Given that women are twice as likely to suffer with depression as men, there is a tendency – even in clinical diagnosis – to associate depression with symptoms more likely reported by women. These include sadness, hopelessness, trouble sleeping, changes in appetite, loss of interest in people and activities, and suicidal thoughts. According to the STAR-D study, there are physical differences in the overall pattern of depression symptoms between men and women which may go unnoticed: Whereas both men and women may report low mood as a symptom of depression, women are more likely to gain weight while men are more likely to lose weight; women report symptoms associated with anxiety while men report symptoms associated with obsessive –compulsive disorder; women feel less energetic and men typically feel agitated; and men are more likely to develop alcohol or substance abuse in conjunction with major depression. In his cross-cultural research on depression, Jules Angst, MD found that both men and women reported stress as a cause of their depression. Whereas women cited family as the primary source of stress, men were more likely to cite work and unemployment.
- Whereas women choose to share and disclose their stress as a way of seeking help, men are far less likely to disclose stress to others. More common in men than women, depression is often reflected in stress headaches, stomach problems and chronic pain – Something missed by men as well as the people around them.
- Also more common in men is the masking of feelings with anger, irritability or changes in behavior, such as becoming controlling and, in some cases, abusive or violent. It is unlikely that a partner will move closer to support someone whose pain is hidden by angry put-downs or abuse. By Suzanne Phillips, PsyD
about as close
as you get to
What makes depression in men so dangerous? It too often goes unrecognized and untreated because it is masked by physical complaints, substance abuse, anger and other stealth symptoms.
• Undiagnosed depression is the leading cause of suicide. Men are four times more likely to die by suicide than women.
• Depression is highly associated with cardiovascular disease, heart attack and stroke. Men develop these diseases at a higher rate and earlier age than women.
• Depression is the most common disorder suffered in conjunction with post-traumatic stress disorder (Ursano, Grieger, and Mccarroll, 1996)
• In a recent RAND Corporation study, one in five veterans of Iraq and Afghanistan reported symptoms of combat stress or major depression. In turn, service members with such problems more often report heavy drinking or illicit drug use.
• National Highway Traffic Safety Administration (NHTSA) statistics reveal that the number of boomer-aged men dying behind the wheel rose from 2000 to 2009. Analysis showed men are three times as likely to be intoxicated when getting into a fatal accident as women.
A mix of biological and cultural factors often conspires to keep men and those who love them from recognizing and addressing their depression. By Suzanne Phillips, PsyD
One in six people suffer depression
or a chronic anxiety disorder.
These are not the worried well
but those in severe mental pain
with conditions crippling enough
to prevent them living normal lives.
Most people with addiction problems feel that they have a disease. Alcoholics Anonymous, Narcotics Anonymous and Gamblers Anonymous all see addiction as a disease. Professionals mostly feel that the situation is more complex than this. It must be recognized that viewing addiction as a disease helps many people to overcome their problem. The evidence for biological and genetic factors being important in addiction bolsters the illness argument, but there is also evidence for social and psychological factors being important. Low levels of serotonin – a brain chemical – appear to be an important cause of addiction. ‘Drugs of solace’ may increase serotonin levels and depressed people take them for this reason. Alcohol raises serotonin levels in the short-term, but the levels fall in chronic alcoholics. Ecstasy produces the same effect. Cigarettes may increase serotonin levels, adding to their addictive properties. Gambling problems also seem to be associated with low levels of serotonin. Low levels of serotonin may be the result of inheritance, but low status in society also seems to reduce serotonin levels. Drug and alcohol abuse is more common in people from lower socio-economic backgrounds. Studies in animals demonstrate that they will self-administer substances – such as alcohol, cocaine, amphetamines, nicotine, barbiturates and some benzodiazepines. Therefore, these drugs are described as rewarding or reinforcing. The fact that drugs and alcohol are rewarding does not explain why some people become addicted but not others, but it does lend weight to the argument that addiction is an illness or disease. Do You Have an Alcohol Dependence Problem?
Ask yourself the following four questions (the “CAGE” questionnaire).
+ Have you ever felt that you should cut down on your alcohol consumption?
+ Have you ever felt Annoyed when others criticized your alcohol consumption?
+ Have you ever felt Guilty about your alcohol consumption or the consequences of alcohol consumption?
+ Have you ever had an Eye opener in the morning?
If you answer ‘yes’ to two or more of these questions, it’s possible that you are drinking too much and should seek help. The obvious answer to addiction is to stop taking the consumed substance, but of course this is far from easy. The important thing to remember is that help is available. Probably the most important source of help (it reaches the greatest number of people) is Alcoholics Anonymous. Someone who has been consuming alcohol heavily may require admission to the medical ward of a local hospital in order to ensure safe withdrawal. Coming off alcohol quickly can result in delirium tremens, which can be a fatal condition and must be treated carefully. By Dr. Ciaran Mulholland
When you live in an alcoholic family
or an abusive family, you tiptoe,
you don’t want to step on any mines.
