By Victor M. Parachin

Men Down and Out

Ways for priests to help men deal with depression

For two years I lived in a funk. Something very dark was growing inside me, and I couldn't seem to stop it.

Those two sentences describe a time of depression in the life of recording artist Garth Brooks. He was courageous enough to publicly acknowledge depression.

Too often many men are unable or unwilling to recognize and deal with depression in their lives. The main reason for this hesitation is cultural, says John S. Tamerin, M.D., a New York City psychiatrist:

Why do so many men fail to recognize their own depression? The main reason is shame. Our culture expects men to be competent, optimistic, energetic, decisive, clear-thinking, happy, and, of course, sexually aggressive -- all characteristics that depression impairs. Men are expected to keep their doubts to themselves. Acknowledging depression may leave red-blooded men in our culture feeling weak and unmanly.

When male depression is left undiagnosed and untreated, the results can be tragic. ''I see the consequences of untreated depression every day: ruined marriages, faltering careers, drinking problems, sexual dysfunction, loneliness, even physical ailments,'' notes Dr. Tamerin. Untreated in a man, depression can ruin lives, limit lives and take lives. No man experiencing depression needs to live in such self-limiting and self-destructive ways. Depression is a treatable condition. Here some ways clergy and other spiritual leaders can help men deal with depression.

  •  Assure men they are not alone. Winston Churchill suffered with depression, calling it his ''black dog'' and something he tried to block off by excessive drinking and compulsive overwork.

Other prominent men who went public with their depression were author William Styron, TV reporter Mike Wallace, and humorist Art Buchwald. The National Institute of Mental Health estimates that 6 million men per year are diagnosed with depression and millions more suffer in confused, lonely silence.

Depression and depressive episodes are frequently described in the Bible. David, the author Psalm 38 describes the physical and emotional impact of his depression: ''I am bowed down and brought very low; all day long I go about mourning. My back is filled with searing pain; there is no health in my body. I am feeble and utterly crushed. I groan in anguish of heart'' (Ps 38:5-7, NIV). Another who experienced depression was Abram. His depression is described in Genesis 15:12: ''Abram fell into a deep sleep, and a thick and dreadful darkness came over him.''

  • Help men recognize male depression symptoms. Men experience depression differently from women. It's not clear whether this is due to hormones, brain chemicals or coping methods. However, these are some of the signs and symptoms more likely to occur with male depression:

- Inappropriate anger and rage

- Violent or abusive behavior

- Feeling underappreciated and unloved

- Anxiety, tension, frustration

- Escapism: workaholic, alcoholic, drug abuse

- Risky behavior such as aggressive and careless driving

- Withdrawal and isolation from coworkers, friends, family

- Hostility, argumentativeness, defiance, sarcasm

- Thoughts of suicide

  • Suggest examining possible causes. When a time of depression comes, it's worth a studying it closely to determine possible causes. Some are easy to identify: grief resulting from the death of a loved one, the demise of a relationship or the loss of a job. Others are more subtle and can take time more time and thought to uncover.

In the case of Garth Brooks, he decided to put his performing career on hold and return home to Oklahoma. ''I had to learn to find myself as a person separate from the entertainer that had previously seemed to define me.'' The time away from the spotlight enabled him to see that much of his depression was due to his hectic work schedule.

He was so busy performing and traveling that ''I never knew what day it was, let alone the hour. . . . I didn't have a clue what was going on in the world in general, and sometimes not even in my own world,'' he says. Because he stepped back to examine the source of his depression, Brooks experienced relief, saying: ''over a period of time, I came to terms with so much. And I'm happier than I've ever been.''

Women Seek Help -- Men Die

Today he offers this advice to others who experience depression: ''What I know is this: when the blues are coming up fast behind you, sometimes it's better to confront them quietly, alone, from a rocking chair on your own front porch.''

  • Recommend professional help. Sadly, one study found that among depressed individuals, 75 percent of people who sought professional help were female, whereas 75 percent of those in the same population who committed suicide were male. The researchers concluded: ''Women seek help -- men die.''

