Are men with depression or PTSD taken less seriously than women with the same symptoms? That might explain the disproportionate number of men who are dying.
Shortly before my departure from Australia in late October to attend the Male Survivor Conference in New Jersey I received a phone call from a female friend who was deeply troubled about the mental stability of her partner. Because he had made threats of suicide there was little I could offer in terms of professional help. He needed the immediate care and attention of a Psychologist and an appointment for referral via a Doctor had already been made for the following day. I took a little comfort in knowing that although it was going to be a long road for him, the process was at least underway. Less than a week later I learned the tragic news of his death.
In this global issue, here are some of the frightening statistics around men and suicide.
In Australia, BeyondBlue.org reports that men make up 80 percent of the 2200 suicides each year, which comes out to an average of five men per day who lose their lives. In the USA there are 30,000 deaths by suicide each year, and American Council for Prevention of Suicide reports “the CDC data shows that men continue to die by suicide at a rate of roughly four times that of women” — that’s 24,000 men. In Canada 3,890 suicides were reported in 2009 at a ratio of 3:1 men.
The comparison statistics for attempted suicides in each of these three countries is staggering. This tells us that we need to be much more aware of the men in our society and how we treat them in relation to mental health.
Men resolve issues in a way that is different to women. So it is not enough to treat them the same as women or expect them to respond positively when we do.
In many cases, even in the presence of a medical professional, men will deny their deep-rooted feelings because they are often shrouded in a layer of debilitating shame. As stereotypical as it is, women will talk about issues that men do not always speak freely about, even when in confidence.
We still largely accept the ideology that men will be tough and strong, yet this is in direct contrast with how they often see themselves. It is their self-view that keeps them silently struggling with their pain.
While around the world there is significant male-centered work being done, I believe we need to do more. We need to separate women’s services from men’s and start to accept the significant differences in how men think, feel and behave; we need to understand and respect the male psyche.
Matthew Cole* recently shared a personal account with me and I share it now as one man’s experience to shed light on just some of the issues men face in relation to Mental Illness. Most importantly, his story also illustrates how different his wife’s experience was, even though the circumstances we similar.
Matthew had already been diagnosed with Post Traumatic Stress Disorder (PTSD) and then endured further trauma in 2011 when his infant daughter passed away from Sudden Infant Death Syndrome. In the aftermath of this event, and living with the unimaginable pain there were many times in his daily life when he became anxious. He often found family events and gatherings extremely stressful.
On a particular day before a family get together Matthew took his prescribed anti-anxiety medication. A short time later, his wife found him unconscious on the floor biting his own tongue and blowing bubbles. He had overdosed.
Recently, Matthew’s wife also presented at the hospital suffering from an anxiety related condition. How she was treated was vastly different to his experience and resulted in much more care and consideration.
Matthew and I talked about his experience with anxiety and the treatment he received.
Can you tell me what the issues were leading up to your episode?
Matthew told me how he had taken his medication due to the build up of anxiety with the family event. He was stressed and his PTSD was high.
“I would snap at any given time and so I had taken my meds as normal, thinking whatever lets get it (the gathering) over with.”
Then after taking his normal dosage; “I recalled my doctor put up the strength of the meds but then I said to myself, ‘What’s the worst that could happen, death? I welcome it, I don’t care.’”
And this is the often unspoken truth of a depressed man. The inner dialogue is one of despair and self-loathing. Matthew says this wasn’t a suicide attempt, but when he faced being heavily medicated and numbed to the pain of real life the outcome of what may have happened became something that he didn’t fear.
How would you describe yourself when you presented for help at the hospital?
Matthew told me that he had blacked out and has only little memory of the event. His wife had found him on the floor chewing on his tongue. She phoned 911 and he was taken by ambulance unconscious. He remembers being on the gurney, and seeing faces and people, but little else.
What treatment were you given?
Matthew felt he was treated with indifference and that the treating staff were not sensitive to a man’s way of communicating.
“I was given no treatment, as all they did was take my blood oxygen levels and watched me suffer basically. They wanted to know what I wanted but I could not talk to them and they would not listen to my wife’s point of view”
What do you feel would have been more beneficial?
