Mind Over Masculinity: Breaking the Stigma of Men’s Mental Health

This article is a repost which originally appeared on RHODY HEALTH/Cranston HERALD

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Written by: Eric Tirrell, clinical manager of the Transcranial Magnetic Stimulation (TMS) program and the research operations manager for the Center of Biomedical Research Excellence (COBRE) in Neuromodulation at Butler Hospital and Joshua Davis a program therapist in the Butler Hospital’s Cognitive Behavioral Therapy Program. 

Mental health is a crucial part of our overall well-being, yet it remains a topic that is often misunderstood, stigmatized, and overlooked, especially for men. For far too long, men have been expected to suppress their emotions, to tough it out, to soldier on through difficult times. This resulted in a significant gap in our understanding of men’s mental health needs and an alarming disparity in the rates of suicide, substance abuse, and other mental health issues among men.

By breaking down the walls of stigma and shame surrounding men’s mental health, we can start addressing this critical issue with compassion, understanding, and empathy. Here we will explore the importance of men’s mental health, the challenges men face when seeking help, and the available treatment options that can help them achieve greater emotional well-being and fulfillment.

Sobering Statistics

• Men are more likely to die by suicide than women. In the United States, men account for nearly 75% of all suicides.

• Men are less likely to seek help for mental health issues than women. In a survey conducted by the American Psychological Association, only 35% of men reported they would seek help from a mental health professional, compared to 58% of women.

• Men are more likely to struggle with certain mental health conditions. For example, men are more likely to be diagnosed with alcohol dependence and antisocial personality disorder, while women are more likely to be diagnosed with depression and anxiety disorders.

• Men are more likely to experience workplace stress and burnout. According to a survey by the American Institute of Stress, men are more likely to report feeling overwhelmed at work and are less likely to take time off to care for their mental health.

• Men are more likely to engage in risky behaviors as a coping mechanism. This can include substance abuse, reckless driving, and other dangerous activities.

Importance of Men’s Mental Health

Men’s mental health is important for many reasons.

1. Mental health issues can severely affect a man’s quality of life. This includes relationships, work, and personal goals.

2. Depression, anxiety, and other mental health conditions can impact a person’s ability to function, causing them to feel hopeless, isolated, and overwhelmed.

3. Untreated mental health conditions can lead to physical health issues like heart disease, stroke, and diabetes.

4. Mental health issues can have a ripple effect on those around them, including family members, friends, and colleagues.

5. When men struggle with mental health issues, it can impact their relationships and those closest to them.

6. Addressing men’s mental health is crucial for building a more equitable society that prioritizes all individuals’ well-being, regardless of gender.

Contributing Factors

Several factors contribute to men’s reluctance to seek help for mental health issues. These include societal expectations of masculinity, mental health stigma, and a lack of awareness about available resources.

Men are often expected to be strong, stoic, and self-sufficient, making it difficult to acknowledge their struggles and ask for help. Additionally, mental health stigma can make men feel ashamed or weak for struggling with mental health issues, further preventing them from seeking help.

Treatment Options for Men’s Mental Health

Fortunately, several treatment options are available for men struggling with mental health issues. These include:

• Therapy: Talk therapy can involve working with a mental health professional to identify and address mental health issues. Therapy can be conducted in person, online, or over the phone and can help men develop coping strategies, manage symptoms, and improve their overall mental health.

• Medication: In some cases, medication can be used to treat mental health issues. This may include antidepressants, anti-anxiety medication, or mood stabilizers. Medication can help manage symptoms and improve overall mental health but should always be prescribed and monitored by a healthcare professional.

• Support groups: Support groups can be valuable for men struggling with mental health issues. These groups provide a safe space for men to share their experiences, connect with others going through similar challenges, and receive emotional support.

• Lifestyle changes: Making lifestyle changes, such as eating a healthy diet, exercising regularly, and practicing stress-management techniques, can also improve mental health. These changes can help reduce symptoms of depression and anxiety, improve mood, and promote overall well-being.

• Electroconvulsive Therapy (ECT): ECT uses brief, low-energy electrical pulses to stimulate nerve-cell activity in the part of the brain that affects mood. Stimulating this area helps to alleviate symptoms of depression. The electrical impulses are delivered through electrodes placed on the scalp. Patients are given anesthesia to relax and ensure the procedure is pain-free.

