Men and Depression: The Internal Conflict

“Depression is rage spread thin” - George Santayana

Depression affects 6 million men every year in America alone.  Reasons for depression that men have reported include: trouble in an important relationship, unemployment, pregnancy or childbirth, separation/divorce, retirement, and work stress.

There is a lot of pressure upon men in our society to maintain a sense of “masculinity” and being a “real man”. Sometimes this means that when a man feels desperate, lonely or depressed – he will hide his feelings and keep things bottled up. Because of this, men are three times more likely to commit suicide than women (statistic from the Royal College of Psychiatrists).

There is a common misconception that women are the more body conscious, the more emotional and the more soulful of the sexes – but this is not true. A man may look into the mirror and hate his appearance, doubting himself for not being muscular enough, for being short, not having much chest hair etc. Similarly, men feel the same emotional range as women and can also suffer from depression or anxiety. They just tend to keep it much more hidden.

If you think you know a man who is suffering with depression, be sensitive about it. He may not want to admit to himself or you that he is out of his depth. Men traditionally see themselves as having a lot of responsibility; earn the wage, be the protector, be man of the house. And when they start to struggle they see it as a failure. A crisis of masculinity, if you like.

Things you need to know and look for concerning Male Depression:

·         Coping Mechanisms – Male coping mechanisms differ a lot from female coping strategies. A man might throw himself into an activity, focussing a lot on work or sport to avoid dealing with his problems or distract himself. Also, the man in question might resort to impulsive strategies such as alcohol or drugs to cope with the feelings they are experiencing.

·         Downplaying signs or symptoms – Men are much more likely to ignore or justify the feelings they are experiencing than females.

·         Reluctance to discuss things – Men probably wont want to discuss they feelings with anyone, let alone a mental health professional. It’s better to reach out to your man in a caring, casual way when encouraging to seek help, e.g. “It’s probably nothing darling, but it might be worth just popping to see Dr Smith in case he has any suggestions” than “You are depressed and I’m taking you to see a Psychiatrist on Monday!”.

·         Emotions – Men are likely to feel anger, violence or frustration rather than sadness when they are depressed.

·         Physical vs Emotional – Males are likely to report feelings of physical pain such as headaches, backaches, dizziness, chest and joint pain rather than emotional discomfort.

If you think that your partner, son, brother, father or male friend is suffering from depression, try to encourage them to seek help from a Doctor or Psychotherapist without pressuring them or making a big “fuss” about it. The Royal College of Psychiatrists offers helpful information here:

http://www.rcpsych.ac.uk/expertadvice/problems/depression/mendepression.aspx

 

From Angry to Assertive in 10 Steps

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“Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned." Buddha

It’s National Anger Awareness week this week- an opportunity for us to increase our understanding of and get more savvy with ways of managing our anger.  In my experience as a Therapist, Anger is one of the most misunderstood emotions; either one to be feared or revered- allowing a gain or loss of control over situations. 

Due to faulty conditioning as children and living in a culture of suppression, rather than expression of feelings, anger can often become a toxic rather than empowering emotion.  We characterize it with the person that loses control at the wheel, the man who beats his wife- it is bad to have anger we say as it can do so much harm.  I always say to my clients that every emotion is a valid one and anger can be more positive than most if channeled in the right way.

For example, if none of us felt any anger, would we ever fight injustice or stand up and be counted?  I doubt it.  The problems come when we choose to repress our feelings and allow them to fester until they transform into something else that can do harm.  The solution? Quite simply, learn to be assertive and say it like it is! 

Being assertive or congruent with your feelings may feel foreign to you at the moment.  Though, it can be learned, like any skill and you may be assertive in some situations more than others.  Think back to times at work or in your personal life when you exhibited more assertive behaviour, what was the difference?  Perhaps there is a certain context such as with your partner where you struggle with being assertive. To begin with, try these steps for learning new ways of changing your communication:

1.    Create some space around the argument before mentally scripting what you need to say using positive language: “I want to clear the air between us and discuss this..”

