Although I’ve been fairly receptive to getting help for depression, I went through a long period of refusing to consider it and denying that I had a problem, even though I needed treatment more at that time in my life than at any other. When I read about the stereotypical behavior of men in dealing with their emotions, I have to say I was a living, breathing example of everything the studies say about my gender.
I was out of touch with my feelings, got angry and aggressive instead of overtly depressed, denied have any emotional problem (in fact, I’d get angrier while denying I was angry), never talked about my feelings, believed I could handle any problem on my own and blamed others for any unhappiness I might be experiencing.
Getting help was out of the question - who needed help? But one crisis after another finally left me with nowhere else to go, and I went to see a psychiatrist for the first time in 10 years. Even then, I wasn’t willing - let’s be honest, I was scared - to discuss everything I was going through and tended to understate and dodge the really tough stuff. So it took another five years and several further crashes before I really opened up and made my own commitment to work as hard as I could to recover from depression.
I know a lot of men who have been through this cycle of moving ahead a step, then back again, never quite able to make the full commitment to follow through with treatment. This ambivalence and the difficulty in being honest about emotions don’t disappear, even after a man has admitted he has a problem and takes the first step toward getting help. The inner drag on openness can continue to color every phase of the treatment process, right from the first visit to a doctor’s or therapist’s office.
To begin with, he may seek help for a problem, but not the problem of depression. It’s much easier to talk about other symptoms that men experience like uncontrollable anger, anxiety, nightmares, insomnia or trouble at work than about a mental disorder like depression. One study quotes a great example of this form of avoidance by a man during an intake interview. He reports having trouble sleeping, concentrating, doing well in his classes.
When prompted, he says that at about the time those problems started, his girlfriend broke up with him. He denies being sad about that, and when asked by the therapist what he’d like counseling to accomplish he says: “I want you to help me not think about it.” Hopefully, he got beyond that expectation during the counseling sessions, but his initial description of the problem sounds all too familiar to me.
Research bears out that idea that men don’t say a lot. As some doctors report, men tend to “undersell” their symptoms. Other providers describe what they see as gender differences: men bring out their symptoms in the midst of a crisis, women before a crisis. Some confirm the difficulty men have in identifying the underlying problem: they talk about physical symptoms instead of their state of mind. Either they don’t think much about feelings or they believe that talking about them will only make things worse. They’ll be “wallowing” or succumbing to negative emotion instead of doing something they think is positive, like going out with cheery friends to have a good time.
