Boys dont cry
Boys dont cryMale Pattern Depression
A glimpse into the Male Mind proceed with CAUTION!Challenge
Frightening
Fun Collecting intelligence from the other side
DisclaimerI am a lot of things:FatherHusbandParamedicGoof-ballI
am NOT a licensed mental health professionalProduct of personal
experience and a sincere desire to teach othersIve also been a guy
for a little over 42 years
What does it mean to be a man?
Popular cultural stereotypes:Sexually, financially, and
physically POWERFULProvider, head-of-household,
disciplinarianIndependent, self-reliant, the RockWhat happens when
he fails to meet these expectations?
Forms of DepressionMinorLess severeNot as long lastingDysthymic
DisorderLess severe symptoms than major depressionLong lasting (2
or more years)Major DepressionSymptoms severe enough to disrupt
most aspects of life: work, sleep, relationships, etc.May be a
single episode, but several over a lifetime are not uncommon
General Symptoms10 15% of populationMajor Depressive EpisodeMost
of the day, nearly every dayMarkedly diminished interest in
pleasurable activitiesSignificant weight loss / gainInsomnia or
hypersomniaPsychomotor agitation or retardationFeelings of
worthlessness or excessive inappropriate guiltDiminished ability to
think / concentrate or indecisivenessPreoccupation with death
(risk-taking behaviors)Major risk factor for suicide
Men vs. Women: Arent we basically have the same?
Okay, I guess there are important differences
Men are from Mars and Thats Probably a Good Place for them!Women
tend to:Blame themselves (internalize)Feel sad, apathetic, and
worthlessAnxious and scaredAvoid conflictsFeel slowed down and
nervousTrouble setting boundariesTalking is easierUse food,
friends, & love to self-medicateMen tend to:Blame other
(externalize)Feel angry, irritable, and ego-inflatedSuspicious and
guardedCreate conflictsFeel restless and agitatedNeed to feel in
control at all costsFind it weak to admit self-doubt or despairUse
alcohol, TV, sports, and sex to self-medicate
What Do Depressed Men Look Like?Depression affects approximately
6 million men each yearNot just the blues, feeling
down-in-the-dumps, or any other similar characterizationExperience
trouble coping with daily lifeLose interest in everything for weeks
at a timeMore likely to express depression
asIrritabilityAngerExtreme fatigueWomen tend to internalize and
express feelings of sadness and worthlessness
Male Depression and SuicideWomen attempt more often, but men are
more likely to complete (degree of lethality of method = 75 to 80%
of deaths due to suicide are men)Tendency to act more quickly on
suicidal ideationDenial, mask symptoms, social isolation,
unwillingness to reach out / seek help
Why Do Men and Women Experience Depression
Differently?GeneticsPredisposition NOT destinyBrain chemicals How
they are used, produced, and maintainedHormonesCan affect brain
chemistryLife ExperienceLose a job, divorce, promotion, baby
Often masked by unhealthy coping mechanismsDenialSubstance
AbuseInfidelity or unsafe sexual behaviors
Common S / S in MenInability to meet responsibilitiesHopeless,
irritable, anxious or angryLoss of interest: work, family, even
SEX!!!Not being able to concentrate or remember detailsInsomnia to
sleeping too muchSuicidal ideation / attempts (lethality)Aches /
pains, headaches, cramps, digestive problems
ComorbiditiesSubstance Abuse
Anxiety Disorders
Schizophrenia
Why Might Depression Go Undiagnosed in Men?Failure to
recognizeNot necessarily feel sad or emotionalOften complain of
physical symptoms rather than feelingsHeadachesDigestive
problemsFatigueIrritabilityChronic painDownplay signs and
symptomsIts not my problem, its you (denial)Oblivious (willful
ignoranceI have no right to feel depressedSupposed to be successful
tough guyReluctant to discussSeeking isolation as well as loss of
interest commonEmphasis on emotional control (talking =
weakness)Social stigma
Okay, MAYBE Im depressed Now What?Seek helpSchedule a doctors
appointment referral to mental healthUnderstand that this is not a
sign of weaknessDepression is unlikely to just go away and may get
worseCauses problems in every aspect of your life!
Most importantly:Depression makes you and those that care / love
you
MISERABLE
Common MedicationsSelective Serotonin Reuptake Inhibitors
(SSRIs)Fluoxetine (Prozac)Citalopram
(Celexa)Serotonin-Norepinepherine Reuptake Inhibitors
(SNRIs)Duloxetine HCl (Cymbalta)Tricyclic Anti-DepressantsLess
commonly prescribed due to the potential for overdose
Cool Things I Found on GoogleThese can be contrasted with the
more widely used selective serotonin reuptake inhibitors (SSRIs)
which act upon serotonin alone.
Serotonin
Cool Things I Found on GoogleSNRIs act upon, and increase, the
levels of two neurotransmitters in the brain known to play an
important part in mood: serotonin, and norepinephrine.
SerotoninNorepinephrine
Cool Things I Found on Google
Cyclic antidepressants block the absorption (reuptake) of the
neurotransmitters serotonin (ser-o-TOE-nin) and norepinephrine
(nor-ep-ih-NEF-rin), making more of these chemicals available in
the brain. This seems to help brain cells send and receive
messages, which in turn boosts mood.
Cool Things I Learned from Google: Neurotransmitters
Truth About MedicationsAntidepressantsDont make you happyTake
time to workUse caution when adjusting doseSide
EffectsHeadacheNauseaDifficulty sleeping / anxietySexual
problems
Talk to MD: change / adjust the medicationSide effects should
decrease over time
TherapyThe key is finding a competent individual that you can
work with fit is everythingMany different typesDevelop new ways of
thinking / behaving (fake it til you make it)Change habitsBuild on
coping skills
Coping SkillsMaladaptive: denial / blunting through substance
abuse, isolation, angry outbursts, working longer hoursBetter
techniquesGoal settingSeek supportActivities: borrow a friends
dogDelay big decisions
LifestyleExercise RegularlyBoosts serotonin and
endorphinsAdjusts brain structure / chemistry similar to
antidepressantsBoosts self-esteem and helps improve sleepEat
WellKeeps up energyMinimizes mood swings
Lifestyle Changes: Embrace the Power of Less and NoGet enough
sleepSymptoms are worse when you are tired7 to 9 hours per night is
averageReduce stressNot eliminateEustress vs. DistressManaging
stressRealistic goalsBreaking tasks down into manageable partsBuild
social support networks (find a good friend)
Create Win-Win Scenarios: 1 + 1= 3Get an exercise buddy or join
a group (accountability)10 minute walks with a friend + 30 minutes
of vigorous exercise can boost mood all day ;-)Add mind-body
elementSensation of feet touching the groundMuscle working as you
lift the weightLet family and friends help youParticipate in social
activities even if you dont want to volunteer, common interests,
email an old friend
How Do I Help Someone that is Depressed?Help him to find a
doctor or mental health professional Offer support, understanding,
patience, and encouragementTalk and listen carefullyNEVER ignore
comments about suicideInvite him to participate in activities keep
tryingEncourage him to report concerns about therapy and / or
medications side effectsRemind him that it gets better with
time
How Do I Talk to a Man About DepressionFocus on changes in
behavior rather than talking about feelings (at least
initially)Suggest a doctors visitRule out medical causesExpert
opinion may be less threateningOffer to go with him on the first
visitEncourage him to make a list of symptoms to discussFeelings,
physical ailments, and honest disclosure about alcohol and other
substance use / abuse
Thank YouQuestions?Brian Ehlenbach, MBA, NREMT-PCritical Care
[email protected]
