Quite a few questions come my way about mental illness, treatment options and the like; most of which I'm able to give an answer to, even though that answer won't necessarily solve the problem. A lot of mental health is like that. Ways to alleviate rather than cure, ways to cope rather than solve, and explanations as to why we think something is the way it is. So, when I'm asked the question, "why is my dad depressed," the most I can really do, along with the person who is asking the question is speculate and offer advice.
I start with the most obvious question, "why do you think he's depressed?" I typically get the sort of answer that lists about five or six of the major changes or symptoms and I tease the rest out. I learn he's become indecisive, lacking in confidence, moody, self-absorbed. He won't meet with his friends. He constantly complains about things, about the people around him, about the meal he had last night, about the broadcasters on television. They hear him moving around during the night, boiling the kettle, bumping doors. The atmosphere in the house has changed. Everyone feels upset, nervous about his moodiness and his denial there is something wrong. They can't see that anything in his life has changed. He's middle-aged, in a steady job that he enjoys, and up to now he's always been calm, measured and good humored.
Everything at this stage points to depression, but it's not my place to diagnose especially on the basis of third party information. This is when I probably start to sound evasive, but diagnostic practice is both tried and tested, and exists for a very good reason. I point out that the signs of depression can occur for a number of different medical reasons and it's standard practice to rule these disease processes out before settling on depression. Sometimes this can be the tipping point in overcoming the male reluctance to seek help from their doctor. If there's a chance their symptoms point to something physically wrong, then they may swallow pride and go.
I think most people appreciate that the onset of depression can be caused by some major life change like a divorce, job loss, bereavement or maybe a clinical diagnosis with a poor prognosis. From what I gather at this stage, no such events have been identified, but it doesn't mean they don't exist. Another issue that comes to mind is the age of this man. As a middle-aged man there is always the danger that depression is viewed as a midlife crisis. Sometimes cynically referred to as the male menopause, we know that symptoms can last up to a decade and perhaps affect 20 per cent of middle-aged men. There is some evidence that men can experience huge levels of disquiet about the meaning of their life, it's purpose and their future, but overall the area is under-researched and poorly understood.
Activity seems to protect men from depression. Those whose lives tend to revolve around a desk and a car are therefore more prone unless they compensate in some fashion. Companionship is also important, so it was a little concerning to learn how he is putting this part of his life to one side, although understandable as a feature of depression.
It's just possible that if the problem is depression only, then it may resolve after a period of time. Twelve weeks is often used as a yard-stick, but if within this period symptoms are worsening then clinical intervention really is needed.
I won't deny there is something of a stigma attached to depression and it's just possible this man is fighting against the prospect of being diagnosed with a mental illness. Many men don't view depression as a "proper" disease and see it as reflecting some other weakness on their part. They seek solace and distraction in other places. If antidepressants were at the bottom of a bottle I wonder if quite a few problems might be solved. It doesn't work like this of course.
Despite everything, the central issue here is that depression is a treatable condition. There's no need to suffer or cause suffering to others. However, getting an otherwise healthy person to see the doctor is something difficult to avoid. Only the doctor can run the appropriate tests and only the doctor can prescribe the relevant pharmacological therapy.
You may have to chip-chip away in order to persuade him to see the doctor. You may want to consider pointing out that his misery can be lifted, that he and those whose lives he touches, are all being affected. Often, when men feel control over their emotions being taken from them, they resist with hostility. Despite this, they crave warmth, comfort, understanding and support from loved one's. Somewhere amongst this is an appreciation that what you are saying is right. You may need to sew a seed and let it germinate, but hopefully once the doctor hurdle is crossed things will become a little easier.
Published On: November 14, 2011