“I Don’t Want To Talk About It”: Guys With Depression

Years ago, 1997 to be exact, I was thinking about writing an article for a lawyer’s magazine about my experiences with depression while practicing law.  I had lunch with a good friend of mine, Bob, who at that time worked in a large litigation firm in New York City.  Since then, Bob has become a federal judge and remains a dear friend.

After we had ordered, I told Bob about my idea to write the article. He sat quietly and listened, looking down at his salad as I spoke.  Finally, he said, “Dan, this is an awful idea.  While noble, why would you expose yourself to the insults some people are going to hurl your way.”  We spoke at length and I finally told my dear friend that I was going to write the article anyway.

male depression

For the first few years after that initial talk, Bob would call me regularly and check in, “How’s it going, Dan? Is everything all right?”  I so appreciated Bob’s loving concern.  More importantly, however, something began to change in our relationship.  Bob eventually disclosed to me that he had had a episode of major depression some years ago and had tried to commit suicide.

It seems to me that my willingness to speak frankly about my depression gave Bob permission to speak about his.

Unfortunately, talking about depression is not easy for most men. They have lots of trouble coming to terms with depression, even when they get treatment. All the more so if they’re a lawyer.

Lawyers aren’t supposed to have problems; we’re supposed to fix them. Most male lawyers I know would rather drop dead than admit that they have problem with depression. I guess the exception to this observation is when the wheels have fallen off for them. Then, and only then, do they recognize (hopefully) that they are suffering from depression and the toll that it is taking on their lives. The consequences for failing to recognize this basic fact can be serious (loss of productivity at work, sleep problems, etc.) or fatal (middle aged lawyers commit suicide at twice the rate of the national average).

Psychologist, Terrance Real, the author of the book, I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression, makes the observation that we don’t think of men as depressed. This is so because what we are really thinking about is “overt” depression and more women show signs of that – weeping, a willingness to discuss painful feelings, etc. Men suffer from “covert” depression that expresses itself in addiction, isolation, workaholism, isolation and increased irritability.

“Men are just as feelingful, just as relational, just as connected, just as dependent, just as needy, as women are. Men have been coerced since childhood to forego these relational qualities and skills and squeeze their sense of membership and self-esteem through performance. Girls are taught to filter their sense of self-worth through connection to others, and boys are taught to filter their sense of self-worth through performance. That’s a vulnerable foundation for one’s self-worth,” notes Real.

The excellent website, Men Get Depression, says there are three distinctive signs of male depression:

Pain. 
Depression may show up as physical signs like constant headaches, stomach problems, or pain that doesn’t seem to be from other causes or that doesn’t respond to normal treatments.

Risk Taking. 
Sometimes, depressed men will start taking risks like dangerous sports, compulsive gambling, reckless driving, and casual sex.

Anger. 
Anger can show itself in different ways like road rage, having a short temper, being easily upset by criticism, and even violence.

So often, the first symptom that male lawyers notice that they are slipping is in the performance department. One of the symptoms of clinical depression is difficulty concentrating. This leads to problems in getting work out the door. They may try to hide that their work is slipping – ask for extensions, take much longer to do tasks that were simple and routine in the past. If the problem doesn’t go away, some will seek out help – usually through their family doctor (who distribute 80% of the prescriptions in this country for antidepressant medications). Some will go the extra step of seeing a therapist that they can talk with about their problems.

My therapist used to liken my depression to a caveman camping out of his cave. It took a lot to coax me out of there. Men need to come out of their caves into the light of day where the colors are brighter, others can help them and they can get better.

 

 

Overwork/Underwork: Two Sides to Male Depression

Al commented: “I have never been a guy who can just take time off without feeling wrong and guilty. So I work 70 hours or more a week. It is killing me, I think, but what in the world would I do with the time if I was not working?” Al represents the kind of depression that hides in overwork and lack of social contact. He feels low self-worth and does not believe he is loveable. He is home so rarely that his family takes vacations without him and he has been known to work on holidays. He is a man who cannot fill his life with meaningful connections, so work becomes the point of his existence. He is one short-term illness away from despair: Unable to work, he would succumb to feeling useless or worthless and his depression would well up and swamp him.

Marlin on the other hand was out of work but he was also unwilling to discuss how deeply he feared not getting a job he interviewed for. He had struggled against networking, embarrassed and unwilling to test the strength of friendship among acquaintances he contacted for his job search. Instead, he railed against the rules of unemployment that demanded he had to demonstrate applying for 4 jobs per week. “No one can tell me how to live!” he declared. “I will live on my nest egg until I am out of money rather than knuckle under to the way some agency wants me to conduct my job search.” Being out of work was grinding his self-esteem to a fine powder, and depression’s hopeless and helpless attitude blocked his job hunting. He became increasingly isolated, avoiding people to avoid discussing his unemployment, and thus he limited his options for receiving help and support. Being angry at least gave him a sense of power.

Both of these men with low self-esteem also reflect the problematic low levels of serotonin common to depressed brains. That neurochemistry shows in the persistent negativity and the inflexibility in problem solving that will keep both these men stuck in their unfortunate patterns of behavior. Because most men strongly connect their value and identity with their work, work carries exceptional power to define their worth. Al’s overwork and Marlin’s embarrassment about unemployment reflected their sense of value. They found ineffective, albeit different, solutions: Al hiding in his work and Marlin using anger to cover his fear of unemployment and defend his inflexibility.

