On a pill and a prayer

pillandaprayerDepression and the Canadian male

by Doug Koop

Even cowboys get the blues sometimes. And firefighters. And middle managers. Factory workers, executives, truck drivers and pastors all get down in the dumps. In fact, feelings of melancholy and apathy are a reality for men in every trade and profession, occupation and calling. And for many of them, this is more than an ordinary session of sadness. Much more.

While most men would rather not talk about such feelings, this condition is very real and surprisingly widespread. In fact, depression has become so prevalent that it’s known as “the common cold of psychological disorders.” The good news is that it’s usually treatable. You do not need to live in a prolonged state of disinterest and discouragement.

So how can a man recognize what is happening and take the right steps to put things in order?

Grant Mullen is a mental health physician whose specialty includes depression, especially as Christians experience it. “The most important thing men need to know about depression is that it’s a very common medical condition—not a sign of personal or spiritual weakness,” he says. “Men think they should simply ‘pull up their socks’ and ‘tough it out. ’While we don’t say that about diabetes, we do about mood disorders. This is what keeps men out of treatment. They think they should be manly enough to overcome their sadness. They don’t see it as a medical problem.”

How is depression different from “mere” discouragement? “Discouragement is transient, with an obvious cause, and the person is still able to enjoy other activities.

It resolves with time and supportive counseling,”  writes Mullen in Emotionally Free, a book he wrote primarily for Christians. Depression, on the other hand, “is usually very prolonged, with unrelenting symptoms.

It is often, though not always, characterized by sadness. There is general hopelessness and a lack of ability to control or steer thoughts. This is a much more disabling condition than discouragement.”

And just how common is this disabling condition? Six percent of the work force in North America is depressed at any time (men and women). And this indicates only the serious cases. People experiencing milder symptoms—the walking wounded— rarely get reported. Men in particular are reluctant to admit they have a problem, to go for help and to stick with the treatment, observes Mullen.

If women are more likely to go for help, “men tend to lose themselves in manly activities like drinking, sports, television and tinkering.”

So how do men typically act when they experience symptoms of depression? According to Mullen, the number one expression is denial. “They put on a mask and pretend they’re fine. It’s that way with most emotional issues. Men have tremendous difficulty admitting there’s a problem outside their control.”

This is particularly true among Christians who’ve been taught to “take every thought captive.” They tend to feel guilty and ashamed. “Not being able to control thoughts is shameful for many Christians,” says Mullen. “They don’t want to admit they have a problem and need help from someone else. Mental health issues are soft, can’t be tested, so they’re not manly disorders. There’s a real stigma. There are many social and cultural factors saying men shouldn’t ask for help. It’s no wonder they have trouble with the idea of taking treatment for a condition they consider a sign of personal weakness.”

Mullen also encounters resistance from Christians against the idea of taking medications for mood disorders. “I like to think of depression as a physical condition that causes difficulty with thought control or ‘blurred’ thinking, much like disorders of sight cause blurred vision,” explains Mullen. “Depression should not be over-spiritualized any more than vision problems. For those of you who need glasses to read, how well does the Bible speak to you if you try to read it without your glasses? The Bible is silent if you can’t see the words. Is this because you are spiritually dead?

Has the Bible lost its power in this circumstance? Are you under spiritual attack because you can’t see the page of Scripture? “Not at all,” he says. “You just have to put your glasses back on. It’s just common sense.”

Mullen, a 53-year-old from Grimsby, Ontario, is fully attune to spiritual realities and the possibilities for personal failure. “One of the reasons why the church misunderstands depression is that it has so many spiritual symptoms. Depression wipes out a person’s devotional life. It interferes with concentration. They stop reading, praying and worshiping. They cut back on social activity. When church people see this, they presume a spiritual problem. But it may well be a condition to be treated, not an attitude to be condemned.”

He maintains that the church should be a place of healing and recovery, rather than of condemnation, shame and denial.

In order to make a proper medical diagnosis for his patients, Mullen distinguishes between symptoms caused by chemical imbalance, by wounds of the past or by attacks of Satan. “Depression is happening when you can’t shut your mind off,” he explains. “Loss of thought control tells you it’s a medical problem. That’s the basic criteria I use. People with clear thought control may need a counselor, not medication.”

Mullen acknowledges that spiritual warfare or conflict is also very real for depressed Christians, an issue he deals with at length in Emotionally Free. “The loss of concentration and the cluttering of negative thoughts make a person particularly vulnerable to occult influences,” he writes.

He advises people who are living with a depressed person to become fully informed. “The more people understand the condition, the easier it is to deal with it. Understanding it as a medical condition rather than personal problem helps attitudes.” It’s also important for family members and friends to encourage sufferers to stay in treatment. Many drop out too early. And, says Mullen, it’s helpful to go with the person to the medical appointments. “Spouses are very valuable for insight and encouragement.”

The bottom line is that the prospects for recovery are really quite good. And the sooner you treat the symptoms, the quicker the recovery. Diagnose early. Don’t wait until you crash. Assess yourself. Then find a doctor. The best treatment will likely be a combination of medications and counseling.

Doug Koop is editoral director for ChristianWeek and managing editor of SEVEN.

The article above was featured in the March 2009 issue of SEVEN magazine.