it hard for men to acknowledge they have any health problems, let alone a mental health problem.
But depression is a serious and common condition that will not get better by itself. If you had a broken arm or a deep cut on your foot, you would not expect that to heal without medical help. So depression should not be treated any differently.
What is depression? How is it different to just ‘being sad for a bit’?
Men are more likely to recognise and describe the physical symptoms of depression (such as feeling tired or losing weight) than women. Men may acknowledge feeling irritable or angry, rather than saying they feel low. Everyone feels ‘down’ occasionally but if you have been sad, moody, angry or unable to sleep or concentrate for more than a couple of weeks, it could be depression. You might also lose interest in work, sport, sex, going out, or other things you used to enjoy.
Depression is very common, with one in eight men experiencing it at some stage of their life. You need to know the signs – not only for you, but also for your mates, work colleagues and family. A person may be depressed if, for more than two weeks, he or she has felt sad, down or miserable most of the time or has lost interest or pleasure in usual activities, and has also experienced several of the signs and symptoms across at least three of the categories below.
It is important to note that everyone experiences some of these symptoms from time to time, and it may not necessarily mean a person is depressed. Equally, not every person who is experiencing depression will have all of these symptoms.
Behaviour in people with depression can change from their usual patterns to exhibit new behaviours, such as not going out anymore, not getting things done at work, withdrawing from close family and friends, and relying on alcohol and/or sedatives. Furthermore, you may find that the person in question, be it you or someone else, no longer enjoys doing things or engaging in activities that were previously enjoyable, in addition to being unable to concentrate on things.
People experiencing depression can be prone to feelings of being overwhelmed, feeling guilty, irritable and/or frustrated. They may be lacking in confidence while feeling unhappy, indecisive, disappointed, miserable and/or sad.
People suffering depression tend to experience negative thoughts, such as ‘I’m a failure’, or ‘It’s my fault’. They may think ‘Nothing good ever happens to me’, and that ‘I’m worthless’. Worst of all, these thoughts and feelings can often lead to a belief that ‘Life’s not worth living’, and ‘people would be better off without me.’
Such thoughts and feelings are often accompanied by physical symptoms, such as being tired all the time, sick and run down along with experiencing headaches, muscle pains and a churning gut. This can be compounded by sleep problems, a loss or change of appetite, and significant weight loss or gain.
It is important to note that there are different types of depressive disorders. Symptoms can range from relatively minor (but still disabling) through to very severe, so it is helpful to be aware of the range of disorders and their specific symptoms.
Major depression is sometimes called major depressive disorder, clinical depression, unipolar depression or, simply, depression. It involves low mood and/or loss of interest and pleasure in usual activities, as well as other symptoms, such as those described earlier. The symptoms are experienced most days and continue for at least two weeks. The symptoms interfere with all areas of a person’s life, including work and social relationships. Depression can be described as mild, moderate or severe; melancholic or psychotic (see below).
This is the term used to describe a severe form of depression where many of the physical symptoms of depression are present. One of the major changes is that the person can be observed to move more slowly. The person is also more likely to have a depressed mood that is characterised by complete loss of pleasure in everything, or almost everything.
Sometimes people with a depressive disorder can lose touch with reality and experience psychosis. This can involve hallucinations (seeing or hearing things that are not there) or delusions (false beliefs that are not shared by others), such as believing they are bad or evil, or that they are being watched or followed. They can also be paranoid, feeling as though everyone is against them or that they are the cause of illness or bad events occurring around them.
Bipolar disorder used to be known as ‘manic depression’ because the person experiences periods of depression and periods of mania, with periods of normal mood in between.
Mania is like the opposite of depression and can vary in intensity – symptoms include feeling great, having lots of energy, having racing thoughts and little need for sleep, talking fast, having difficulty focussing on tasks, and feeling frustrated and irritable. This is not just a fleeting experience. Sometimes the person loses touch with reality and has episodes of psychosis. Experiencing psychosis involves hallucinations (seeing or hearing something that is not there) or having delusions (e.g. the person believing he or she has superpowers).
Bipolar disorder seems to be most closely linked to family history. Stress and conflict can trigger episodes for people with this condition and it is not uncommon for bipolar disorder to be misdiagnosed as depression, alcohol or drug abuse, Attention Deficit Hyperactivity Disorder (ADHD) or schizophrenia.
