Men and Women Differ When they Suffer From Depression By Gay Moore M.Ed. RNC

Dave spends most of his time working, watching sports on TV, and playing computer games. Uncommunicative and uninvolved, he seems to have lost interest in his family. He often has difficulty sleeping or sleeps most of his non-working hours. His interest in lovemaking is practically non-existent, and he has an increasing number of vague physical complaints. Small matters upset him out of proportion to the seriousness of the situation. He complains about his work and has difficulty getting along with others. Pleasing him is nearly impossible and he is increasingly pessimistic. In short, living with him is increasingly frustrating. Rather than being deliberately difficult, he may be depressed.

Depression is often considered a women’s disease, even by physicians and pharmaceutical companies. Women are often pictured in those glossy drug company advertisements and physicians are generally alert to the signs of depression in their female patients. The Diagnostic and Statistical Manual of the American Psychiatric Association (the manual that describes mental illnesses for purpose of diagnosis)  describes depression as a complex of symptoms: loss of interest in previously pleasurable activities; decreased sexual desire; difficulty sleeping or over-sleeping; weight gain or loss when not seeking to do so; increased agitation, anger, hostility or over-reacting; increased pessimistic thinking and feelings of hopelessness; vague physical complaints in the absence of identifiable illness; loss of energy; and feeing as of guilt and thoughts of suicide.

While research indicates that women are twice as likely to be diagnosed with depression as men, one in six men will suffer from depression at some time in their lives, as compared to one in four women. However, men often exhibit different symptoms than women. Women are more likely to acknowledge and verbalize feelings of sadness and hopelessness. Men are more likely to follow the pattern of adolescents and children, experiencing increased irritability, agitation, withdrawal from others, loss of energy, and physical complaints. This is especially true in more moderate episodes of depression.

When we look at the other symptoms of depression: markedly diminished interest and pleasure in almost all activities, insomnia or over-sleeping, weight gain or loss when not dieting, agitation or loss of energy, and difficulty concentrating, a picture of male depression emerges.

If you suspect a man in your life is depressed, convincing him to seek treatment may be difficult. Many men see depression as a woman’s illness and a sign of weakness. Suggestions that he see a psychiatrist or counselor may be met with angry denial. However, you may be able to convince him to see a physician for his lack of energy or other physical complaints.  While one can not count on a physician detecting depression in a man who is an expert at looking “okay,” if you have a good relationship with his doctor you might inform the physician of your observations and suspicions prior to the visit.

A supportive, non-accusatory discussion may induce him to consider the possibility. Giving him information from the Internet or even this article may convince him to seek help.

Fortunately, medicines developed in the past few years can effectively treat depression. The newer drugs are relatively free of side effects, and if side effects, especially sexual side effects, develop a different medicine can be substituted. Research shows that combining medication with counseling is the most effective treatment for depression. The Employee Assistance Program at his place of work or a member of the clergy may be more acceptable to him, but certainly there are many good counselors and psychologists who can assist him.

Even if he refuses to seek professional help, there is still hope for improvement and possible recovery. Most depressive episodes are self-limited and some improvement is likely even if he receives no treatment.

The better news is that mild to moderate depression responds well to aerobic exercise. Researchers at a number of different institutions indicate that exercise has multiple benefits in helping manage depression. Indeed, up to 90% of research participants report some relief from depression by following an exercise regime.  Research conducted at the Mayo Clinic indicates that “exercise positively affects the levels of certain mood-enhancing neurotransmitters in the brain.”  Some researchers believe that regular exercise alters the levels of two neurotransmitters found in the brain, serotonin and endorphins, leading to elevation of mood and easing of depression.

Furthermore, exercise tends to promote better sleep, increased energy, and a sense of calm self-control, as well as providing a distraction from cycles of pessimistic thinking. Since exercise is generally done outside and with others, there is even a mood elevating benefit from increased sunlight and decreased isolation.

Almost any enjoyable physical activity may result in decreased depression. Walking, biking, jogging, swimming, softball, and weight lifting, even dancing, yoga or Taekwondo, will likely reap beneficial results. (Exercise with him. Living with someone who is depressed is depressing and exercise may well help you as well.) The best news is that research indicates that even 30 minutes a day three to five times a week is helpful. Exercise “may not be the magic bullet, but increasing physical activity is a positive and active strategy to help manage depression and anxiety,” according to Mayo Clinic psychologist, Dr. Kristin Vickers –Douglas.

