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!
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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.
You can also check us out at http://riversidetraumacenter.org or on Facebook www.facebook.com/riversidetraumacenter
National Suicide Prevention Lifeline: 1-800-273-talk
American Foundation for Suicide Prevention: www.afsp.org
Photo—hilighters/Flickr
As I said earlier, I think this is a good and important article. One problem with the warning signs is that they apply to so many people its difficult to recognize who may be at highest risk for suicide. Dr. Thomas Joiner, one of the world’s leading experts on suicide, has found that there are three critical factors: 1. Thwarted belongingness, and feelings of being alone, 2. Feeling like you’re a burden on others, 3. Capacity for suicide. Excellent article here: http://www.thedailybeast.com/newsweek/2013/05/22/why-suicide-has-become-and-epidemic-and-what-we-can-do-to-help.html
Amazing article Sarah, I have had depression since I was quite young and to all those men out there who have it. GO GET HELP. I have been in and out of all sorts of places since I was 5-6 yo and it wasn’t till recently (last 4-5 years) that I finally got medication for my depression, and the RIGHT help and now while I’m not perfect I’m slowly working toward building a career and I have two great children who I raise on my own. Some days are hard and others are a blessing. What helps me is knowing… Read more »
My ex husband committed suicide seven years ago . He suffered all these signs. V accurate article.
I want to ask you for your permision to translate this article into spanish and to publish it in my blog.
I believe that this article is a valuable contribution for men.
I respect the intelectual propierty of others and I wont publish it without your permision.
I will be waiting for your reply.
Daniel,
I would be honored and delighted to have this translated into Spanish. Is there any chance you would be willing to email me a copy of the link to your blog when you have published it?
Thank you,
Sarah
[email protected]
Sorry to see so few men commenting.
its too much of a downer , Tom . . . actually wonder if the reason is partly the same things driving this thread . . . ht tp://goodmenproject.com/marriage-2/open-thread-why-are-men-reluctant-to-write-about-marriage/ Here’s a thing. . . the common stereotype is that depressed men are violent. Here there are, what, 15 comments – about half to deal with a violent man. (Not a problem Joy, just noting it). So “Yes yr honour, I was being treated by a professional for mental problems, yes depression, no I wasn’t violent, yes I know some depressed men are violent, No sir I don;t have any guarantees… Read more »
Tom, I’m not surprised so few men comment. Emotional states are harder for men to verbalize, just in my experience. Women start talking more when we need help, then we may go inward and sink. I’ve noticed with depression or other emotional states, men’s behaviors and non-verbal language changes, sometimes it’s very subtle, other times it’s very abrubt. I suspect, this is where our family dysfunction and male-female dysfuntion may play a role in increased depression, because families are less involved in each other’s daily life. Rezam, I’m not in total agreement with our therapy-schools of thought either. Many of… Read more »
The biggest stumbling block you’re going to find is that it’s always more rewarding for people to declare an angry man to be nothing but a violent, abusive, misogynistic monster and attack him so they can “win” than it is to consider that his anger may be the result of depression and provide him with better tools to manage it.
Thanks good people, Archy, Sara and Joan. Sara thanks for understanding that leaving isn’t always so easy, especially because this is our 4th month since we reunited after a 6month separation. I am trying to get us into counseling, although he swears it’s the last thing he’ll do in this life. He says it’s stupid to have another person sort out your issues yet you’re ‘grown up.’ I know it’ll take a while, I’ll keep trying but if it fails then the only other option is to bail out. Archy I totally understand the importance of getting a secure place… Read more »
Joy, I’ve walked through infidelity myself, and yes I even bought a self-esteem for dummies book because I couldn’t figure out why I felt worthless: it was his subtle criticisms that wore me down. I promise, the little black raincloud over your head right now, will eventually blow over. Be safe and don’t do anything rash…eventhough you may want to. Love and prayers back to you.
