Nov 27, 2013 — When it comes to staying healthy, men generally think that means watching what they eat and knocking out a workout at the gym a couple times a week. The aspect of health men don’t really think about much is their mental health, but it’s just as important as their physical health. Believe it or not, you don’t have to talk about your feelings all the time to keep in tip top mental shape. Psychiatrist Dr. Benjamin Chan talks about a why seeing a counselor doesn’t mean that you’re broken, signs it might be time to talk to someone and what men can do to stay healthy emotionally. Good news, it may be as simple as watching a game with the guys. Listen to find out more.


Interviewer: During the month of Movember it's all about men's health issues and one of the things that a lot of men don't like to talk about: their feelings, their mental health. We're going to talk about it, coming up next on The Scope. It's going to be okay, really. It's fine. We can talk about this.

Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio.

Interviewer: Men's mental health, it's one of those health issues that men generally don't talk about, especially with other men, but it's actually a good thing to do that. I'm here with psychiatrist Dr. Benjamin Chan. Do men and women experience mental health issues differently?

Dr. Chan: If you look at statistics, women have higher rates of depression, have higher use of antidepressants, anti-anxiety medications. However, the feeling is that men also experience the exact same symptoms, they just don't seek professional help as much. Men have a much higher rate of substance abuse, including alcoholism, recreational drug use compared to women.
So the thought is that when women feel depressed they seek professional help. They go to the doctor, they begin therapy, they engage in endeavors like that. Men tend to go down to the bar. They use substances, they engage in other type of activities that could be self-destructive.

Interviewer: Yeah.

Dr. Chan: Women are probably more likely to have a better support structure just in their regular life. Men don't talk to other men about what's bugging them, on that level anyway. That's one of the things I would recommend, is for men to get connected. It's incredibly important as human beings, our experience on this earth, to feel connected to other people. One of the ways I've seen this is through sports. Sports is this great common denominator throughout our culture. It cuts across socioeconomic lines. Men who make a lot of money, men who don't make much money at all, they all can cheer for the local sports team.
When I've engaged men in therapy and they're very reluctant they tell me they don't have a lot of friends. They don't feel connected to very many people. I start asking, well, do you have favorite professional sports team? Do you have a college team that you like to cheer for? The majority of men do. That's one of the things I say. Look, why don't you seek out other fans? Why don't you watch a game together with someone?

I find that true of myself. I have my favorite teams. I have a group of guys I like to go watch with and it's just fun on Saturday or Sunday to order a pizza, watch a football game, and you don't really talk about football the entire time. During half time you start talking about each other's lives. What's going on? It's a great way to get connected to another person.

Interviewer: So it doesn't need to necessarily be this deep conversation, it doesn't sound like.

Dr. Chan: Not necessarily. It's just being in a room with someone and just talking and maybe engaging in a common activity. A lot of people do this with movies or listening to music together. It's just being in a room with someone and connecting to them.

Interviewer: Interesting. So when you talk to a guy that comes in and he says, "I don't really have any friends," is that a big warning sign to you? Does that worry you a little bit?

Dr. Chan: Well, it really worries me if they tell me they don't have friends and they're also thinking about suicide.

Interviewer: Sure.

Dr. Chan: That really worries me. It's interesting because men talk about a degree of loss. When men are single they have a lot of single male friends. They go out and do things together. Then when they get married then they kind of transition into "I need some male married friends to spend time with." Couples talk about going on double dates.

Interviewer: Yeah.

Dr. Chan: What's very fascinating is research has shown that when women get married they still maintain those same friendship networks. Single, married, doesn't matter. Women still are able to make time, go out to lunch, and do things like that. Men struggle with that.

Interviewer: Interesting.

Dr. Chan: They don't stay as connected with their single friends as much as women do after they get married.

Interviewer: Outside of just having some friend networks, which sound like they can do wonders for your mental health, what if things get very serious and you just want to talk about some stuff that you don't want to talk to your guy friends about? That would be a time to maybe seek out a counselor.

Dr. Chan: Yeah.

Interviewer: But there's a stigma to that. What is that stigma that you found?

Dr. Chan: The stigma is getting better, but there's a stigma out there. Like, "Oh, I'm going to see a therapist. I'm going to see a counselor. I'm in therapy." People feel very self-conscious about that. It's like the concept of men who are lost don't want to ask for directions. When men feel lost in their lives they don't really want to ask directions.
The way I liken unto it, when you go in to see a therapist, you go see a counselor, you talk about things, some subjects may be difficult, and you're forced to be very introspective. You kind of take an accounting, a stock of your life, and see what has happened. It's really hard. It's really hard to do.

