Depression and anxiety are issues that transcend gender, and not all people experience depression the same way. This particular post focuses on depression from one man's point of view. Here are some posts looking at depression from other points of view.
1. You aren't weak.
You're surrounded by lies. The hyper-masculine culture we're raised in lies to you. It tells you that the world isn't interested in your feelings. This culture is particularly damaging to women and minority groups, but men suffer too. No question. We suffer because we're taught to bottle feelings up, to forget them, to believe emotions hold no value. Depression also lies. It tells you that no-one cares about you. It's incredibly difficult to overcome these beliefs and speak up. But asking for help is not weak.
I'm tall, broad, strong. I always prided myself on being fit and healthy. Depression was a blow to that self-image – by the time I was diagnosed, it had taken a physical and mental toll. But it was also a relief. For all my exterior scaffolding, I'd long felt brittle and fragmented inside, and I didn't know why. Speaking about it was difficult at first, but it's comforting to be able to open up to another human and feel reassured and accepted. By talking through my feelings, I was better able to understand what I was going through, and why.
2. You might not know you're depressed.
Because we don’t talk about it, because we bottle it up, men are half as likely as women to report depression and receive treatment for it. Perhaps as a result, in the UK, men are three times more likely than women to have a drinking problem, seeking to numb the pain rather than deal with it. Also in the UK, suicide is the leading cause of death for men under the age of 35. Our silence is literally killing us. It doesn't have to be that way.
I wasn’t diagnosed with depression until I was 30, but I’d been suffering quietly since adolescence. After going so long without treatment, I'd built an arsenal of damaging behaviours and coping strategies, ways to deal with feelings I didn't want to have. Over time I've been able to unlearn them, to replace them with healthier alternatives, and I'm in a much better place than I was two and a half years ago. Just knowing that the way I feel is an illness, one with a name and a range of treatments, was a big part of my recovery.
3. It's OK to not be a morning person.
You're not lazy. Depression is exhausting. As well as being physically painful at times, it leaves you tired, groggy, and lacking energy. And for many people with depression, symptoms can be worse in the morning. Some people are morning people. Don't let them make you feel you have to be, too.
I'm not good at mornings. Most days just being awake is a challenge. Being vertical and dressed doubly so. After the ordeal of a morning commute, I'm likely to be stressed, anxious, and spent. I don't want to be rude, but smiling, waving, or saying good morning with any vigour is completely beyond me. I need a while to calm down, settle in to my day, and recharge some. It's nothing personal, I just have no energy to pretend. And that's OK. I made it into work. I'll smile and wave this afternoon.
4. You're not innately grumpy.
Irritability is a common symptom of depression. In men especially, depression will manifest in irritable and aggressive moods, rather than simply appearing 'sad'. Depression is not simple. It's a complex, insidious parasite that rears ugly heads throughout your personality. It's an imposter that looks and sounds like you. At times it's easy to let it take over. But that isn't really you. Don't forget that.
Not being able to regulate my mood is incredibly frustrating. Not knowing how I’ll feel one minute to the next. Not having control over it. I don't mean to snap, or to complain, or to speak with "that tone", but it does happen. When I was younger I thought my grumpy, irritable nature was just part of who I am. Realising this is part of the depression, and not part of me, was huge. It opened up a world of possibility: I'm the kind of person who enjoys things! Who knew?!
5. Depression is a bully.
Another lie depression tells you is that you're worthless. It cripples your self-esteem, and distorts your self-image. It fills your mind with pessimistic thoughts that only reinforce your mood: I'm a terrible person. I look awful. I'm not worthy of love. It's a difficult voice to silence, but you can quiet it. You can start by being kind to yourself. You wouldn't let a stranger talk to your friend that way, so don't let your depression treat you like shit.
Before I knew what my depression was, I'd find myself in slumps – spirals of negative thoughts and feelings – and I'd seek out a dopamine fix to fill the void. In my early twenties, exercise and casual sex were my surrogate meds. Later, when my depression worsened, I lost myself in food. I'd binge on carbs, sugar, caffeine, anything to give me a spike of pleasure. Without the energy to exercise, I gained weight. Not a lot, but enough for me to notice. Enough for the voice in my head to tell me I looked awful. I began avoiding photographs and mirrors – I still don't have a mirror in my bathroom. I'm working on accepting myself, but I have a long way to go. Being on the journey is a great start.
6. It's OK to cancel plans...
Depression rarely travels alone. It carpools with other disorders: anxiety, insomnia, social phobia. To the sufferer it can be overwhelming, but to the outside world, you'll probably look fine. If you're suffering in silence, the pressure to maintain the facade, along with your friendships, relationships, and social engagements can leave you exhausted. But depression is an illness. Just as you wouldn't go out to dinner if you were sick with a virus, it's more than OK to cancel a plan because you don't feel well enough. Your main priority should be your health. Friends will understand, and if they don't, perhaps they weren't great friends in the first place.
Plans are my Voldemort. The knowledge of a prior engagement that I am required to attend, to participate in, and to enjoy, is a crushing burden that often leads me to cancel. This is especially difficult with new friends, or friends I haven’t seen in a long time, where the pressure to be "on", or to present a veneer of competence is greater. Sometimes at the end of the day I just need to go somewhere quiet and recharge. This isn't always about isolation. It's about preservation. I retreat so that I can better fight another day.
