The divi­sion be­tween mind and body is il­lu­sory, and both are sim­i­larly vul­ner­a­ble to break­down. Yet many men still mis­take ill­ness for weak­ness. Author Matt Haig shares his per­sonal ac­count and ex­plains why we ur­gently need to speak up about anx­i­ety

Men's Health (UK) - - In This Issue - Il­lus­tra­tions by Paul Blow

Author Matt Haig opens up about anx­i­ety and why it’s time to shed our guilt

When I was 24 years old, I em­barked on the strangest, most ter­ri­fy­ing ex­pe­ri­ence of my life. I be­came ill. I had been ill be­fore, but never like this. I had a panic at­tack that lasted a week – but the words “panic at­tack” don’t quite cover it. I had no con­trol over my thoughts or my rac­ing heart. It was a to­tal break­down, and I hadn’t seen it com­ing be­cause I had been ig­nor­ing the signs and mask­ing my feel­ings with al­co­hol. Now, the dam had bro­ken. My mind was in a mess that I couldn’t es­cape, and I very nearly threw my­self off a cliff. It wasn’t be­cause I wanted to die, but be­cause I was sud­denly un­able to go on liv­ing un­der the weight of so much pain. It was like hold­ing on to an emo­tional bar­bell stacked with too many weights. I could hardly stand.

This was the be­gin­ning of three years of de­pres­sion and anx­i­ety. Three years of con­fu­sion. Of keep­ing se­crets from my slowly di­min­ish­ing cir­cle of friends. Of strug­gling to ar­tic­u­late how I felt, even to my doc­tors. Much later, I re­alised that one of the rea­sons why it took me so long to re­cover was stigma. The stigma of so­ci­ety, but also self-stigma. I couldn’t ac­cept what was hap­pen­ing to me. I couldn’t ac­cept the la­bels. I couldn’t ac­cept the thought of telling my friends about it.

I wasn’t just de­pressed. I was de­pressed about be­ing de­pressed. The knowl­edge that I wouldn’t be able, in the grip of this ill­ness, to hold down a nine-to-five job felt like a judge­ment. It was a vi­cious cir­cle, made worse by how I felt like less of a man. What kind of man can’t go to a su­per­mar­ket with­out hav­ing a panic at­tack? What kind of man has an ex­is­ten­tial cri­sis while choos­ing which socks to wear?

An ill kind. Any­one with a mind can have an ill­ness of that mind. I felt very lost and very alone. But I wasn’t alone. What was hap­pen­ing to me was com­mon, and so was the stigma I was feel­ing. If you are a man and un­der the age of 50, the most dan­ger­ous part of your own body – the part that is most likely to kill you – is your own brain.

Boys Don’t Cry

For all the progress we are mak­ing around men­tal health, for all the celebri­ties and sports stars will­ing to open up about their strug­gles with anx­i­ety and de­pres­sion, peo­ple – men, in par­tic­u­lar – still find it dif­fi­cult to talk about their own prob­lems. Men are less likely to be di­ag­nosed with a men­tal health con­di­tion than women, but we are more likely to die from one.

Men are less likely to get the right treat­ment than women, or even to ask for it (only 36% of psy­cho­log­i­cal ther­apy re­fer­rals, for in­stance, are men, ac­cord­ing to the Men­tal Health Fo­rum). In­stead, we, as a gen­der, are more likely to “self­med­i­cate” in an at­tempt to rem­edy our prob­lems. Men are nearly three times more likely than women to be­come de­pen­dent on al­co­hol. We are also more likely to use il­le­gal drugs – and to die from them. When you con­sider that three out of four sui­cides are men, you start to re­alise there is a bit of a prob­lem.

If there is a stigma around men­tal health, it is partly be­cause we don’t fully un­der­stand it. While men are per­fectly com­fort­able when it comes to dis­cussing a torn ham­string or even chest pain, we have his­tor­i­cally found it hard to talk about our feel­ings.

When I was at school, most of the com­mon in­sults – af­ter the ones call­ing you some­thing gen­i­talia-re­lated – were those that re­lated to your state of mind: “psy­cho”, “schizo”, “div” and, of course, “men­tal”. As in: “You’re men­tal!” Which is a – ahem – crazy thing to say, if you think about it. Of course you’re men­tal. I’m men­tal. Ev­ery­thing we feel is men­tal. Our per­cep­tion of the en­tire world is men­tal. To think is to be men­tal. To not be men­tal would be to ex­ist as a plant, or a rock, or a fan of Sean Penn’s fic­tion writ­ing.

Ques­tion­ing some­one’s men­tal state is still the go-to in­sult method in the Twit­ter­sphere – think of the far right’s con­tin­ual use of “autis­tic screech­ing” as a po­lit­i­cal put-down. Add all this to the way that men are still ex­pected to be silent and stoic in the face of emo­tion and pain – to “man up” and get on with it. Re­cently, I tweeted about how ridicu­lous it is that we, as men, are con­di­tioned to feel ashamed about cry­ing. “Men cry,” I wrote. “They have tear ducts and lacrimal glands just like other hu­man be­ings. A man cry­ing is no dif­fer­ent from a woman cry­ing. It’s nat­u­ral. Gen­der roles are toxic when they don’t even al­low an out­let for pain. Cry, men. Cry your hearts out.” Many peo­ple liked it, but oth­ers took is­sue with what I had writ­ten. One Amer­i­can man, with an AK-47 as his pro­file pic­ture, said there are only three times a man should cry: if the Chicago Cubs win the World Se­ries, if your wife dies, or if you get caught in a bear trap. In other words, if you are un­mar­ried, don’t like base­ball and aren’t presently stuck in a bear trap, then you have no ex­cuse

to cry at all. This is an ex­treme ex­am­ple, but it shows the prob­lem that ex­ists for men and men­tal health.