Unfortunately, it's much easier in society just to ignore it and pretend it goes away, maybe engage in illicit substances to make you forget, suppress those memories, thoughts, and feelings. So that's the stigma: the open acknowledgment that there is something wrong and you are a little bit broken and you need to go fix this.

Interviewer: A sign of weakness maybe?

Dr. Chan: A sign of weakness.

Interviewer: Yeah.

Dr. Chan: I like to tell people, especially when they come in to see me, I say, "Hey, everyone's a little broken. There's no perfect person on this planet. We're all struggling with something in our lives at any given time."

Interviewer: So how do you frame it so men maybe don't feel that it's a sign of "broken" and it's a sign of . . .

Dr. Chan: I kind of give the numbers and statistics. I don't have it off the top of my head, but more and more men are seeking help. It's becoming more accepted in our society and popular culture. I'll talk about various men who are celebrities who have talked about seeing a therapist and how they're trying to be examples to others.
So the stigma of acknowledging, talking about mental illness is getting better, but the vast majority of men at the end of their first, second, or third session of therapy feel better and we kind of talk about that. Like, "How do you feel right now?" It's like, "Wow. I got this all off my chest. It feels good to say this in front of someone and not be judged and kind of talk about what the next step is."

Therapy is incredibly liberating as far as that goes. It's very powerful. Most people, when they enter therapy and they engage in the therapeutic process and they connect with their therapist, they feel great. The hardest step is the first one, making that first appointment.

Interviewer: I'm a son of a western South Dakota rancher. We keep things close to the vest.

Dr. Chan: Yeah.

Interviewer: Hug once a year whether we need it or not as a family around Christmas time. What I kind of came to is I can go to this person. They can give me some tools, just like I'd get tools to do any job, to cope with this crazy world that we live in because it is a crazy world, right?

Dr. Chan: Yeah.

Interviewer: Not one person has everything they need to figure out how to do that.

Dr. Chan: Yeah. I like your analogy. There are a lot of misconceptions. Let me talk about some. The first one is that people are going to be in therapy "forever." The way it works nowadays is people kind of go in and out of therapy. Sometimes you need to only go once or twice.
Using your analogy of tools, I kind of use like a tune-up because our lives our very long. We go through a lot of different experiences, marriages, birth of children, some people go through divorces, there's loss. Everyone's parents eventually pass away. So you go through these different periods of your life so you may need therapy during those more stressful periods. So I tell people, look, come in. We'll talk for a month and then we'll take stock of how you're feeling, and then if you want to take a break for a few months, just let me know. Therapists are always available for that reason.

I like your analogy of tools because that's exactly right. Depending on what you're going through you might need certain tools during that time. Dealing with the death of a parent versus going through a divorce, some similar things but there are some key differences. Maybe it's good to kind of talk about those.

Interviewer: And have an expert guide help you through that that's seen this before and knows how to help you through it.

Dr. Chan: So a question I always get is: how do I know if I should see a therapist? I always go back to how are you feeling and how are you functioning? If you're getting up in the morning and you're going to school or going to work, and your marriage is doing well, and your relationships with other family members is going well, you're functioning pretty high. If you're really struggling, if multiple people are telling you maybe you should talk to someone, if you're not going to work as much, if you're not going to school as much, if you're not functioning how you used to be maybe, that's when you should go in and talk to someone.
So I always say how you're feeling and how you're functioning. Going back to feeling, if you're having those thoughts of suicide, suicidal thoughts are never a normal feeling. That is a red flag to me. That's when you should definitely go in and talk to someone.

Interviewer: Even just wondering like, oh, I wonder what the world would be like if I wasn't here? Is that not normal?

Dr. Chan: We call that passive suicide ideation. "What if I were to go to sleep and never wake up?" things like that. That, I would argue, is a little bit more normal because people kind of have those theoretical, hypothetical situations in their brain, but, honestly, if those persist, if it becomes more than just a passing thought, if it was like a daily thought or it starts coming up in conversations, if you're daydreaming about that I would highly recommend going in and talking to someone.

Interviewer: What are your final thoughts for men and their mental health?

Dr. Chan: Try to get connected or stay connected. Realize you're not alone and it's normal to go through periods of feeling down and you're going to have a lot of trials in your life. Don't be afraid to talk about that with someone.

Announcer: We're your daily dose of science, conversation and medicine. This is The Scope, University of Utah Health Sciences Radio.