Dr Nicholas N Maraj

“Doc, I just doh know what to do. I doh have any mon­ey com­ing in, I can’t feed my fam­i­ly, the rent due, the bills pil­ing up. I un­der plen­ty pres­sure. I feel­ing like I fail­ing my fam­i­ly. I feel­ing like less than a man” – Tim (not his re­al name), a pa­tient of mine in clin­ic says to me when I try to get down to the core is­sue of his prob­lem. I feel his pain.

This seems to be one of the most re­cur­ring things I hear these days in my prac­tice. I see a lot of peo­ple. Work­ing class peo­ple. Econ­o­my-class peo­ple. Busi­ness-class peo­ple. This type of sto­ry is re­lat­ed by not less than 50% of the men I treat.

One of the core at­trib­ut­es of be­ing a man is be­ing able to pro­vide for one’s fam­i­ly. That is mul­ti­di­men­sion­al, but most­ly takes the form of meet­ing their fi­nan­cial, phys­i­cal and emo­tion­al needs. No man wants to have their fam­i­ly want­i­ng for food, cloth­ing or shel­ter.

Im­pact of COVID-19 pan­dem­ic

How­ev­er, men’s abil­i­ty to be bread­win­ners have been sig­nif­i­cant­ly af­fect­ed by the Covid-19 pan­dem­ic. Lots of men have be­come un­em­ployed or un­der­em­ployed. Men have used up all their sick days, their no pay leave and then some have been let go by their em­ploy­ers. Worse hit are those who have ac­tu­al­ly had Covid-19 and have the “Long haul” Covid-19 symp­toms of dif­fi­cul­ty with their men­tal clar­i­ty. Fur­ther­more, the price of goods and ser­vices has sky­rock­et­ed due to glob­al sup­ply chain is­sues. This dual ef­fect has led to many, many men not be­ing able to pro­vide fi­nan­cial­ly for their fam­i­ly. When a man is un­able to meet this need, he feels like much less of a man. He feels he has failed as a man.

In many so­ci­eties, men are taught that they need to be strong, self-suf­fi­cient, not show their emo­tions and worse yet, not talk about any of these things. Be­ing fear­ful, de­pressed or anx­ious are signs of “weak­ness” that aren't com­pat­i­ble with be­ing “re­al men”. We are sold these stereo­types by the male role mod­els in Hol­ly­wood, in sports and in our lo­cal TV com­mer­cials. It is per­pet­u­at­ed by men and women alike (vis a vie “The strong silent type”). But many stud­ies have linked this pat­tern of “tox­ic mas­culin­i­ty” to many ad­verse ef­fects for men.

The da­ta is un­de­ni­able. USA Sta­tis­tics:

- Over six mil­lion men in Amer­i­ca suf­fer year­ly from De­pres­sion.

- More than four times as many men as women die by sui­cide.

- Ap­prox­i­mate­ly 20% of all men de­vel­op al­co­hol de­pen­den­cy dur­ing their lives.

- By not ad­dress­ing the core rea­sons for this, we are fail­ing our broth­ers and our fa­thers.

What are the signs to look for?

Many men ad­mit to feel­ing de­pressed about their sit­u­a­tion. Giv­en so­ci­ety’s bur­den on men to not ap­pear “weak”, many men sub­con­scious­ly man­i­fest this stress it­self in many ways such as vague headaches, dif­fi­cul­ties with con­cen­trat­ing, fa­tigue, back pain and sleep­ing dif­fi­cul­ties to name a few. When the soft­ware of the per­son (the mind) is dis­tressed, the symp­toms are usu­al­ly man­i­fest­ed in the hard­ware (the body). These symp­toms when not ad­dressed cre­ate a neg­a­tive feed­back loop which fur­ther com­pounds the un­der­ly­ing is­sue.

Some men al­so utilise mal­adapt­ed cop­ing mech­a­nisms such as al­co­hol mis­use (Health guide­lines ad­vo­cate for males to con­sume two or less al­co­holic bev­er­ages a day). Ex­ces­sive drink­ing how­ev­er, is a dark abyss which per­pet­u­ates the prob­lem as it dam­ages your brain and liv­er, drains your lim­it­ed funds and in the most un­for­tu­nate cir­cum­stances, can lead to vi­o­lence. The sad part is, your prob­lems are still there the day af­ter, and may ac­tu­al­ly be worse from poor de­ci­sions made while in­tox­i­cat­ed.

How to talk about it?

This is al­ways a top­ic of dis­cus­sion. Men gen­er­al­ly do not like to ap­pear in­fe­ri­or to oth­er men. So, talk­ing about these kinds of top­ics is typ­i­cal­ly taboo. Men need to be com­fort­able with some­one to be able to talk about their men­tal health is­sues. We need to give men ac­cess to safe spaces to be able to vent their thoughts and emo­tions, to pro­vide bet­ter adapt­ed cop­ing mech­a­nisms and to en­able bet­ter sup­port sys­tems. They need to be able to de­com­press with­out feel­ing judged, with­out feel­ing like less of a man, in the eyes of both men and women. We need to have more male role mod­els (sports­men, mu­si­cians) val­i­dat­ing that it is ok, to NOT BE ok, that talk­ing about it is OK and that get­ting sup­port for it is OK.

Where can help be at­tained?

There are sev­er­al places men can go, just to get some­one to talk to.

There are two “Stress Re­lief Cen­tres” re­cent­ly opened dur­ing the pan­dem­ic, one in St Joseph, one in Ch­agua­nas (num­bers be­low), staffed with trained men­tal health pro­fes­sion­als which cater to both men and women. They are ab­solute­ly free and no ap­point­ment is nec­es­sary.

COVID-19 has af­fect­ed us all, from the well off to the less well off. It has tak­en a great toll on all of our men­tal health. Be­ing a man now is hard­er than it has been for a long time. But with both men and women sup­port­ing each oth­er, we can all live a lit­tle bet­ter and get out of this pan­dem­ic to­geth­er.

The num­bers for the men­tal health walk in clin­ics are as fol­lows:

St Joseph : 397-7016

Ch­agua­nas : 672-4357

About the Au­thor

Dr Nicholas Maraj is Con­sul­tant Physi­cian at the De­part­ment of Med­i­cine, EWM­SC. He is fel­low­ship trained in Vas­cu­lar and Gen­er­al Neu­rol­o­gy from the Uni­ver­si­ty of Cal­gary, Cana­da. He is a Fel­low of the Roy­al Col­lege of Physi­cians, Ed­in­burgh. Dr Maraj is the man­ag­ing di­rec­tor of Synapse Med­ical Ser­vices Ltd with of­fices at St Au­gus­tine Pri­vate Hos­pi­tal and South­ern Med­ical Clin­ic. The of­fice con­tact is 367-9368.