Mark Minear, Ph.D., a psychologist at Des Moines Pastoral Counseling Center, went on sabbatical in the Spring of 2016. He wanted to walk the Old Lincoln Highway from river to river across the State of Iowa. His initial reasons included to fulfill a dream, get some exercise, contemplate, and experience a bit of Iowa history. Along the way, he met a lot of local people who shared food and stories. Family, friends, and others joined him on his walk. He communed with nature in ways not possible when driving. Local radio and television stations interviewed him and followed his progress. He had meaningful conversations with his walking stick. You can read his blog posts documenting his epic fourteen-day walk at www.dmpcc.org/walkwithmark.
Dr. Minear, inspired by Ellery Duke, the Center’s executive director at the time, and his bicycle ride across the U.S., decided to use his walk as a platform to increase awareness about mental health services for men and boys and to raise money for the Center’s Client Assistance Fund with an emphasis on uninsured and underinsured men and boys. He shared that 17% of men seek mental health services while 29% of women do so. In 2018 the Center’s clientele was 37.5%, 3/8, men and boys. So far in 2019, the demographic is 36% men and boys.
Dr. Minear originally became aware of and interested in the gender differences in mental health issues when he was in graduate school. He cited strong influence by the work of the late Royda Crose who wrote Why Women Live Longer Than Men and what men can learn from them. Dr. Crose divided the sections in her book to include aging, biology, health and wellness, physical health, mental health, social health, occupational health, spiritual and environmental health, and longevity. There are life choices men can make in taking care of themselves. When the book was published in 1997, men lived an average of approximately 73 years and women 79 years. Current life expectancy is 76.1 years for men and 81.1 years for women
In his blog post on April 24, 2016, Dr. Minear wrote “over six million men in the U.S. suffer from depression with, perhaps, half of these going undiagnosed.” Dr. Minear reported that, while more women attempt suicide, men are four times more likely to complete suicide. He stated that men at mid-life comprise the highest suicide rate. A 2016 report by the American Association of Suicidology indicated “in 2014, 2,421 African Americans died by suicide in the US. Of these, 1,946 were male (80.38%). The overall suicide rate per 100,000 was 5.46. … This was the first national study to show observe higher suicide rates for African Americans than for Caucasians in any age group.”
The well-known mid-life crisis can shatter a man’s life. Men evaluate their life and find their present circumstances deficient. They may have all the trappings of a successful life and still feel life or personal inadequacy. Some men in mid-life crisis end significant relationships, quit their job, relocate, or have illicit extramarital relationships. These abrupt life changes only add to the stress.
Men may mask the signs of depression with anger and aggression. Life stressors such as financial strain, grief in all areas of life, and loss of employment contribute to depression. Men with genetic predisposition toward depression or who have a major illness may be at a greater risk for developing depression. Chronic depression in all people can result from low levels of the neurotransmitter serotonin, necessitating the need for antidepressant medication. Men may shy away from medication because they fear being judged by pharmacy staff. So, they may self-medicate with alcohol or illicit drugs.
Dr. Minear stated that women pay more attention to their bodies than men. However, eating disorders such as anorexia, bulimia, and binge eating affect men as well. Men may become obsessed with calorie counting or working out at a gym. One report stated that men may obsess about “their muscles, skin, genitals, nose, or hair.”
Dr. Minear said men have fewer social supports than women. Boys are socialized to withhold tears, suppress most emotions, ignore their bodies, and rely on fortitude to get through problems. There is social stigma against men seeking mental health services which is viewed as a sign of weakness. While men and boys are discouraged against the display of most emotions, they are encouraged to express frustration, anger, and rage either explicitly or implicitly through stoic silence or making excuses for them when they are angry. He stated men’s anger can be intense and there’s a need to help them find healthy expression.
Out of Dr. Minear’s raising awareness about men and boys and mental health, a group of colleagues formed and meets monthly. ”When Life Gives You a Full Court Press” was born out of those meetings. The 2019 two-day event, sponsored by The Center and Des Moines University (DMU) takes place Thursday, July 11, and Friday, July 12 at DMU. The speaker for Thursday’s free event, “Rebound with courage,” is former NBA player and Iowa State basketball star Royce White. White has been open about Generalized Anxiety Disorder (GAD) and how it derailed his life. He has become an advocate for mental health treatment. Friday’s event, “Pivot to health,” features four break-out sessions, two facilitated by mental health professionals and two by medical professionals. Headliners Dr. David Vogel and Patrick Heath, MS, will discuss their research into mental health treatment for men and boys which keenly interests Dr. Minear. CMEs and CEUs are available for Friday’s workshops. Information about both segments of the event can be found at www.dmpcc.org/MEN.
GAD generally begins in adolescence or young adulthood. It is less common in men than in women. Estimates indicate approximately four million people suffer annually. It often travels with depression.
GAD is diagnosed by using blood and urine tests to rule out medical conditions. Trained professionals also use psychological assessments. The list of possible symptoms is long. They include excessive worry and anxiousness, easily startled, headaches and fatigue, and problems with concentration. For years, my experience with GAD went untreated. I often felt as though I would have a psychotic break. Two psychiatrists diagnosed me with and treated me for Attention Deficit Hyperactive Disorder (ADHD). My current psychiatrist accurately diagnosed the GAD. Medication, counseling, and journaling are very effective in keeping me balanced.
GAD cannot be cured, and there are no quick fixes, but a number of treatment options may be used to mitigate symptoms. Any one of a variety of medications, taken orally, may be prescribed. Medications take several weeks to notice efficacy and your primary care physician or psychiatrist may need to try different ones to find the one that works best. Cognitive Behavioral Therapy (CBT) is a talk therapy that helps build and strengthen coping skills. Lifestyle changes that may help are regular exercise, adequate sleep, healthy eating, and the avoidance of alcohol, recreational drugs, nicotine, and caffeine.
Dr. Minear hopes to open a pathway of communication between the medical and mental health communities. Greater awareness by the medical community of the need for mental health services for men and boys could lead to earlier detection and referrals.
We all can play a role in addressing the mental health needs of men and boys. Dr. Minear shared some tips:
- Talk more openly and candidly about mental health and mental health treatment.
- Erase stigma by treating mental illness as a viable topic rather than taboo.
- Educate and engage medical providers.
- Equip the medical community to make referrals.
Dr. Minear added that mental health should not be gender specific. Mental illness affects men, women, boys, and girls. We can learn as much as possible about men and mental health. We can be attentive to the signs of depression and anxiety shown by the men in our lives. We can be supportive and encouraging by listening. We can all benefit by showing sensitivity and compassion. The state of mental health services for men and boys is vital to stronger, healthier, and more resilient relationships which contributes to the well-being of everyone.
For more information about “When Life Gives You a Full Court Press,” visit the Center’s website at www.dmpcc.org/MEN or call Terri Speirs, 515-251-6670.