Wellness & Fitness

Men and mental health: Signs your maturing son is suffering depression

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Anxiety is severe excessive and persistent worry and fear about day-to-day situations. PHOTO | SHUTTERSTOCK

As a parent, how involved are you in your son’s transition to adulthood? How often do you check on him to find out if he has any concerns that need to be addressed – especially concerns pointing to anxiety and depression? This is vital to minimise toxic pressure which can affect him psychologically as he matures.

Here are a number of questions that most parents present with in my clinic regarding their son’s upbringing.

What is anxiety and how different is it from depression?

Anxiety is severe excessive and persistent worry and fear about day-to-day situations. It is usually accompanied by the heart beating faster, breathing faster, or feeling out of breath, sweating, discomfort in the abdomen, dizziness and other physical symptoms that occur when the flight or fight response is activated.

Although they are both mental health disorders, anxiety is different from depression, which is a disorder of mood. In depression, one experiences a lot of sadness on an almost daily basis, feels like they are hopeless, have no energy for day-to-day activities, has changes in sleep and appetite, may experience difficulties in concentration and paying attention, has no pleasure from most activities they take part in, and has recurrent suicidal ideas.

What are the causes?

As in all mental disorders, the causes are complex and most times, not only one cause can be pinpointed. The causative factors are usually biological, psychological, and social.

Having a family member with anxiety and depression increases one’s risk of getting the illness. Going through stress or trauma, especially during childhood is another factor. This can include bullying, loss of a close family member or friend, emotional or physical abuse, poverty, or unemployment.

Serious or long-term physical illnesses put one at risk, and this includes illnesses such as diabetes mellitus, hypertension, cancer, and HIV/Aids. The use of recreational drugs and alcohol also increases one’s risk. Certain personality types are also more prone to anxiety and depression, such as those with low self-esteem, self-criticism and negativity, perfectionism, tendencies to worry a lot and sensitivity to criticism.

What are some of the warning signs?

Parents should be on the look-out for certain habits like withdrawal from people and loss of interest in activities, excessive use of drugs and alcohol, declining academic performance for those in school, suicidal tendencies- making threats, suicidal notes, attempts, reckless behaviour, poor self-care, loss of appetite and weight- can be increased or decreased and sleep changes - too little or too much.

How do you differentiate between normal stressors and clinically significant anxiety or depression in young adults?

The assessment should be made by a doctor or a mental health professional as they are trained to use certain criteria before making the diagnosis.

But as a rule, if the symptoms are there for a long period of time, are present on most days and last for many hours in a day and are severe enough to cause problems in one’s day-to-day life (school, employment, relationships and family life), then it is clinically significant and requires a professional’s assessment.

What coping mechanisms or strategies are effective?

Different coping strategies work for different individuals, and you may need to try them to find out what works for you. They include having a good social support system (family, friends, social and religious groups), finding ways to relax (this could include music, sitting in nature, meditating), actively solving your problems and not letting things build up, exercising at least three times a week, ensuring that you eat a balanced diet, making light of stressful situations through humour, positive thinking and forgiveness, journalling one’s thoughts, taking part in art, learning to express oneself.

What emerging trends or challenges you have observed in the mental health of young adults?

Since the COVID 19 pandemic, mental health challenges among the population has been on an upward trend. There has been an increase in the diagnosis of various mental illnesses, and this could be due to the increased awareness and better health-seeking behaviour among the population, as well as the current challenges the youth in the country are facing due to the harsh economic situation, such as unemployment, insecurity,

There has also been an increase in the cases of suicidal attempts.

There have been emerging new drugs of abuse being used among young people, as well as addictions to social media, gambling and pornographic materials.

How does stigma around mental health affect young men's willingness to seek professional help?

Stigma refers to discrimination against a person because of a certain characteristic.

Stigma may be by the person with a mental illness towards themselves or by other people. Stigma leads to a person not wanting to seek medical attention due to shame or fear of being judged which leads to delayed treatment or not receiving the treatment at all. It also leads to poor adherence to treatment, as well as a lack of understanding by one’s family and as a result poor support.

What are common triggers for anxiety and depression in young adults and how can they be managed or prevented?

Common triggers include loss (death of a person-friend, family, of significant things in one’s life such as employment or property, of relationships-romantic or platonic), unemployment and resultant poverty even after completing tertiary education, traumatic events in one’s life such as being bullied or physically/ emotionally abused, diagnosis of a serious or lifelong physical illness, failures- such as in school or of business ventures, excessive use of recreational drugs and alcohol.

They can be prevented by being able to identify these triggers early and preventing them, adopting good and effective coping mechanisms, having a good social support network, and seeking professional help early.

What are some misconceptions about depression and anxiety in young men that you’d like to address?

That men don’t get mental illnesses and if they do it is a sign of weakness or weakness of character. They should not seek for help but need to “man up” and snap out of it.

That men don’t need help- “Mwanaume ni kuvumilia shida”

That using alcohol and other drugs is a sign of strength and solves problems.

How do societal expectations and stereotypes impact the mental health of young men?

Society expects men to be tough and not to be affected by the challenges that they face. This leads to men having poor coping mechanisms, not seeking help in time, and coming to the hospital when they are very sick. They also will be discouraged from taking the medication prescribed to them and thus have poor compliance to treatment, leading to complications such as suicide.

Dr Wawa is a Consultant Psychiatrist at Aga Khan University Hospital, Nairobi.