You’re physically fit: You eat your vegetables daily and run three times a week. But what about your mental fitness?
Sure, it’s a little harder to evaluate — you can’t measure it with calipers or a scale. Yet, given the deep connections that researchers have found between mental and physical health, it is crucial that you pay attention to your psychological well-being.
According to experts, many of us don’t realize we are suffering psychologically because we aren’t exhibiting “classic” signs like exhaustion, panic attacks or frequent crying.
But, specialists warn, psychological problems can take many forms.
” Mental health problems are massively under-diagnosed in men,” says William Pollack, M.D., of Harvard Medical School and Director of the Center for Men and Young Men at McLean Hospital in Belmont, Mass.
Have you found yourself getting in more arguments with your wife? Are you angrier with drivers on the road than you used to be? Are you hurting people around you? Do you worry you might be drinking too much?
These all can be signs of psychological problems in men and a growing number of experts are trying to help people recognize and treat them.
Boys Will Be Boys
Dr. Pollack, author of several popular books on the psychology of males, including “Real Boys: Rescuing Our Sons from the Myths Of Boyhood” and “New Psychotherapy for Men” argues that we should be careful about generalizations based on gender. However, he and other experts say that many men do experience depression and anxiety in ways different from women.
“They are more likely to show psychological distress in overt, external ways,” observes author and family therapist Terry Real. “They might be self-destructive, engaging in dangerous behaviors, such as driving too fast or drinking too much. They might show distress through sex, perhaps by engaging in affairs. Or they may be violent, maybe toward people in their own families.”
In fact, many habits or actions that we might consider typically male — getting in fights in school, going through a “midlife crisis” — are not signs of normal male behavior. Instead, Real and Dr. Pollack say they are often indications that something is wrong — actions that some take, often unconsciously, to hide their unhappiness.
Risks Of The Unexamined Life
Specialists see some common threads in the causes of emotional stress among men. Many experts believe that some mental problems stem from how men are treated by society.
“From birth, a lot of boys are encouraged to be self-reliant and independent, to suck it up when things go wrong,” says Reed Schimmelfing, a Northampton, Mass. therapist, who specializes in treating men. “Obviously, these attributes aren’t all bad, but they can leave males feeling very alone when they really need help but are too ashamed to ask for it.”
Real, author of “I Don’t Want To Talk About It: Overcoming the Secret Legacy of Male Depression”, says men often focus almost entirely on their jobs, feeling a strong societal pressure to work hard and make money. Some, especially those who are the chief breadwinners in their families, don’t feel they have the luxury to think about whether they are really happy or not.
“For a lot of men,” says Pollack, “the so-called ‘midlife crisis’ is the result of living an unexamined life and suddenly, after years of hard work, feeling trapped.”
For men like this, retirement can be devastating. “After a guy gets to be 65, gets his cake and a gold watch, he may suddenly find himself totally alone,” adds Schimmelfing.
Suicide in men rises precipitously in old age. “A lot of the ‘old codgers’ that we call cranky are actually depressed,” says Pollack, “sometimes deeply depressed.”
Cultural and social differences can make a significant difference in how men react to stress. “Studies have indicated that many black men feel a particularly intense pressure to keep up a rigid mask, to act as if nothing bothers or affects them,” Pollack says.
“They are less likely to seek help because of it.”
People who have grown up in poverty often don’t have, or don’t feel they have, any psychological help available to them.
Gay adolescent boys and young men also suffer greatly, Pollack asserts, “not because they’re gay, but because of the way they are shamed and mistreated by society.”
Gay men have some of the highest rates of suicide in the country.
Counting The Costs
The mental and physical costs of chronic psychological problems cannot be overstated. In almost every country, women outlive men – in some countries by as much as ten years. This discrepancy may not be all genetic.
Instead, a man’s tendency to try to remain solitary, self-reliant and closed-off can mean that he is less likely to go to the doctor’s, less likely to be treated, and less likely to follow medical advice.
Getting help, whether it’s going to a doctor or taking medication, in their minds, is a sign of weakness.
Holding in emotions can have bad effects too. Recent studies indicate that people prone to rage are more likely to suffer from heart disease, high blood pressure, stroke and early death (see “Can Anger Predict Heart Disease Risk? ). Women may have more suicide attempts, but men are more likely to succeed in killing themselves.
Getting Off The Psychiatrist’s Couch
In a culture that often expects men to be tough and independent, many guys are reluctant to seek therapy. But you should realize that there are many kinds of treatment. While some men respond well to more “traditional” long-term therapy, you don’t have to take a weekly lie down on the psychiatrist’s couch if you don’t want to.
Many practitioners like Dr. Pollack, Real and Schimmelfing are treating therapy more like “coaching” or “consulting.” The differences are not merely semantic.
Coaching is often a very focused kind of treatment. Together, a therapist and a client will identify specific problems and figure out hands-on ways to solve them.
“A lot of guys want concrete results,” says Real, “As one client said to me, ‘I don’t need to be understood; I need to be helped.’ Group treatment also works well for men, since it helps them see that other men have some of the same problems that they do.
Treatment often involves a two-pronged approach. “You frequently have to deal with both an underlying condition and the psychological defense to this condition,” says Real. “For instance, you might have a case where underneath, a man is depressed, but on the surface, he’s drinking too much and cheating on his wife.” If you don’t address the surface issue — that a man has an alcohol problem and is ruining his marriage — you can’t really get to the deeper issues underneath.”
Help Among Ourselves
All three experts stressed that the most important suggestion they could give to men is to establish a network of family and friends to rely on. An absence of connection with other people — your partner, your children, and your friends — is a common source of trouble. Can golfing and stopping at the bar with some buddies count? Not necessarily. Men need to have people that they can really talk to and confide in.
What if you don’t have any friends like that? Real suggests that you think about a few people you know who might be good candidates for taking friendship to a deeper level. See how they react if you talk about some of the things that matter to you. If they clearly prefer to stick to safe topics like sports and the weather, try someone else.
Pollack encourages clients to think about people who helped them when they were down in the past. Try getting in touch with an old friend from high school or college.
“A lot of guys are jealous of the friendships their wives have with other people,” says Dr. Pollack, “so I tell them to follow their wives as an example.”
Although it takes some courage to risk exposing yourself to people, you may find that a lot of other men need support in just the same way you do.
Finally, don’t give up on therapy simply because you don’t like your therapist.
“Just as you would look around for the best price and selection for an appliance,” says Schimmelfing says, “you should try to find the best therapist for you.”
October 2005,, By R. Morgan Griffin, InteliHealth Correspondent
