Depression

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What this is about

How you recognise that you or your friends are depressed, and how to deal with it.

Depression is a real, serious illness with very real effects which can be devastating and can lead to death. Research repeatedly finds that gay men are more prone to depression than straight men. For instance, more than 17% of American gay and bisexual men suffer from depression, compared with 9.5% of all adults. There are also higher rates of anxiety and suicide than among straight men (gay men are more than twice as likely to attempt suicide); a far higher rate of self-destructive or compulsive behaviour (including substance abuse and sex addiction), and issues around intimacy and forming relationships.

Discussing these issues within the gay community has unfortunately been difficult and embarrassing, but depression in our community has reached crisis level requiring gay community activists and leaders to take more positive steps to tackle it. We are also unsure about when we should intervene in the lives of our friends. Hopefully this page will make things clearer. Since this page was first published, more research into the problem has been completed and more resources are available to help.

Because many gay men have been so depressed for so long, they often lack the will power or desire to help themselves, even if they already know and recognise that they must do so.

What causes depression?

Things which cause depression can begin as early as childhood, for instance:

A feeling that you are not good enough or do not meet other people’s expectations of you

Bad diet

Natural things like the time of year, the weather, whether it is dark or sunny

Shock

Injury

Abuse of you by adults

Something happens to you which you had not expected and were not prepared for

Alcohol

Social exclusion

Living in poor housing conditions

Living on your own

Unemployment

Limited or no access to supportive and understanding health care services

Poverty

Being unable to tell anybody you are gay

Being bullied

Lack of educational or work opportunities

Lack of family or neighbour support

Lack of role models while growing up

Lack of information

Lack of a romantic partner (note: not losing a romantic partner)

Anti-gay violence and homophobia

Domestic violence or abuse

Poor self-image: not identifying as gay or feeling alienated from the wider gay population; hating or being appalled by yourself; feeling guilty that you are gay; feeling that you are unloved or unloveable, second rate, unworthy

Living with HIV or other debilitating condition

Not having control of things

Feeling out of control of your body

Depression makes your life worse in many ways, like:

An inability to enjoy anything or concentrate properly

Feeling very tired and perhaps having aching limbs

Starting to feel hopeless, guilty

Loss of weight

Reduced sex drive

Reduced appetite

Increased anger or irritability.

Medicines. Many prescribed medicines can make you depressed. Read the leaflets supplied with any medicines you are taking to see if it is the medicine making things worse instead of better

(Do not confuse depression with grief. If someone has died and that has made you feel unwell you are grieving for them, which is not the same as depression, and is a natural condition, not an illness. Ask at your local library for details of bereavement counselling and support groups.)

What to do if you are depressed

It is important for you to receive help and support if you are suffering from depression. Just making one phone call could save your life.

You can talk anonymously and confidentially to someone over the phone.

The National Depression Helpline, 0800 111 757

Samaritans, 08457 909090

Or phone your local gay switchboard.

You can go and see a doctor. (If you have not got a doctor, in the UK you can go into any doctor’s surgery and ask to register with them. You may have to fill in a form and there may be a medical examination before they accept you. If you cannot find a doctor, or have any questions, phone NHS Direct on 0845 4647.

Don’t worry about anyone else finding out. Your doctor is required to keep your details confidential. He will be able to provide much more information regarding depression and the avenues of support you have open to you. The doctor’s surgery may also have other resources which can assist.

The main treatments for depression that your doctor may recommend are:

medication (taking tablets);

talking with someone (a counsellor, the doctor’s surgery may have one);

cognitive therapy, such as Mindfulness, and

you doing something to fight your depression. Your doctor may recommend any or all of those.

Your doctor’s surgery may have some booklets about depression. (You can also ask in any pharmacy if they have any booklets or anyone who can help). You can also enquire at your local library.

As well as doctors, who are usually busy and pressed for time, there may be nurses at the practice who can spend more time with you. Ask the receptionist what services are available.

You must be able to trust your doctor. If you can’t, then ask whether other doctors are available instead. They will not mind.

Check that any leaflets you are given contain impartial advice and are not financed by vested interests, e.g. drug companies.

“Mindfulness based cognitive therapy” is a set of skills that you can learn either by reading a book or going on a training course, that help you to regain control of your body and your depression. It is regarded as being very successful.

You may also benefit from learning relaxation techniques.

The things you can do to fight your depression and recover from it include

Drink less alcohol

Review your medicines with your doctor

Change your behaviour

Eat better. Alcohol, caffeine, chocolate, cheese and bread can make your depression worse. Your surgery nurse, or a pharmacist, may be able to give you ideas on what you can do and there are lots of books available about healthy eating

Get more fresh air and exercise and get as much sunshine as you can; throw the gloves and scarf away on cold days because the more natural light your body can absorb, the better you will feel

Join in something and make new friends

Find out more about depression so you understand what has happened to you and why you feel like this. Information is power and it will help you get better. Ask at the doctors, a pharmacy, the library

Join a group of other people fighting depression

Draw up a list of the resources available to help you

With the help of a friend, draw up coping strategies that can help you deal with life changing events like the death of someone close to you, or losing your job or your home, write them down and keep them somewhere safe where you can find them (the list you are reading is a coping strategy)

Don’t get upset if you can’t sleep – get up and do something (quietly, don’t wake others up) then go back to bed an hour or so later

Improve your relationships with the people you already know

Map out your future goals as a gay man

Draw up an action plan of things you enjoy or can look forward to and try to have something to look forward to every month of the year (a year planner is ideal for this)

Look after yourself and give yourself treats

Find someone who understands to mentor or support you

Make an inventory of all the things you like, or enjoy, or are proud of, or remember with pleasure. These are the things you value and show you how good your life actually is

What to do to help a friend who is depressed

Talk about it and give your friend the information, love, respect and support he needs. Know the phone numbers.

Ask your friend who his doctor is and make sure he has one.

If your friend talks about suicide or self harming a lot, this is a warning sign that things are really bad. It is time to intervene gently. Suggest to your friend that you should accompany him to the doctors and should go in and see the doctor with him; this will help him realise that this is important and you are a good friend; two heads are better than one, and between the two of you, you will remember better what the doctor said; and you will be able to ask the doctor how else you can help your friend.

If you think your friend is in immediate danger, you really must intervene now. First ask yourself if you yourself are in any danger. If you might be, leave and as soon as you are safe, phone the police. If you are safe, call the emergency services (such as a paramedic) who can intervene professionally, stay with him and keep him away from anything he might kill himself with, such as kitchen utensils and medication.

You now need to be supported yourself. Make sure you tell someone you are helping a friend through a crisis and that you have your own support network.

What we all can do to help gay men fight depression

Campaign for gay rights, accept and befriend gay people, fight homophobia and prejudice.

Do all we can to make all members of our community happier in themselves and their lives.

This page will be updated as more information becomes available.

Gay Activist welcomes your comments about this page. If you have any tips for beating depression, have your own experiences or have any other advice for people who are depressed, please leave a comment.

book Mindfulness based cognitive therapy | Caffmos Community | National Alliance on Mental Illness Fact Sheet – Depression and the GLBT Community | The Velvet Rage: Overcoming the Pain of Growing Up Gay in a Straight Man’s World | Guardian – Velvet Rage review | Guardian – 2010 Research in UK Gay Community | Pace |