GENEVA - Depression is usually associated, in our minds, with women. Yet of course men suffer from it too, and often it comes with an extra stigma even in our modern society.
Genevan psychiatrist Theodore Hovaguimian talks about it in his new book, La Depression Masculine (Male Depression). This breakthrough book helps break a taboo that can sometimes have dramatic consequences.
Depression is fundamentally a reaction to an important loss: the loss of a loved one, the loss of a status or the foreseen loss of life itself. This creates a special reaction: feelings overflow and destroy instead of rebuilding. What is considered as an irreparable loss? Here is the first difference between men and women, says Dr. Hovaguimian. The trigger for women is usually linked to their love life, the absence of motherhood or children leaving the nest – while for men the trigger is linked to work, a layoff or retirement.
No matter what the reasons are, men are affected by depression as much as women. But they are not depressed as often as women – this is the second important difference between the two genders. This difference is part of the reason why male depression is often overlooked. The gap varies depending on age, but in general, men are half as likely to be depressed than women.
The difference is quantitative but also qualitative. Men suffering from depression usually show very different attitudes than women suffering from the same condition. Men have also much more difficulty accepting their situation and are prone to denial. Less inclined to question themselves, they find a thousand reasons to blame others for what they are feeling, and can become very irritable. They have frequent explosions of anger, which contrast highly with the general feeling of sadness depression is known to bring on. Furthermore, instead of sinking into apathy, they often become hyperactive, giving the image of being strong, when inside they are really feeling very weak.
“Men see their body like a machine,” explains Dr. Hovaguimian. “When it doesn’t work, they punch it hard. Unlike women, they are less likely to analyze and question themselves. This kind of attitude has its advantages. Rushing headfirst into action can help protect and comfort oneself. Nevertheless this attitude has also its disadvantages.”
More explosive, the masculine personality can lead to escapism and alcohol – and sometimes even violence. “Men tend to withdraw into themselves and get less involved in their family or professional life in order to invest themselves in a superficial social life, such as the one that be found in bars,” observes Dr. Nathalie Nanzer, from the Child and Teenager Psychiatric Services of the Geneva University Hospitals.
Waiting for help
Theodore Hovaguimian says it is a kind of a Stockholm Syndrome, in reference to the syndrome where hostages end up bonding with their kidnappers. “When they have been hostage by depression, women call for help, while men tend to withdraw into themselves in a face-to-face with depression, which consists in surrendering to their persecutor.”
“Men are more reluctant to see a specialist,” confirms Alain Sauteraud, a psychiatrist in Bordeaux, “and when they finally do, it’s at a more advanced state of depression. Before going to see a doctor, they will have already resorted to products like nicotine, alcohol or cannabis.”
This kind of behavior complicates the detection of depression. As much as women attract sympathy by sharing their problems, men become unlikeable by closing themselves off to others and being aggressive. Hence it is not surprising that female depression can be detected and treated much earlier than male depression.
“In this kind of situation, seeing a family doctor is the best thing,” says Dr. Nanzer. “A practitioner who knows his patient well will be able to tell if his patient has always been angry or if he suddenly became like this – and be more likely to diagnose the presence of depression.”
Another obstacle to the detection of male depression is to blame on society. We learn early on that “Boys don’t cry.” So how could they be depressed? “Doctors themselves, men or women, have a tendency not to look for depression in men,” says Dr. Hovaguimian, who explains doctors often look for organic reasons for male depression, instead of psychological reasons.
By continuously denying the truth, and living in a society that refuses his weakness, a man who is experiencing depression will be all the more easily rejected by society than a woman. This can lead to homelessness and suicide. “Men get depressed half as much as women but commit suicide twice as much,” says Dr. Hovaguimian.
He says that there is an efficient way to talk to depressed men: by telling them the truth – that depression is nothing to be ashamed of but a sickness. By telling them that they are not powerless victims and that their recovery depends on them. They should also be told that they should not feel guilty about what is happening to them but that they should take charge. It’s ok to fight as long as you are fighting against an enemy that has been identified.”
“If we want to improve the way we treat male depression, progress has to be made,” says Dr. Sauteraud. We have to improve society’s acceptance of it. The best thing we can do is to raise awareness about it. Don’t forget that some of the world’s most famous historical figures suffered from depression.”
Local villagers in western India have been forced to live with a mining waste site on the edge of town. What happens when you wake up one day and the giant mound of industrial waste has imploded?
BADI — Last week, when the men and women from the Bharwad community in this small village in western India stepped out for their daily work to herd livestock, they were greeted with a strange sight.
The 20-meter-high small hill that had formed at the open-cast mining dumpsite had suddenly sunk. Unsure of the reason behind the sudden caving-in, they immediately informed other villagers. In no time, word had traveled far, even drawing the attention of environment specialists and activists from outside town.
This mining dumpsite situated less than 500 meters outside of the Badi village in the coastal state of Gujarat has been a matter of serious concern ever since the Gujarat Power Corporation Limited began lignite mining work here in early 2017. The power plant is run by the Power Gujarat State Electricity Corporation Limited, which was previously known as the Bhavnagar Energy Company Ltd.
