It’s time to address men’s depression in a new way

We’ll know that men like you are busy leading your life by lifting impossibly huge weights, imagining scoring the goal in the World Cup Final and thinking about putting up shelves.  And you’re just too busy to think about things like; what does my brain do? Should I look after it?  Or even can it go wrong? Just in case you’re wondering, the answers to those things are; keep me alive, yes and yes.

This article talks about depression in men, starting with what it is, then looking at why men are less likely to seek help, then considering the problems with commonly used approaches for depression, and finally outlining a new way to think about these issues that’s tailored for men.

What is Depression?

Let’s start by stopping to think aboutwhat depression actually is. On a simple level it’s where your brain makes you stop as it believes you are under threat.  You will likely feel down, depressed and hopeless, and have little interest in doing things you would normally do, like work.  These things can go on for some weeks, months or even years.  If you’re experiencing this, you may thinki you’re on your own, but in any one week 3% of the UK population will experience this, and three-quarters of  men report some form of mental health problem over their life.

As well as these symptoms there are often other problems as well including disturbed sleep, changes in appetite, tiredness, feeling worthless and even considering suicide.

Male Depression behaviour is different

Now we’ve thought about the traditional view of depression, let’s consider what this is like in men, who we know likely to have different symptoms. These include being aggressive and difficult to be around, engaging in high-risk behaviours like speeding, or using alcohol and drugs in ever increasing amounts.  These are not usually asked about by GPs and can therefore get missed, or mislabelled as having a different diagnosis

Men are less likely to seek help

Let’s consider the reasons for men like you being less likely to seek help. Despite Men being almost as likely as women to have Depression, they use the NHS talking therapy service only 36% of the time.  Furthermore, male suicide figures show the tip of the iceberg.  The UK has approximately 6,500 suicides per year, with men being 75% of those.  Men aged 45-49 are the most likely group to end their life.

Other issues include men are less likely to see  the GP, reasons include being busy and not getting appointments that fit with work.  We know only about a quarter of men are happy to discuss  personal issues with a GP or other healthcare professional. But why is this? Part of the reason for men like you not feeling they can approach doctors is that basically one of four things may happen; you may not feel listened to in the 10 minutes a doctor has; you may be offered tablets or talking therapies which you may not want; and you may be offered time off, which men can be reluctant to do.

One more important issue is that the process is disempowering.  You are ‘wrong’ or ‘broken’ in some way, you are offered things to ‘fix’, but no explanation as to how this works, or why you ended up in this situation in the first place.  Furthermore, men also may outright reject the model of mental health illness, particularly if they are severely unwell, and thus it is counter-productive to offer this.

One final point is that our understanding of the causes of mental health has evolved.  Whilst our genetics is important, thinking about neurochemical imbalances is going out of favour, and being replaced by a model of inflammation in the body and brain, with multiple triggers including long term diseases and lifestyl.

Male mental health stigma still exists

There are multiple issues to consider around stigma. We all know about what men ‘should’ be like, stigma and stereotypes are powerfully embedded in our society.  It can be interpreted when we are struggling in a very black and white way, which can be unhelpful.  For example, strength and self-reliance and thinking  ‘I should be able to cope, otherwise I’m a failure and not a man’ leads to us becoming trapped in our own thoughts, and not seeking help.  A more positive way of looking at this would be to use the strengths in resources we know we have to hand, for example ‘I don’t understand what’s going on, but I’ve got my partner and mates I can speak to, and I can try to share this problem’.  

There are multiple reasons to be positive though. One reason being younger men are moving away from negatively framed media representations of men, and reporting of mental health generally seems to favour positively framed messages

Another is there also seems to be an increasing number of public male figures acting as role models.  Two notable examples are BBC newscaster Huw Edwards, and F1 Mercedes Team Principle Toto Wolff.  I’ve also written and spoken about my own experiences.  Hopefully, the more men feel this is normal to speak openly, and positively about their experiences, the easier it will be to approach

Finally, existing as a man can be tough.  Men have a lower level of life satisfaction, live less longer, and are increasingly likely to report an absence of friends than women.  This is often not acknowledged, and can fuel some of the factors which cause depression.

A different approach is needed

Fortunately, there has been lots of research undertaken in the area of how to try and overcome the barriers for men accessing help for their mental health. These are positive role models; offering a supportive ear, non-medical approaches; and using education to improve skills, autonomy and problem solving.

I’ve developed Men’s Mind GP Explorer – adventure into your mind.  It’s 12-week programme, tailored for men’s mental health issues which incorporates all you need to start your journey to mental health improvement.  It looks at your whole life, has an experienced, supportive ear, and will empower you to make changes to start living your life.  If you’d like to know more, please contact me and I’ll happily speak to you about what I can offer.

Dr Ed Rainbow is a practising GP, Lifestyle Medicine Practitioner and Men’s Mental health expert.  He posts regularly on LinkedIn and on his blog.

Getting help

The first step is always the hardest, asking for help.  Please use the resources below if you are worried

999 – If you or someone else needs immediate help

If you are in a crisis point there are multiple sources of help

Your local A&E will have access to a mental health crisis team

Your local Crisis team are available to call

SHOUT: SMS 85258 for anonymous support 24/7

Samaritans: offer emotional support 24/7

Call 116 123 (UK) – it’s FREE or email jo@samaritans.org.uk in confidence

CALM offer a National helpline for men to talk about their troubles.  

0800 58 58 58 5pm–midnight, 365 days a year

Your local GP can also be approached to help your mental health.

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