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Depression in Recession

Posted May 14 2009 4:50pm

The BBC has an  Interesting Article on how the economic crisis is leading to an emotional crisis in many men in the face of trouble providing for their families.  The report on a survey that found men are twice as likely currently to report having suicidal thoughts, half as likely to discuss their trouble with friends or family, and while experience mental health problems in roughly equal numbers with women, they go untreated far more often.

This is interesting to me for several reasons.  The suffering goes on largely in silence.  Men don’t use health care in general to the extent that women do and they absolutely don’t use mental health care to the same extent.   One could look at this as evidence that women in our society are oppressed, if it suited their purpose.  You could argue that men are healthier because they are more free from the trap of poverty and childcare.  You could also be dead wrong.  This is a perfect example of how using mental health statistics to prove an oppression argument only feeds the monsters of stigma and prejudice.

It is deeply ironic that refusing to get help is ever considered a show of strength.  The only strength I’m seeing is a two tons of stigma flexing its muscle with men everywhere bending to its will.   Unfortunately, in our society, to go to the doctor is to admit weakness and trouble coping, and to have weakness and trouble coping is to be less than a man.  Strangely, it is the need to be strong that causes and reinforces the depression, the problem aggravated by the need to avoid itself.

These are emotions I am far too familiar with.   I have a be strong, perfectionist trifecta going against me personally, with my gender, profession and faith.  I have ranted and raved about the Mormon angle of this prejudice in the past, so this time I’ll focus on the other two aspects.  If men are not allowed weakness, it goes double for physicians.  People are relying on us to function calmly and coolly, often in the face of dire emergency.

     To be mentally unwell as a doctor is to put the public in danger.  Currently I have the distinct privilege of turning over some very personal health information over to a state medical board all for the sake of protecting the public.  As the healers of and advocates for the sick and infirm, we cannot afford to ever join their ranks.  At least that’s the conventional wisdom.   Doctors cannot afford to have weakness.

Trouble is, we doctors do have weaknesses.  When an emotional or health problem can threaten a career, and when one’s identity is invested in that career and in providing for your family,  health or mental health issues become a dangerous secret. 

     Doctors face a tremendous amount of stress in their professional life, for exactly the reasons stated above.   Increased stress will lead to more depression.  We learn this in our own traning.  We also learn how to treat it, yet my own experience is that actually getting treatment for ourselves involves serious risks to our career.  

     This is the great secret.  Mental health stigma actually puts patients in danger by by shutting off the help required for good physician function.   In reality, getting help is the only responsible thing any of us can do.  Yet we raise the stakes for those who do to the point that it takes one collosal crisis for anything to be done.

   Western society is founded on a strong belief in the power of the individual.  The American dream is the idea that we can pull ourselves out of the very depths of poverty through sheer will and determination.   While this idealism is behind a lot of what America has achieved, we have lost something in the process. 

     Humankind is a social animal.  No man is an island.  Without some degree of shoring up each others weaknesses with other’s strengths, we are all lost.  This becomes very clear when we are all stressed at once by the same problem, as in a recession.  It is paradoxical how empathy and compassion often experience a groundswell in the face of hard times.

  In much the same way it is paradoxical how one can come out of a deep depression a stronger, more adjusted individual.   It took me near destruction from perfectionism to learn how to be better adjusted.   It is a destruction that would have been certain if I had not been forced kicking and screaming to the care of some of the most wonderful and compassionate individuals I could ever imagine.  It was in concession and defeat that I finally learned what it truly is to be a man.

Tagged: doctors, gender, male, men, mental health, perfectionism, physicians, prejudice, recession, stigma, stress, suicide, vulnerability, weakness
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