Men, mid life and mental health
By Tim Armstrong
The American poet and philosopher Henry Thoreau once made the statement that many men “lead lives of quiet desperation”. This may be especially true for men in mid life. As the psychologist Erik Erikson puts it, mid life may be seen as a transitional period of deepening self understanding, challenge, psychological growth and maturity, or as a period of crisis, stagnation and despair. Either way, for men between 35 and 55 years, this period involves significant change, risk and mental readjustment to the inevitable process of growing older.
Men in mid life have a significantly increased risk of heart disease, work related stress, obesity, alcohol addiction, and more recently, depression and suicide. Interestingly, there does not appear to be much gender difference in the overall prevalence of mental disorders, but the pattern of disorders differs between men and women. As adults, men engage in more alcohol and drug abuse and antisocial behaviour, while women experience more anxiety, depression and eating disorders.
Much of the research on men’s attitudes to their health suggests that men are aware of health promotion campaigns and understand the risks associated with inappropriate diets, excess alcohol consumption, work stress and dysfunctional relationships, but fail to change their behaviour or seek help. They find it even more difficult to discuss their emotional issues and have few friends outside work, and limited coping strategies.
While some men experience a loss of meaning and sense of isolation and loneliness around work, marriage and sexual satisfaction, others attempt to regain their sense of identity by revisiting their youth. As Peter O’Connor suggests in Understanding the Mid Life Crisis:
“In a society that idolises youth and associates it with all the good things in life, the tendency is to deny the ageing process. Thus suburban streets and local parks are full of desperate, panting joggers attempting to jog age into oblivion and grasp the elixir of youth.” Furthermore, “the fading physical strengths in the mid life transition can only be experienced as a fading sense of self.”
In a broader social context, three social characteristics associated with mental disorder are age, employment and family circumstances. As society undergoes change and redefinition of family, work and relationships, middle aged men sometimes experience disproportionate effects of such changes. They may include increasing rates of long term unemployment, redundancy or early retirement. Change within family units requiring men to give up some of their economic power, marriages that are more flexible, and the prospect of absent fatherhood as a result of separation or divorce.
While economic and technological change is inevitable and has many positive benefits for society in general, so too is the prospect of long term unemployment for middle aged men - and its negative impact. Given that men frequently gain a sense of self and ego from their jobs, it is not surprising that there is increasing evidence that, for many men, mental health depends on satisfactory employment.
From a counselling perspective, engaging middle aged men about mental health and emotional problems often requires a direct approach that circumvents the presentation of vague physical symptoms or statements that may disguise underlying turmoil. Questions to men about mid life issues should be positive and can be strategically used to explore potential underlying problems. They may include:
- What have you achieved recently that gives you satisfaction?
- How do you think about yourself?
- When was the last time you had a good laugh?
- What do you do for yourself in your spare time?
- Do you have many male friends?
- Has anything caused you to reflect on your life lately?
- Who do you talk to about yourself?
- When you’re not at work what do you enjoy doing most?
- Do you feel secure in your relationship/marriage?
- Do you like change in your life?
- Do you get sexually aroused often?
- What do you look forward to?
- Where will you be in five years time?
While employment, sound physical health and stable relationships are clearly fundamental to positive mental health, as Peter O’Connor suggests, the ability for middle aged men to develop a set of values and meanings beyond the physical and material realm is important to ensure that “the mid life crisis will be no more than an uncomfortable, irritating period in a man’s life”.
This article was published in the August 2000 issue of GPSpeak, the magazine of the Northern Rivers Division of General Practice. Tim Armstrong was the division’s mental health project officer at the time.
Reproduced with permission.
