That summer I found out just how relentless the sun can be. The kitchen gets sunlight most of the day and can get unbearably hot with nothing filtering it. With my Multiple Sclerois, I couldn’t be in the kitchen more than a few minutes on warm days, as getting overheated can awaken new MS symptoms. Plus, we wanted to use the table in that corner to put bread and produce on, and the sun made that impossible. Condensation built up inside bread wrappers and mildewed the bread, and the produce literally cooked within a day in the sun.
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Here’s the problem – the prevailing wisdom is wrong. In fact, we’re not heading away from the most dangerous time of the year for suicide, we’re heading towards it. Suicide rates are actually at their highest during late spring and early summer, and at their lowest around the holidays. There does appear to be a jump on New Year’s Eve and New Year’s Day, which is thought to be due to the holiday season ending and harsh reality settling in.

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Now that it’s easier to recognize depression symptoms in a man we know, our next step is to talk to him about it. However, that’s easier said than done. I was involved with a man who went through bouts of depression. It was understandable – he had had a rough childhood and had a parent who was mentally ill. I knew when he was going through a bout – he would drink heavily. But when I would bring up the topic, he would insist that he wasn’t depressed – he was just “in a funk.”

If you want to talk to a man about depression, or have already tried, you may be realizing that it’s a tough subject. The biggest stumbling block may be the threat that being depressed poses to a man’s masculinity. (By the way, I absolutely hate generalizing about any group of people, but unfortunately it’s essential here). If we look at some of the icons of manhood – John Wayne, James Bond, Clint Eastwood – they all have one thing in common. They’re stoic and unemotional. Not the best role models for a man when he’s struggling with depression. Following their example, he would never talk about how he feels about anything, let alone something like depression.
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I don’t find these conclusions particularly surprising. To my mind, there are very few situations in which someone with mild depression should be prescribed an antidepressant. Actually, I can’t think of even one, but bear in mind that I’m not a doctor. However, I think that most doctors would agree that other approaches are as effective, such as talk therapy and exercise. Whether or not moderate depression should be treated with antidepressants is a little more complicated. My take on it is that antidepressants shouldn’t necessarily be the first line of defense.
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I detailed my past antidepressant history for my doctor, with the thought that this might help him choose a new medication for me. In addition to Wellbutrin I had also taken Norpramin for most of the first decade that I was on antidepressants. Norpramin is a tricylic antidepressant that had been very successful in banishing my depression, but it’s a decade-old medication with side effects including dry mouth and teeth decalcification. During one year of that decade I had taken Prozac, but went back to Norpramin since the Prozac made me feel flat emotionally (although it did help my obsessive compulsive disorder).

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Another tipoff is my nail biting. I’ve bitten my nails as long as I can remember, down to the quick. I’ve tried to stop many times, and have even succeeded, sometimes for a year or more, but the majority of my life has been spent with virtually no nails. It took me a long time to figure out why I could stop sometimes and why I couldn’t, but I think I’ve finally hit on it. I think that when I go through periods of heightened anxiety, I start biting my nails again. When I am going through those fairly rare periods of low anxiety, it’s a snap to stop.

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Unfortunately, for some seniors, the golden years are more like leaden, especially if they’re living with depression. Not only can depression suck all the enjoyment out of life, as it can at any age, but depression can also be dangerous to an older adult’s physical health.

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But this one is definitely not your fault, and probably not your doctor’s either, for that matter. Last week a paper published in The New England Journal of Medicine showed that publication bias put antidepressants in a more positive light than was warranted by the evidence. To put that in plain English, when drug makers ask the FDA to approve a drug, they have to submit all studies that have been done for that drug, even the ones that show the drug to be less than successful. However, they are under no obligation to publish all the studies in medical journals. They can, and apparently did in this case, cherry-pick the studies and only submit the positive ones for publication. Not only that, some of the negative studies that were published were slanted to make them appear more positive.

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If you’re suffering from depression, you’re probably thinking, “How nice for you.” After all, you can’t even contemplate exercising when you’re depressed. Just getting through the day is an accomplishment. Trust me, I do know how you feel. I went through twenty years of untreated depression. But I also know that some of my best periods during those two decades were the times when I was exercising regularly.

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