Our lives are constantly changing. Whether it’s childhood or retirement, our thirties or our fifties, just as we start to master one stage, it comes to an end and we move on to the next stage. Our experiences and educational background, our relationships with family and friends, and our faith and belief systems help prepare us for the unknown.

Some enter the unknown, eager for new experiences; while others shy away from change and cling to the familiarity of the past. But sometimes, those changes can be overwhelming. Life is a maze and the decisions we make can get us closer to the exit or lead us directly into a dead end.

Society puts a lot of pressure on men to be professional navigators. Men have traditionally been expected to be strong, physically and emotionally. And perhaps because of those expectations, we shy away from talking about our feelings. As though, it’s not masculine to discuss our thoughts and emotions. Unfortunately, not taking control over our health can lead to shorter lives and higher risk for all fifteen leading causes of death.

One of the hardest things for a man to do is to ask for help. When men do seek medical help, it’s often for physical ailments, and they are less likely to discuss the feelings that accompany the issue.

Dr. Aleem Khan is a psychiatrist at Piedmont Psychiatric Associates and he says, “It’s a general rule that men like to procrastinate and not deal with medical issues. With depression, they are even less likely to act because they think they can deal with whatever stress is going on in their life.”

This reluctance, be it in our DNA or in the expectations of society, can have extreme consequences and can impact every area of our life. It can lead to depression, alcohol and drug abuse, relationship and employment troubles, even suicide. “Men sometimes start drinking alcohol to self-treat their depression. They will become irritable, angry, hopeless, and sad. They will experience low self-esteem. And usually won’t get a lot of sleep,” Dr. Khan said.

It’s important to know that you aren’t alone. One in three people suffer some form of mental illness. And about one in five people has a prevalence of depression during their lifetime.

What is Depression?

Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.

Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, counseling, and other methods can effectively treat people with depression.

What are the symptoms?

Doctors often look for you to have five of the following eleven symptoms simultaneously.

•  Persistent sad, anxious, or “empty” feelings

•  Feelings of hopelessness or pessimism

•  Feelings of guilt, worthlessness, or helplessness

•  Irritability or restlessness

•  Loss of interest in activities or hobbies once pleasurable, including sex

•  Fatigue and decreased energy

•  Difficulty concentrating, remembering details, and making decisions

•  Insomnia, early-morning wakefulness, or excessive sleeping

•  Overeating or appetite loss

•  Thoughts of suicide or suicide attempts

•  Aches or pains, headaches, cramps, or digestive problems that do not ease

even with treatment

Why am I depressed?

According to Dr. Khan, “Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important neurotransmitters—chemicals that brain cells use to communicate—are out of balance in depression.”

Some types of depression tend to run in families. However, depression can occur in people without family histories of depression as well.

Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that the risk for depression results from the influence of several genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger.

When the conditions start to become obvious, it’s common for men to try to mask the issues and many times this leads to deeper feelings of depression and can cause other issues such as alcoholism or drug abuse. Alcohol and illegal drugs are multipliers that always make things worse.

What can I do?

The first step towards solving the problem is to accept that there is a problem. For men, this is often easier said than done. There are at a minimum three different types of depression (Major – severe & long term, Dysthymia – less severe but still long term, and Minor – even less severe and shorter term) and it can all be confusing. Choosing a mental health care provider whom you can trust with your feelings is very important.

There are several ways to treat depression. The three most popular ways are medication, counseling, and lifestyle changes. Each has its benefits and it’s important to discuss all of the available options when choosing your treatment choice.

Dr. Khan says that each individual is different. “For some, counseling is the best choice. For others a good treatment is medication. Sometimes, you have to do both together. But exercising often helps as well. There’ve been a lot of clinical trials done showing that exercising will reduce physical pain and reduce emotional pain.”

Do not wait too long to get evaluated or treated. There is research showing the longer one waits, the greater the impairment can be down the road. Try to see a professional as soon as possible. Try not to isolate yourself, and let others help you. Expect your mood to improve gradually, not immediately. Do not expect to suddenly “snap out of” your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts. Remember that positive thinking will replace negative thoughts as your depression responds to treatment.

One thing to keep in mind is that many things in this world are out of your control. On the flip side, many things are completely within your control. You can’t control the actions of others, but you can control your own actions. You can’t control who you work with, but you can control where you work. You can’t control the expectations that others have for you, but you can control the expectations you have for yourself. The list is endless, but the recurring theme is that you only have control over yourself and your choices.

How can I help someone who’s depressed?

Seeing someone close to you dealing with emotion problems is very taxing. Dr. Khan recommends “offering emotional support, understanding, patience, and encouragement. Talk to him or her, and listen carefully. Never dismiss feelings, but point out realities and offer hope. Never ignore comments about suicide, and report them to your loved one’s therapist or doctor. Provide assistance in getting to the doctor’s appointments. Remind your loved one that with time and treatment, the depression will lift.”

Can lack of sleep be causing my issue?

Lack of sleep can be a major contributor to a lot of men’s health issues.

Dr. Khan said, “Sleep has proven to be a critical thing. When a person can’t sleep, it is one of the first indicators that someone is having depression or anxiety. Sleep is also the number one treatment for depression. If someone starts sleeping better they will be able to slow down, focus better at their work, become more productive, and end up less depressed, because they are more productive. Sleep is also good for diabetes and high blood pressure, too. If you don’t sleep you will gain weight. Recently there was a study done at the Cleveland Clinic for heart patients that showed if you don’t sleep properly, you will gain 12 pounds in just one year. “

Gaining control over sleep can help you gain some positive momentum that can snowball into other areas of your life. It will reduce your stress and whether it’s with medication or through natural means, it is often the best starting point and one that shows an immediate return.

Regaining Control

Men often need to feel like they are in control to be happy. It’s obvious in everything from who handles the remote control to who turns off the GPS navigational systems. When we lose control over our feelings, we have to deal with feelings that are unfamiliar. The key to rebounding is to focus on one area at a time. A little positive momentum in one area will help you gain a foothold in another area. Clearly, the most important step is the first one. If you don’t feel like yourself, then you probably aren’t. It’s up to you to recapture the man you are.

Dr. Aleem Khan is a psychiatrist at Piedmont Psychiatric Associates located at 201 South Main St, Suite 3400. He can be contacted at 434.799.4588.

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