I was 41 when it seemed like my world came crashing down around me.
My first experience with depression could be what some call situational depression. It started shortly after I received a promotion at work. I had been an assistant principal in a large urban school district for several years and was being promoted to principal in a different building.
I was thrust into a new role with a great deal of responsibility. At the same time, I had a 5-year old, a 3-year old, and two newborns at home. It started with a knot in my stomach that wouldn’t go away, making it difficult to eat. My mind seemed to be racing all the time, and I could barely sleep. There were times when I had no more than 10 hours of sleep for the entire week. I found myself dreading the thought of showing up to work.
Eventually I realized that I needed help. I reached out to my family doctor and also started seeing a therapist. Within a couple of months, I felt as though I was on the road to recovery.
Three years later, almost to the day, I experienced my second major bout of depression.
Things were going well at work and at home when I noticed, with no previous signs at all, that things were changing in my body. I remember telling my brother, “My body feels different… this isn’t going to be good.” What I didn’t realize is that I was about to fall into a depression that made my last experience seem like a walk in the park.
Many of my symptoms were similar, yet much stronger, than my first bout of depression. I lost almost 50 pounds because I couldn’t eat, and I was again struggling to get any sleep at all. I had a hard time remembering things and staying focused. I avoided social settings as much as possible. I began to isolate myself. I had uncontrollable crying bouts in the evenings.
I took some time off from work, but in hindsight this maybe wasn’t the best choice. Without structure, I found my symptoms getting worse. I couldn’t get off of the couch. At this point, I started to have generalized thoughts of suicide.
Two weeks after I went back to work, those thoughts became more of a detailed plan, and the idea that I might actually go through with it seemed possible. I spoke with my family and my psychiatrist and checked myself into a three-week partial hospitalization program.
This program was the start to my lengthy recovery. I’m happy to say that I’ve been symptom-free for four years. Since my recovery, I’ve dedicated much of my free time to mental health advocacy, especially for other men struggling with depression.
Admitting there’s a problem
Although I masked my depression for some time, as many men do, I sought help relatively early because of the sudden debilitating nature of my symptoms. But many men continue their day-to-day lives, masking their depression for years, attempting to appear as though nothing is wrong. They often isolate and keep their feelings to themselves. And as they mask their depression, the symptoms often continue to worsen.
Growing up, many boys are taught that they are supposed to be “tough.” We learn that certain emotions (like anger) are fine, but things like fear and sadness — or anything that would make us appear vulnerable — should be kept under wraps. Those lessons follow us into adulthood.
After I completed my treatment program, I joined a support group for men with depression and continue to attend meetings to this day. Many of the other men I’ve met there speak of the shame and guilt of having a mental illness. They’re concerned about the impression others may have of them due to the stigma and the discrimination they may face if they seek professional support.
Looking back on my own situation, there was definitely shame. When I would pick up my medicine at the pharmacy, I’d look around to make sure that nobody I knew was there. When I got home, I’d tear any documentation into pieces to make sure that nobody would find any proof that I was taking medication for depression. On the way to my therapist’s office (which was only blocks away from the school where I worked), I’d try to shield my face so that nobody would see me entering the building.
Together, stigma and stereotypes of masculinity can prevent men from seeking the support they need from a medical professional.
Paul Gilmartin of the Mental Illness Happy Hour podcast told me that he first realized he needed help after a road rage incident. He found himself in his car screaming angrily at pedestrians who continued to cross the road in front of him while the light was red. Paul says that one of the pedestrians walked up to his window, leaned in “with a look of disgust and pity,” and said, “Son, get a hold of yourself” before walking away. That was Paul’s moment of clarity.
When I asked him why he hadn’t sought help prior to that incident, he told me that he believed his emotions were fleeting, and even so, he didn’t know how to go about getting help.
“I did a pretty good job lying to myself that I had my sh** together,” Paul said. “That event turned that idea upside down.”
In recent years, the scientific community has also learned that depression may manifest itself differently in men than it does in women. A 2013 study in JAMA Psychiatry found that men experiencing depression were more likely to exhibit signs such as:
- self-destructive behaviors
- substance abuse
- low impulse control
The study encouraged clinicians to seek out these symptoms and other “alternative negative outcomes” when caring for men whose depression may be undiagnosed. Delays in care due to stigma or misdiagnosis often mean that many men continue to suffer in silence, which can lead to disastrous outcomes.
While more women attempt suicide, men die by suicide nearly four times more often than women.
SUICIDE PREVENTION: If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. The National Suicide Prevention Lifeline is available 24 hours a day, 7 days a week at 800-273-8255.
The question remains: How can we support men in seeking support for depression and other mental health issues?
Getting the help we need
It’s encouraging to learn about clinical advancements in mental healthcare, and to see more and more work being done by various organizations to shine a light on depression. Those are big picture initiatives that can help a lot of people. But in my opinion as someone who’s lived with depression, I believe that we also have to start small and focus on our own communities and do the work to dismantle the stigma around depression.
More men who have overcome the challenges of depression or who are still struggling with it should share their stories. The more we’re able to have conversations around men and depression, the more likely it is that more men will take the first necessary step of reaching out for support.
For those men who are struggling, it’s important to recognize that you do have an illness — and that depression is, in fact, a medical condition and not some character flaw or moral failing. A great first step might be to share what you’re experiencing with a trusted loved one. It’s also very important to reach out to a professional.
While nothing can replace the advice of your doctor, there are a few online resources that might be helpful as you take these first steps:
The bottom line: Guys, it’s OK to not be OK, but you don’t have to suffer alone. Seeking help is a sign of strength, not weakness. Looking back at my own situation, I’m incredibly thankful that I made the decision to leave work in order to enter a program for recovery. It was one of the hardest things I’ve had to do, but it was so incredibly worth it.
Al Levin has worked in education for nearly 20 years. He is married and has four children between the ages of 6 and 11. After recovering from two severe bouts of major depressive disorder, he has become very passionate about learning more about mental health and supporting others with a mental illness, particularly men with depression. In addition to his blog, he speaks publicly for the National Alliance on Mental Illness (NAMI), and you can find him on Twitter. His latest project is a new podcast called The Depression Files, which can be found at allevin18.podbean.com or on iTunes.
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