7. ...but don't cancel ALL plans.
There are many occasions that aren't ideal for the depressed and anxious person. Surprise parties, for example, are festivals of fuckery. Many organised group activities are also made exclusively of badness. Make sure your friends tell you plans in advance: You need an opt-out. Birthdays, Christmas, and New Year's Eve, times when the expectation to have fun is at its bastardly peak, can be a nightmare. But not impossible. Coping with plans is all about having realistic expectations, and not agreeing to go somewhere you're not comfortable going. Fun is relative. Fun doesn't have to be the greatest night of your life. Fun can be a couch, a blanket, and a movie. Last New Year's Eve I stayed home with The Goonies and a fine single malt. I can't think of a better way to start the year.
One of my most damaging mantras is "I hate fun." Of course I don't mean it. What I'm really saying is that what's fun for one person isn't necessarily fun for others. I know what I enjoy, and when in doubt I stick to that: I like to dance. I like to sing karaoke. I like movies. I like to see live music. I love catching up one-on-one over dinner and drinks. Often I'll be convinced I'm going to hate something, and I'll try to talk myself out of going. Sometimes I just need a nudge. A friend telling me to stay for one drink. One drink is almost always manageable, and it's almost always the first step to a fun night out.
8. It's all about small steps.
Depression destroys hope. It not only renders the steps to recovery oblique and impossible to see, it also strips you of your ability to place one foot in front of the other. It's difficult to see that it can get better, and that it does get better.
My ex used to ask me where I saw us in the future. Happy, hopefully, I'd say. A vague effort at placating her. In reality I had no clue. I didn't know what I wanted, or how to get there. When it's a struggle just to fight through each day, trying to plan for an event five years away is impossible. I was resigned to feeling low, and the idea that I might be actively happy at some point didn't seem realistic.
I still can't plan that far ahead, but I can concentrate on enjoying the present. Life isn't a series of five-year plans, it's a series of small moments. I've found that if I can enjoy the little things, if I can find something to enjoy every day, it makes tomorrow that much easier to face. The steps to recovery weren't always clear, but now I see them, it doesn't feel so hard to take them, one at a time.
9. It's OK to not feel up to sex.
Depression affects libido. Low self-esteem and lack of energy can affect your appetite for sex, and can make getting or maintaining erections difficult. Certain antidepressants can affect both erections and your ability to orgasm. Coupled together, they can make a healthy sex life a challenge.
There are often expectations in groups of male friends to be promiscuous, but don't put pressure on yourself to feel or behave a certain way. Your friends are never getting laid as often as they say they are. If you have a partner and are feeling anxious about not being able to perform, let them know you don't feel up to it. Communication helps, and you will probably find solutions that work for you both. You can always pay them lots of attention, for one. Or you can just build a blanket fort, curl up together, and hide from the world.
10. Don't shut yourself away.
Depression is difficult to be around. Between the lack of energy, irritability, negativity, and cancelled plans, it can put a lot of strain on a relationship. But it's important to make the distinction between you and your illness: You are not your depression. You are not a burden. Sometimes you need to be alone, but recognising when you need to be around people is a helpful step. If you feel up to it, see your friends: Social groups can help alleviate depression symptoms and prevent relapses.
My instinct is often to run. I want to go home, I want to avoid people. Right after my last relationship broke down, I moved to a cabin in the mountains and made myself entirely miserable. Without company to comfort or challenge me, my negative thoughts and feelings were reinforced and amplified. I wanted to be alone, but I quickly realised I didn't want to be that alone. People are pretty good, if you give them chance to be.
11. It's OK to be sad.
The misconceptions and misinformation about depression are not only wide and varied, they're also dangerous. People who've never experienced symptoms might offer platitudes like "cheer up" or "just try harder" without realising the negative effect their words can have: how alien and broken they can make you feel, and the pressure this can put on you to pretend. Not only is it OK to be sad, it's healthy, and it's human. But you don't have to be sad all the time. There are lots of ways to get help.
When I was first diagnosed, I took antidepressants. They helped me through a very difficult nine months. I was going though a major break-up, and learning how to better manage depression. It was difficult for me to feel anything while I was on meds. Ultimately, I didn't like being that flat, and I didn't like how difficult they made sex. I stopped taking them after about nine months. I wanted to feel, even if sometimes that meant not feeling so good. For many people, antidepressants are a life-saver. For me they're an option. I'm lucky. With therapy, exercise, and a healthy diet, I can maintain without them. It's a comfort to know they are an option, should I ever bottom out again.
Seek support from people who understand what you're going through. Therapy is another option. As well as being an understanding ear, my therapist offers guidance, and works with me to undo some of my negative thoughts and patterns. It's a slow process, prone to setbacks, relapses, and dark days. But it does get better. You don't have to suffer alone. Take it from someone who's been there.
In the UK:
You can call the Rethink advice and information service on 0300 5000 927 (10am–1pm).
Also the Depression Alliance, a charity, has a network of self-help groups.
Samaritans offers a 24-hour confidential helpline: 08457 90 90 90
In the US:
You can call the Crisis Call Center on 1-800-273-8255 at any time of the day.
If you're more comfortable talking via text than on the phone, 7cupsoftea.com offers an anonymous chat service.