Part 1
I have been a health care professional for more than fifty years. During that time I have risen in my profession and helped thousands of men and women to live fully, love deeply, and make a positive difference in the world. I have also been stressed, depressed, and suicidal during much of my professional life. I’m not alone. According to Mark Olfson, MD, MPH, professor of Epidemiology at Columbia University,
“Health care workers compared with non-healthcare workers have greater risks for mental health problems and long-term work absences due to mental disorders, and are at increased risk of suicide, compared with workers in other fields.”
It took me a long time to recognize and accept my own problems and to get the help I needed. Like many health professionals I thought I could save the world. I put the needs of my clients ahead of my own and suffered as a result. I also believed that most health problems were gender neutral, with the same treatment applicable for males and females.
That changed for me when our son went into treatment for his alcohol and drug problems. My wife and I were invited to come visit him during family week. As part of the education we received about addictions and the underlying causes, all the family members were given a standard depression questionnaire. Most experts agreed that people who suffered from addictions, as well as family members, often suffered from depression.
My wife, Carlin, scored high on the depression scale (indicating that she likely had some degree of depression). I scored low, indicating that I didn’t. When we returned home she saw a doctor, received a more in-depth examination, which verified the findings. She started on medications and counseling and things improved greatly in her life as well as mine.
Two months into her own therapy she suggested that I might also be suffering from depression. “I don’t think so,” I told her. “Remember, you are the one that scored high on the test. I scored low.”
“Maybe so,” she told me. “But tests don’t always tell the whole story. I still think you could use some help.”
I disagreed and got busy doing my work seeing clients, but my stress and irritability increased. Things got worse between us and I finally agreed to see someone, hoping it would put her mind at ease. Instead the therapist agreed with her, though my symptoms were different than hers, my depression was real, I was told.
Carlin shared some of her frustrations with the therapist.
“Jed has rapid mood changes. He’s angry, accusing, argumentative and blaming one moment. The next he’s buying me flowers, cards, and love notes. He can be happy and the life of the party one moment, then become irritable, anxious, and depressed the next minute.”
I spent seven years in treatment which included medications, in addition to psychotherapy. Things began to improve and many lifelong issues that I had avoided were dealt with and resolved. I wrote two books about what I learned, The Irritable Male Syndrome: Understanding and Managing the 4 Key Causes of Depression and Aggression and Mr. Mean: Saving Your Relationships from The Irritable Male Syndrome.
In the process, I heightened my awareness about differences between men and women and why understanding gender different are important for clinicians and clients. According to Marianne J. Legato, MD, Founder of the Partnership for Gender Specific Medicine,
“Until now, we’ve acted as though men and women were essentially identical except for the differences in their reproductive function. In fact, information we’ve been gathering over the past ten years tells us that this is anything but true, and that everywhere we look, the two sexes are startingly and unexpectedly different not only in their normal function but in the ways they experience illness.”
I delved more deeply into the science of gender-specific medicine and learned that new information on genetic differences between males and females were also important to our understanding. David C. Page, M.D., is professor of biology at the Massachusetts Institute of Technology (MIT) and director of the Whitehead Institute, where he has a laboratory devoted to the study of the Y-chromosome.
“There are ten trillion cells in the human body and every one of them is sex specific,”
says Dr. Page.
“We’ve had a unisex vision of the human genome, but men and women are not equal in our genome and men and women are not equal in the face of disease. A great deal of the research going on today which seeks to understand the causes and treatments for disease is failing to account for this most fundamental difference between men and women. The study of disease is flawed.”
Pamela Wible, M.D., is a family physician, author, and expert in physician suicide prevention. In her book, Physician Suicide Letters Answered, she says,
“I’ve been a doctor for twenty years. I’ve not lost a single patient to suicide. I’ve lost only colleagues, friends, lovers–ALL male physicians–to suicide. Why?”
Males are not the only ones who die by suicide, but we are much more likely to die. Dr. Wible details the reasons that so many doctors and other healthcare professionals die by suicide including the following:
- Our greatest joy is the relationship with our patients.
- Doctoring is more than a job; it’s a calling, an identity.
- With so much need, we often put the needs of others ahead of our own.
- Assembly-line medicine undermines the patient-physician relationship.
- Most practitioners are burned out, overworked, or exhausted.
- Workaholics are admired in medicine and other healthcare professions.
- Many of us function in survival mode and our personal and family lives suffer.
- We’re not supposed to make mistakes.
- Caring for sick people can make us sick if we don’t take care of ourselves.
- Seeing too much pain and not enough joy is unhealthy.
- The reductionist medical model is dehumanizing for patients and providers.
- We are bullied by insurance companies, employers, and patients.
- Patients and the public see us as superhuman and we often forget that we have problems just like the people we treat.
- We don’t take very good care of themselves or each other.
- We don’t acknowledge the reality that we are at high risk of overwork, overwhelm, breakdown, and self-harm.
There are many problems with our healthcare system. Stephen C. Schimpff, M.D, is one of the world’s foremost experts on health care. He says,
“The nation leads the world in spending for medical care but lags in quality because it lacks a health care system.“
Instead, he says, the United States has a “sick care” system. It is one of the reasons that many doctors and other health professionals are leaving the field, just at a time when they are needed the most.
More than 145,200 clinicians exited the healthcare workforce in 2021 and 2022 with physicians—in particular internal medicine and family practice doctors—at the head of the line, according to a newly updated industry report from Definitive Healthcare. Beyond the physician population, 2021 and 2022 also had about 34,800 nurse practitioners, 15,300 physical therapists, 13,700 physician assistants and 10,000 licensed clinical social workers leave the workforce.
We need more male health care professionals and we need more men who are trained in understanding gender-specific medicine and health care. I will be offering a series of courses later this year to address these needs. In a recent article “Calling All Men: Are You Ready to Get Healthy in Body, Mind, and Spirit in 2024?,” I summarize the main topics.
If you’re interested in learning more, drop me an email to Jed@Menalive.com. Put “Men’s Courses” in the subject line.
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In Part 2 of this series I will continue to explore these issues.
