Sadness, hopelessness, fatigue and anxiety.
These are some typical symptoms of depression that are relatively easy to recognise in ourselves or someone close to us.
However, in men, the signs are not as clear-cut.
Men are more likely to avoid expressing the vulnerable emotions that come with depression.
“Instead, they might complain about physical symptoms such as sleeping and stomach problems, headaches, back pain and fatigue,” says Cassey Chambers, operations director of the South African Depression and Anxiety Group (SADAG).
“Avoidance can also lead to typical symptoms being suppressed by abusing alcohol and drugs, womanising, overspending, workaholism and other high-risk behaviours,” Chambers adds.
In fact, men in South Africa are four times more likely to commit suicide than women, according to a recent report by the World Health Organization.
From when they are little, most boys are directly or indirectly taught that showing distress is “weak” or “unmanly”.
According to young men are told they should “just grow a pair”, and “this is life, deal with it”, say psychologists Sian Green and Marteleze van Graan of Satori Centre for Interactional Wellness in Pretoria.
They say these messages stay with boys when they become men and try to deal with depression and dayto- day life.
“Men are as relational and as emotional as women, they are simply trained to disconnect,” adds Terry Real, an American clinical social worker and expert in male depression.
NOT A WEAKNESS
Depression is more than just the blues. “To a person suffering from depression, it is a big thing.
It is not just the usual sadness when you wake up and you’re not in the mood,” says Johannesburg psychiatrist Dr Jan Chabalala.
He explains that it is a severe, universal illness that can take away your ability to function.
Depression can affect personal relationships, work, sleeping and eating patterns and can lead to suicide.
Chabalala says trauma, losing a loved one and post-traumatic stress also increase your risk of developing depression.
“People must look for help. There are people who understand it and are willing and able to assist,” he says.
The number of calls from men to the SADAG helpline have increased in the past decade.
“Especially from older men,” Chambers says. “But they still tend to leave it until late and then the calls are of a more serious nature.
“There is still the perception that someone with a mental illness is dangerous or weak. Because there is often an absence of physical symptoms with mental illness, it’s considered not real, a figment of the imagination.”
She adds that sufferers are afraid of being discriminated against at home or being let go from work if they admit to being depressed or feeling suicidal.
“Many also don’t know where to go to get help,” Chambers says.
“Nurses, doctors and social workers at government clinics, as well as support groups, counsellors, community leaders and traditional healers can step in where institutionalised help is not available.”
Treatment for depression can range from talk therapy to lifestyle changes or medication, and it can be temporary or lifelong. HOW TO
HOW TO SUPPORT SOMEONE WITH DEPRESSION
Just be there, says American psychologist Deborah Serani.
“When I was struggling with my own depression, the most healing moments came when someone I loved simply and wordlessly held my hand or spoke warmly to me with statements like, ‘We’re going to find a way to help you to feel better’.”
– Don’t judge or criticise. Avoid saying things like, “I think this is all just in your head. If you got up out of bed and moved around, you’d see things better,” Serani says.
“These words imply that your loved one has a choice in how they feel – and they have chosen, by free will, to be depressed. It’s insensitive and can isolate your loved one even more.”
– Avoid the tough-love approach. Some people might intentionally be impatient with their loved one, push their boundaries, use silence or even give an ultimatum like, “You’d better snap out of it or I’m going to leave,” Serani says.
“This is as useless, hurtful and harmful as ignoring, pushing away or not helping someone who has cancer.”
– Learn about depression. Once you understand depression, you can better support your loved one.
“For instance, some people assume that if a person with depression has a good day, they’re cured.
Depression is not a static illness. There is an ebb and flow to symptoms that many nondepressed people misunderstand,” Serani says.
– If your loved one is thinking about suicide seek medical attention ASAP.
Talk to the person about what you’ve noticed and why you’re concerned. “Explain that depression is a medical condition, not a personal flaw or weakness, and that it usually gets better with treatment,” Serani says. “Tell them that you’re willing to set up appointments and go with them if necessary.