We know – and joke about – how, generally, men don’t particularly like seeing doctors for physical ailments, but getting them to see a professional for behavioral health issues is nearly impossible.
Dr. Alexander Miano, physician psychiatrist at the outpatient behavioral health clinic at Backus Hospital in Norwich, has been at it for nearly 25 years. He explained that, whether by genetic design and/or social and cultural adaptation, deeply rooted stereotypes of men as power brokers and strong providers hold them back when they need help for such things as chronic bad mood, tension, chronic stress, depression, poor concentration and focus, anxiety and even more serious behavioral health conditions.
History, he said, has not been kind to behavioral brain illness. Whether the brain was suffering from seizures, anxiety, inflammation, depression, distractability or psychosis, the lack of scientific knowledge about the brain’s inner workings and treatments placed a lot of undue fear and stigma alongside the conditions. While things have greatly improved, he said some obstacles to good health remain.
“It’s ingrained in both western and eastern cultures that, traditionally, men have been the providers, protectors and power brokers. As such, when confronted with illness, the resulting need for help or ‘needfulness’ equates to loss of power and weakness. Illness and disease make us feel helpless, needful and at the mercy of a doctor, nurse, partner, pharmacy, etc.,” Dr. Miano said. “It is easier to deny and think of oneself as ‘not so bad’ than to deal with the implications of being unwell and in need of help.
“Women can outnumber men in getting the needed help as they generally are more apt to ask for help, perhaps because doing so is not necessarily connected with their ego as much as with the need to just get better.”
It’s important for men to understand, he said, that there is little to nothing as precious as wanting to improve their health, their thinking abilities and, therefore, their lives. When behavioral health concerns flare, their entire being is affected, sometimes in ways that is difficult to connect. Consider, he suggests, that depression might present with such symptoms as low energy, low stamina, poor focus, poor appetite and intimacy/sexual difficulties.
“I often advise that getting prompt help puts them on the road to quick recovery so they can regain their mood, concentration, peacefulness, energy and stamina,” Dr. Miano said. “I try to find a way to make them see it’s a way to increase their strength, improve their thinking, coping skills and energy level.”
Signs of Behavioral Health Issues
Behavioral health concerns, such as depression, in men often manifest as behavior, mood and thinking inconsistencies such as:
- Impulsivity.
- Anger and angry responses to neutral stimuli.
- Irritability.
- Changes in sleep patterns.
- Weight changes.
- Forgetfulness and distractibility.
- Increased consumption of alcohol, tobacco or drugs.
- Behavioral or personality changes.
- Changes in libido and intimacy.
- Lack of social interests or activities.
He stressed the intrinsic connection of the health of the body with the health of the mind as a key reason for men to seek professional help with behavioral concerns.
“The brain gets its influence by both outside sources like environmental stimuli and stressors and internal signals from all over our body,” he said. “In turn, this link with every organ of the body makes its connection felt in a variety of ways. Think of when a moment of great stress is interpreted by the brain as danger and transmitted to various organs in preparation to meet the danger – pounding chest, tight muscles, sweaty palms, wide pupils. The ‘fight or flight’ system is activated in preparation of meeting the event, be it real or perceived.”
When he sees men in the office, Dr. Miano offers information on the short- and long-term benefits of self-caring. Besides the one-on-one visits, he will encourage the patient to bring his partner to get a full picture of the situation at home. The partner knows the patient best. It is important to obtain good collateral from someone who lives with and experiences the person more often.
“I try to meet the patients where they are,” he said. “Initial physician visits can be very stressful, especially in behavioral health. I watch their body posture and listen carefully to the words they use and will help draw their thoughts and state of mind out. I focus on the symptoms – ‘What is your lack of good sleep taken away from you?’ ‘How has your current energy level affected your family life?’ When was the last time you felt physically good and mentally happy?’”
There are several options for helping the patient find relief from their various behavioral health concerns, including:
- Medications, which can help curb depression or anxiety so the patient can further improve their lives. “Being anti-depressed and happy are two different things,” Dr. Miano said. “Antidepressant medications act to scaffold your mood in ways that your mood will not burden your progression to a happier, healthier existence while you improve coping skills and frame of mind in the hands of a good counselor.”
- Cognitive behavior therapy is proven through research as a method of looking at and addressing what it is that brought you to chronic bad mood, stress or anxiety and it will help prevent its recurrence. “It is meant to maximize innate performance, whether you’re an athlete, young father, seasoned warrior or high-flying professional,” Dr. Miano said.
For more information on treatment for depression, click here.