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…
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
HE MUST FEEL SAFE: What will get a man over the speed bumps and into the home stretch? He has to trust you. He has to know that all that fear and confusion and uncertainty will land him in a SAFE place. Everyone wants to feel safe, right? You can help him feel safe by giving him every reason to trust you. Give him every reason to feel comfortable with you. Listen to him talk. Share parts of your life with him. Offer a listening ear when he needs it. Share your thoughts and feelings – within reason, of course. The closer you get, the more comfortable he will feel. The more comfortable he is, the safer he will feel. Soon he will be sharing everything he feels with you. That fear will gradually fade away.
Don’t ever play
with someone’s feelings,
you could win the game
but you could lose
that person forever.
THEY DON’T UNDERSTAND WHAT THEY FEEL: Think about falling in love. Really think about it for a minute. It is exhilarating. It can make you feel so alive! It can make you smile even in your sleep. But let’s be honest: falling in love is often scary, too. It’s scary because the emotions are so intense and so overwhelming that it’s hard to sort them all out. It can be so confusing to fall in love. If you don’t understand what you feel, your natural instinct is to hide from those feelings. If you see something you don’t like, your natural instinct is to shield your eyes. If you taste something you don’t like, your instinct is to spit it out! That’s a pretty graphic example, but you get the picture. When a man is afraid of his emotions, the first thing he does is trying to hide them away in a little closet far away from his heart. Getting over this reason to hide his feelings takes time. It takes some courage, too. But he can do it with plenty of reassurance from you. The more open you are, the more likely he will eventually talk about what he feels. And once he’s talking about it, he will understand it.
Feelings are not
supposed to be logical.
Dangerous is the man
who has rationalized
There are people who are never content, never appeased, forever dissatisfied; who continually look to what escapes them, convincing themselves that if only they could attain that one desire outside of reach, they would be happy. It seems almost pointless to give to these people because their eyes immediately shift from the gift to stare miserably at the portion held back. Their wants, demands, expectations, appetites are never satiated, thus, they refuse to be happy. And you cannot make them so. Richell E. Goodrich
Millions of couples out there practiced the art of sadomasochism every day, without even realizing it. They went to work, came back, complained about everything, insulted their wife or were insulted by her, felt wretched, but were, nonetheless, tightly bound to their own unhappiness, not realizing that all it would take was a single gesture, a final goodbye, to free them from that oppression. Paul Coelho
The only thing that feels worse than being stuck in a situation that makes you unhappy is realizing that you are not ready or willing to change whatever it is. Ashly Lorenzana
For a torture
to be effective,
the pain has to be
it has to come
at regular intervals,
with no end in sight.
Boundaries are sort of an imaginary line between you and others. It divides up what’s yours and somebody else’s, and that applies not only to your body, money and belongings, but also to your feelings, thoughts and needs. That’s especially where codependents get into trouble. They have blurry or weak boundaries. They feel responsible for other people’s feelings and problems or blame their own on someone else. Some codependents have rigid boundaries. They are closed off and withdrawn, making it hard for other people to get close to them. Sometimes, people flip back and forth between having weak boundaries and having rigid ones. A consequence of poor boundaries is that you react to everyone’s thoughts and feelings. If someone says something you disagree with, you either believe it or become defensive. You absorb their words, because there’s no boundary. With a boundary, you’d realize it was just their opinion and not a reflection of you and not feel threatened by disagreements. By Darlene Lancer, JD, MFT
People who violate
They steal time
that doesn’t belong to them.
Elizabeth Grace Saunders
Men have emotions. Women need only adjust how they listen. Men express plenty of feelings; they just do it differently than women and there’s nothing wrong with that. You know how Eskimos supposedly have 4 dozen words for snow? It’s the same thing for women and feelings. They have over 4 dozen ways to describe happy, angry, sad… When a woman says, “men need to be more sensitive and in touch with their emotions,” I hear, “men need to be more like women.” Bad idea. If women want to be with men who can talk about their feelings and daily minutia just like their best girlfriend, then why don’t they just get together with their girlfriend? Men are more solution-focused while women are process-focused. There have been numerous studies (of questionable methodology) asserting that women use more words than men per day. Recent research finds such assertions are unfounded. Men and women actually use about the same number of words a day. It’s not a matter of women being more verbal; generally speaking, we’re equally verbal. Here’s the difference: women use words to process their feelings, often wallowing in emotions without reaching resolution. Men state their feelings and use words to achieve resolution. As a collective, women have told men that not talking about feelings as much as they do makes them inadequate. Dr Tara J. Palmatier, PsyD
Love is misunderstood
to be an emotion; actually,
it is a state of awareness,
a way of being in the world,
a way of seeing oneself and others.
David R. Hawkins