Men’s mental health is a topic not often spoken and, when it is, few people discuss the question: how do you tell your GP, and what happens next?
There is still a perception that men should cope with their feelings, not reveal them to others. Despite this, the biggest killer of men aged 18-30 is suicide, with just as many men experiencing depression as women.
From my own experience, a lot more women consult with me about low mood and depression than men. And, as I work in a GP surgery staffed entirely by women, I know it’s not because my male patients are seeing the male doctors.
I personally really enjoy helping patients with mental health problems because it is a journey that you can go on together. Quite often, the GP is the only person that the patient has confided in and, for me, I think that it is a huge privilege.
We have to start talking about men’s mental health.
‘Am I depressed?’ The signs and symptoms of depression in men
People experience depression in different ways – no two people are the same. There are key signs of depression to watch out for, however, where you may:
Be experiencing low mood, tearfulness, feelings of worthlessness and unjustified feelings of guilt
Be struggling to find pleasure in things, particularly if they used to be enjoyed
Have low energy levels and poor motivation
Find it hard to control your temper
Experience physical symptoms like your heart racing, stomach pains, aching joints and headaches
Have low self-esteem and confidence
Consider harming yourself, or have suicidal thoughts
Whilst these are all feelings someone with depression can experience (but can vary hugely from person to person) certain behaviours can start to become apparent, too. This includes:
Difficulty concentrating or remembering things
Loss of interest in sex
Changes to your sleep patterns, such as problems staying asleep, waking up early, or finding it hard to sleep at all
Not performing well at work
Losing your appetite, or overeating, which can cause changes to your weight
Getting into a habit of abusing alcohol or recreational drugs as a coping mechanism
Whilst it is completely normal to experience these feelings occasionally, if you have experienced any of these symptoms or signs on most days for longer than 2 weeks, then you may have depression and it might be worth seeing a doctor.
What to expect when you talk to a GP about depression
My first piece of advice to those looking to get better? Don’t suffer in silence.
It’s so important that you speak to your doctor about your thoughts and feelings, so they can assess how severely you’re being affected and what treatment they can offer to support you.
What will a doctor ask during an appointment about depression?
When you see your GP, it is important to work out how long you have had your symptoms for, and how much they have been impacting you, so you can be diagnosed properly.
I ask my patients several specific questions when they first visit me about their mental health, including:
How long have you felt like this and what prompted you to get help from the GP?
How are you sleeping?
What do you enjoy doing?
Are you using alcohol or recreational drugs?
Who is supporting you? Do you have a good support network of family and friends?
How are your symptoms affecting your relationships?
What work do you do? How are your symptoms affecting your work?
Have you had any thoughts about harming yourself or taking your own life (if the answer is yes, then I would ask if any plans have been made, and what has stopped you from carrying out the self-harm, what makes you feel safe)?
What have you done to make yourself feel better?
And, finally, I ask my patients what treatment they are hoping for. This helps me to manage expectations and offer the right kind of support for them. My sessions always end in deciding when to catch-up again, and by offering advice on where a patient can get support outside of their friends and family.
How to beat depression; talking therapies or anti-depressants?
There are two routes you can follow when trying to treat depression – antidepressants and talking therapies. Often, these treatments can be most effective when used together.
You are absolutely not a failure if your depression is severe enough to need antidepressants. Depression occurs when the chemicals in the brain change. It is an illness of the mind, just as you can get an illness of the body.
How do antidepressants work?
There are lots of different types of antidepressant medications, but the class of medication that I most commonly prescribe are the SSRIs (selective serotonin re-uptake inhibitors).
They work by increasing the amount of serotonin, one of the chemicals involved in messaging, in the brain. They are particularly effective when used with a talking therapy, like Cognitive Behavioural Therapy (CBT),
I always warn my patients that it takes at least 2-3 weeks to feel the effect of the tablets, and you may even feel worse. This is, however, is temporary and after this period you will start to notice a positive change as they take effect.
Patients need to stay on antidepressants for a minimum of 6 months, and ideally a year, to stop the depression from coming back.
Should you take antidepressants?
Antidepressants won’t make you feel ecstatically happy straight away. But the reason that doctors often prescribe antidepressants is that, when prescribed for the right person, they really work!
What they do is lift your mood enough to allow you to sleep, eat properly and improve your motivation and concentration enough to do the other things (like exercise) that we know help in the recovery from depression.
Any decision for a patient to go on antidepressants is made after we have discussed how bad a patient's symptoms are, and what they have already tried to lift their mood. You don't have to go on medication even if your doctor recommends it - it's entirely up to you.
One man who did confront his problems with depression is adventurer, author and motivational speaker Alex Staniforth. Alex shared his story about where he sought help and how he manages his condition:
What is CBT? How talking therapies help with depression
I normally recommend CBT (Cognitive Behavioural Therapy) to my patients. CBT helps manage depression and anxiety and works by looking at how you manage negative thoughts and feelings, and gives you practical skills to help change how you cope with those feelings.
We recently spoke to Ryan Sheppeck, who has been experiencing depression and anxiety for a number of years. Ryan spoke to us about how he overcame his problems:
CBT isn’t like counselling; you don’t have to share your past with your therapist. I have had really good feedback from patients about CBT and would always encourage my depressed patients to go.
Going to CBT requires a commitment from the patient to attend sessions and it won’t make you feel better overnight. But, the advantage is that CBT will give you coping skills that can be used in your life long after the course is completed.
My advice is to not suffer is silence. A lot of men come to talk to me and cry - and that's okay. Find a supportive GP who will give you the advice and guidance you need to navigate these difficult times.
I really enjoy helping my patients with their mental health problems because it's a journey we can go on together. For me, it's a huge privilege being able to see someone recover and overcome their struggles.