What both these men were missing may have been healthy levels of serotonin, but they were also missing social involvement that might have reversed the pattern. Depression can lead a man to feel worthless and block his understanding of why family and friends want to be with him. However, being with others in pleasant social contexts, whether family or friends, is an automatic lift to the mood and raises energy. Forcing oneself to participate, even though the desire to participate is minimal, can begin to shift intractable behavior. If Al or Marlin had spent time with people who cared about them, they might have been able to get perspective on their value as well as on their options.

It is true that being depressed makes it very hard to reach out to others. Any person who lives with the over-worker or stalled job hunter can see that their perspective is narrowed and their self-worth is damaged. Broadening perspective can be accomplished in making small connections, putting a wedge into the wall of their disbelief that others see them as more valuable than their work. What gets through? Working from ‘the outside in” can help. Urging, encouraging, even insisting on behavior change can change feelings and that can change the brain to a more balanced brain. If a man can insist with himself, fine, and if not, therapist or family member can push in these directions:

Insist the man with no worth make a list of people in his life and identify whether they love him (according to what they say, not according to whether the depressed man feels loved.) Then review the list daily.

Insist he participate in a social activity however much the depressed man resists. Follow up with identifying whether it was pleasurable or unpleasurable. (No middle ground).

Insist that he identifies 3 blessings a day, every day, in writing. And yes, eating popcorn can be a blessing if you like it. No activity is too small to be a blessing. He should read it to himself every day and read the list to someone else once a week.

Insist that he spends time with family, participating in an activity together. (And everyone sitting in a restaurant looking at their individual handheld devices does not count as together time.)

Insist that he reconnects with others. For example, making a list of people he could socialize with, even if it has been a while, and then call or email or text one person per week to set up a contact, such as golf game, drinks after work, bike ride, meet at the gym, have a lunch, etc.

Always follow up with evaluating how the connection felt. When men are depressed, they are slow to acknowledge that something made them feel good. They do not easily credit the pleasurable aspects of the connection. And reviewing that it felt good makes it harder for him to ignore the good feeling and re-stimulates the pleasure of the experience strengthening its value as an antidepressant. Connection is the way out of depression, in part because it contradicts worthlessness. Once an Al or Marlin believes he is not worthless in the eyes of others, he might be more balanced about work and separate his identity from his job status. As his sense of value increases, the hold of depression decreases.

By Margaret Wehrenberg, Psy.D.

Coming Out of Our Caves: Male Depression

Guys have lots of trouble coming to terms with depression. All the more so if you’re a lawyer. Lawyers aren’t supposed to have problems; we’re supposed to fix them. Most male lawyers I know would rather drop dead than admit that they have problem with depression. I guess the exception to this observation is when the wheels have fallen off for them. Then – and only then – do they recognize (hopefully) that they are suffering from depression and the toll that it is taking on their lives. The consequences for failing to recognize this basic fact can be serious (loss of productivity at work, sleep problems, etc.) or fatal (middle aged lawyers commit suicide at twice the rate of the national average).

Psychologist, Terrance Real, the author of the book, I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression, makes the observation that we don’t think of men as depressed. This is so because what we are really thinking about is “overt” depression and more women show signs of that – weeping, a willingness to discuss painful feelings, etc. Men suffer from “covert” depression that expresses itself in addiction, isolation, workaholism, isolation and increased irritability.

“Men are just as feelingful, just as relational, just as connected, just as dependent, just as needy, as women are. Men have been coerced since childhood to forego these relational qualities and skills and squeeze their sense of membership and self-esteem through performance. Girls are taught to filter their sense of self-worth through connection to others, and boys are taught to filter their sense of self-worth through performance. That’s a vulnerable foundation for one’s self-worth” notes Real in an interview.

The excellent website, Men Get Depression, says there are three distinctive signs of male depression:

Pain
Depression may show up as physical signs like constant headaches, stomach problems, or pain that doesn’t seem to be from other causes or that doesn’t respond to normal treatments.

Risk Taking
Sometimes, depressed men will start taking risks like dangerous sports, compulsive gambling, reckless driving, and casual sex.

Anger
Anger can show itself in different ways like road rage, having a short temper, being easily upset by criticism, and even violence.

So often, the first symptom that male lawyers notice that they are slipping is in the performance department. One of the symptoms of clinical depression is difficulty concentrating. This leads to problems in getting work out the door. We may try to hide that our work is slipping – ask for extensions, take much longer to do tasks that were simple and routine in the past. If the problem doesn’t go away, some will seek out help – usually through their family doctor (who distribute 80% of the prescriptions in this country for antidepressant medications). Some will go the extra step of seeing a therapist that they can talk with about their problems.

My therapist used to liken my depression to a caveman camping out in his cave. It took a lot to coax me out of there. Men need to come out of their caves into the light of day where the colors are brighter, others live who can help us and where we can finally feel the sun of being worthy without having to perform twenty-four seven in our legal careers.

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