Wednesday, January 18, 2012

Time for Sanity About Men's Mental Health

The Guardian today raises some interesting and life-impacting questions about men's mental health. Here's the headline:
We tell boys not to cry, then wonder about male suicide
This story is timely. In the last year we've heard reports of hockey players, with a history of depression, who have taken their lives. Also, many of us have male friends and acquaintences who have killed themselves. The Guardian article, by Ally Fogg, is based on the weekend disclosures by former English footballer Dean Windass that he twice tried to take his own life.

Fogg, correctly noting the horrid teaching that many of us men had as boys, that we shouldn't cry, that tears are a sign of weakness, and not appropriate for a real man, writes: 
With such beliefs (literally) beaten into us from an early age, it is easy to be shocked by the candour of the former footballer Dean Windass. In a heartbreaking interview on Sunday he described two suicide attempts in the past few days. "Everyone thinks that Dean Windass is a laugh and a joke and a kid blah blah blah, and got loads of money and his wife and kids are lovely," he told the People. "But that's all a mask. I was in pieces, I couldn't stop drinking or crying. I've cried every day for the last two years."
 Windass is suffering from depression. Interesting, at 42, he is the same age as the Wales manager Gary Speed who committed suicide in November.

From the Sunday story on Windass: "The former Hull City striker admitted to The People this week he is battling booze and depression after retiring from the game he adored.... He said: 'I have cried every day for the last two years since retiring.'

Whether men are taught to repress emotion and tears, or not, we still have emotions. And many men, who won't admit it in public, cry in private. We suffer from depression, but often are reluctant to seek help, or to become so weak as to accept the stigma (often self-imposed and only in our own minds) of having to take anti-depressants. Many men instead self-medicate. For years, as I coped with chronic depression, the local bar was a favorite place to self-medicate.

It stuns me when I hear boys are still told that men don't cry, to wipe up the tears and don't carry on as a sissy. Such ill-founded advice can become the words which help drive some of them to a self-inflicted death as men, or even when they're teenagers.

Retirement is a horrendous experience for many men, especially for top footballers such as Windass and other athletes who, due to the relentless process of aging, have to retire from what they love so much at relatively young ages. Why should anyone be surprised that depression and suicidal thoughts often follows such retirements?

For any of us who have work for which we feel passion and are good at, depression ramps up when we can no longer do what we love. It's that work which provides meaning and purpose for many men (and women), and when we can't do that work the meaning leaks out of our lives, to be replaced with feelings of desolation. With the desolation it's common for thoughts of suicide to arise. I'm on disability, unable to do the work I love (spiritual care and therapy), and so I speak from experience. In the last year, for the first time in my life, I have faced thoughts of taking my own life. It's scary as hell.

But unlike some of the people we read about, and all too many of those who actually take their own lives, I am fortunate. I have an excellent psychiatrist who I see weekly. I have my mindfulness practice. I began taking karate in fall 2010. I take my medication - and yes, though often I still feel the incredible pain of depression, the medication helps. It shifts the balance of forces in my favour. Anything that helps is good. And, I live with the growing hope that by the end of this year, I can again be a working chaplain and therapist - everything I do in the meantime is aimed at that, and that's the point. I am fortunate enough to have a plan and a strategy, and all the professional help I need. All too many men do not. The same goes for women, and youth of both sexes.

Also, during more than a decade of providing spiritual care and therapy to others, I relearned the valuable lesson that there's a place for tears. Tears help. They may not solve a problem, but they provide a valuable release. I feel no shame about my tears, even though I grew up with the "men don't cry" teaching.

The Guardian story notes men often don't do a good job of accessing mental health services. When they do, they may also have alcohol or drug problems. Traditionally, both the mental health and addictions services have not worked well together, and that means increasing the chances of patients falling through the cracks created by professionals who should know better.

(Dr Ken Minkoff, a Harvard psychiatrist, has developed what's known as a co-occurring disorders initiative, so that any person with both a substance abuse problem and a mental health issue can receive timely, integrated care. He's created what he calls a "Comprehensive, Continuous, Integrated System of Care (CCISC) Model." I urge people to check out his site; it reflects an ideal which in most places doesn't exist, yet it provides a strategy for how care can be provided for people with alcohol/drug and mental health issues. Minkoff is doing some of the most important work in the field today.)

Another aspect to men and mental health has to do with the somber reality that men, as well as women, are sexually abused as children. Some estimates say as many as 20 percent of men may have experienced childhood sexual abuse (compared with 30 to 35 percent for women). Yet, men are much less likely than women to disclose their sexual traumas. That's changing, and some courageous men in professional sports have set a good example by disclosing. The point, though, is that undisclosed, untreated childhood sexual trauma becomes one more suicide risk factor for men later in life.

From my perspective, we need to do much more for both men and women to ensure the availability and utilization of good mental health care. It's time to deal with stigma, and to ensure health care systems and professionals provide the care we deserve so we can heal, and so suicide statistics decline.

I'll give the last word to Ally Fogg, using the last words of his fine article in The Guardian today:
There is no single, simple solution to the suicide epidemic. The first stage must be to acknowledge the problems, at both an individual and societal level. It takes immense courage and strength for men to speak about their own mental health, flouting our deepest conditioning. For that reason, we should not only wish Windass a full recovery from his current illness, but recognise that in speaking up and seeking help he did something more courageous, more important and, perhaps, more truly manly than anything in his distinguished career on the pitch.


  1. This is important. I am a fellow traveller with respect to all problems mentioned, and really appreciate the thoughts, and the links given, etc. It should continue to be visible.

    Tho. Sissy article, eh? &^)

  2. John, thanks for the feedback. I appreciate it.


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