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Men's Health Experts work to break stigma of mental health for men

Tribune-Democrat - 11/7/2020

Nov. 6--Men and women develop mental illness at about the same rate, but there are some significant differences in men, local experts say.

"The difference is: Women often seek treatment much more than men," said Dan Ayers, a psychotherapist with Nulton Diagnostics in Richland Township.

"It's a stigma that says if a man seeks mental health treatment, he's weak," Ayers said. "He can't handle his problems. He's a wimp."

Although the stigma is not as pervasive as in the past, it remains a factor, especially for rural and blue-collar men, Ayres said.

The World Health Organization notes that reluctance to seek treatment has been an issue for both men and women. Only two in five people who experience a mental disorder seek assistance in the first year.

The mental health stigma, along with under-diagnosis by physicians, contributes to WHO's estimate that less than half of those who meet diagnostic criteria for psychological disorders are identified by doctors.

Depression disorders are more common in women, but psychologist Eddie Riley, assistant program director for inpatient behavioral health at UPMC Altoona, says men's depression disorders are sometimes identified in conjunction with other behavioral health issues as dual diagnoses.

"A lot of times the secondary disorder for men is an addiction disorder -- drug and alcohol addiction -- or antisocial disorder," Riley said. "That is very prevalent with men."

Alcohol dependence is twice as common in men and antisocial disorder is three times as common.

Depression disorders, anxiety disorders and post-traumatic stress syndrome are the most common mental health diagnoses in men, Riley said.

'More than a bad day'

The global pandemic, business lockdowns, political conflict and financial turmoil have raised anxiety levels for almost everyone and can lead to feelings of depression.

Psychologist Ryan Dunne, with Conemaugh Memorial Medical Center's behavioral health office, stresses that clinical depression is a medical condition that can be treated.

"Clinical depression is more than a bad day," Dunne said. "It can persist for a very long period of time if they don't get help."

Although, Dunne noted, "there is a lot of stress going in 2020," duration of symptoms and their effect on daily living activities differentiate mental disorders from sadness or anxiety that many people experience.

"The key phrase is: When it becomes detrimental to your social occupational health safety and other areas of adaptive functioning," said Dr. Joseph Buzogany, psychiatrist and director of mental health sciences for Indiana Regional Medical Center and Neuropsychiatric Associates.

"If you are experiencing insomnia, lack of interest in things you previously enjoyed, poor energy, poor concentration, poor appetite or increased appetite," Buzogany said, "if you mope around, don't want to get out of bed -- that's when you go out and seek help."

'Rabbit hole of depression'

Symptoms of depression or anxiety are more intense and last at least several days or weeks for those with mental disorders, Riley said.

"If we are just struggling with everyday stressors, we rebound and come up with a plan -- set something into action," Riley said. "When somebody is starting to go down that rabbit hole of depression, they may actually get to the point where they don't have the ability to act. They don't have the ability to self-care.

"That's very different in intensity."

With treatment, those with mental disorders can develop feelings of hopelessness and thoughts of suicide. Although women are more likely to attempt suicide, "completed suicide is a white man's disease," Buzogany said.

Men usually use more immediate and lethal methods of suicide -- primarily firearms in the United States, he said.

There are stages of what doctors call "suicidal ideation," Buzogany said, explaining the process begins with just thinking about taking one's own life, advances to making a plan and then moves on to taking some action to further the plan, such as buying a gun or loading a gun.

'Asking for help'

The good news is that mental disorders can be treated and many people can feel better, regain hope and live normal lives, the experts say.

"People need to be asking themselves: Am I struggling more than I have in the past? Is it looking so very different for me?," Riley said. "It can't hurt to pick up the phone and ask a professional to assess you."

He reminds people that mental disorders are medical conditions, just like heart disease, diabetes and high blood pressure. And like those conditions, mental diseases can get worse if they aren't treated.

More people are seeking help, Dunne said.

"The stigma has decreased over time," he said. "More and more people realize that it actually takes courage to go to somebody else and admit they need help. I always try to tell people asking for help is a strength."

The experts offered some suggestions for men to improve their mental health.

"Start with the three pillars of health: Good sleep, good nutrition and regular exercise," Buzogany said. "When you can go back to those basics when you are in a stressful situation, it could help immensely.

"Start with the three pillars and then go from there. If they don't do those things, no matter what medication I put them on, it's probably not going to be very effective."

'Exercise' therapy

Riley also said mental health is related to physical health and taking care of the body.

"I really do a lot of preaching about self-care," Riley said, noting proper sleep habits and a healthy diet are important.

"Exercise for men is a huge one," he said. "Working out -- I really push that because that's a natural high. It gives us structure and routine. We are working things out mentally and physically. We naturally feel better."

Spending time with loved ones and making time for oneself are also healthy practices, he said.

Buzogny stressed being aware of changes in one's behavior and listening to those around them who are concerned about changes.

"I tell patients to try to be self-aware," he said. "One of the worst things people do when they start to get depressed, they tend to isolate."

And treatment works, Ayres stressed.

"People like it," he said. "They tell me they didn't realize they could feel as good about things as they end up doing."

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