A commentary in response to the current public discussion on depression arising from Greg Boyed's sudden death and the release by the Chief Coroner of the latest suicide statistics. 10% increase in rate from last year. Suicide has increased each year for the past four years. Time for some critical thinking about what we are doing.
The news of Greg Boyed’s sudden death and that he had been struggling with depression once again brings into sharp focus the increasing number of men who are living and dying with depression in this country. These men are our sons, grandsons, fathers, grandfathers, uncles, cousins, friends and workmates. Statistics released by the Chief Coroner this week has shown that suicide for the fourth year in a row has increased. The Generation X men I was working with thirty years ago when I led the first national response to youth suicide have continued to kill themselves as they have aged. There is evidence that more of the young men suicide come from families where other men have killed themselves.
While I do not in any way presume to know exactly of Greg Boyed’s personal struggle with depression, I do have an understanding of how depression can transition into a fatalistic despair. As a man who has have lived with an enduring melancholic depression since early adolescence and having, for over thirty years, worked with depressed and suicidal men across the lifespan, from different ethnicities and social economic backgrounds there are insights from which I draw upon to contribute to an informed public discussion on addressing depression and suicide in men.
With leadership from people like John Kirwan, who have broken the silence around depression and anxiety, there is now a much more open public conversation on depression and anxiety. Men are now more readily presenting to GPs or attending counselling. These are positive indicators of changing societal attitudes to mental illness. However there is still a level of misunderstanding of what is depression. People who are in a state of depression often report how difficult it can be to describe to someone who has not experienced depression what it is to be depressed.
A common misconception is that depression is an extreme form of sadness whereas the reality is absence of emotion. It is a deep void of an oppressive nothingness that sucks all pleasure out of living. It disorients, making it difficult to remember what life was like before the onset of the depressive episode or to visualise what it is to be well again. The constancy of this depressive void becomes a fertile ground in which insecurities and inner fears overshadow personal strengths and self-belief. This negative self-perception leads to an amplified critical voice which diminishes and depletes and the catastrophising of issues.
I would be described as a high functioning depressive, i.e. my depression on the whole is managed and only rarely interferes in my day to day functioning. My episodes of clinical depression have mostly been short-term with sufficient resiliency to navigate my way through the darkness. While it may have felt hopeless it never transitioned into despair. In 2014 I experienced my most darkest and persistent depression. In my early fifties, I didn’t seem to have the energy to fight the depression. I caved into the constant bombardment of depressive and distorted thinking that framed my life as failure and futility, resulting in self-loathing, my sense of personal and professional efficacy and confidence eroded and for the first time in my life, where death seemed more attractive than living. This experience added some very important insights into the suicidal thought process which both affirmed and gave new depth to the knowledge gained from the research and considered wisdom in suicide prevention as well as the insights gained from my work with numerous suicidal people.
Listening to stories of depressed and suicidal it is clear to me that we must broaden the focus of prevention and intervention from just the psychological factors to a much broader enquiry on how the changing roles, expectations, social and economic status of men has impacted on their wellbeing and depression.There needs to be far more cognisance of how traditional notions of masculinity affect the way men make sense of and manage their depression. Studies have shown that it is men’s staunch is much more a reason why they are hesitant to reach out for assistance than the stigma around depression as is more commonly thought. There needs to be greater emphasis on early intervention, in particular to trauma related depression and suicide.
Effective depression and suicide prevention strategies must address the confusion in many men about what it means to be a man in 2018, the growing sense of redundancy or futility, the deep feelings of loneliness and isolation. The enormous pressures on men to succeed and the fear of failing or disappointing is leading to unprecedent anxiety in men. We need to give men permission to stuff up but not give up and encourage a move away from an emphasis on the pursuit of happiness to living lives that are profoundly satisfying and which engender a deep sense of purpose and meaning. Research suggests that men who invest and value more their social roles of grandad, father, uncle, son, brother and mate rather than the functionary roles of provider and protector have a greater sense of satisfaction.
Surely it is time for us men to have courageous conversations about why so many of us are experiencing depression and anxiety. To debate whether contemporary notions of masculinity are freeing men up to critique traditional gender roles? Failure to have these important conversations means we will continue to apply band aids to ever gaping wounds and in thirty years’ time we will be still asking why men are so depressed and killing themselves.
As a society we need to say to men, it does matter if you live or die. It is an issue of concern that men are increasingly unwell, and action is required to help men to become well again. We have to start early. Well boys become well men. Well men contribute to well whanau, communities, workplaces, economies and society. Well men matter.