Vail health feature: Mental health issues often go untreated in men
Editor’s note: This is the second part of a three-part series on men’s health. Read the first article in the series at http://www.vaildaily.com.
Mental illness in men is often referred to as a silent crisis. Societal mores dictate that men are supposed to be strong and impervious to the arrows that life hurls at them, and to a man, seeking help may be construed as a sign of weakness.
“The last thing any man would want is for his family to question his ability to provide or for co-workers to question his ability to perform,” said Dr. Dennis Lipton, an internist at the Vail Valley Medical Center.
In order to begin fighting the stigmas surrounding mental health treatment for men, it’s important to understand the prevalence of mental illness and how symptoms differ between genders.
The National Institute of Mental Health states that women are 70 percent more likely than men to experience depression during their lifetime. Because of this, it stands to reason that much of the gender-based research regarding mental illness focuses on the effects these diseases have upon women.
“Historically, women seek professional treatment more often than men,” said Kris Vandenberg, a doctoral prepared psychiatric advanced nurse practitioner for Mind Springs Health. “Men generally view their friends and family as their primary support system and often believe the need for professional help is a sign of weakness.”
Since many men do not admit to or seek treatment for mental disorders, they frequently go undiagnosed, Lipton said. Therefore, substance abuse is the one mental disorder that is more common in men than women.
“Often, they are self-medicating an undiagnosed, underlying depression or anxiety disorder,” he said, adding that mental illnesses are routinely associated with poor health outcomes in general. “It’s very well documented, for example, that men who are depressed after a heart attack do much worse than men who are not.”
Men can also exhibit physical symptoms of depression and other mental illness that belie the underlying mental issues.
“Women often seek treatment for the emotional symptoms of depression, while men are more comfortable acknowledging physical symptoms, such as trouble sleeping, fatigue, appetite disturbances and sexual dysfunction,” Vandenberg said.
These physical symptoms often drive men to seek medical care from their primary-care physician, rather than a psychiatric provider. Physicians are encouraged to screen for depression during any medical encounter, Lipton said, which is a good first step.
“In men, especially as they age, symptoms of depression may not be obvious or typical,” Lipton said. “It may manifest as anger or aggression instead of sadness. Lower energy level, sleep disturbance and difficulty concentrating may also be present.”
Fighting the stigma
Vandenberg said that though primary-care providers do a great job of recognizing mental illness, their time constraints often require that they refer patients to psychiatric providers. This referral process can be tedious and time consuming, she said.
“A new approach across the nation has been to integrate mental health professionals into primary-care clinics to more effectively take care of patients,” she said, adding that this move has also made a great impact on fighting stigmas.
“I believe stigma is the biggest issue,” she said. “Unfortunately, men have been taught to suppress their feelings — ‘don’t cry’ — and seeking mental health treatment is often difficult for them.”
Despite lower diagnosis rates, according to the National Alliance of the Mentally Ill, approximately 6 million men suffer from depression each year in the United States, Vandenberg said, and new resources have begun to emerge as mental illness begins to come out of the shadows through increased exposure on television and talk radio.
She pointed to websites such as Man Therapy (mantherapy.org), an interactive mental health campaign targeting working-age men (25 to 54) that employs humor to cut through stigma while focusing on illnesses such as depression, divorce and anxiety.
Vandenberg said mental illnesses like depression can stem from a variety of factors, including biology, societal pressures and environmental stress.
“At our clinic, we see men dealing with a multitude of mental illnesses, including depression, anxiety, bipolar disorder, (attention deficit hyperactivity disorder), schizophrenia and substance-use disorder,” she said. “This valley attracts men from all over, which, in turn, leads to the diversity of mental illnesses that we see.
“The lack of resources can greatly affect our ability to care for those with more chronic mental illnesses (such as schizophrenia), and therefore, our clinic works closely with many different community agencies to meet the complex needs for these individuals.”
If you believe a loved one might be suffering through mental illness, it’s important to encourage him to seek mental health treatment or counseling.
“Any change in a man’s personality or usual behaviors, such as irritability, anger or loss of interest in a favorite hobby or pastime, is a sign of potential trouble,” Lipton said. “A man will generally not want to talk about his emotions with anyone, except maybe a close friend or a spouse, depending on the situation.”
Left undiagnosed and untreated, mental disorders such as depression can lead to poor performance at work and at home, alcohol or other drug abuse or worse. While there is a larger proportion of women who struggle with depression, men have a two to three times greater risk for completing suicide and are more likely to use lethal means such as firearms or hanging, Lipton said.
“Men are at a great risk for depression and suicide, its important to let men know that it is okay to seek help professionally when things feel out of control,” Vandenberg said.