Vasudev Gohil, a 43-year-old resident of Badi village says that though the dumping site is technically situated outside the village, locals must pass the area on a daily basis.
"We are constantly on tenterhooks and looking for danger signs," he says. Indeed, their state of alert is how the sudden change in the shape of the dumpsite was noticed in the first place.
Can you trust environmental officials?
For someone visiting the place for the first time, the changes may not stand out. "But we have lived all our lives here, we know every little detail of this village. And when a 150-meter-long stretch cave-in by over 25-30 feet, the change can't be overlooked," Gohil adds.
This is not the first time that the dumpsite has worried local residents. Last November, a large part of the flattened part of the dumpsite had developed deep cracks and several flat areas had suddenly got elevated. While the officials had attributed this significant elevation to the high pressure of water in the upper strata of soil in the region, environment experts had pointed to seismic activities. The change is evident even today, nearly a year since it happened.
It could have sunk because of the rain.
After the recent incident, when the villagers raised an alarm and sent a written complaint to the regional Gujarat Pollution Control Board, an official visit to the site was arranged, along with the district administration and the mining department.
The regional pollution board officer Bhavnagar, A.G. Oza, insists the changes "aren't worrisome" and attributes it to the weather.
"The area received heavy rain this time. It is possible that the soil could have sunk in because of the rain," he tells The Wire. The Board, he says, along with the mining department, is now trying to assess if the caving-in had any impact on the ground surface.
"We visited the site as soon as a complaint was made. Samples have already been sent to the laboratory and we will have a clear idea only once the reports are made available," Oza adds.
Women from the Surkha village have to travel several kilometers to find potable water
A questionable claim
That the dumpsite had sunk in was noticeable for at least three days between October 1 and 3, but Rohit Prajapati of an environmental watchdog group Paryavaran Suraksha Samiti, noted that it was not the first time.
"This is the third time in four years that something so strange is happening. It is a disaster in the making and the authorities ought to examine the root cause of the problem," Prajapati says, adding that the department has repeatedly failed to properly address the issue.
He also contests the GPCB's claim that excess rain could lead to something so drastic. "Then why was similar impact not seen on other dumping sites in the region? One cannot arrive at conclusions for geological changes without a deeper study of them," he says. "It can have deadly implications."
Living in pollution
The villagers have also accused the GPCB of overlooking their complaint of water pollution which has rendered a large part of the land, most importantly, the gauchar or grazing land, useless.
"In the absence of a wall or a barrier, the pollutant has freely mixed with the water bodies here and has slowly started polluting both our soil and water," complains 23- year-old Nikul Kantharia.
He says ever since the mining project took off in the region, he, like most other villagers has been forced to take his livestock farther away to graze. "Nothing grows on the grazing land anymore and the grass closer to the dumpsite makes our cattle ill," Kantharia claims.
The mining work should have been stopped long ago
Prajapati and Bharat Jambucha, a well-known environmental activist and proponent of organic farming from the region, both point to blatant violations of environmental laws in the execution of mining work, with at least 12 violations cited by local officials. "But nothing happened after that. Mining work has continued without any hassles," Jambucha says. Among some glaring violations include the absence of a boundary wall around the dumping site and proper disposal of mining effluents.
The mining work has also continued without a most basic requirement – effluent treatment plant and sewage treatment plant at the mining site, Prajapati points out. "The mining work should have been stopped long ago. And the company should have been levied a heavy fine. But no such thing happened," he adds.
In some villages, the groundwater level has depleted over the past few years and villagers attribute it to the mining project. Women from Surkha village travel several kilometers outside for potable water. "This is new. Until five years ago, we had some water in the village and did not have to lug water every day," says Shilaben Kantharia.
The mine has affected the landscape around the villages
Resisting lignite mining
The lignite mining project has a long history of resistance. Agricultural land, along with grazing land were acquired from the cluster of 12 adjoining villages in the coastal Ghogha taluka between 1994 and 1997. The locals estimate that villagers here lost anything between 40-100% of their land to the project. "We were paid a standard Rs 40,000 per bigha," Narendra, a local photographer, says.
The money, Narendra says, felt decent in 1994 but for those who had been dependent on this land, the years to come proved very challenging. "Several villagers have now taken a small patch of land in the neighboring villages on lease and are cultivating cotton and groundnut there," Narendra says.
They were dependent on others' land for work.
Bharat Jambucha says things get further complicated for the communities which were historically landless. "Most families belonging to the Dalit or other marginalized populations in the region never owned any land. They were dependent on others' land for work. Once villagers lost their land to the project, the landless were pushed out of the village," he adds. His organization, Prakrutik Kheti Juth, has been at the forefront, fighting for the rights of the villages affected in the lignite mining project.
In 2017, when the mining project finally took off, villagers from across 12 villages protested. The demonstration was disrupted after police used force and beat many protesters. More than 350 of them were booked for rioting.
The villagers, however, did not give up. Protests and hunger strikes have continued from time to time. A few villagers even sent a letter to the President of India threatening that they would commit suicide if the government did not return their land.
"We let them have our land for over 20 years," says Gohil.