• Transcranial Magnetic Stimulation (TMS): TMS is an FDA-approved outpatient treatment that uses magnetic fields to stimulate nerves in the brain non-invasively. This innovative and safe technique requires no sedation or anesthesia and successfully treats individuals suffering from Major Depressive Disorder and Obsessive-Compulsive Disorder. Published reports from TMS treatment studies for depression show that more than half of patients treated with TMS Therapy experienced significant improvements in symptoms, and one-third of patients experienced full remission of their depressive episodes.

Disclaimer: The content in this blog is for informational and educational purposes only and should not serve as medical advice, consultation, or diagnosis.  If you have a medical concern, please consult your healthcare provider, or seek immediate medical treatment. 

How Can Sleep Affect Men’s Health?

By Hidaya Aliouche, B.Sc.
Reviewed by Sophia Coveney

This article is a repost which originally appeared on News Medical

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Adults should get an average of 8 hours of sleep per night.

‧ A lack of good sleep can cause many serious maladies.

‧ The use of a CPAP can be beneficial in many cases of sleep apnea

Sleep is known to affect several systems and processes in the body. Overarchingly, sleep deprivation is associated with negative health consequences.

With regards to specific effects of sleep on men’s health, dysfunctional sleeping patterns have been shown to impact erectile dysfunction, lower urinary tract symptoms, hypogonadal symptoms, low testosterone, and male infertility.

What is considered to be appropriate sleep?

The average number of hours of sleep required for an adult is between 7–9 for optimal health. However, a considerable number of adults do not meet this requirement.

A study conducted in 2012 demonstrated that 29.2% of men achieved an average of 6 hours or less of sleep each evening. the institute of Medicine further estimates that between 50 and 70 million Americans suffer from a chronic sleep disorder; this epidemic is associated with societal changes which include increased reliance on technology, increased working hours, and poor sleep hygiene.

In addition, non-standard shift working patterns can divulge significantly from circadian patterns which further increases the risk of impaired sleep quality.

The interrelationship between disrupted or inadequate sleep and the manifestation of disease

The relationship between health and sleep is bi-directional. There are several medical conditions associated with inadequate or disrupted sleep which include restless leg syndrome, insomnia, hypogonadism, sleep apnea, and depression.

Furthermore, several studies have revealed that short and sleep or disrupted sleep can produce health conditions including diabetes, coronary heart disease, hypertension, heart attacks, stroke, and several endocrine and cardiovascular disorders. Moreover, poor sleep also impacts the patients’ perception of symptoms and their severity alongside the clinical responses observed.

Combined with independent risk factors such as age, body mass in tax, mental health conditions that affect the perception of symptoms such as depression, and clinical characteristics, sleep functioning can moderate clinical symptoms and impact the quality of life experienced by patients.

Sleep and erectile dysfunction

In the general population, longitudinal studies have revealed that approximately 50% of men experienced erectile dysfunction to some degree. Several studies have reported that sleep can affect erectile dysfunction. For example, a cross-sectional analysis of 2676 men over the age of 67 found that those with a sleep dysfunction called nocturnal hypoxemia were more likely to experience moderate or complete erectile dysfunction.

In the same study, a similar condition that disrupts sleep, sleep apnea, was studied in relation to erectile dysfunction. In a randomized sham-controlled trial, a total of 61 men were assigned to groups to investigate whether the use of continuous positive airway pressure (CPAP) could improve erectile function in men who suffered from both erectile dysfunction and obstructive sleep apnea.

Overall, men who were randomized to CPAP showed no change in erectile dysfunction; however, when further examined in terms of patients who used the CPAP machine for over four hours per night, those who did so experienced a significant improvement. A placebo trial showed that a medication commonly used to treat erectile dysfunction did not significantly improve erectile dysfunction in these men.

These results suggest that in men with obstructive sleep apnea, sleep quality contributes to the condition, and may not respond to first-line treatment for erectile dysfunction with a PDE5 inhibitor; suggesting that in fact, correcting the underlying sleep impairment could produce more significant improvement in erectile dysfunction.