No man should permit his depression to push him over the edge emotionally. Men need to be courageous and decisive and seek professional help. Remind them that depression is a problem for which solutions are both available and effective. Encourage them to seek out a medical doctor or schedule appointments with a clinical psychologist.

A medical doctor can prescribe appropriate medication and a psychologist can help with talk therapy. This combination is highly effective in combating depression, something noted by Harvey B. Simon, M.D., in The Harvard Medical School Guide To Men's Health. ''Like other psychological disorders, depression can respond to 'talking' therapies, medications, or combinations of the two. Among the many forms of psychotherapy, two -- interpersonal psychotherapy and cognitive-behavioral therapy -- were specifically developed to treat depression. Studies indicate they can be as effective as medication for mild to moderate depression.''

Dr. Simon suggests that people with mild to moderate depression try psychotherapy first but that more severely depressed individuals seek medication in their initial treatment program.

  • Advise joining a self-help group. Another effective step for dealing with male depression is joining a support group. Those who have done so experience reduced symptoms and substance abuse, reduction in hospitalizations, improved social skills, increased self-esteem and healthier behavior.

After his wife separated from him, Nate realized he needed help. ''I joined a men's group that talks about relationships, family and career issues. It was profound to see that I didn't need to be ashamed of what I was feeling and what I was going through. I learned that I wasn't alone and that it was OK to admit that I needed help,'' he says.

  • Promote exercise to strengthen body. Physical exercise leads to a healthier body and a happier mind. There is a strong link between physical activity and emotional health. In The Paleolithic Prescription, authors S. Boyd Eaton, M.D., Marjorie Shostak, Ph.D., and Melvin Konner, M.D., Ph.D., note:
Our genetic constitution has been selected to operate within a milieu of vigorous, daily and lifelong physical exertion. The exercise boom is not just a fad; it is a return to 'natural' activity -- the kind for which our bodies are engineered and which facilitates the proper function of our biochemistry and physiology.

Men dealing with depression should find an exercise program they enjoy and then do it six days of the week.

  • Lead them toward prayer and trust in God. A state of depression brings a dark cloud over the thought process. The darkness can be pushed back through prayer and trust in God. The Bible says that those who do so will regain hope and perspective -- ''(God) gives strength to the weary. . . Those who hope in the Lord will renew their strength. They will soar like eagles; they will run and not grow weary, they will walk and not be faint'' (Is 40:29,31).
  • Encourage involvement in an enjoyable activity. Some men find they can offset depressive feelings by doing something they truly enjoy. This is something that country and western singer Ty Herndon does when he begins to feel depression coming on.

His tactic is to sponsor a family gathering. ''I call up my relatives and invite them to dinner, then I go buy groceries and come home to cook. I make chicken-fried steak, mashed potatoes, white gravy, biscuits and corn bread, green beans, corn on the cob, lima beans. I guess it's a three-part therapy starting in the grocery store, moving to preparing the food in the kitchen, and ending with sharing a meal and an uplifting conversation with family. The blues fly right out the window.''

  •  Remind men to stay connected. They need to let others in. Men must resist the temptation to isolate and withdraw. Doing this when feeling depressed only deepens and lengthens the depressive episode. A healthier step is to remain engaged and connected with others. Inher book Why Men Die First, physician Marianne J. Legato advises men:
If you do feel sad or hopeless, resist the impulse to avoid contact with others. Talk to someone you trust and ask for help. Emotional turmoil affects everyone at some time, and it's not a sign of weakness or lack of masculinity. It takes real courage and resourcefulness to ask for help.

Men need to resist the temptation to cut themselves off from a world of support. They need to maintain their link with family, friends and spiritual community.

Depression is not something to be taken lightly and casually. When men recognize depression in their lives, they must become proactive and take the necessary steps. There are many easily accessible options which can relieve the pain and restore the joy of living. TP

REV. PARACHIN, an ordained minister in the Christian Church (Disciples of Christ), writes from Tulsa, Okla.

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