Part 1
I have been a healthcare professional for over fifty years. During that time, I rose to the occasion and helped thousands of men and women live fully, love deeply, and make a positive difference in the world. I have also been stressed, depressed and suicidal for much of my working life. I’m not alone. According to Mark Olfson, MD, MPH, Professor of Epidemiology at Columbia University,
“Health workers compared to non-health workers have a higher risk of mental health problems and long-term absence from work due to mental disorders and are at increased risk of suicide, compared to workers in other sectors.”
It took me a long time to recognize and accept my own problems and get the help I needed. Like many health professionals, I thought I could save the world. I put my clients needs before my own and suffered as a result. I also believed that most health problems were gender neutral, with the same treatment applied to men and women.
That changed for me when our son went into treatment for his alcohol and drug problems. My wife and I were invited to visit him during family week. As part of the education we received about addictions and underlying causes, all 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 probably had some degree of depression). I scored low, indicating I didn’t. When we returned home, he saw a doctor, received a more in-depth examination, which verified the findings. She started with medication and counseling and things improved a lot in her life as well as mine.
Two months into her own treatment, she told me I might be suffering from depression too. “I do not think”, I told her. “Remember, you’re the one who scored high on the test. I scored low.”
“Maybe,” told me. “But tests don’t always tell the whole story. I still think you could use some help.”
I disagreed and went about my business seeing clients, but my anxiety and irritation 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, although my symptoms were different from hers, my depression was real, they told me.
Carlin shared some of her frustrations with the therapist.
“Jed has quick mood swings. He is angry, blames, argues and blames a moment. The next day he will buy me flowers, cards and love notes. He can be happy and the life of the party one moment, then irritable, anxious and depressed the next minute.”
I spent seven years in treatment that included medication in addition to psychotherapy. Things began to improve and many lifelong issues I had avoided were addressed and resolved. I wrote two books about what I learned, The Irritable Man Syndrome: Understanding and Managing the 4 Root Causes of Depression and Aggression and Mr. Mean: Saving your relationships from irritable man syndrome.
In the process, I increased my awareness of the differences between men and women and why understanding the different genders is important for clinicians and clients. According to Marianne J. Legato, MD, Founder of the Gender Specialist Medicine Partnership,
“Until now, we have acted as if men and women were essentially identical except for differences in their reproductive function. In fact, the information we’ve been collecting over the last ten years tells us that this is far from true as well Wherever we look, the two sexes are initially and unexpectedly different not only in their normal functioning but also in the way they experience illness.”
I delved deeper into the science of gender-based medicine and learned that new information about genetic differences between men and women was also important to our understanding. David C. Page, MD, is a 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 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. Much of the research being conducted today that seeks to understand the causes and treatments for the disease fails to explain this most fundamental difference between men and women. The study of the disease is flawed.”
Pamela Wible, MD, is a family physician, author, and physician suicide prevention expert. In her book, Responses to Doctor’s Suicide Letters, she says,
“I have been a doctor for twenty years. I have not lost a single patient to suicide. I have only lost colleagues, friends, lovers – ALL male doctors – to suicide. Why?”
Men are not the only ones who die by suicide, but we are much more likely to die. Dr. Wimble details the reasons why so many doctors and other health professionals die by suicide, including:
- Our greatest joy is the relationship with our patients.
- Medicine is more than just a job. it is a calling, an identity.
- With so much need, we often put the needs of others before our own.
- The medical assembly line undermines the patient-doctor relationship.
- Most practitioners are exhausted, overwhelmed or exhausted.
- Workaholics are admired in medicine and other health professions.
- Many of us operate in survival mode and our personal and family lives suffer.
- We must not make mistakes.
- Caring for the sick 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 to 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 ourselves or each other.
- We fail to recognize the reality that we are at high risk of overwork, burnout, collapse and self-injury.
There are many problems with our health care system. Stephen C. Schimpff, MD, is one of the world’s leading health care experts. He says,
“The nation leads the world in spending on medical care, but lags behind in quality because it lacks a health care system.”
Instead, he says, the United States has a “patient care” system. It is one of the reasons many doctors and other health professionals leave the field, just when they are needed most.
More than 145,200 clinicians exited the health care workforce in 2021 and 2022 with physicians—particularly internal medicine and family medicine physicians—leading the line; according to a recently updated industry report from Definitive Healthcare. Beyond the physician population, approximately 34,800 nurses, 15,300 physical therapists, 13,700 physician assistants, and 10,000 licensed clinical social workers had also left the workforce in 2021 and 2022.
We need more male health professionals and we need more men who are trained to understand gendered 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 themes.
If you are interested in learning more, please email me at 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.