@Joy: Big safe hug…! Yes, please listen to all the good words from Joan, Archy, and Sara…! Whatever and whenever you decide to do anything if anything we are here to listen….unfortunately, I know too much about DV situations….I have been punched in the face on 2 separate occasions (and saw stars!) and that was enough to see that that was the end of that sorry relationship….(BTW he was married, but not to me! There is no excuse for what he did to you!) It took me 7 years to see a way out of the sand trap he built… Read more »
Archy ~ You are right on!!! While we can understand factors that may play a role in violence, there is never ever an excuse. The first step is to seek safety from the situation, if not for one’s self then at least for the children. Exposure to domestic violence greatly increases a child’s likelyhood to grow up and be a batter themself never mind all of the other damage it can do. Joy~ I hope you will follow Archy’s recommendation. Yes, he may very well be depressed however, he has a responsibility to you, himself and his family to get… Read more »
And if caught early on the chances of reoffending probably drop considerably.
Sarah, I agree with you and Archy, Joy be safe and make sure he’s safe too. Also, infidelity comes with a lot of guilt, self-esteem issues, criticism, deception, and silent treatment. The infidelity and contact with the other woman needs to stop first, before anything will get better and trust can be rebuilt. Maybe, if you can, bring up the subject of exclusivity and see where he stands on this issue. Give him some time to think about it and break it off with the other women. Let him know his infidelity hurts you. I’m concerned about your self-esteem too.
Oh goodness. This list is everything me and my husband. He has become extremely irritable over the last two months. Last Monday he banged a mug of tea against the wall in front of guests just because I had asked him a question. Same night he slept at 3am, but after pissing all over the loo. Saturday night, just 5 days later he started a fight just because I had missed his call. He called me all the names in the book, hit my face, twisted my arms and shoved the baby. Then he drove off at 1230am and came… Read more »
I’d advise first looking up information about domestic abuse, how to stay safe specifically. What you’re describing could be depression but it’s abuse fullstop. Depression can help make abuse worse but it doesn’t cause it in all people, I get irritable myself but I just hide away in my mancave or whatever, I don’t go hitting people. Tell him he HAS to see someone about it, anger management and a therapist to overcome the depression and abusive behaviour because you shouldn’t put up with it. Don’t expect it to be cured overnight and you have to make the decision on… Read more »
Hi Joy – the important messages re ensuring safety for you and you child have been sent so I will just say I will pray for you and for the best outcome. You clearly are going above and beyond to make it work even with outrageous and unacceptable behavior from your husband. But be safe first – that is the most important thing for you and your child.
Great article…especially #1….My karate master would be a rage machine sometimes when he came to class…I only got the details later after he spilled out his anger on us….sometimes it is so hard for women to figure out why men behave the way they do….especially when they act so scary and out of control….sometimes he will open up and tell me what sort of drama is going on in his life….sometimes he self medicates with alcohol or other substances to calm down, which makes me keep my distance from him…
Thanks for writing this…it explains a lot!
Anger and irritability is a big sign along with motivation, I think many people just don’t realize that can be depression. Most of my friends suffer depression, it’s pretty sad how prevalent it is amongst men and very few of them goto the doctor for it and I doubt their female friends n family even realize they’re depressed.
Archy, you bring up a really good point that even female friends and family don’t realize it. I see this as a symptom of our larger problems with men in our society. I’ve worked with men that are in the range of the minor cases of the blues to full scale depression. It’s hard for men to express, hey I need someone. Men usually don’t ask for help, but men’s actions speak louder than words. That’s why being connected is important. I’m always preaching about marriage and bringing men and women together for that sense of belongingness we all need.… Read more »
I had a female friend say that in highschool I was CONFIDENT but really that was one of the worst times for my depression, I was suicidal, I had major social anxiety disorder and was very shy. I guess my poker face can be excellent?
Sarah, Thanks for your fine article. I’ve been working with depressed men for more than 40 years as a professional (I’ve also dealt with my father’s attempted suicide and my own feelings of anger and hopelessness). I’ve written a book called The Irritable Male Syndrome: Understanding and Managing the 4 Key Causes of Depression and Aggression. I also developed a new assessment scale that offers new criteria (such as the ones you mention) to help us better diagnose and treat depressed men. Feel free to contact me for more information.