Tuesday, 27 October 2009

Depression - A Silent Killer

It seems that one of the most prevelant conditions being treated by doctors in Ireland at the moment is depression.  As a counsellor it is certainly one that I am seeing more and more in clients that present for therapy.  Maybe the recession is having an effect.  Perhaps the economic situation is so precarious that people are worried about their jobs, bills to pay and everything that comes with an economic downturn like we are currently experiencing.

Anecdotally there are more prescriptions for anti-depressants being filled at the moment than most other medications.  It would be interesting to see if there's a study being done on the gender balance of those filling the prescriptions / being treated for depression.  In an article in the "Irish Examiner" on 17th September 2009, Conall Ó Fátharta reported that:

"RECESSION depression among Irish men is on the rise as people struggle with unemployment
and changed financial circumstances in the midst of the downturn."



In the article, Edel Fortune, clinical manager of the wellness and recovery centre of St. Patrick's Hospital commented that men do not sem to have the same support structure as women.  They tend not to want to talk about it - they don't want to be "the odd one out".  According to Aware, which provides support for those suffering from Dpression,  there are over 400,000 sufferers in Ireland.  They say that women are three to four times more likely to suffer from depression than men.  This may well be the case, but there is also a school of thought that says that a lot more men suffer from depression, but because they don't seek help, it's not reported and therefore not included in the statistics.

These statistics are stark and highlight the need for a greater emphasis on mental health services, particularly during recessionary times.  When money gets tight and jobs are lost, mental health becomes less of a concern.  Yet it is exactly at this time that more people need support from these services.  While "Recession Depression" is recieving some coverage, it is important to note that this illness is quite pervasive and just because someone still has their job, and is "doing quite well" in financial terms, doesn't mean they are immune.

As I mentioned in my previous post, I recently attended the funeral of a man who died by suicide.  Almost everyone there was shocked to be at his funeral.  Most people spoke in terms of a "fun guy" who was great craic.  This is often the case. Very few people were aware that he was suffering from Depression.  This is yet another common trait.  Certainly in Ireland there is a stigma attached to depression and other mental illnesses.  It's not talked about, quite often brushed under the carpet or ignored.  Men, in particular, are in denial when they are suffering from this condition. 

Because men don't seek help, the duty of care falls to those around them.  In Ireland we are great at making sure our friends and colleagues are OK if they've had a physical illness.  They take time off work, they are encouraged to go to the doctor / physio etc.  However, we are also great at turning a blind eye to anything else.  If our colleague / friend / brother / dad / husband or lover is mentally or emotionally "not himself" we tend to "leave well enough alone".  Unfortunately, too many of us have stood at the graveside of friends and family and listened to people saying "If only I knew".  We need to make it our business to know.  If someone seems "out of sorts" - they probably are.  Why not ask if they're ok.  Make sure they know that there's someone around who can listen - or point them in the right direction.  Over 400 Irish people died by suicide last year - actual deaths, not attempts.  Suicide has touched everyones life.  Depression and suicide are linked.  Ask the question!  Isn't it better to have a row about being nosey and interfering than to wonder "If only?"

It is important to know what to look for.  The following are the symptoms cited in cases of a major depressive episode.  These normally develop over a period of a few days / weeks.  Diagnostcally 5 of these should be present in the same two week period.  For a major depressive episode, symptoms should be present on a daily basis.


  • Depressed mood (such as feeling sad, empty)


  • Markedly diminished pleasure in all (or almost all) activities


  • Insomnia (or hypersomnia)


  • Increase / decrease in appetite or significant weight loss


  • Fatigue / loss of energy


  • Feelings of worthlessness


  • Excessive or inappropriate guilt


  • Diminished ability to think, concentrate, and/or take decisions


  • Recurrent thoughts of death, suicidal ideation, having a suicide plan or making a suicide attempt.

Aware have a support line (1890 303 302)  for those suffering from depression or their concerned family and friends.  The Samaritans have a 24 hour helpline on 1850 60 90 90.  Childline are on 1800 666 666, Schizophrenia Ireland are at 1890 621 631.  Your local GP can help you if you are concerned about a family member.  Let's not lose any more friends to depression and suicide. 

As R.E.M say in their song "Everybody Hurts":
"When the day is long and the night,
the night is yours alone,
When you're sure you've had enough
of this life, well hang on
Don't let yourself go, 'cause everybody cries
and everybody hurts sometimes"

Monday, 26 October 2009

Why do men not seek help?

Why is it that a man will notice the slightest “odd sound” in his car’s engine, and rush off to either fix it himself or take it to a mechanic to have a look at it? How often have you been in a car with a male friend or relative and they’ve suddenly said “Did you hear that? That doesn’t sound right, I must have that looked at as soon as I get home”. Then suddenly there’s whole big project around making sure that whatever work is required is done,and in the most expeditious and efficient manner possible. Sound familiar? We probably all know this guy. He’s our dad / brother / boyfriend / husband / lover.

Compare that with how often you’ve heard a man say “I really don’t feel great, think I’ll pop along to the doc and have him check me out” or “I’ve been a little bit down lately, I’m worried about myself. I’m going to take a little time and try an figure out what’s upsetting me”. Sound famliar? I’m not so sure many of us know this guy.

I’ve just returned from the funeral of a man that I didn’t know very well. (He was an old friend of my partners). This man was in his late 40’s and died by suicide last Sunday (18th Oct 2009). Ar dheis Dé go raibh a anam. There was an estimated 4,000 people at the removal and between 2,000 and 3,000 at the funeral mass. The one comment that struck me over the last couple of days, was the amount of mourners that said, “If only he could see the amount of people that turned up for him” or “And he thought he was alone”.

As I sat in the church after the mass, while people sympathised with the various family members, I was struck by the amount of people who were genuinely upset,in some cases distraught,at the loss of this person from their lives. As usual, in my experience of Irish funerals, all of those upset were female. There were numerous women, of all ages, openly grieving their friend, while practically every man was being “brave” and “stoic”.

You could ocassionally see a male hand scratching the side of a nose,or rubbing an eye. Openly wiping a tear, would nor have been acceptable? Whilst I can’t claim to have seen every man at the funeral, the difference was notable. Personally, I too had very itchy eyes / nose at what was a moving service for someone who else who has gone too soon.

Why do we do this? What is it in men, that prevents us from reaching out? Do we rather suffer in silence , than ask for help with our pain? whether it’s physical or emotional. In 1975 a man was 2.4 times more likely to die by suicide than a woman- in 2005 that ratio had risen to 5:1 (W.H.O. Figures). How much more suffering an needless death must we experience before we start to wake up and smell the coffee?

Maybe it’s time to change our definitions of masculinity and male-ness. Is it time to accept our weaknesses, insecurities and vulnerabilities and allow those who love us, see and share our fears and worries? As Dr. Robert Anthony said:

“Courage is simply the willingness to be afraid and act anyway”