Matthew explained that he felt he needed better and safer medication and for an investigation to be done into what would have suited him better. There was no dialogue about this by his treating staff. He told me that his Doctor was aware that his memory was bad from a combination of the trauma and the medication, and as a consequence of this overdose he really needed assistance in finding a medication or treatment that was better suited to his situation.
In the years since his diagnosis Matthew has not received counselling for his PTSD. He explained to me that he was offered assistance, which he agreed to, and was put on a waiting list. When he enquired about the length of time he was likely to wait for treatment, he was told it was determined by how bad his case was. This same screening that determined that he was not a priority for treatment also determined that he was unfit for work.
“I still to this day am yet to see someone for my PTSD, but all I get told is I am on the list and to wait. It’s been nine years now. My nan told me I always had patience of a saint.”
The pain and anguish Matthew was feeling was debilitating and then further exacerbated by the stigma of being unable to return to work because he was deemed mentally unfit. Feelings of shame and guilt have shrouded him to the point where he now has such a close affiliation with them that he can’t find a way to let them go.
How common do you think it is for men to be in this situation?
Matthew explained he sees the rates of suicide around him as very high. He feels men are being forgotten about and that they slip through the cracks of the mental health system with many of the men becoming homeless.
In your opinion, what is the cost to society to not address men’s mental health with equal importance?
Matthew’s answer to this question is a stark reminder of the depth of pain men feel around not being acknowledged.
“The cost is death, just death. We either end up killing someone or kill ourselves with drugs or drink or both or worse. The way I see it we are just a overlooked stat.“
Why do you think we view men and women differently?
Matthew was discharged from the hospital as soon as he became conscious and was out of immediate risk from the overdose. He remembers little of his discharge, only waking up in his own bed still wondering what had occurred. His wife was left to explain to him what had happened.
Recently when his wife, who also suffers from PTSD, presented to the hospital for an anxiety-related condition. Matthew explained it was like night and day to his experience. She was admitted and cared for, including having someone on watch at her door. When she was discharged, she was sent with paper work for outreach services, government assistance and aftercare, all of which was forthcoming for her.
“I feel men’s health was left back in the early 40s or 50s when if men are MEN they don’t listen and they take care of themselves and can take a sucker punch and keep women barefoot and pregnant in the kitchen. The system is broken.
I feel sad for my two boys growing up in this world, we need to do better.”
What issues do you think men face, that women don’t?
Matthew feels that the war of gender and rights is what is inhibiting men’s treatment in 2014. He feels there is an inequality in services and treatment and that men are still being viewed as capable and competent and able to take care of themselves.
He went on to express a deep sense of confusion in modern times, that men are meant to understand and sympathise with women, but women are not willing to recognize their needs.
He explained his fears around the way boys are treated in schools and how he thinks the prevalence of female teachers affects that. He feels it’s confusing to a boy’s innate sense of identity that his feelings are not recognised as important.
“Men have to be careful what we say and how we act or it’s looked at as discrimination. You have to be so careful and this is why there is a trend that men are turning away from women.”
Matthew’s sentiments here are something that I hear often as a men’s coach. They are frustrated and angry that their needs are not recognised and as a consequence they are turning to their anger as a method to be heard for their needs and recognition that they are different from women.
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. With the overwhelming number of suicide deaths each year being male, it’s time we changed how we provide services for men.
Matthew’s story is just one man’s experience and is in no way meant to represent the experience every man has, or will have, with the mental health system. However, it highlights the need for us to objectively look at how we relate to men in order to get a deep sense of what they feel and experience.
Anxiety and depression will most likely make you feel less than you want to be, but they are not weaknesses, they are a form of mental illness, which affects a significant proportion of our global population.
*”Matthew Cole” is not his real name
If you need help:
Beyond Blue – 1300 22 4636 http://www.beyondblue.org.au/
Lifeline – 13 11 44 https://www.lifeline.org.au/
www.hopeline.com This will connect you with a crisis center in your area.
Mental health Hotline 1-866-531-2600
Photo: Flickr/Dennis Fidalgo