___M_A_L_E __ D_E_P_R_E_S_S_I_O_N :
just take the pills, guys
MEN WOULD RATHER KILL THEMSELVES -- LITERALLY --
THAN ADMIT THEY ARE SUFFERING FROM ONE OF THE MOST COMMON
DISEASES IN THE WORLD.
SALON OFFERS A WEEK'S WORTH OF SPECIAL FEATURES ON LEGAL DRUGS. HERE'S THE LINEUP: MONDAY, JULY 14, 1997:
IN DRUGS WE TRUST
>TAKE THE PILLS, GUYS
TUESDAY, JULY 15, 1997:
FIGHTING THE BIG MONSTER
GEN RX
MELATONIN MANIA
WEDNESDAY, JULY 16, 1997:
READIN', RITIN' AND RITALIN
MEDITATION VS. MEDICATION
THURSDAY, JULY 17, 1997:
NO SEX PLEASE, WE'RE MEDICATED
FRIDAY, JULY 18, 1997:
THE COFFEE CONNECTION
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The 2,000-word piece had just three paragraphs about my own experience, but it was those paragraphs that attracted the most attention. A surprising number of male colleagues at the San Francisco Examiner, where I then worked, came to me and quietly confessed to their own depression; after reading my article, they said, they felt emboldened to try antidepressants. One of them, a copy editor with whom I had worked closely for years, cried. For a while, I became a sort of in-house therapist and drug enabler. I received many letters and was a hit at parties. Connie Chung's people called me. Partly suspecting an ambush, but mainly because I had no wish to become a media poster boy for Prozac, I declined their invitation to appear on a CBS show on the subject. That was over four years ago. Since then, reams of copy have been written on depression and Prozac has become a household word. Everybody's taking it, or so we are told. Countless clinical studies have demonstrated depression's link to brain chemistry and the effectiveness of drugs in treating it. Yet of the 17 million Americans currently suffering from the disease, two-thirds go undiagnosed, untreated or mistreated, according to the National Institute of Mental Health. In the past four years, more than 120,000 Americans have committed suicide, mostly as a result of untreated depression. Those who don't put a gun to their heads are liable to die in other untimely ways: Researchers at the Johns Hopkins School of Hygiene and Public Health found depression to be as big a factor in fatal heart attacks as high blood pressure and high cholesterol. By the year 2020, according to a massive survey by the World Health Organization and the Harvard School of Public Health, acute depression -- not war, not hunger, not global warming -- will be the world's second leading cause of death and disability, behind only heart disease. How could this be? Mainly because we're not yet out of the dark ages on this issue. No matter what the scientists say, depression is still regarded as reflecting the content of one's character, not one's brain chemistry. Forty-three percent of Americans in a Gallup poll said they believed depression is not an illness but a sign of "personal weakness." That's an attitude shared every bit as much by liberal dope smokers as by right-wing bible-thumpers. It's also very male. "For men and women, the illness is basically the same," says George Bach-y-Rita, a psychiatrist at California-Presbyterian Medical Center in San Francisco. "It's how they respond to it that's different." What men do, rather than seek treatment, is kill themselves or drink heavily. Men have a hard time dealing with the stigma of depression, says Bach-y-Rita. "If you can't 'handle' it, it means you're not competent, you're not strong. This attitude still pervades organizations like the military and police and athletic groups, where 'toughness' means putting up with pain -- and you certainly don't accede to emotional pain." While women suffer a higher incidence of depression than men, and are not doing much better at getting treated, there is, in my own experience, something particularly threatening about depression to men. For one thing, it literally "un-mans" you. Shut in a dark room, rarely changing out of a bathrobe, spending most of one's waking hours filtering through various ways to kill oneself, you become a shadow, inactive, lacking all independence, a negation of oneself and one's gender. Being in such a state is hard on anyone around you, but in my experience, it was especially so for my male friends. One, whom I had known for 20 years, felt so hopeless in the face of my unrelenting bleakness that he suggested that suicide was not such a bad idea. Taking drugs for the condition is also battering to the male psyche. In the mid-'80s, when I got into really bad shape, I associated antidepressants with shock treatments and lunatic asylums, prescriptions of madness and shame. The first 100mg tablet of Doxepan -- a "dirty" ancestor of the Prozac generation -- put me to sleep for 20 hours. I flushed the rest of them down the toilet. Only at the gentle urging of my empathetic M.D., who was about my age, did I try again. After about two and a half weeks of Doxepan in the morning and a Xanax in the afternoon -- my depression came with an anxiety chaser -- the steel vise began to loosen. I experienced some dry mouth and also some weight gain from water retention -- common side-effects of these older tricyclics. Nothing I couldn't handle through sucking a boiled sweet and exercising for the first time in years. Doxepan may have been "dirty," but it enabled me to rejoin the human race, and had I not been drawn by the appeal of the hipper, more refined Prozac, I would probably still be taking it. This submission to pills remains rather more politically incorrect than one might think. For one thing, it undermines the rationale of talk therapy, not to mention the entire underpinning of psychoanalytic theory. And there is a peculiarly twisted notion, one held especially by older male baby boomers, that illegal drugs are good, legal drugs bad. Having your head twisted around by some Maui Wowie, in the views of these counterculturistas, is a truer path to health than taking a pill to alleviate the symptoms of a dreadfully oppressive disease. Supporting the lifestyle of a cocaine baron in Colombia or a marijuana grower in Mendocino County is more acceptable than feeding the corporate maw of Eli Lilly and Smith Kline Beecham. A dear friend of mine, fond of berating American society for the ills of the world, has always looked upon my choice of medication with purse-lipped disapproval. He wants me to break the chain of pill dependency. I would like him, now with wife and child, to smoke marijuana a little less frequently than on a nightly basis. That admitting to depression and taking medication for it can still be the mark of a loser was brought home more recently at a party of intellectuals and journalists. During a discussion of Salon, a very senior editor of the newspaper I had quit to join the magazine declaimed for all to hear "Well, I hope he's still taking his Prozac!" Yes, that says more about this particular editor -- who is partial to hefty slugs of Jack Daniel's on the rocks -- than it does about me. But it also suggests that beneath the veneer of acceptance and understanding, there remains a great deal of male scorn. I believe that these attitudes, and the chasm of ignorance about depression, kill people. I believe that Vincent Foster, Adm. Jeremy Boorda and journalist J. Anthony Lukas all died partly as a result of them. Foster and Lukas reached out much too late, their years of internalized shame having kindled a psychic conflagration that was out of control. Can you imagine the obviously depressed Foster, in the vicious, unforgiving arena in which he fought to survive, confessing earlier to such weakness? Boorda went down with what he perceived to be the sinking ship of his honor -- an irrational hopelessness that is so typical of depressive illness. As for Lukas, well, don't all writers get moody? "I was sitting at home in the dark, with a glass of Jack Daniel's, as is my wont," Samuel G. Freedman quotes him as telling his class, "and then Linda came in and said, 'Oh, Tony.'" Lukas was gently mocking his own darkness even as it engulfed him. Close friends had heard he had recently gone on medication, but according to colleagues, he refused to talk about it, at least with other men.
Perhaps the cloud of silence and shame that hangs over male depression is beginning to lift. With this subject, one must be grateful for even small breakthroughs, even when they come courtesy of celebrities. Rod Steiger, it turns out, hadn't worked in eight years until recently because of severe depression. He couldn't even get out of bed in the morning, according to the Associated Press. "Now, he takes antidepressant medication ... and he has had no recurrence." That's wonderful. My only question to Steiger would be, What took you so long?
Are men ashamed to admit they suffer from depression? Discuss in Table Talk. |
