Men & Depression Work-Life Connections clinicians, Ellen Clark, LCSW, and Chad Buck, Ph.D., discuss the phenomenon of depression in men, why they are underserved, and ways that they can reach out for help.

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Janet McCutchen: Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast. I am Janet McCutchen with Work/Life Connections. I am here today with my colleagues, Chad Buck and Ellen Clark, and we are going to take about actually a topic that is not discussed very often. We are going to talk about men in depression, and it is well known that men are very underserved population when it comes to depression and seeking help. Chad, could you talk to that point, how underserved men are when it comes to diagnosing and treating depression? Dr. Chad Buck: The studies typically show that women are more likely to seek treatment, and it is not necessarily showing though that women have more severe types of symptoms or issues, and I think it is more a reflection of cultural values of seeking mental health treatment, the expression of emotion in general where men are more appropriate to be angry or upset rather than to be sad or to cry, and there is also the issue of independence and then feeling that they have to handle everything on their own, and so they do not seek out the treatment because they do not feel like it is manly enough or it is not appropriate given the role in their families. Janet McCutchen: So, we know then that women tend to seek treatment more frequently than men. Are men’s symptoms of depression different from women’s? Dr. Chad Buck: A lot of the symptoms are similar. They will be depressed mood, and there may be some changes in appetite, either wanting to eat more or less depending on how you cope, but men are more likely to show irritability rather than crying specifically. There may be an increase in substance abuse or using alcohol or drugs to manage their emotions. Risky behaviors may be driving carelessly, not putting a premium on their wives, and not taking care of themselves as they should, and they may also act out in anger more aggressively or physically or just in general be hard to approach, so shut down. Janet McCutchen: And all of those then what we may see as symptoms being mental health professionals of depression, other people may not really pickup on that, that may not be not only that person may not identify as feeling depressed, but other people may not identify and then approach them. Ellen, you have a very personal story from your family around depression and seeking help and the benefits of that, share that with our listeners if you would. Ellen Clark: Well, my father got depressed later in life, probably in his mid 70s, and he started turning his days and nights around when he would sleep all day and be up to the night, withdrew from friends, was much more irritable with my mother, and would get angry and have outbursts with her, and this was very uncharacteristic of him. My mother was concerned and she called me. They were living in Florida, and I was living in Tennessee. She was concerned, and I wrote a letter about her concerns and the symptoms she saw to his primary care physician and she took him to the physician, but the physician just asked my father if he cried a lot, and my father never cried, and so the primary care physician kind of discounted that he was not depressed as he was not crying. So, after that, we encouraged him to see a psychiatrist and he would not do that, and finally, a neighbor down the street that he had been close with for a long time came down and talked to him and said that “I just want to tell you that a few years ago I got very depress and I saw a psychiatrist and it really really helped me and if you want the name of the person I saw then I would be glad to give it to you.” That seemed to give my father permission. Janet McCutchen: Right. Ellen Clark: To seek help, and so he did see that psychiatrist and he got treatment and that turned his life around, and the last few years of his life were of high quality, he felt good, and he often commented to me how he was so glad he had gotten help, initially being very resistant to doing that. Janet McCutchen: That is outstanding, and that happened of course when your father was in his late 70s, and an oftentimes it is true. The people can be depressed their entire lives and just kind of have a low-level depression if they do not identify until later in life, particularly men. Ellen Clark: That is true, and I really think my father probably did have a low grade. He had been through World War II, and I think he had a low grade depression throughout his life but could function fine, but then with all the losses and his health was declining, physical health was declining, and his ability to cope was being compromised that he slid into a major depression and that is when he really needed help but had a hard time accessing and being willing to go and seek that help. Janet McCutchen: That a wonderful story, and Chad, hearing that too and speaking as a man as well as a clinician, what are some of the things that people can do if they know someone in their life who they think is depressed or a man listening today, what will be the motivator? What could motivate someone to get help? Dr. Chad Buck: Well, often the thing that motivates men to seek help is usually a loved one saying something to them, usually their wife or spouse bringing up concerns, and then they will come into therapy, and then it is the job of the therapist to normalize, how all people who suffer from depression or anxiety or other issues, and it is not that he has a specific weakness or problem that he has an issue that he needs to maybe address differently. A lot of men respond better to the idea of coaching or consulting or education rather than therapy. A lot of that is about feeling like they are on the same level or it is more of a collaboration where they have more control or say over what happens to them, and they can define what they are going through differently than depression, and it is not so much about the label of depression as much as it is trying to address the different behaviors or emotions that are going on, and sometimes that is a better approach for people too, but also as we get older, we face lots of different types of challenges that change our identity in a lot of ways. Not being able to work or having changes in job or divorce or any kind of life change or illness, challenges our sense of who we are as a man or as a person, and that existential issue certainly can affect what we are looking at. So, the earlier you can address the signs of depression, the better. Janet McCutchen: And with our population here at Vanderbilt, we have a lot of high achievers, high performing male employees in all various aspects of our university hospital setting with the economy stressors and men’s typical role as providers is coupled with the usual stress that comes with being a high performer, I would think that this in our culture here that topic is very relevant to the people that work here at Vanderbilt. Dr. Chad Buck: Absolutely. Janet McCutchen: Well, June is men’s health month, and I am really glad that the two of you are here today to talk about this very important topic. Men are underserved when it comes to seeking mental health care and certainly those annual checkups and that type of things that are really important for us all to be sure that we engage in preventative health. So, thanks very much Chad and Ellen for speaking with us today, and any of our listeners, this is men’s health month. So, if there is any way that Work/Life Connections can support you by all means, feel free to call us. Thanks so much. Thanks for listening. Please feel free to leave us any comments on this Wellcast by clicking the “Add New Comment” link at the bottom of this page. If you have a story or suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the “Contact Us” link on our website at healthandwellness.vanderbilt.edu. Thanks for listening. -- end of recording  --