2.    Use 1^st Person Language and own your point of view- “I feel…”

3.    Get out of the Blame/Shame game: Remember, you have choices as to how you feel, no one can make you angry!

4.    Be specific on what triggered your anger and the degree of it- slightly annoyed- rage?

5.    Acknowledge your part in the situation- own responsibility for anything you did- remember this is a strength, not a weakness.

6.    At the same time, avoid self put-downs or criticisms.  Backing down from an argument in order to please only gets you into the passive role.

7.    Get out of Mind reading what the other person is thinking or feeling.  You need to have evidence based on fact not assumptions!

8.    Focus on the Behaviour, not the person.  i.e. “That was a selfish thing that you did.” rather than “You’re a selfish/angry person.”  

9.    Offer a positive for changing the behaviour- i.e. “We will be able to feel more able to communicate in future and get our needs met.”  

10. Finally, always use Assertive rather than passive or aggressive language: “I feel”, “I would like”, “In my opinion..” 

Remember, assertiveness also encompasses your voice tonality, body language and posture- this is supposed to be 55% of how we communicate so it is key to how others receive your communication, not just the words.

If you feel anger is something that is controlling your life, take a look at the beating anger website or consider speaking to a Therapist in confidence. 

Jingle Hells- How Avoid the Christmas Stress

 

“Next to a circus there ain't nothing that packs up and tears out faster than the Christmas spirit!” – Frank McKinney Hubbard.  

Christmas can be a very stressful time of year – so much planning and organising, living up to expectations, spending time with that Uncle you hate, making sure everything is perfect…There are lots of things you can do to prevent the Christmas stress from getting to you.

Some top tips are:

Give up unrealistic Internal Demands: Too many people at Christmas think “Everyone must have a good time” or “I must organise things perfectly”.  Therapist Yvonne Wildi  says that “Magazines, shops and television programmes create an almost impossible to achieve level of perfection which often bears little in relation to reality but many of us still feel driven to try and achieve the fantasy.” To set yourself such idealistic targets is surely going to add to your stress greatly. It’s much better to think of things in a more flexible way. You’re not responsible for other people’s enjoyment – they are. Stop hoping to reach the impossible levels of expectation, as it’s not going to happen. 

Try not to Pressurise yourself: This is closely related to the internal demands, but on a more basic level. If you don’t reach your targets, never mind. Try again tomorrow. 

Stop Catastrophising:  Something might go wrong and you think “This is awful! It’s the end of the world!” but really just sit back, relax and try to look at the situation. Be rational about the problem. Is it really “awful” or is it just an annoying hassle? Looking at things rationally will help you deal with things better and find a solution for these (often trivial) problems.

Look after Yourself: With everything going on, we might forget to eat or drink or take some time out. Make sure you eat well and healthily, drink enough fluid, and have time to relax. Meeting these criteria will keep your body at a normal level and help you concentrate better on the tasks ahead. 

When dealing with Teens: At Christmas some parents act in certain ways or say certain things that push their teenagers back into “Child mode”. Try to remember that they are young adults now, and will not want to do the same things as they used to. By treating them with respect and talking to them in a mature way, you can ensure that any conflicts or “Stop babying me!” situations will be avoided.

Dealing with Loss or Grief at Christmas: Christmas can be a dark and lonely place for those who are suffering loss. It will draw your attention to those who “Should be there but aren’t” and often make you feel sad and even guilty for continuing without them. The glaring happiness others feel can sometimes have a negative effect, but just try to remember that although loved ones are gone, loved ones still remain. Try to enjoy your time with your friends and family as much as possible, whilst fondly thinking of those who are no longer with you. It’s okay to feel sad at Christmas. 

Remember not to forget the main point of Christmas and allow any stress diminish from the pleasure of enjoying time with family and friends. As Calvin Coolidge says: "Christmas is not a time nor a season, but a state of mind. To cherish peace and goodwill, to be plenteous in mercy, is to have the real spirit of Christmas."

