Avoidance is not the key to longevity
With most men more likely to look after their cars better than their own health, JCU GP supervisor and Chair of Northern Australia Primary Health Limited Dr Michael Clements says people should check on their mates regularly, and not only during initiatives such as Men’s Health Week.
The Townsville-based GP has a passion for mental health and knows first-hand how stressful life can get. His GP practice was one of many businesses to fall victim to the one-in-one-hundred-year flood in 2019. He’s taken the time now to offer some words of wisdom.
Did you know most men do better preventative care for their cars than they do for themselves?
They are used to checking the oil levels, spark plugs, timing belts and tyre pressures in the car more often than they get themselves checked out with their own blood pressure, cholesterol, skin checks and mental health.
Most men will typically only see the doctor when something's broken or when they think that there's something the doctor might be able to fix, which might be too late for some problems. Sometimes it might be their partner or their spouse urging them to come in. There’s some interesting evidence that married men live longer because they get pushed by their partners to visit their doctor.
We want men to start looking after themselves a bit more, like they'd look after their cars. Seeing your GP when there's something that's a bit awry is important. But taking on routine check-ups can make sure you're going to stay on the right path and won’t blow a tyre doing 100 kilometres an hour on the highway.
How to recognise signs of depression and anxiety
There's a lot to be stressed about at the moment with COVID-19 and job losses; a lot of businesses and industries are under threat.
Men often have a lot of their identity and self-worth tied into their job or income earning status and COVID-19 has shaken that foundation for many men. People should be aware that there is a lot for their mates to be stressed about and they should have their antennas up, looking around them to see if there's anybody who isn't operating at 100 per cent.
One of the common ways that men will deal with stress or depression and anxiety is to use alcohol. Most of us are used to using alcohol on a weekend or in social settings as part of socialisation and relaxation, but men will often use alcohol when they're under a lot of stress to dampen their anxiety or help them sleep. Often we'll find they're drinking more than four standard drinks a day, most days, which suggests they are relying on it as a medication rather than for enjoyment. When I take a male patient’s alcohol history I'll ask why they are drinking. Why are they reaching for the third, fourth or fifth drink? For some men it might be a habit and tradition, but it will often be a clue as to some depression or anxiety that they are trying to manage.
Another clue that we see is when men withdraw from activities that they normally found rewarding. For example, most men will have some kind of activity that they do to relax and regenerate, like exercising, fishing on the weekend, going hunting, going to the tool shed or workshop and tinkering away. If you find they've actually started withdrawing from that and are not doing their normal hobbies and activities, this can be an early sign of depression.
They may be getting melancholic, or having negative thought spirals and a state of mind where they cannot see a positive future. If you are noticing your mate or your partner starting to withdraw or regress from intimacy or their normal social interactions then that's a bit of an alarm sign and we should encourage them to seek advice.
Advice for students and young doctors who might be struggling
We do see a lot of professionals and medical staff still fall victim to mental health disorders.
You can't out-think depression and anxiety through having degrees and certificates, as academic achievement is not going to prevent chronic mental health conditions. Students, professionals and academics need to recognise their own vulnerabilities to mental health disorders and seek help.
Generally speaking, doctors don't make very good patients. We don’t like to feel vulnerable and we often seek to cure ourselves or figure ourselves out, whereas we're also the first to tell other people to seek help. So we need to be realistic and kind to ourselves and reach out for help just like we advise our patients to. There are a large number of GPs in North Queensland happy to see other doctors, and we are used to dealing with some of the intricacies of the professional relationship. So call ahead and ask the practice if their doctor will see other doctors and make that first appointment.
Strategies for coping with stress
I went through the most stressful period of my life after the 2019 floods.
My practice had flooded. I had to start again and deal with the stresses of insurance and rebuilding. I’ve never had to go through anything like that before, so I had to start practicing some of what I had been teaching my patients. Some of the techniques that I used to cope and that I recommend to others include:
- Connecting with those around you. Find support, whether that be friends, colleagues or clinicians. Find people around you who you can connect with that will keep an eye out for you and make yourself accountable to them.
- Try and recognise the good habits. Even when you don't feel like it, still practice good mental health habit keeping, including things like exercise. Regular exercise forms a foundation of treatment for mild to moderate mood disorders and combined with healthy diets and avoidance of alcohol, these simple steps can make a significant difference.
- Protect your ‘ME’ time. Often I’ll talk to men about their down time. What do you do to regenerate yourself, what do you do for enjoyment? Sometimes, particularly when there's a lot of work stress and pressure, we forget to take time out for ourselves. In the literature, they talk about mindfulness or medication, and for men mindfulness could mean fishing, going for a drive, a bike ride or camping. It’s about making a concerted effort to do some of those activities, even when you don't feel like it or you feel too busy.
How to support the man in your life
Whether you’re a partner, friend or family member, you’ve got to approach the men you are concerned about in your life in a non-confrontational, no-blame and supportive way.
Be honest; most men appreciate honesty. Say, 'Look, I'm worried about you, I've noticed this, I've noticed you're not fishing anymore and that worries me'.
Most men are pretty good at chatting to their friends about what's going on. It might be while they’re fishing, out hunting or shooting, while they’re out exercising on their bikes wearing their lycra, or maybe down the pub after work with their mates. This is where there's a real opportunity to support each other and be accountable to each other in that peer group, and say, 'Actually, you’d better go see somebody about that'.
Health and wellbeing hotlines
DRS4DRS is a service that has been set up specifically for doctors and medical students. It’s a network of doctors’ health advisory and referral services and promotes health and wellbeing for doctors and med students across Australia. They have a 24/7 telemedicine line set up for those who might need to talk to someone on 1300 374 377.
If anybody has an immediate family member in defence or ex-defence, they would be eligible for Open Arms, which is a free psychotherapy or counselling support service for Veterans and their immediate families.
There are lots of 24-hour hotlines, such as Lifeline (13 11 14), for when people are really in distress. But also, most employers offer employee assistance programs, so you can ask around at work or look at your employer's website to see whether or not there's an assistance package that can give you access to psychotherapy.