It's "Movember"! Since 2003, men have been encouraged to grow mustaches during the month of November to bring awareness to premature death in men. The average lifespan of American men is about five years shorter than women. The Movember Foundation is the leading charity addressing some of the major health issues faced by men: prostate cancer, testicular cancer, and mental health and suicide prevention. Their goal is to reduce the number of men dying prematurely by 25% by 2030.
A significant cause of premature death in men is suicide. Globally, one man dies by suicide every minute and six out of ten suicide deaths are men. The recent start of the NBA season makes it the perfect time to discuss men's mental health and suicide prevention. According to the CDC, in 2014 men were half as likely as women to go to the doctor over a two-year period; more than three times as likely to go more than five years without a doctor's visit; and more than twice as likely to have never had contact with a doctor as an adult. When men do present to the doctor, it will most likely be a primary care physician. One in four primary care patients have depression but less than one-third are identified by primary care physicians. Talking about sports can be a segue to discussing mental health with our male patients and the men in our lives.
According to the Anxiety and Depression Association of America, anxiety disorders (generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, obsessive-compulsive disorder, and posttraumatic stress disorder) are the most common mental illnesses in the United States, affecting 18% of the adult population yearly. Only 37% of those with anxiety disorders receive treatment. Almost seven percent of American adults had at least one major depressive episode in the last year. Depression is the leading cause of disability in the United States among people ages 15-44. Thirty-seven percent of adults with major depression do not receive treatment. Men are less likely to seek treatment than women due to downplaying symptoms, reluctance to talk, and social norms. Six million men are affected by depression each year. Men are more likely to report fatigue, irritability, and loss of interest than sadness; so, their symptoms are often not recognized as depression. Three million men per year have panic disorder or a phobia.
Last NBA season, several players revealed their struggles with depression and anxiety. Other male athletes and celebrities have discussed their mental health, but these three players disclosed symptoms while in the midst of their careers and receiving treatment. Their transparency revealed some of the myths that men have about mental health and also emphasized some of the facts.
Myth 1: "If you can function, you must not be depressed."
In February 2018, DeMar DeRozan of the Toronto Raptors revealed his struggle with depression in an interview with "The Star." He tweeted in the middle of the night, "This depression gets the best of me." He wanted others with depression to know success is possible: "Even if it's just somebody can look at it like, 'He goes through it and he's still out there being successful and doing this,' I'm OK with that."
Myth 2: "Talking about depression (or other mental health issues) only makes it worse."
DeRozan's disclosure led to Kevin Love of the Cleveland Cavaliers writing an article for "The Players Tribune" in March 2018. He revealed having his first panic attack in November 2017 during a game. He didn't tell those closest to him, "But I didn't share — not to my family, not to my best friends, not in public." Kevin stated, "…people don't talk about mental health enough. And men and boys are probably the farthest behind."
Myth 3: "Men should not ask for help. They should be able to cope on their own"
Love believed that he needed to "Be strong. Don't talk about your feelings. Get through it on your own."
Myth 4: "Depression (or other mental health issues) will make you a burden to others."
Love was worried that his teammates would view him differently, "I didn't want people to perceive me as somehow less reliable as a teammate..."
Myth 5: "Mental illness is a sign of weakness."
Love also stated, "To me, it was a form of weakness that could derail my success in sports or make me seem weird or different…"
Kelly Oubre, Jr. of the Washington Wizards talked about his depression in March 2018. He discussed what he was taught as a child, "I'm really good at keeping a poker face because when I was growing up my dad used to always tell me, 'Don't let anybody see you're weak.' Nobody sees that I'm weak, but deep down inside I'm going through a lot and hell's turning over…"
Fact 1: Cognitive behavioral therapy, mindfulness-based cognitive therapy, and interpersonal therapy have shown effectiveness in reducing symptoms of depression and/or reducing relapse rates.
Oubre discussed how mindfulness has helped him, "Just being mindful is the only way I know how to get through any anxiety, any depression or anything like that."
Fact 2: Mental illness can affect anyone, regardless of income, career, or fame.
Oubre stated, "We're normal human beings. We face a lot more adversity, a lot more problems... It's a little bit more amped up, we just can't show it…I feel like people who are on the outside looking in don't really understand because they see us as superheroes, but we're normal people, man. We go through the issues that normal people go through…"
Many men admire and want to be like their favorite athletes. When they see these athletes prioritizing their mental health and successfully managing their symptoms of depression and anxiety, it reduces the stigma and makes it easier for men to seek treatment. Treatment of depression and anxiety leads to less suicides.
These resources are available for men:
- Your primary care physician
- Your job's EAP (employee assistance program)
Danielle J. Johnson, MD, FAPA is a board-certified psychiatrist. Her interests include women's mental health and minority mental health. Dr. Johnson is co-author of the book "The Chronicles of Women in White Coats." Follow @drdanij on Instagram and Twitter. She is a 2018–2019 Doximity Author.
References:
- Movember Mental Health and Suicide Prevention: https://us.movember.com/mens-health/mental-health
- Heads Up Guys: https://headsupguys.org/
- Man Therapy: http://mantherapy.org/
- NIMH Men and Depression: http://www.nimh.nih.gov/health/publications/men-and-depression/index.shtml
