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Posted January 24, 2006

Fr. Joe
A Case Study

Lynn M. Levo, CSJ, Ph.D., is Director of Education
and Editor of Lukenotes at Saint Luke Institute

Case Study: Fr. Joe

Fr. Joe and Sr. Mary are friends. They met each other 15 years ago when they both were assigned to the same parish. Over the years, they have maintained their friendship by phone contact, spending a day off together periodically and by attending significant events in one another's lives. In the last several months, Fr. Joe has cancelled 3 gatherings, stating that "I am just too busy with the plans for the new church." Unlike in the past, he is not initiating phone contact and was quite irritable when Sr. Mary called to see how he was doing. Reluctantly, he did share that he had a "bum knee" and then quickly moved on to say "I am fine." Recently, when they met at a social event, she noticed that uncharacteristically, he was drinking rather heavily. When she asked him about his drinking, he was overtly hostile and walked away. Several days later, Fr. Joe called Sr. Mary to apologize and they agreed to meet for lunch to "catch up" with one another.

When they got together, Fr. Joe was berating himself for his past behavior even though Sr. Mary had accepted his earlier apology. He was unusually quiet, unable to talk openly as in the past, and seemed quite depleted. Realizing that Fr. Joe was not himself, she decided to share her observations with him. Having experienced some depression herself in the past year, Sr. Mary wondered if Fr. Joe might be depressed. When she asked if he felt depressed, Fr. Joe was surprised and with some unexpected tears in his eyes he said "men don't get depressed, women do." Fr. Joe was able to hear her concern, agreed that something was not quite right, and then said very little else.

Depression and Gender

The data is clear that a large number of women do experience depression, are more likely to speak about being depressed and to be diagnosed as experiencing depression. Current research suggests that many men also experience depression, challenging the past belief that women are twice as likely as men to experience depression. This popular notion that women are more depressed than men is most likely related to the fact that men who are depressed are less likely to seek out mental health professionals for help and men are not likely to show what have become known as typical depressive symptoms: crying, sadness, withdrawal, and sleeping too much to name a few. What is becoming more apparent is that depression is a salient, although often hidden, problem for many men, with the toll from untreated depression being both physical as well as mental. A recent Johns Hopkins study found that depressed men were twice as likely as non-depressed men to develop heart disease or die suddenly because of heart problems. And, the Center for Disease Control (CDC) found that men in the U.S. are about four times more likely than women to commit suicide.

Men and Help Seeking

Why is it that men are less likely than women to seek help for both physical and mental health problems? Part of the answer seems to lie in who men think they should be: self-reliant, strong, logical, rational and not emotionally needy. The dominant image of masculinity today seems to encourage men to be emotionally stoic and physically tough. Given that many men believe that expressing feelings and being vulnerable are what women do, it is not surprising that men neither acknowledge their depression nor are they willing to seek help for it. In addition, the data suggests that a man is least likely to seek help for a problem that he sees as unusual; i.e., other men do not seek help for this kind of problem. When fear that others will think poorly of him or will put him down is also at play, asking for help is even less likely.

Male Depressive Symptoms

The symptoms of male depression can be different than the classic symptoms we usually associate with depression. Fr. Joe is exhibiting a mix of both some classic symptoms and some typically male symptoms. Although Fr. Joe is not expressing classic feelings of sadness or emptiness, he is experiencing some excessive guilt as he continues to berate himself about his encounter with Sr. Mary. Lack of energy, usually associated with depression, is also quite evident.

It is clear, however, that without an awareness of the symptoms of depression that men exhibit, Fr. Joe may not be seen as depressed either by himself or others. Withdrawing from relationships, overworking and sleeping less are some signs that a man may be depressed. Although he did not share this with Sr. Mary, Fr. Joe is blaming himself about the difficulties with the new church. Men are more likely to be at risk for depression when they feel they are not measuring up and making things happen as they should. In addition, Fr. Joe's increased irritability, hostility and even the creating of some conflict with Sr. Mary, are more likely to occur when a man is depressed. It is also true that men are more likely to increase their use of alcohol or other drugs as well as to spend more time watching TV as means of self-medicating or numbing their feelings. Some men also use sex or cybersex to medicate their dysphoria. While Fr. Joe tries to dismiss that he is struggling with his bum knee, his physical difficulty may be adding to his depression. For many men, illness or feeling physically weaker, can be direct attacks on their sense of virility, strength and self-definition and may trigger depression.

It is well documented that approximately eighty percent of people who seek help for depression will get relief from antidepressant medication, therapy or a combination of both, the usual treatment regimen. Unfortunately, for many men, therapy, like depression is often seen as feminine. In addition, they often have little experience verbalizing feelings and few male role models for how to talk about feelings and their problems. The stigma associated with male depression and asking for help must be removed so that men will seek help and receive the available effective treatment for depression that they need.

Lynn M. Levo, CSJ, Ph.D., is Director of Education and Editor of Lukenotes at Saint Luke Institute

LUKENOTES is a bimonthly publication of Saint Luke Institute. Telephone (301) 422-5579 Fax (301) 422-5400 lukenotes@sli.org

All previous and current LUKENOTES, both articles and case studies, are on our SLI website.