Alongside obstruction to breathing, non-standard shift work that has a significant effect on sleep has been shown to impact erectile dysfunction. A correlation between insomnia and erectile dysfunction has been confirmed by several studies. Some of these studies suggest that the correction of poor sleep in isolation may lead to a clinical improvement in manifestations of erectile dysfunction. This body of research continues to grow.

Sleep and lower urinary tract symptoms

Aging male populations commonly experience lower urinary tract symptoms. This is frequently associated with benign prostatic hypertrophy. Symptoms include poor urine stream, incomplete emptying of the bladder, straining, changes to the frequency of urination, urination hesitancy, and nocturia.

The urge to urinate is often exacerbated during the night, which leads to disrupted sleep and a decrease in overall sleep quality. A survey conducted on 5335 men who were diagnosed with lower urinary tract symptoms demonstrated that only 13% reported continuous sleep periods of more than two to three hours, illustrating the degree to which urinary tract symptoms can affect sleep.

Other studies have verified an association between lower urinary tract symptoms and other sleep-affecting conditions. For example, men with obstructive sleep apnea are more likely to experience urinary tract symptoms compared to those who do not. The severity of obstructive sleep apnea in this context has been found to correlate the most strongly with daytime frequency, urgency, and frequency of nocturia.

CPAP machines have been found to reduce lower urinary tract symptoms in those with obstructive sleep apnea. For example, a man with both lower urinary tract symptoms and obstructive sleep apnea who implemented CPAP for 12 months showed a significant increase in bladder compliance, as well as decreases in nocturia frequency and nighttime urination volumes.

Insomnia is also considered to be an aggravator of lower urinary tract symptoms as well as non-standard shift work.

Sleep and male fertility

Several studies have demonstrated that sperm counts have been decreasing over the past 40 years (50 to 60%). Unlike the linear correlation between erectile dysfunction and sleep, the relationship between sleep and male fertility is less clear.

Evidence suggests that an inverted U shape relationship exists, meaning that excessive and insufficient sleep are equally associated with reduced fertility. In a study of 198 infertile men, this relationship was found. However, interestingly no differences in semen volume, sperm motility, luteinizing hormone, or follicle-stimulating hormone were observed.

An additional study found via testicular biopsies in idiopathic infertile men that full circadian disruption – as manifested by too little or too much sleep – may affect the oxidation state of the testicle, shifting spermatogenesis.

Despite these correlative studies, no studies have assessed the impact of obstructive sleep apnea on fertility. With regards to non-standard shift work which impairs sleep quality, this has been suggested to impair spermatogenesis, although findings from studies have been inconsistent: some studies have demonstrated that men performing shift work had higher odds of experiencing infertility, while others have found no effect.

Conclusion

Poor sleep affects men and women alike. However, the unique effects in men concern urological problems, including erectile dysfunction, lower urinary tract symptoms, hypogonadism, and male infertility.

Alongside these, poor sleep is associated with a higher risk of several health problems that affect the quality of life including but not limited to cognitive impairment, social impairment, mood disturbances, and an increased risk of cardiovascular disease and associated manifestations such as atrial fibrillation.

References

‧  Kohn TP, Kohn JR, Haney NM, et al. (2020) The effect of sleep on men’s health. Transl Androl Urol. doi:10.21037/tau.2019.11.07.
‧  Irer B, Celikhisar A, Celikhisar H, et al. (2018) Evaluation of Sexual Dysfunction, Lower Urinary Tract Symptoms and Quality of Life in Men With Obstructive Sleep Apnea Syndrome and the Efficacy of Continuous Positive Airway Pressure Therapy. Urology. doi:10.1016/j.urology.2018.08.001.
‧  Soterio-Pires JH, Hirotsu C, Kim LJ, et al. (2016)The interaction between erectile dysfunction complaints and depression in men: a cross-sectional study about sleep, hormones, and quality of life. Int J Impot Res. doi:10.1038/ijir.2016.4.
‧  McBride JA, Kohn TP, Rodriguez KM, et al. (2018) Incidence and characteristics of men at high risk for sleep apnea in a high volume andrology clinic. J Urol. 10.1016/j.juro.2018.02.1358.