Combining appropriate medication with counseling and increased activity often leads to dramatically improved mood and functioning.

Depression is one of the most successfully treated emotional illnesses, but failure to treat it may result in more than living with a grumpy coach potato. While more depressed women attempt suicide, depressed men are more likely to actually die by suicide. So act and act forcefully. You may not only improve the life of a man you love, but you might also save it.

 

For more information check out the following websites:

www. overcoming-depression.com/man-and-depression.html www.mayoclinic.com/health/depression-and-exercise/MH00043 www.betterhealth.ic.gov.au/bhcv2/bhcarticles.nsf/pages/Depression_andexercise  

Interview with Brennan Francois, MS Chief Executive Officer Parkridge Valley Hospital

Recently I sat down with CEO Brennan Francois in his office at Parkridge Valley Hospital, a local psychiatric facility owned by HCA Healthcare, to discuss some of the major issues confronting mental health care.

Personable and articulate, Mr. Francois began his career in mental health care while still in college with Parkridge Valley as a technician in the adolescent treatment unit. Rising through the ranks to his current position, he has seen psychiatric care from the point of view of an entry level employee through his current CEO position.

When asked about the some of the major issues impacting the delivery of mental health services, he immediately stated that while Congress passed the Mental Health Parity Act some years ago, requiring insurers to pay for mental health care at the same level as physical health care, the regulations as to how such parity is to be achieved have yet to be passed by Congress and implemented by the Department of Health and Human Services.

Thus insurances companies continue to reimburse providers at sub-parity levels resulting in short hospital stays (six days on average) which are woefully to adequately treat serious mental illness. Add to this the lack of out-patient resources to provide continuing care and we have a national mental health care system that is in crisis. Small wonder that jails and prisons have become de-facto treatment options for many mentally ill persons.

Anther factor adding to the difficulties faced by those who access the mental health treatment system is a shortage of psychiatrists, resulting in wait times for non-emergency out-patient appointments of up to six to eight weeks.  Mr. Francois stated that the region which includes Hamilton and several surrounding counties is currently twenty-eight full-time psychiatrists short.

Another issue is the shortage of both private and public in-patient beds. This is coming at time of not only stagnant re-imbursement rates to private hospitals, but also in the wake of dramatic reductions in funding for state regional psychiatric hospitals.

Mr. François would also like to see an increased number of psychiatric beds designated for the treatment of young adults, 18 to 25 years of age. At present, an in-patient psychiatric unit may include three or four generations, often negatively impacting the therapeutic milieu when younger patients, who may be more disruptive and who certainly have different life concerns, are housed with older adults.

 

Mental illness is seldom a discrete, acute condition, which can be “cured” with a single in-patient stay. Instead, most psychiatric conditions, like major depression, bi-polar disorder, and schizophrenia, are chronic. Thus clients require a continuum of care from in-patient hospitalization to out-patient counseling and community services. Such services are currently over-stretched and inadequate. Mr. François cites the need for more social workers to assist clients in managing chronic illness and group homes for those who experience difficulty functioning outside of a structured environment. He also cited the need for respite care for the high percentage of the mentally ill who are cared for by family members, as well as medical group homes for those who suffer from chronic medical illness as well as mental illness.

 On the positive side, Mr. François sees the increased use of partial hospitalization and intensive out-patient programs as effective ways of helping clients avoid repeat hospitalizations.  Increased partnering and cooperation among mental health providers, including the local Crisis Response Team, is also a positive development. Additionally, the local sheriff’s department and county jail personnel have received intensive training in handling mental health issues which has also netted positive results. He also cited the increased presence of specialized dementia assessment and treatment units as a positive approach in meeting the needs of the growing elderly population.

When asked how health care reform will impact mental health care, Mr. Francois reiterated that while there is much uncertainty about the effects of new government policies and regulations, he hopes that health care reform will finally result in parity for psychiatric treatment and increased incentives for cooperation and collaboration among mental health care providers.