Sarah Gaer lays out a list of things to look for, a list that might just save the life of a man you care about.
I am a suicide prevention specialist for Riverside Trauma Center in Needham , MA and I have been given the task of targeting middle aged men for suicide prevention as they are in the highest risk category. Because I am not middle aged or a man, I have had a lot of learning and research to do. I have also been very fortunate to meet many men who are willing to have conversations with me about their (insert hushed voice) “feelings” and their experiences. They have taught me a lot. I have also learned from wives/partners of men who suffer from depression or who have died by suicide. Listening to these women made me realize that in relationships we often don’t recognize depression symptoms for what they are or we don’t see them in the moment because of the slow progression. Knowing the symptoms may not be enough, we need to know how these symptoms may look in someone we have a personal relationship with.
So, I have created a list of some of the ways depression can look in any type of relationship:
- Anger: We often times think of depression as being sadness or tearfulness but many men will not exhibit depression that way. They will be more irritable and angry. They may be more aggressive or harsh with their partner, their children, friends and family or even family pets. This can increase gradually which means we sometimes don’t notice the progression in the moment. This often times is a coldness that seems out of character or perhaps even name calling. In later stages it can be physical aggression or violence. Often times we blame ourselves our make excuses . He’s not happy because ( give specific examples: “Dinner was late; the house wasn’t clean, etc or “he hates his job”
- Tired/Lack of motivation: Was his workshop once immaculate; was he always on top of paying the bills? Was his motorcycle gleaming and now he doesn’t seem to care? Did he go to the gym all of the time or meet the guys out for football? Depression makes people tired and feel less motivated. This is true in both genders and again can progress slowly making it hard to recognize in the moment. Depression can also make people feel groggy and therefore be less organized or able to solve problems.
- Disturbed Sleep: Insomnia may be the least recognized symptom of depression but it may be the most insidious. Lack of sleep has many consequences, depression not the least of them. If he is complaining that he has been tossing and turning a lot or he doesn’t feel rested in the morning, he should talk with his doctor about it. Poor sleep and depression are a catch 22. If you’re not sleeping well, you get more depressed which makes you not sleep well. Recent research indicates interrupted sleep may be one of the highest risk factors for suicide.
- Isolation: Women, in general are thought to be more social. In fact, there is evidence that suggests that as time goes on women become more social. But men, generally become less social making isolation of significant concern especially when combined with depression. Did he used to hang out with guys more? Is he not calling his family as much? Does he ignore his phone ringing because “he doesn’t feel like talking.”
- Physical Complaints: Often times, people don’t notice they are “depressed” as it often starts gradually and progresses slowly. But they do notice not feeling well. They notice the headaches, body aches, and upset stomach. If he is complaining of aches and pains that do not seem to have a medical explanation this could be an indicator of depression. Of course, you always want to rule out a medical problem before assuming it is depression, so an appointment with a primary care physician is a good place to start.
- Sense of humor: Life is full of stress. Most of us are living on a tight budget, trying to raise families, keep our spouse happy and our jobs. Hopefully in the midst of all of life’s stresses, we can maintain our sense of humor. Has there been a significant decrease in joking around, acting silly and laughing? Again, this is something that can decrease slowly so we don’t notice it as much but laughter and play are really important to maintaining mental health.
- Increase in substance use: Lots of people have a couple of drinks with dinner or while watching the football game but that is not what I am referring to. Is your partner using substances as an escape or drinking more then they used to?. They may be getting intoxicated more often. Their substance use may be getting in the way of their responsibilities. They may be drinking by themselves, which suggests it is not “social drinking” anymore. Their mood may change dramatically when they drink. All of these things can be indicators of a deeper problem.
- Changes in sexual interest: Yes, there are definitely medical causesfor decreased libido but depression can be one of them. Not only is “sexual dysfunction” a symptoms of depression but it can often exacerbate the depression. It always fascinates me that men are willing to talk to their doctor about sexual dysfunction but not depression when in reality dealing with the depression could not only improve their sexual functioning but their life in general. This is another symptom that women often accept blame for. Instead of recognizing that something may be going on for their husband, partner etc., they think, “He must not be into me” …“It’s probably because I have gained weight.” Allowing insecurities to take responsibility instead of recognizing that something may be going on for him can increase the likelihood that we are overlooking these important clues.
- Relationship problems: It makes sense really. If your significant other is depressed and agitated its going to have a negative impact on your relationship. You might chalk it up to his/her just not being happy with you, which is a terrible way to feel. You may be sharing in the discouragement and not recognize that your relationship is falling apart not because you aren’t a good enough partner, but because he is depressed. If this sounds familiar, you may want to consider marriage counseling. Yes, marriage counseling is hard but if you find the right counselor and you and your spouse are both dedicated to making your marriage work, it will be worth every minute and dime!
If this list sounds familiar, I suggest you take action. Seek support, preferably from a trained counselor who can help you determine what is going on and your best action steps. The earlier you deal with depression, the better the chances of a strong recovery. Some people who are depressed will show a lot of signs; some people may only have a few. Approximately 8 million Americans contemplate suicide every year, about 1 million adults will make an attempt and nearly 39,000 will die by suicide. Being depressed doesn’t mean someone will take their life but it does put them at increased risk. The earlier we recognize these subtle signs of depression and get them treated, the greater our odds of preventing suicide and improving quality of life.
For more information on depression and signs of suicide, please check out: http://riversidetraumacenter.org/documents/DepressionSuicideWarningSigns6.pdf. If you are concerned about a man in your life, I recommend you check out http://mantherapy.org/#/center which will allow you to take a quiz with your special guy in mind and provide a lot of great tools that can help.
National Suicide Prevention Lifeline: 1-800-273-talk
American Foundation for Suicide Prevention: www.afsp.org