NORMAL -- Depression in men can be a lonely disease, in large part because men make it that way.
But help is available from the nearest loving woman.
That's a theme of the latest book by longtime Bloomington-Normal psychiatrist Dr. Douglas Bey Jr. "Loving a Depressed Man: Understand the Symptoms, Find the Help He Needs and Maintain Your Morale" is written largely for wives, girlfriends, mothers and other women who love men with clinical depression.
Bey wrote the book for women because in his more than 40 years as a practicing psychiatrist he has found that women recognize symptoms of depression sooner than men and are more likely to ask for help.
"Men aren't very good at identifying depression," Bey said. "They think depression is a sign of weakness and don't see it as an illness.
"If things aren't going well, they are more likely to go for a walk, to have a couple of beers or to try to pull themselves up by their bootstraps," Bey noted.
But if a person has clinical depression - more than "the blues" - he needs more than a workout, a drink and more hours at the office, Bey said. He needs therapy and anti-depressant medicine and often the door to treatment is opened by his wife or girlfriend.
The appearance of Bey's book is timely. The ongoing recession has resulted in men losing their jobs or seeing their hours and pay reduced.
"Most of a man's identity is tied to his job so he may feel like a failure and that he is not supporting his family," Bey said.
Some of these men already had depression but the worsening stress of job loss and financial constraints deepen depression symptoms, he said.
Karen Zangerle, executive director of PATH (Providing Access To Help) - the Bloomington-based, 24-hour crisis information and referral agency - said PATH is getting more calls linked to economic stressors and depression.
In recent months, at least two suicides in McLean County have been linked to job loss, she said.
"Now we do have women calling about their partner's depression," Zangerle said. "Women are more likely to reach out than men."
Zangerle has read Bey's book, believes that men and women would find it helpful and has ordered copies for PATH's call center.
Tips in the book will be helpful to call center volunteers who take depression-related calls.
"By giving partners the tools to get a man into treatment, everyone wins," she said.
Bey, 71, is a Normal native who served as an infantry psychiatrist in Vietnam before beginning his general psychiatry practice in 1970 in Normal.
Throughout his professional career, many of his patients have been depressed. Women are more likely to recognize symptoms and say they need help.
Men don't recognize the symptoms, which include difficulty concentrating, loss of energy, loss of interest and pleasure in activities that he used to enjoy, hyper-irritability, loss of sleep and appetite, difficulty making decisions, social withdrawal and irrational guilt.
Instead, men may react to specific symptoms, admitting that their stomach hurts or that they aren't sleeping well.
Dangers of untreated depression are numerous.
Depressed men don't take care of their health, putting them at increased risk of heart disease and diabetes, Bey said.
In addition, some depressed men engage in compulsive activity to cope with depression and those activities result in other health risks. Activities include becoming a workaholic, gambling, risky sexual behavior and self-medicating with drugs or alcohol.
Men who feel their situation is hopeless are at risk of suicide, Bey said.
Even men who suspect depression don't want to admit they are depressed because they consider it a sign of weakness.
"Depression to a lot of guys is a red flag," Bey said. "They say ‘You think I'm nuts?'"
To Bey, depression is a chronic disease that must be managed, like high blood pressure and diabetes. The good news is depression is treatable with anti-depressant medicines and therapy.
"The earlier you get treated, the better," he said.
When a woman is concerned about her man's mental health, Bey suggests that she focus on what's bothering the man, saying something like, "You've been complaining about not sleeping and about stomach upset. I'm concerned. How about if we call the nurse to see about getting you in to see your doctor?"
When making the appointment, the woman should tell the nurse that she thinks her husband is depressed. Then the wife should tell her husband that she'd like to join him for the appointment.
"If the guy goes in by himself, the doctor will ask ‘How are you?' and the man will say ‘Fine' and the doctor will say ‘OK, I'll see you in six months.'"
But if the wife or girlfriend joins her man, she can prompt him to recall symptoms, making diagnosis and development of a treatment plan more likely, Bey said.
The woman also may remind the man to keep up with his medicine, therapy, exercise, nutrition and other things to maintain his mental health, Bey said.
"Once the guy gets hopeful, you've turned the corner and everything is going to get better," Bey said.
Meanwhile, the woman needs to take care of herself so she doesn't burn out.
She needs to advocate for herself when the man is being rude, while recognizing that the disease may be talking rather than the man, Bey said.
She should have friends and relatives who listen to her when she needs to talk and who can keep on eye on her husband when she needs a break. She should exercise, eat well and get enough rest.
Once the man has his depression under control, it's OK to use humor because many men use humor to cope.
"Once the guy is safe and you know that he can take it, tell him he's a pain in the butt and it's time to get going."
For more help
"Loving A Depressed Man: Understand the Symptoms, Find the Help He Needs and Maintain Your Morale" by Dr. Douglas Bey Jr. has been published by LaChance Publishing. It retails for $16.95 and is available through major book sellers.