Diagnosis depends on the person having had an episode of mania and, unless observed, this can be hard to pick. It is not uncommon for people to go for years before receiving an accurate diagnosis of bipolar disorder. It can be helpful for the person to make it clear to the doctor or treating health professional that he or she is experiencing highs and lows. Bipolar disorder affects approximately two per cent of the population.
Cyclothymic disorder is often described as a milder form of bipolar disorder. The person experiences chronic fluctuating moods over at least two years, involving periods of hypomania (a mild to moderate level of mania) and periods of depressive symptoms, with very short periods (no more than two months) of normality between. The duration of the symptoms are shorter, less severe and not as regular. Therefore, they do not fit the criteria of bipolar disorder or major depression.
The symptoms of dysthymia are similar to those of major depression but are less severe. However, in the case of dysthymia, symptoms last longer. A person has to have this milder depression for more than two years to be diagnosed with dysthymia.
Seasonal Affective Disorder (SAD)
SAD is a mood disorder that has a seasonal pattern. The cause of the disorder is unclear; however, it is thought to be related to the variation in light exposure in different seasons. It is characterised by mood disturbances (either periods of depression or mania) that begin and end in a particular season. Depression which starts in winter and subsides when the season ends is the most common. It is usually diagnosed after the person has had the same symptoms during winter for a couple of years. People with Seasonal Affective Disorder depression are more likely to experience lack of energy, sleep too much, overeat, gain weight, and crave carbohydrates. SAD is very rare in Australia and more likely to be found in countries with shorter days and longer periods of darkness, such as in the cold climate areas of the Northern Hemisphere.
It is not easy to say exactly what causes depression and anxiety – it is different for everyone. Sometimes a difficult time in you or your mate’s life can set off depression or anxiety, sometimes it is caused by a combination of things that has built up over time and, sometimes, there is just no obvious cause at all.
Some risk factors for men developing depression or anxiety include:
- physical health problems
- relationship problems
- employment problems
- social isolation
- significant change in living arrangements (e.g. separation or divorce)
- drug and alcohol use.
Dealing With Depression
Depression and anxiety are like any other medical condition – you need ways to get through them and stop them happening again later on.
Some people think that it is weak to admit that they are going through a tough time. But if you have depression or anxiety, you cannot just ‘snap out of it’ or ‘pull yourself together’. There is much more to it than that.
If you think that you have some the symptoms described above, start by talking to someone you trust – keeping it to yourself only makes things worse. Discuss your situation with a mate, partner, family member, or a colleague.
A doctor is also a good source of information and can assess whether what you are feeling is depression or anxiety, and then work out an action plan with you if it is.
Your action plan can cover a wide range of options. This plan can include exercise, stress management, how to improve your sleep and maybe working with a psychologist who can help you to address things like negative thinking and how to deal with hassles in your relationships.
For some people, medication might also be necessary, but only if the depression or anxiety is severe or has not improved with other treatments. Most people using medication report a significant improvement in their condition, and a greater capacity to get back to the things they used to enjoy. Find out about all the treatment options for anxiety and depression. There are a number of different health professionals on hand to provide advice or services if you are experiencing depression or anxiety. Find out who is who and what they do.
In addition to all this, there are lots of things you can do to help yourself recover. Things like staying active and making plans for the day – they do not have to be grand plans, just small things like going for a run, talking to a mate or doing some gardening. Try to include things or hobbies that you specifically enjoy. At first, you may not enjoy them as much as you did before, but if you keep active and persist, the pleasure should eventually return.
It is also important to look after your body by staying physically active, eating healthily and getting plenty of sleep. Try not to drink alcohol or take drugs to block out how you are feeling and what is happening – this is not a positive solution and only makes the depression or anxiety worse. Learn more about recovery and tips for staying well.
If you think you or someone you know might be suffering from depression, you can call the beyondblue help line on 1300 22 46 36. They have trained professionals on standby any time of the day or night. Simply select from the voice menu or simply hold on the line to talk with a trained mental health professional.
They are there to listen, offer support and point you in the right direction for the cost of a local call (could be more from mobiles).
Alternatively, some people may not feel like talking on the phone, so why not chat to a professional online? Beyondblue have people available online from 3:00pm to 12:00am (AEST) every day. To get started, simply visit the beyondblue website www.beyondblue.org.au and click ‘Chat online’.