Wednesday, March 21, 2007

To Your (Mental) Health!

This is my column for the latest issue of our local paper. Obviously, I'm not a doctor, so I apologize if I don't have all my facts exactly right--if you believe you have depression, don't make decisions based on my one little blog entry; talk to your doctor.

It’s no surprise to any of us that men and women are different. We think differently, we use language differently, we are different when it comes to friendships and even simple things like the way we use the telephone.

It took a long time for the medical community to recognize that men and women are very different in some very important ways that go beyond our plumbing and hormones. For instance, many years ago most research on heart disease was done on men, and women were assumed to be just the same in the ways heart disease affects us, the symptoms we have, and so forth. Then it was discovered that this isn’t the case. The classic heart attack symptom—crushing pain in the chest that radiates to the arm and jaw—is common in men, and when a man appears at a hospital ER with this symptom it’s immediately recognized as a heart attack and treated accordingly. But women don’t always have this symptom when they have heart attacks; they may have nausea, or more vague complaints, so for a long time ER staff would not immediately recognize what was going on, but might diagnose anxiety or indigestion. Fortunately, as doctors have learned more about the differences between men’s heart attacks and women’s heart attacks, this is changing.

There was a cover story in Newsweek magazine recently about another health-related difference between men and women. It has to do with depression. For a long time it was assumed that many more women than men suffered from depression. But here lately we’re finding that depression, like heart disease, is an equal-opportunity illness. It just manifests itself in different ways. The classic symptoms of depression, such as spending lots of time crying or sleeping, are more commonly women’s symptoms. Men with depression tend to lash out with anger, or drink too much, so we don’t always recognize them as depressed. One man in the article said something like, “I had no idea I was living with depression. I just thought I was a jerk.” But once his depression was correctly diagnosed and treated, he wasn’t such a jerk anymore.

Why is this important? Just like heart attacks tended to be fatal for women more often before we came to understand the different symptoms women have, depression tends to be fatal for men more often as far more men than women successfully commit suicide. Men tend not to seek treatment for depression, partly because it’s still seen in our culture as “unmanly.” Or they might deal with the alcoholism or drug addiction that has become part of their lives as a result of trying to self-medicate their depression, but not deal with the depression itself. Or they might not realize they even need treatment—who goes to the doctor complaining of being a jerk?

Depression is an illness, just like heart disease. It’s not a character flaw but a brain disease that can be treated with medication and therapy. There is no more shame in having depression than there is in having the flu. Men, this goes for you, too. Talk to your doctor.