Coercing Depressed Men into Treatment Acceptance…
Rochlen, A., Paterniti, D., Epstein, R., Duberstein, P., Willeford, L., & Kravitz, R. (2009). Barriers in Diagnosing and Treating Men With Depression: A Focus Group Report American Journal of Men’s Health, 4 (2), 167-175 DOI: 10.1177/1557988309335823
Women are diagnosed with depression two, four times or even more often than men are, and yet, men kill themselves ‘four to five times more often than women’ (Rochlen et al. 2009, n.pag.). Here, Rochlen et al. (2009) suggest that masculine ideals like ‘self-reliance, restriction of emotion, and toughness’ make it ‘difficult for men to recognize or acknowledge’ their own depressive symptoms. I find this a rather odd and implausible suggestion, at least with respect to the recognition component. While many men might indeed practice gender according to masculine ideals and therefore, purposefully hide or mask their depressive symptoms, it is quite the leap of logic to add that they might not even know what those depressive symptoms are.
Part of the confusion lies, I think, in confounding the lived experience of depression with the ways in which many men practice gender, as if masculine ideals like being isolative and avoiding help (2009) become alternative symptoms of the actual disorder of depression. That many men avoid seeking help for their physical and emotional problems cannot be automatically construed as symptomatic of anything. However, that avoidance largely explains why depression is such a gendered phenomenon. The greater acceptability of women rocking up to their GP feeling angry, low, flat, upset, or distressed and walking out the door with a truckload of mood stabilisers would be the other main contributor to the dearth of men in official depression statistics.
This article by Rochlen et al. (2009) reads like a marketing strategy to get more men onto meds. It certainly does not progress thinking on the relational problems caused by masculine ideals. For example, the authors advise health professionals to ‘maintain a high index of suspicion for depression amongst men’ who present ‘atypically’ (2009). That reads like poorly disguised code to me for health professionals to widen the net as far as possible and count almost anything as ‘depression’. As the closing words in this article call for greater ‘treatment acceptance’ (2009) by men who are allegedly depressed, I am left wondering why any man must accept treatment so blithely? Rather than trying to fit men within the prescribed box of medical orthodoxy, I say we should instead:
1. Pay closer attention to the causative factors behind depression; and
2. Critically analyse the treatment of depression in both women and men.
See also:
Rabinowitz, F., & Cochran, S. (2008). Men and Therapy: A Case of Masked Male Depression Clinical Case Studies, 7 (6), 575-591 DOI: 10.1177/1534650108319917
as man with serious depression and coming off ssris, i wish i never got “help”. i got given ssris with horrible side-effects making no difference to my depression and now i find out the ssri withdrawal could last months, and even discovered the possibility of long-term side-effects(Post-SSRI sexual dysfunction). i was even offered acupuncture…
the system of treatment for depression was a complete joke in my case, were the doctors ignorant or on the payroll?
http://thelastpsychiatrist.com/2009/05/ramachandrans_mirror.html – i thought this was a fantastic post on how simple treatments/solutions are often overlooked. the lack of logic involved in the treatment of depression and many other ailments is gob-smacking.
I have seen men do really well on medication in terms of treating their depression. I have also seen men for whom medication did nothing to ease the severity or duration of their depressive symptoms. My own professional belief is that changing negative feeling states requires attention to what brought that person to that point in their life in the first place and what tools they need to muster on to a brighter future.
ah, but that would require therapy, and Manly Men don’t talk about their feelings! So much easier to just stuff them full of pills and shoo them out the door, with a manly pat on the shoulder as encouragement [/sarcasm]
Seriously, it’ll take a long time before stigma of “talking about your feelings” will die off well enough that talking problems through to allow for a solution tailored to the problems of the individual. Especially in light of the fact that it’s easier to just stuff someone full of pills than to do non-medicated therapy. It’s the same problem as with preventative care: it’s just not very profitable, so in the current health-care system it isn’t being encouraged.
When my ma became unwell with dementia, health professionals simply would not believe that me and my da could actually care for her. That is, how could two men, indeed any man cook, clean and attend? The answer was, we could. We did. I think that we buy way too much bullshite about what men can and can’t do. Men can talk about their feelings, if they so choose. They can sort things out and kick on. I have sat across from way so many men, hard men, men who you wouldn’t guess would ever utter a word to anyone about how they were feeling and yet, these men showed to me that it is possible to shatter the stereotype that men always ‘bottle things up’.
oh, I never said that men couldn’t speak of their emotions, or be caring; but it does seem like society is actively working to prevent them from doing so, when in the case of depression being able to talk and arrive at an individual solution is crucial.
add to this healthcare systems that prefer treatment to prevention, and one-size-fits-all solutions to individual care, and you’ve got a massive problem. I understand this may be less of a problem in Australia than here in the U.S. (it certainly was less of a problem in Germany), but I can’t imagine it not making the problems worse.
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and completely OT, but I’m thrilled to have discovered your blog. The problems that toxic masculinity (or, I guess you call it hegemonic masculinity) causes for men has interested me for a while, but it was difficult to find resources that didn’t look suspiciously like “it’s all the feminists fault” type MRAs
bookmarked and stuff
When the recently released men’s health policy was being devised here in Australia, two words that could never be uttered individually, let alone together, were ‘hegemonic’ and ‘masculinity’ (see Saunders & Peerson, 2009). That was because the men’s rights movement fuckwits had captured the ears of the bean counting dolts in the Federal Department of Health, and suddenly it made perfect sense that recognising the fundamental role that hegemonic masculinity plays in stuffing around men’s lives (and those of anyone else caught up in those lives) was like opening up an almighty can of worms. Better to wish for the delusion that men are fundamentally okay and that there is nothing that can’t be solved by another men’s shed, red ute or blokey, blokey brochure.