The immature personality: Some people never really become mature adults. They may remain unduly close to their parents. They often boast about those few things that they have actually accomplished, are unable to form close relationships with others, and are self-centered.
The anti-social personality: These people are unable to accept frustration. They live for, expect and must have easy and continuous gratification. They often eat a lot, chew sweets and smoke, as well as drink heavily. They drink for two reasons – to reduce the personal discomfort that results from frustration and to provide instant and dependable gratification. They are impulsive and do not learn from their mistakes.
The self-punitive personality: Some outwardly docile people are actually repressing aggressive tendencies. This results in inner tension and alcohol helps to relieve this tension. Often alcohol releases the aggression.
The stressed or anxious personality: Some people find stress more difficult to deal with than others. They may use alcohol in an attempt to cope.
The passive-aggressive personality: This term refers to someone with an outwardly calm and acquiescent shell that hides inner anger. They find it impossible to deal with anger-inducing situations.
Many addicts do not have these personality types, and of course if you recognize yourself above it does not automatically follow that you are at increased risk of addiction. It’s important to remember that no personality is immune to addiction. Proneness to alcoholism is better recognized by examining someone’s existing drinking habits than by assessing their personality. Modern, well-organized studies do not support a role for personality in addiction. Most of the theories outlined above are not well supported by scientific evidence. By Dr. Ciaran Mulholland
There are two questions a man
must ask himself: The first is
‘Where am I going?’ the second is
‘Who will go with me?’ If you ever
get these questions in the wrong order
you are in trouble.
There is much controversy as to the causes of addiction, not least because the exact biology of addiction is unknown. There are a number of theories, briefly explained below, but none should be considered to be the definitive account nor is any one theory mutually exclusive of any other. It appears that characteristics of the individual including their personality), the properties of alcohol and drugs, and environmental factors interact to produce addiction. But it’s difficult to determine whether the individual’s personality or their environment is the primary factor in causing addiction. A considerable body of research suggests that a tendency to alcoholism may be inherited. Alcoholism seems to be much more common in some families and this inherited type of alcoholism particularly affects men. Individuals may inherit a higher tolerance for alcohol (they need more drink than others to achieve the same effect), or they may inherit an increased chance of becoming dependent. Cognition is the process by which we attain knowledge and awareness of the world, and it has been argued that addiction is not inherited but is a learned behavior. The more one consumes the more likely one is to be become addicted. Addiction can thus happen to anyone. The cognitive approach to addiction assumes that:
* Addictive behavior is ‘learned’
* Addiction is not a disease
* The behavior can thus be ‘unlearned’.
The phrase ‘addictive personality’ is used so commonly in our culture that few of us question whether an addictive personality type really exists, yet many doctors and psychiatrists believe that the term means little or nothing. Certainly, there is little evidence for an addictive personality as such. Personality is complex and the role of personality in addiction is uncertain. It’s difficult to disentangle the effects of personality on addiction from the effects of addiction on personality. There’s no single addictive personality. However, there are a number of personality types that have been associated with addiction, and they are outlined below. The strongest evidence exists for ‘antisocial personality. By Dr. Ciaran Mulholland
I used to think a drug addict
was someone who lived
on the far edges of society.
and living in a filthy squat.
That was until I became one…
‘Substance misuse’ is a term used to describe the situation when a drinker or drug user experiences mental or physical harm as a result of their habit without necessarily being addicted to the substance in question. Substance misuse needs to be contrasted with substance dependence (also known as addiction). Dependence occurs at a more advanced stage of the addiction process. Doctors make a diagnosis of addiction if three or more of the following features are present.
+ A strong desire or sense of compulsion to take the substance.
+ Difficulties controlling the substance-taking behavior in terms of when it occurs, and or being able to stop, and or being unable to control the amount consumed once started.
+ A physically unpleasant withdrawal state when not consuming the substance.
+ Further substance use to relieve or avoid the withdrawal state.
+ Evidence of increased tolerance (increased doses are required in order to achieve effects originally produced by lower doses).
+ Progressive neglect of alternative pleasures or interests because of the substance use.
+ Persisting with substance use despite clear evidence of harmful consequences.
+ Narrowing of a person’s ‘personal repertoire’ or lifestyle – i.e. taking the substance becomes more important than anything else. By Dr. Ciaran Mulholland
If you’re an addict,
it controls your life
and your life becomes
It’s boring and painful,
filling your system
with something that makes
you stare at your shoes
for six hours.