 

 

Men Prone To Worry and Anxiety May Develop Heart Disease and Diabetes Risk Factors at Younger Ages

Middle-aged men who are anxious and worry more may be at greater biological risk for developing heart disease, stroke, and type 2 diabetes, also called cardiometabolic disease, as they get older, according to new research published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

This article is a repost which originally appeared on SciTechDaily

The American Heart Association - January 24, 2022
Edited for content and readability - Images sourced from Pexels
Source: DOI: 10.1161/JAHA.121.022006

Our Takeaways:

  • Heart disease and Type 2 diabetes developed earlier in life among those who reported more feelings of worry or being overwhelmed.
  • The study suggests that men prone to worry and anxiety may need to pay extra attention to cardiometabolic disease risk factors, such as maintaining a healthy weight and taking blood pressure or cholesterol medicines, if needed.
  • The findings also suggest that treating anxiety disorders may lower cardiometabolic disease risk.

“While the participants were primarily white men, our findings indicate higher levels of anxiousness or worry among men are linked to biological processes that may give rise to heart disease and metabolic conditions, and these associations may be present much earlier in life than is commonly appreciated – potentially during childhood or young adulthood,” said Lewina Lee, Ph.D., lead author of the study, an assistant professor of psychiatry at Boston University School of Medicine, and an investigator and clinical psychologist at the National Center for Posttraumatic Stress Disorder at the U.S. Department of Veterans Affairs, both in Boston.

To track the relationship between anxiety and cardiometabolic disease risk factors over time, the investigators analyzed data on participants in the Normative Aging Study, which is a longitudinal study of aging processes in men, founded at the U.S. Veterans Affairs outpatient clinic in Boston in 1961. The study includes both veterans and non-veterans. This analysis included 1,561 men (97% white), who were an average age of 53 years in 1975. The men completed baseline assessments of neuroticism and worry and did not have cardiovascular disease or cancer at that time. A personality inventory assessed neuroticism on a scale of 0–9. In addition, a worry assessment tool asked how often they worried about each of 20 items, with 0 meaning never and 4 meaning all the time.

“Neuroticism is a personality trait characterized by a tendency to interpret situations as threatening, stressful and/or overwhelming. Individuals with high levels of neuroticism are prone to experience negative emotions – such as fear, anxiety, sadness and anger – more intensely and more frequently,” said Lee. “Worry refers to our attempts at problem-solving around an issue whose future outcome is uncertain and potentially positive or negative. Worry can be adaptive, for example, when it leads us to constructive solutions. However, worry can also be unhealthy, especially when it becomes uncontrollable and interferes with our day-to-day functioning.”

After their baseline assessment, the men had physical exams and blood tests every 3-5 years until they either died or dropped out of the study. The research team used follow-up data through 2015. During follow-up visits, seven cardiometabolic risk factors were measured: systolic (top number) blood pressure; diastolic (bottom number) blood pressure; total cholesterol; triglycerides; obesity (assessed by body mass index); fasting blood sugar levels; and the erythrocyte sedimentation rate (ESR), a marker of inflammation.

A risk factor for cardiometabolic disease was considered in the high-risk range if the test results for the risk factor was higher than the cut-point established by national guidelines, or if the participant was taking any medicines to manage that risk factor (such as cholesterol-lowering medications). Cut points for ESR as a risk factor are not standardized, so the participant was ranked as high-risk if they were in the top 25% of those tested. Each participant was assigned a risk factor count score, one point for each of the seven risk factors classified as high-risk. The men were then stratified based on whether they did or did not develop six or more high-risk factors during the follow-up period.

“Having six or more high-risk cardiometabolic markers suggests that an individual is very likely to develop or has already developed cardiometabolic disease,” said Lee.

The researchers found:

  • Between ages 33 to 65, the average number of cardiometabolic high-risk factors increased by about one per decade, averaging 3.8 risk-factors by age 65, followed by a slower increase per decade after age 65.
  • At all ages, participants with higher levels of neuroticism had a greater number of high-risk cardiometabolic factors.
  • Higher neuroticism was associated with a 13% higher likelihood of having six or more cardiometabolic disease risk factors, after adjusting for demographic characteristics (such as income and education) and family history of heart disease.
  • Higher worry levels were associated with a 10% higher likelihood of having six or more cardiometabolic disease risk factors after adjusting for demographic characteristics.

