According to The World Health Organisation, depression is the world’s leading cause of ill health. An estimated 300 million people of all ages live with the illness around the globe. Additionally, the South African Depression and Anxiety Group (SADAG) has concluded that 4.5 million people are living with depression in South Africa alone. Despite these staggering numbers, mental illnesses such as depression remain difficult to talk about. In many black communities,mental issues are still treated as a taboo subject. These conditions are either incorrectly perceived as western phenomena or believed to be the influence of witchcraft.
In a patriarchal society, men who display signs of depression are often the subject of mockery. Consequently, many of them go without diagnosis or treatment even though effective measures are available to deal with the illness.
WHAT IS DEPRESSION?
Depression is characterised by persistent sadness, hopelessness and a loss of interest in activities that you would normally enjoy. It affects men of all ages and backgrounds and, just like most illnesses, can be successfully treated or managed. The most common signs in men are anger, reckless behaviour, physical pain, difficulty in concentrating, fatigue, stress, anxiety, sexual dysfunction and substance abuse.
Dr Ravi Govender, a psychiatrist based in Cape Town, encourages men to seek help immediately should they experience any of these symptoms. “It is never a good idea to ignore depression, and it is not advisable to deal with it on your own. Effective treatment through therapy or medication is available, and most men respond well to it. The first step is to talk to your doctor and be completely open about how you feel,” he advises.
“REAL MEN DON’T CRY”
Clinical psychologist Dr Noel Mzwamadoda Mangxola says men battle to come forward and address depression because of the stigma attached to mental health. “Due to social norms, men are regarded as strong and in control of their emotions. Therefore, depression in men is seen as a sign of emotional weakness or the failing of masculinity. So, instead of addressing their depression, many men choose to hide or deny it, which often leads to tragic consequences such as suicide,” he says. According to SADAG, women are twice as likely to suffer from depression.
But, men who suffer from it are five times more likely to commit suicide than women. Unfortunately, Siyanda Ndwaluthwa’s* father was one such man. Forty-eight years old with four children, Kumkani* committed suicide last year following a long and silent battle with depression. ‘We all knew that he was suffering from depression, but we wouldn’t dare say anything. This is because as a traditional Xhosa man, he blatantly refused to acknowledge or even mention it. Instead, he resorted to alcohol abuse and destructive behaviour until he couldn’t take it anymore,’ Siyanda explains. Kumkani’s problems started when he lost his job as a firefighter in 2015. He could no longer provide for his family and became financially dependent on his wife.
This put a strain on their marriage, which ultimately led to a separation. ‘He would drink heavily and lock himself inside his room for days. My older brother and I managed to convince him to seek medical help, and he was diagnosed with clinical depression. He refused to take treatment, and continued with his destructive ways until he ultimately took his life,’ he recalls.
THE ESCALATION OF DEPRESSED MEN
SADAG founder Zane Wilson says the number of men with depression in South Africa is on the rise. This is evident from the increase in calls made to the group’s health line. “Men resort to delay tactics before asking for help,” he adds. The escalation can also be seen in the high rate of suicide among men across the country. According to Men’s Foundation, a non-governmental organisation that seeks to create awareness about health issues that affect men, an average 18 of them take their own lives each day in South Africa.’It is a crisis when we’re losing 18 men daily, don’t talk about it and the public is not aware,” says founder and CEO Garron Gsell.
IT DOESN’T ALWAYS END WITH SUICIDE
Unlike Kumkani’s case, untreated depression doesn’t always manifest through suicide.
Dr Noel says suicides due to depression are more common in middle-aged to older men between the ages of 45 and 65. ‘Teenagers with untreated depression tend to resort to substance abuse and withdrawal from society. In young adults, it can manifest through alcohol abuse,’ he says.
In 2008, Mfundo Dafeti from Cape Town was diagnosed with mild depression at the age of 17. This followed battling with changes in his emotional behaviour. ‘I was very active in high school. I was always eager to develop new skills. This was up until grade 11 when I started losing interest in everything that once mattered to me. I started skipping school just to be alone,” he recalls. Noticing disruptive patterns in his behaviour and the wave of sadness that he constantly felt, he decided to consult a general practitioner, who referred him to a psychiatrist.
‘I know now that my depression was a result of conflict within my family. I was prescribed anti-depressants and went through psychotherapy, which helped a great deal,’ he says.
For 28-year-old Lucky Langa*, getting his life back in order wasa struggle. He experienced extreme highs and lows in his moods for years, but never went for a medical examination. He would get so stressed and emotionally unstable that he relied on over-the-counter medication and stimulants to get through the day. This got worse in 2013 when he was fired from his job. “My job was the only thing that I was good at. All other aspects of my life had fallen apart, so my job was the only thing I lived for. After losing it, I gave up on life altogether,’ he shares.
Lucky started drinking heavily and soon developed an addiction to recreational drugs. His alcohol and substance abuse got out of control, and he started selling his belongings to support his habits. ‘I had hit rock-bottom, and was well on my way to living on the streets or dying. But, my family intervened and I was forcefully checked into a rehabilitation centre. I discovered that I was suffering from severe depression. I am on treatment and slowly rebuilding my life,’ he says.
SEEKING HELP NOT A SIGN WEAKNESS
Dr Ravi adds that men experience depression in different ways. They tend to deny their feelings and emotions or conceal them with other behaviours. “There is a long-standing belief that men are supposed to be resilient, and resist expressing their emotions. This is the very same reason they die in silence at the mercy of mental illnesses,” he says.
We need to de-stigmatise mental illnesses by educating ourselves and supporting one another. That way, our men will stop suffering in silence.
