In many ways older men present healthcare workers and others with issues that belong to a particular generation. Not only may a sense of pride stand in the way of asking for help but this is a generation of men where the language of stress and depression simply doesn't exist. These are men who have very likely seen one or more armed conflicts. Their view of suffering doesn't include personal discomfort. They have grown up with a view of what it means to be a man and its emphasis on independence, strength of character and covering over emotions. However, older men account for one of the highest rates of suicide. As roughly half of suicides occur during depression the warning signs of this group of men must therefore be being overlooked, ignored, or not understood for what they are.
My own father-in-law, who died last November, was a good example. A former WWII pilot, he eventually developed heart problems and had a series of strokes in later life. He lived with us during his last few years of life and in the last few months he became increasingly depressed. The real signs came through body language and behavior as he simply would not discuss or acknowledge his mood. Watching him with his head in his hands and the look of utter despondency in his expression was difficult for everyone. His sleep pattern became increasingly disturbed and whilst we knew this was largely due to his physical state, his mental state suffered too.
There is no evidence to suggest that the symptoms of depression in older men are any different to anyone else. Equally, many of the causes of their depression are probably self-evident. Retirement comes with a loss of status, possibly influence and friendship. For many men their identity is shaped around what they do in life, so remove the job and their purpose in life goes too. Families will probably have moved on, illness and poor health move to the forefront, income levels diminish. Social activities tend to become restricted as mobility due to ill health, or money issues, or both, suffers. Eventually, friends die or they drift into the background because of their own health issues. It's a bleak picture and of course it isn't representative of all older men, but representative enough to be of concern.
Even when directly faced with an older man who is suffering with depression there is a problem of stereotyping. The grumpy old man is seen by many as a caricature, and an almost inevitable feature of aging. Complaints about aches and pains, bowel upsets and poor sleep all seem to be a feature of aging, despite the fact they are also signs of depression. Irritability and hostility do nothing to encourage help and unfortunately these too can be signs of depression in men. Unless these signs are viewed as possible indications of depression and probed a little deeper it's easy to see how depression is passed over, even during a clinical consultation.
Unless we remember to ask questions about loneliness, sadness, thoughts of suicide, and how the person spends their day, it isn't surprising that such people will continue to be overlooked. Even if some older men do see their condition for what it is they may fear the stigma of mental illness far more than what it is doing to them. Then again, some older men may not recognize or understand the symptoms of depression, or where it can lead, so it's up to others to advocate on their behalf.
Published On: May 23, 2011