“We found that cardiometabolic disease risk increased as men aged, from their 30s into their 80s, irrespective of anxiety levels, while men who had higher levels of anxiety and worry consistently had a higher likelihood of developing cardiometabolic disease over time than those with lower levels of anxiety or worry,” Lee said.

The researchers did not have data on whether participants had been diagnosed with an anxiety disorder. Standard evidence-based treatment for anxiety disorders includes psychotherapy or medication, or a combination of the two.

“While we do not know whether treatment of anxiety and worry may lower one’s cardiometabolic risk, anxious and worry-prone individuals should pay greater attention to their cardiometabolic health. For example, by having routine health check-ups and being proactive in managing their cardiometabolic disease risk levels (such as taking medications for high blood pressure and maintaining a healthy weight), they may be able to decrease their likelihood of developing cardiometabolic disease,” said Lee.

It is unclear to what extent the results of this analysis are generalizable to the public since the study participants were all male and nearly all white. In addition, although participants were followed for four decades, they were middle-aged when the study began.

“It would be important for future studies to evaluate if these associations exist among women, people from diverse racial and ethnic groups, and in more socioeconomically varying samples, and to consider how anxiety may relate to the development of cardiometabolic risk in much younger individuals than those in our study,” Lee said.

Men: Ageing and Sexual Health Myths

Men: Ageing and Sexual Health Myths

[email protected] (healthxchange.sg)
Health Xchange4 September 2020

This article is a repost which originally appeared on Yahoo SG

In conjunction with World Sexual Health Day (4 Sep 2020), the departments of Psychiatry and Urology from Singapore General Hospital (SGH), a member of the SingHealth group, help dispel common myths about male ageing and sexual health.

Top 5 myths on male ageing and sexual health

Myth 1: Is something wrong with me as my friends don’t seem to have complaints about their erections?

Fact: Every man’s erection becomes weaker with age. However, men with medical conditions like diabetes, hypertension and high cholesterol may experience erectile dysfunction earlier in their lives.

Myth 2: A short penis is not good for sex.

Fact: Many men have this misconception that good sex requires a long penis. Procedures to lengthen the penis are merely cosmetic and do not enhance erection. In fact, they may even impair erections in some cases!

Myth 3: Is not being able to have multiple erections a problem?

Fact: Most men do not have multiple erections. After ejaculation, the penis will have a refractory period whereby it cannot become erect.

Myth 4: Using erection drugs will improve my sex life.

Fact: Erection drugs do not increase sex drive. They increase blood flow in the penis, allowing erections to be stronger and more rigid.

Myth 5: It is possible to die from taking erection drugs.

Fact: Deaths from erection drugs are very rare and they happen when the drugs are taken without medical supervision. Victims may also have underlying medical conditions like heart problems. When taken properly under medical supervision, erection drugs are actually very safe.​

Treatment for erectile dysfunction

The most common treatment for erectile dysfunction is taking drugs such as Viagra, Levitra or Cialis under medical supervision. The most drastic treatment is a surgical procedure which involves inserting a penile implant.

Reduced libido caused by a lack of testosterone can be confirmed with a blood test and treated with testosterone supplements. The treatment can be given in an oral form or via a series of injections, with regular follow-ups to ensure that the patient’s testosterone is replaced adequately and safely.

Prevention is better than treatment

That is why it is important to maintain a well-balanced lifestyle – physically, emotionally and financially – as it is the first step towards graceful ageing and a healthy sex life.

If you have any chronic medical problems such as diabetes, hypertension, hyperlipidaemia and depression, they need to be managed well so as to prevent long-term complications.

Experts warn against drug and alcohol abuse as these have a toxic effect on the nervous system, damaging nerves that are critical to sexual desire. Smoking causes early atherosclerosis (which leads to premature erectile dysfunction and is also associated with heart attacks, strokes and many cancers) and should be avoided.

Exercising regularly will also help improve your self image (which increases desire and boosts sexual hormones) and promote healthy blood vessels (which means delaying the onset of erectile dysfunction).

On the emotional front, focus on relationships with important people in your life and let go of past grievances. Also, be mentally and financially prepared for retirement. If one enters the golden years possessing financial stability, companionship and meaningful hobbies, one will be well equipped to lead a more fulfilling life in the later years.