How to Change Your Reality in 4 Steps

“Reality is merely is merely an illusion, although a very persistent one"  Albert Einstein

The way we perceive the world is a guide to how we navigate our way through it via out filters of experience- our map.  You see, ‘reality’ as we see it is only an edited version of the ‘real thing’- the territory.  Most of us operate as if our map that we hold in our minds is the reality that everyone else uses.  We then make assumptions and deletions based on our perceptions, resulting in stress and conflict as we learn that others don’t think the same way!

We create a very limited view of the world which often leaves us feeling without choice, stressed and unhappy that others aren’t doing it right. Or, we feel we seem to be getting it wrong (depending on what our model says) !  The question I often ask my clients is, ‘would you like to change this view’?  Most of them say yes of course though with a having a map comes a certain amount of investment in that view of the world and a fear of what might happen if I change it?

As a therapist, I aim to challenge the ‘reality’ of a person’s experience whilst respecting their model of the world as being theirs and unique.  I do not wish to trample on what has been their foundation for years of experience though perhaps offer them a different perspective from a third person’s point of view.  This in itself can be liberating.

To begin shifting your reality, work through the following steps to begin editing your experiences:

1.    Bring a stressful or negative memory or thought to mind- make sure you make it as powerful as possible- sense and connect with the colours, feelings, sounds again.

2.    Check in with yourself- would it be okay to let go of any unpleasant feelings associated with it? If ‘no’ then ask yourself ‘what is the positive purpose of keeping it?  i.e. so you don’t do it again or so you can ‘punish’ that person or yourself? Be curious.

3.    Next, notice how you think about the thought or memory you’re accessing then:

a.    If you’re associated (in it), dissociate (see yourself in it like a movie)

b.    Turn it black and white if it is in colour.

c.     If it is in 3D, make the memory flat like you’re seeing it on a screen.

d.    Shrink it down in size until you have it about the size of a postcard, flat and black and white in front of you.

e.    Reach out in your mind, screw it up and throw it away or burn it.

4.    Test it- Think about the memory now and see how you feel about it now?  If it feels better, you’re finished.  If there is no change, try altering the other submodalities such as making the sound different or quieter or adding a funny soundtrack to the image or memory.  Using humour is very powerful for changing our perceptions of things.  Try it next time you are scared of something or anticipating an event like doing a presentation- imagine the most ridiculous thing or a commentary by someone who makes you laugh and see how it feels. Feel free to play with it, after all, it’s your reality!

Tips for Breaking the Worry Cycle

“Do not worry if you have built your castles in the air. They are where they should be. Now put the foundations under them.” - Henry David Thoreau

Worry can be mentally and emotionally exhausting. Your kids haven’t been abducted, you’re happily married and a month ahead on the rent – so what’s the problem? Why can’t we stop worrying?

We worry about everything and nothing. Most worriers are aware that there is no logic in the act of worrying – it is shutting it off which proves to be the problem! And it can be exhausting.

Dr. Walter Cavert did a study of the things we worry about. He discovered that:


40 % of the things we worry about never happen,

30 % of our worries concern the past,
12 % of our worries are needless worries about our health,
10 % of our worries are insignificant or petty (things that will really not make much of a difference in our lives one way or another).

We have spent 92 % of our emotional energies over things that won’t happen or things we can’t change.
 

Identifying why you worry is a suitable starting point to dealing with this cycle. For some it might be physical; they have had too much sugar or caffeine (it is surprising how much of a difference this can make!) or they haven’t worked out at the gym in a while and feel a bit restless. Or it could be mental, like stress or dysfunctional thought patterns.

Getting to the root of the worry is essential in breaking the worry cycle. Find out what is triggering the anxieties, and avoid those triggers. But how do we figure out what they are? The problem is, worries don’t always have a reason. It could simply be the fact that everything is going so well which makes a person nervous as they are expecting it to change! Sometimes, worrying about something can be reassuring, as if it might solve the problem when the problem isn’t even there yet. Confused? Us too.

The trick is: Just sit back and relax. Take a minute to laugh at yourself – worrying about things that don’t exist or running too many 'what if' thoughts? Try mixing up the associations with the worry- imagine it being like a movie or a comic strip where you can put a funny soundtrack to it or canned laughter. Do whatever makes it light hearted or silly and see what happens!