Men can feel judged by other men for showing their emo­tions. So, when those emo­tions be­come ill emo­tions, they can be re­luc­tant to talk about them, even if those feel­ings threaten their life. When I had my break­down, I ended up los­ing friends, not be­cause they weren’t there for me but be­cause I didn’t give them a chance to be there for me. I stopped re­turn­ing their phone calls. I no longer went out. But I could never quite tell them why, be­yond say­ing that my head was “a bit of a mess”. That was the equiv­a­lent of some­one on fire say­ing they feel “a bit warm at the mo­ment”.

There isn’t a spe­cific type of per­son who can get de­pres­sion. Women get it. Men get it. As­tro­nauts have had it. World lead­ers have had it. Film stars. Sol­diers. Bil­lion­aires. Rugby play­ers. Even the Rock has had de­pres­sion. There is noth­ing un­manly about men­tal ill­ness. When you look at the sui­cide rates, it is clear that peo­ple are dy­ing need­lessly be­cause of stigma – be­cause peo­ple tell them­selves they are wrong to feel the things they feel.

Talk­ing Cures

How do we fix this? Talk­ing helps, of course. Talk is con­ta­gious. The more we talk about our prob­lems, the more oth­ers will talk about theirs. But part of the prob­lem is that we see men­tal ill­ness as some­thing alien and “other”. So much stigma would van­ish if we re­alised that men­tal health and phys­i­cal health are the same thing. The di­vide we have cre­ated be­tween phys­i­cal and men­tal health is an ar­bi­trary one.

René Descartes is largely to blame for this dis­tinc­tion. The philoso­pher best known for say­ing, “I think, there­fore I am,” also be­lieved that minds and bod­ies were sep­a­rate. In the 1640s, he sug­gested that the body works like an un­think­ing ma­chine and the mind, in con­trast, is non-ma­te­rial. And you don’t need to have a de­gree in phi­los­o­phy to have a sim­i­lar view. Most of us have sub­con­sciously in­her­ited it. That’s one rea­son why we have sep­a­rate hos­pi­tals for men­tal health and di­vide the world of work be­tween white-col­lar “skilled” jobs and bluecol­lar “man­ual” jobs.

But think about it. What does men­tal health mean? Even if our view of men­tal health starts and ends with the brain, the brain is a phys­i­cal thing. Even our thoughts, at the mi­cro level, are phys­i­cal pro­cesses. Be­sides, thoughts aren’t just the prod­ucts of brains.

As the cog­ni­tive sci­en­tist Guy Clax­ton writes in his book In­tel­li­gence in the Flesh, “The body, the gut, the senses, the im­mune sys­tem, the lym­phatic sys­tem, are so in­stan­ta­neously and so com­pli­cat­edly in­ter­act­ing with the brain that you can’t draw a line across the neck and say, ‘Above the line it’s smart and be­low the line it’s me­nial’… We do not have bod­ies. We are bod­ies.”

Then there’s the is­sue of the “lit­tle brain” – a net­work of 100 mil­lion neu­rons (nerve cells) in our stom­ach and gut. OK, so that fig­ure is nowhere near the 85 bil­lion neu­rons in our “first brain”, but it’s not to be sniffed at. One hun­dred mil­lion neu­rons are roughly the amount that a ham­ster has in its head.

For me, the way back to health was in un­der­stand­ing that the brain was part of the body. This helped for two rea­sons. First, it led me to ap­pre­ci­ate that it wasn’t my fault. See­ing ill­ness as a judge­ment of char­ac­ter is ridicu­lous and dam­ag­ing. We can’t con­trol what is thrown at us, just how we deal with it. If any­thing, I feel stronger for hav­ing had this ex­pe­ri­ence.

The sec­ond rea­son it helped was that it led me to phys­i­cal ex­er­cise – specif­i­cally, run­ning, strength train­ing and yoga – which was a cru­cial part of my re­cov­ery. It’s very hard to have a panic at­tack when you’re run­ning, be­cause your heart is al­ready rac­ing, and it’s meant to be. Phys­i­cal ex­er­cise is well known to have a pos­i­tive im­pact on all kinds of men­tal con­di­tions, from de­pres­sion to at­ten­tion deficit hy­per­ac­tiv­ity dis­or­der. It worked for me.

More im­por­tantly, I be­came able to talk and write about what I was feel­ing with no shame. And this is the key. I al­lowed my­self to be a dif­fer­ent kind of man. A man who could feel ill. A man who could fail. A man who could cry. I be­gan, in short, to be a hu­man be­ing. Matt Haig is the author of the num­berone best­selling mem­oir Rea­sons to Stay Alive. His lat­est book, Notes on a Ner­vous Planet (Canon­gate), is out now. Haig is back­ing Time to Change’s “In Your Cor­ner” cam­paign, which en­cour­ages men to step in if they no­tice their mate is acting dif­fer­ently. For more in­for­ma­tion, visit: time-to-

“There’s noth­ing un­manly about de­pres­sion – even the Rock ex­pe­ri­enced it”

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