[…] wine unto those that be of heavy hearts. Proverbs

Depression is more than a hollow place. It is empty, dark, unhealthy and dangerous. An illness now – a century ago it was a personality trait. In England, 62% of people seeking help for anxiety and depression are women. The data was part of the 1st annual report on improving access to psychological therapies. It is telling that it’s the 1st report on improving access. Part of improving access has to be the elimination of the stigma of treatment, especially for men. Because men don’t feel comfortable admitting ‘the blues’ or worse – getting access to treatment is impossible. In order to get treatment for the illness you first have to go through what seems like a humiliating process of exposing your soul. Of course that’s not at all accurate, but for the depressed that’s what it often feels like. Just in case it is not obvious from the title or the graph, men self medicate rather than go through the ‘hurdles’ of the medical system to get help.

There is a perception that it’s readily acceptable for women to ask for help. For men, independent, strong, brave, successful, courageous, and possessors of the male-ego, it is an anathema to everything they are supposed to be. Depression is perceived as an embarrassment, if not a humiliation, a defeat, a stigma. The irony because of that stigma, is that it takes tremendous courage to admit the disease of depression. AlcoholDependence2012So what do most male sufferers do? Head to the liquor store, they self-medicate. Which is an unfortunate poison, because it directly contributes to depression, not to mention the threat to both physical, mental and economic health. According to British research, (How Mental Health Loses Out in the NHS, June 2012, p13), 76% of those with depression/anxiety were not getting treatment; not at least via the mental health system…

I don’t want this to be read as an anti-alcohol rip, because it’s not, I like my tipple just as much, maybe more than the next guy. We’ve come a long way since the simple and ‘heavy hearts’ of Proverbs, sort of… The depression industry is serious business, it represents about $150 billion dollars a year in America. The World Health Organization acknowledges that depression is the top cause of disability globally. It’s a vast field that can’t possibly be crossed in a day, let alone weeks. Gazing across the expanse of its reasons, triggers, effects, affects, and correlations, it’s easy to get bogged down in pools of neurochemicals, norepinephrine and dopamine, immune-system chemicals like cytokines, interleukin’s and interferons, lost in fissures of pre, mid and dorsal cerebral hemispheres. Who cares? Not the person on the ground. To the person on the ground, it is often an access issue, how easy is it to get the help needed? Not as easy as going to a liquor store.

Consider the following statements of fact. Alcohol and its metabolites can trigger persistent systemic inflammation. Depression and stress are intensified by inflammation in the body. Chronic stress can cause depression – a vortex in a glass.

In a New York Times bestseller called Everyday Drinking, by Kingsley Amis, there was a telling quote about the Metaphysical Hangover, “When that ineffable compound of depression, sadness (these two are not the same), anxiety, self-hatred, sense of failure and fear of the future begin to steal over you, start telling yourself that what you have is a hangover. You are not sickening for anything, you have not suffered a minor brain lesion, you are not all that bad at your job, your family and friends are not leagued in a conspiracy of barely maintained silence about what a shit you are, you have not come to see life as it really is, and there is no use crying over spilt milk.[…]” The book was written as an ode to drinking, with a grin and an esoteric wink to tipplers. It was duly noted in the introduction that, “the booze got to him in the end, and robbed him of his wit and charm as well as his health.” The point being that Amis, inadvertently or dismissively perhaps, noted the link between booze and sadness.

If going to see a community counsellor was as accessible to the normative male (stoic resistance, repression, or denial of emotions), as getting a bottle of Gin there would be a lot less grief, a lot less Physical and Metaphysical Hangovers in the world. As long as stigma is attached to mental health, and as long as the status quo of formal access barriers exist, the social hangover is measured in lost lives, pain, broken homes, and a massive loss of productivity and human capital.

What communities need are barrier free centres for men that are as easy to walk into as a liquor store, where many an anonymous character peruses the shelves for a remedy.