Avoid the caffeine if you can. It’ll increase your awareness and that fretful part of your brain will be kicked into overdrive.

Try and figure out if you can take any action against what’s worrying you. Chances are it’s something so miniscule and irrelevant that when you moan about it to someone, they’ll tell you to “find some real problems”. But if there really is something, you DO have a bill due soon – think about ways in which you can deal with that. And if it’s all under control and you worry anyway? STOP. Cue the laughter. 

A useful process to follow is to write down all your ‘worries’ and write down all possible solutions to each problem.  Don’t analyse, just brainstorm. Then go back and assess which ones are the best and the pros and cons of each.  Next, decide on the most practical solution.  This helps engage the rational side of your brain and enables you to see the worry from another perspective.  If you struggle with this exercise, think about what advice you would give a friend if they had the same issue, or ask another for some ideas for solutions.  Lastly, ask yourself what is the first step to changing this? Take action and remember to review your progress. 

Life is too short. Kick back, put your feet up, and enjoy the ride. Worrying will get you nowhere and it won’t allow you to have fun. Relax and take some time to think about what’s good in your life. Break the cycle today.

World Mental Health Day- Depression: A Global Crisis

“Even for me life had its gleams of sunshine.” - Charlotte Bronte, Jane Eyre.

On the 10^th of October 2012, we are celebrating the 20th Anniversary of World Mental Health Day!

World Mental Health Day aims to increase the awareness of the public about mental health issues. The day readily opens discussions of various mental disorders; many people don't know what they are or how to get the support they need – World Mental Health Day hopes to change that.

This year's theme is depression. Depression is a serious mental illness affecting over 350 million people world wide, of all cultures and ages. The World Mental Health Survey conducted in 17 different countries discovered that (on average) a shocking 1 in 20 people reported having an episode of depression in the previous year. A study conducted by the European Depression Association (EDA) of 7000 people found that 1 in 10 of them had taken time off work because they were depressed. 1 in 4 confessed they did not tell their employer.

It seems that not only does the general public not realise the seriousness and frequency of depression, they also do not realise what can be done to help and maybe even view it as something to hide or be ashamed of.

This is not the case; Depression is a very serious condition which is often gets out of your control. It is not your fault you feel this way, and you mustn't blame yourself. Depression consists of symptoms such as persistant sadness and low mood, a possible change in diet, trouble sleeping, fatigue, agitation, feelings of worthlessness and poor concentration. It can make life very difficult.

So what can help? 

Cognitive behavioural therapy has proven it's benefits time and time again, as it offers treatment which teaches lasting life skills which can be applied and used in every day life. It looks at how you can change any negative thoughts or patterns that you have in your life, and often helps you to learn how to deal with emotional problems effectively. It can teach you to step out of your automatic thoughts.

Mindfulness is often taught as therapy for depression. It involves learning how to live in the moment and focus on the beautiful tiny features of every single day – be it the smell of that coffee or the sight of the morning sky. By paying attention to the little wonders around you, and not just noticing them but really appreciating them, it can help to ease depression because we realise all the good, special things we have in the world and how lucky we really are. It can be a transformative experience.

World Mental Health Day hopes that by rasing awareness of depression and ways to deal with it, we can collectively improve the general wellbeing and quality of life for people worldwide. For more information, visit the Mental Health Foundation website.

Four Steps to Beating Stress at Work

“The greatest weapon against stress is our ability to choose one thought over another.” - William James

You may not realise the serious implications that stress can have on your every day life. According to recent research in the Lancet Medical Journal, those who have high stress levels in the workplace and low control in decision making have a 23% increased risk of a heart attack.

Stress is caused by our body's natural “fight or flight” defences, releasing chemicals such as adrenaline, noradrenaline and cortisol into our bodies. Although this can be a fantastic defence mechanism at times, when these chemicals remain in our bodies for an extended period of time, they mean business, leading to Chronic stress.

Chronic stress can disrupt your life in many ways, as well as causing physical changes in your body, resulting in ailments such as Irritable Bowel Syndrome (IBS), sickness and insomnia.  It may may also lead to emotional problems such as arguing with relatives, lack of confidence and esteem, forgetfulness and even depression.

