ON MENTAL ILLNESS: Depression of Middle-Aged and Older Men

Jack Bragen
Thursday April 30, 2015 - 03:41:00 PM

In observing the world as anyone may do, to me it is clear that a lot of ordinary men, including those not afflicted with a mental illness, when older become easily irritated, angry and in a bad mood. This is how many men show depression. Depressive symptoms in men may include grumpiness, irritability, and moodiness, sometimes to a point of being abusive. 

I have read that depression may be more common in women than in men. Yet also, when men become depressed, they are less likely to ask for help. Because of this, accurate numbers may be difficult to obtain. 

Depression is sometimes neurochemical sometimes situational, and sometimes a combination of both. Depression can also be caused by having a non-psychiatric medical problem. 

As I have aged, expectations left over from young adulthood come back to haunt me. When younger, I had the expectation that things would be a lot better than they actually turned out to be. I never anticipated that I would be forced to live on Social Security at fifty, and that I would be unemployable. 

Many men could be disappointed with their lack of material progress. Some may have residual anger or hurt left over from a divorce. Many people may compare ourselves to others who seemingly have made more progress in their lives, who may have become wealthy, who may be driving expensive cars and own expensive houses. 

We are looking at a combination of possible sour grapes, envy, changes to the body as men age, and in some men, a preexisting mental health diagnosis. Cardiac problems can also can cause depression. 

At some point, many people may come to the realization that we won't always be here. Acknowledging our mortality can be frightening, or it could be saddening. It entails the acceptance of limits, it leads to the conclusion that there are things that we may never get or do in our lifetimes. (If thought about in more accepting terms, the fact of mortality can also feel like a relief. On the other hand, it can also bring a sense of accomplishment.) 

For some people subject to depression, it helps to take the right antidepressant rather than the wrong one. When I recently switched antidepressants, it did a lot toward easing my anxiety level and it restored a lot of my previous humorousness. Life isn't always hopeless. 

Many people who do not officially have a mental health diagnosis object to the idea of taking a pill to feel better. I am not clear on the specific issues that lead to that objection. A lot of people feel strongly that they do not want to take any more pills than absolutely necessary. They may not feel the same about a high blood pressure medication or a blood thinner. The stigma of taking any type of psychiatric medication is prevalent. A number of people, even to the point of masochism, would rather just suffer with their depression.  

Lately, drug companies have been marketing antipsychotic medication to address depression. This may work for some people, when the depression is created by a great number of negative thoughts. It is not helpful for everyone--this is a strategy of treating depression with a central nervous system depressant. Some people need to take an antidepressant that adds energy rather than subtracting it. 

There are still psychiatrists around who advocate electroconvulsive therapy. This is like going after a fly with a sledgehammer.  

Like it or not we are all getting older. When older, comfort and getting enough rest are raised in priority. When mentally ill on top of the fact of aging, there is a lot that can go haywire. Many persons with mental illness, who have taken medication for a matter of decades, die off before reaching their sixties. There are a whole slew of problems that are unique to geriatric mentally ill people. This is compounded by the likelihood of being financially poor, as many mentally ill adults are. 

Is there a bright side to this? I don't know. People with mental illness live difficult lives. It adds injury to insult when we realize that things may not be materially better when we are older and that we may still have a debilitating psychiatric disorder along with the long-term side effects of taking psychiatric drugs. Perhaps the most we can do is to enjoy our lives when we can and hope for the best.