Men are much more likely to be addicted to alcohol and other substances than women. Two thirds of attendees at Alcoholics Anonymous are men (although this figure was 80 per cent in 1972). A large American study has found that men are twice as likely as women to have a substance dependence disorder, with a lifetime prevalence of almost 36 per cent for men and 18 per cent for women. In other words, over one-third of the male population of the U.S. has been dependent on alcohol or drugs at some stage of their lives. Men in the 25 to 34 year age group were twice as likely as those in the 45 to 50 year-old age group to report substance dependency. Alcohol and drug abuse are strongly associated with an increased suicide rate in men. In a large British study men were three times more likely than women to be alcohol dependent and twice as likely to be drug dependent. Almost 8 per cent of British men and almost 5 per cent of women said that they had been drug dependent at some time in their lives, 3 per cent of men and 1 per cent of women reporting dependence during the previous year. Marriage appears to protect men from addiction problems. Never being married or becoming single is associated with increased alcohol consumption, while getting married is associated with a drop in alcohol consumption. By Dr. Ciaran Mulholland
…most substance-addicted people
are also addicted to thinking,
meaning they have a compulsive
and unhealthy relationship
with their own thinking.
David Foster Wallace
When you date a narcissist, they can be very charming and this is a trap. It’s really up to you to avoid this trap because the narcissist can’t help it. This is an incurable untreatable personality disorder. If you run across a spider who bites you, you can’t blame the spider. It’s your job to avoid the spider as best you can. It’s extremely difficult to avoid a charming narcissist because this is their one huge talent. In the beginning of a relationship, few people are as compelling as a narcissist. It will look as if all your dreams are coming true. Look beyond the charm. How many times has the narcissist been married? How many hearts has this person broken in the past? What are the reasons for the break ups? Question closely, and listen even more closely. In the end, only you can protect yourself from the trap a narcissist will lay. Just remember, once you enter a relationship with a narcissist, you will never get out unless that narcissist gets tired of you. Since you don’t really exist for the narcissist as a human being, it will be nothing for this person to drop you like a stone without looking back even once. No ties, no money, no children, no history, certainly no begging or crying will get this person back. This person will view you with nothing less than contempt and annoyance. You are less than nothing to a narcissist and in danger of becoming less than nothing to yourself.
So many times it seemed like
there were chances to stop things
before they started. Or even
stop them in midstream.
But it was even worse when
you knew in that very moment
that there was still time
to save yourself, and yet
you couldn’t even budge.
Narcissists have a personality disorder that does not allow them to tell the truth to themselves. If they did tell the truth to themselves, it would go something like this: I hate myself. I can’t love anyone outside of myself in a meaningful manner because my emotions are infantile. I feel like an emotional infant and it’s always got to be me, me, me, and I know this, and I don’t like it, so I’m always mad at everyone around me, because I hate myself for being this way. PLUS, I am a brilliant person, a superior person, I’m talented, smart, gorgeous, so I deserve beautiful amazing people around me, and they should all adore me. But if they do, I’ll be mad at them because it will never be enough because everyone around me is a mere reflection of me. Narcissists don’t really see you for who you are. This does not mean they don’t understand you. It’s just that, even if they do understand you, they don’t care. The reason for this is, to a narcissist, you are there for them. You are there for them and you are a reflection of them. Since the narcissist already hates themselves, (too fat, too thin, too poor, too warty, too wrinkled, background too poor, father too abusive, whatever) they want you to be better than they are. But when you are, they judge you for liking them. It’s like the old Groucho Marx joke: I would never belong to a club that would have me as a member. If you think the narcissist is good enough for you, then you are not good enough for the narcissist.
If you ignore me,
I will ignore you.
If you don’t start
we won’t talk.
If you don’t put
in the effort,
why should I?
One thing you will need to spot a person, who is incapable of love, is some experience. The inexperienced person who falls in love for the first time is capable of being blind sided. If you don’t know what you’re looking for, you won’t know when you see it. A person who can’t love can be charming, beautiful, even generous. But we will dissect those qualities so you see what they mean in such a person A person who is charming wants you to like them. It’s not about you. A person who is beautiful, is just fortunate, or spends a lot of time taking care of them selves so they can look good on the outside. Again, it’s not about you. A person who is generous gives for a variety of reasons. Generous people can give because they genuinely care about others. But sometimes it’s because they want to feel good about themselves. It has been said that narcissists can’t love others because they are too in love with themselves. This is actually not true. Narcissists don’t love themselves. They hate themselves but they also have huge egos, which are damaged egos. Narcissists require love from others in order to feed off that love, so they can tolerate themselves.
fall in love
with nice people.