Luckily, Scientists and Psychologists have been exploring ways in which stress can be reduced and managed:

Firstly – Get organised. If that pile of work is growing, plan what you're going to do and by when each week. A good mantra is: Defer, Delegate, Delete. Be realistic and prioritise- don't load yourself up with too much work as chances are this will only increase your stress. Set yourself reasonable, achievable targets and get them done.

Secondly – Reflect on the successes of each day. If you managed to get through the tasks you set yourself, you deserve a pat on the back. If not, don't worry about it – just spread out the remaining work evenly through the rest of your week's plan.

Thirdly – Relax. At the end of a hard day, you deserve to put your feet up and read that novel you started 4 months ago and never got round to. Keep work within the workplace if you can.  A few hours at home should be dedicated to spending time alone or with family switching off on a regular basis.

Fourthly – Employ some techniques to reduce your stress levels. Exercise is excellent for stress prevention, as is sex (lucky us!) ; so is seeing your friends and enjoying time with them- or even more focused activities such as Meditation and Mindfulness. Although this can be hard to grasp at first, there is plenty of help online such as http://www.how-to-meditate.org/.

Finally –We all get stressed at times. You are not alone. It takes some time to reduce your stress levels, but you can get there. The most helpful thing you can do is take a positive attitude and try to smile. Take each day at a time.  If you're finding yourself overwhelmed by the effects of stress, seeking the help of a Counsellor or Therapist may help. Visit: http://www.counselling-directory.org.uk  for more information.

Something for those Sleepless Nights

“A well spent day brings a happy sleep” - Leonardo Da Vinci

 

Insomnia is a common problem in what can be a stressful world. After a busy day, you'd think it would be easy to quickly drop off to sleep, but it turns out to be quite the opposite – we spend hours tossing and turning in what soon becomes a very tedious and frustrating process.

Often insomnia is linked to stress. Vgontzas et al (1998) found that those with higher stress level matched those who got less sleep. Of course the amount of sleep people need can vary, but it is the quality of the sleep which is important. Sleep is vital for rejuvenating your body and mind, and a fresh start in the morning can be just what we need for a happy and productive day.

You've probably heard of the phrase “Woke up on the wrong side of the bed” - Well here are a few useful suggestions as to preventing that from happening.

• Make sure you are comfortable; whether it's the temperature of the room, the amount of light, the quality of the mattress – get to know your needs and work with them to get the best out of the night. This may involve compensating with a partner to balance both your needs.
• Start to relax a few hours before bed; Try and make a nice routine for yourself, such as having a bath with candles, reading a book, having a warm milky drink. Doing all these things and getting used to a bed-time routine can drastically improve your sleeping!
•  Eliminate exogenous zeitgebers; Or in layman's terms, cut out any night-time noise! If you live close to traffic, find some ear plugs. If you have noisy neighbours, ask them to turn the TV down. This is especially important if you are working night-shifts and need to sleep in the day, as these factors will distract you from your sleep and keep your mind in an active state.

As well as doing all or a few of the above, there are certain things to avoid when it comes to nodding off.

• Don't sleep on conflict; If you and a partner/relative are having problems, try to resolve these issues before going to bed, as they will just play on your mind and keep you awake.
• Don't study in bed; Whether it's paperwork, finance, or you happen to be a student, bed is not the place for work. Everything must be dealt with elsewhere, as you will come to associate your bed with stress and work, and you may end up feeling more alert around it! 
•  Don't stay in bed if you can't sleep; Get up, go downstairs and keep yourself occupied – but with a relaxing task such as reading or listening to some calming music.

Remember, if this becomes a recurring problem for you rather than occasional, there are other options you can take. Cognitive Behavioural Therapy (CBT) has been shown in recent study (Morinet al, 2004) to be more effective than sleeping pills when dealing with long term insomnia. It was discovered that in the short term sleeping pills are helpful, but in the long term, the insomnia needs to be fought with using techniques and improved sleeping habits, which is just what CBT can do for you.