Head’s up: when it comes to mental health, we tend to be our own worst enemies – reluctant to open up to friends, and slow to seek professional help when we feel overwhelmed. The number of men who take their own lives bears this out – just over three out of four suicides in the UK are by men, and suicide is the biggest cause of death for men under 35, according to the Office for National Statistics. With 15.8m work days lost due to mental health problems in the UK last year, the levels of stress we’re under only seems to grow. The good news is that mental health has never been better understood. The old stoic male stereotype is dissolving, replaced by a form of masculinity where weakness needn’t be terminal. If you’re suffering, getting the right support is vital if you’re going through difficulties – a visit to your GP should be the first step. But there’s also a lot you can do to help yourself stay mentally fit and find a way through if you’re struggling. Here’s what you need to know about the four of the most common issues in men.
Generalised Anxiety Disorder (GAD)
What is it: Generalised anxiety disorder is a long-term condition that can make you feel constantly on edge, with your mind racing with worries that never seem to stop. Common symptoms: Trouble concentrating; sleep problems; muscular tension; irritability; fatigue. What you can do: Anxiety happens when our body thinks we are in danger – even though we are not facing any kind of physical threat. The trick is to find a way to switch the faulty alarm off and slow your system down. Taking steady, deep breaths will help if you start to feel overwhelmed – count five seconds on the breath in, hold it for six and release it for seven. Many people benefit from a ‘talking therapy’ known as Cognitive Behavioural Therapy, where a therapist will help you to identify the thoughts and behaviours behind your anxious feelings. Sometimes this therapy is prescribed in tandem with medication, such as Selective Serotonin Re-uptake Inhibitors (SSRIs), which can be used to treat depression, too. ‘Exposure’ is another technique a therapist might use, which involves putting yourself in situations that cause you anxiety a little bit at a time so that you can safely face your fears. Some people also swear by mindfulness, regular exercise or hypnotherapy (which aims to change patterns in the unconscious mind). “Unfortunately, there isn’t any one magic treatment for anxiety that will definitely help you,” Chloe Brotheridge, a hypnotherapist, anxiety expert and author of The Anxiety Solution, writes on her blog, Calmer You. “What works for one person as an anxiety treatment can be totally ineffective for someone else and you may need to try a few ones out before you find one that works for you.”
What it is: Depression is more than just feeling down for a few days; when you’re depressed you feel persistently sad for weeks or months and you just can’t see a way out. Common symptoms: Lasting feelings of despair and hopelessness; losing interest in activities you enjoy; tearfulness; severe depression can lead to suicidal thoughts. What you can do: What Churchill called the ‘black dog’ is no joke, but like him, you can and will get through it. The first thing to realise is that you may not be able to just ‘snap out of it’: depression is an illness and may require treatment. As with anxiety, therapists may use Cognitive Behavioural Therapy and some form of medication. It can be tempting to isolate yourself, but it’s vital that you reach out and stay in touch with friends and family. Tell trusted confidantes what you are going through so they can provide you with the support and encouragement you need. Studies suggest exercise can be as effective as anti-depressants in beating depression, though bear in mind that if you are very down, you won’t be able to push yourself like you could when you were well. Maintain your routine as far as possible and try to eat as healthily as you can. Keep a note of activities that bring you a sense of achievement and try to do one or two each day. “Set yourself small goals each day, but don’t worry if you can’t achieve them all,” says clinical psychologist Dr Genevieve von Lob. “For some people, that might be as basic as getting out of bed. But don’t push yourself too hard – the most important thing is to learn to be kind to yourself.”
Post-Traumatic Stress Disorder
What it is: PTSD is an anxiety disorder that can affect people who experience a life-threatening event. Common symptoms: Flashbacks; nightmares; emotional numbness; constantly feeling on edge; angry outbursts; insomnia; headaches; dizziness; stomach pains. What you can do: PTSD doesn’t just affect soldiers in war – anybody can suffer lasting side-effects from a life-threatening experience. It’s normal to feel shaky after suffering a near miss – and in many cases you will soon start to feel better without needing any professional help. But if the distress you feel goes on for longer than a month, then you may need to seek medical advice. Therapists often treat symptoms of PTSD with Cognitive Behavioural Therapy, but growing numbers are fans of a newer approach known as Eye Movement Desensitisation and Reprocessing (EMDR), in which a therapist uses a wagging finger or flashing lights to stimulate bilateral movement of the eyes. Nobody knows quite how it works, but many people report remarkable breakthroughs. One of the most promising alternative approaches is equine therapy: there seems to be something almost magical about the soothing presence of the horse. “So often, trauma survivors find it difficult to work with a therapist because they feel so angry or ashamed. But nobody ever felt judged by a horse,” says Sun Tui, a trauma expert who runs the International Federation for Equine Assisted Learning. Pioneering researchers in the US and UK are also conducting trials on therapy undertaken with the assistance of MDMA – the active ingredient in the club drug ecstasy – which could be available by 2021.
Obsessive Compulsive Disorder (OCD)
What it is: Many people associate OCD with obsessive cleanliness. In fact, OCD is a specific type of anxiety disorder where a person experiences intrusive and unwanted thoughts, feelings, images or sensations that cause them to feel very distressed – and may often involve thoughts of harming themselves or others (even though they would never actually do this). Common symptoms: People with OCD suffer from ‘obsessions’ – a thought that forces itself into your mind and leaves you feeling stressed and anxious. They try to deal with this feeling by developing ‘compulsions’ – a type of behaviour they may repeat hundreds of times. Common compulsions include endless handwashing, constantly checking appliances are switched off, or silently repeating a word. What you can do: OCD is a chronic condition so the goal is to learn to manage the symptoms so they don’t take over your life. Anyone who has experienced OCD knows the vicious cycle all too well: obsessive thoughts start making you feel fearful, so you act out compulsive behaviours to push these fears away. “Doing this usually provides some temporary relief because the person believes that the ritual prevents the fear from becoming reality – it’s a bit like superstition on steroids,” says Dr Siri Harrison, a consultant clinical psychologist who runs a private practice in the City of London. “But rituals can become hugely problematic because, with added stress, they tend to grow and can take up hours of time.” A therapist can help you break out of this cycle using a technique called Exposure and Response Prevention (ERP), often used along with medication and supplemented with mindfulness and Cognitive Behavioural Therapy. The approach works by helping you to learn to tolerate the fears caused by your obsessive thoughts for long enough to realise they are not based in reality. “It may get worse before it gets better, but it definitely gets better if you do this therapy,” Harrisons says. — Matthew Green is the author of Aftershock: The Untold Story Of Surviving Peace, which documents the post-conflict experience of British soldiers. Find out more at matthewgreenjournalism.com