Men Reach Out Late for Health Care

YOUNGSTOWN, Ohio – The myth of Will Kane is as strong today as in 1952 when Gary Cooper played the deserted sheriff in “High Noon.”

Men are supposed to be stoic, keep a tight rein on their emotions, rely solely on themselves when they “take arms against a sea of troubles.” Stiff upper lip and all that.

The numbers tell the story. More than twice as many women as men seek counseling for issues related to mental health. And when men do decide they need help, they take longer than women to schedule that first appointment.

Carl F. Ansevin, M.D.; Amanda Burger, Ph.D.; Loren D’Amore, MSW and LISW-S; Ann Jaronski, Ph.D.; and Joe Simons, MSW and LISW, see few differences in the mental health issues men and women face and try to cope with. The biggest, they agree, is men’s reluctance to get help.

Men’s difficulty in sticking to a course of treatment, Ansevin says, is exacerbated by their work schedules. “Men’s schedules don’t allow them to come in and see doctors,” he says, and notes that men are more likely to work afternoon and midnight shifts than women.

Ansevin, a neurologist, primarily treats sleep disorders that include insomnia as well as some eating disorders. The brain controls both. Physical health and mental health are closely linked, he says.

How well you fall asleep and stay asleep “is controlled by your brain,” Ansevin says. “Insomnia is huge with both sexes,” the result usually of anxiety or depression, which “is more common than [sleep] apnea.”

The less sleep one gets, the more likely that he suffers from anxiety and depression, Ansevin points out. And increased anxiety and depression lead to “eating more and weight gain,” which make it harder to fall asleep. “You feel hungry but you aren’t,” he explains, resulting in a downward spiral.

Those who work afternoon and midnight turns suffer from the disruption of their circadian rhythms. Their day-night or light-darkness schedules are tough to reset, the neurologist says. Weekends aren’t long enough to reset the wake-sleep cycle.

If possible, he advises working steady afternoons or midnights if someone can’t work daylight. “People should get on and stay on a steady shift,” he says. “That way their cycles don’t get fouled up.”

Technology, to wit, the widespread use of computers at home, also disrupts sleep patterns. “Blue light [the light computer screens emit] disrupts sleep when they go online and stay up late at night,” Ansevin says.

A zeitgeber, German for “time giver,” is any external cue that synchronizes an organism’s biological rhythm to the earth’s day-night cycle of 24 hours. So for an insomniac, staying up all night to cure his inability to fall asleep won’t work because he’s ignoring the cue needed to fall asleep and return to a 24-hour cycle.

Alcohol isn’t the answer either, Ansevin points out, because the insomniac falls asleep for two hours before waking up and not being able to fall back asleep. And nicotine is a stimulant, not a substance that induces relaxation, so “nicotine interferes with your sleep big time,” the physician says.

Those who suffer a sleep disorder should not drink beverages that contain caffeine, the mild stimulant in coffee and many soft drinks. “I try to cut people off,” Ansevin says.

Active exercise contributes to restful sleep. “Find something you like,” the neurologist advises, “swimming, bicycling. Dancing is a good activity.” A good exercise regimen helps sufferers lose weight – “Obesity is a factor in not being able to sleep,” he notes – and keep it off.

At Youngstown State University, Ann Jaronski is the new head of its student counseling service, arriving last spring. The students who suffer most from anxiety and depression are those who succeed academically, not those overwhelmed by their course loads, she finds.

“We have conversations about being good enough,” she says. “These students are used to doing well and expect to continue doing well.”

At YSU, 35% of the students who sought counseling in the fall semester 2015 were male, in the spring semester 2016, 38%. Nationally, male college students account for 35% of those who seek counseling, Jaronski says. Jaronski, who holds a doctorate in counseling psychology from Ohio State University, has been working with college students 20 years.

While men are less likely to seek help, Jaronski ventures that her office sees more students who major in STEM (science, technology, engineering and mathematics) disciplines than the liberal and fine arts, business and education. That’s “anecdotal,” she says, because she hasn’t kept statistics.

Some 75% of the students who approach the counseling office “take on too much – classes, [outside] work, family responsibility – and that wears you down,” Jaronski says. A third of the students she sees are going to school full-time and working full-time, she says.

She shares their concerns and asks them, “How do you dial back?”

They don’t see how, usually informing her, “ ‘I won’t sleep.’

“… I don’t do time management,” Jaronski continues, “But I tell them, There are 24 hours in a day and you have 28 hours. What are you going to do? What can you give 90% to and still be successful?”

The majority of the students she counsels can handle the academic challenges, Jaronski finds. “That isn’t what gets them. It’s the commuting. It’s worrying about money.”

That she’s a woman makes it easier for men to open up to her. “Men would rather talk to a woman,” the psychologist says. “It’s harder for a man to show a perceived weakness to another man.”

In her experience, says Amanda Burger, a clinical psychologist for Mercy Health at the St. Elizabeth complex on Belmont Avenue, women are more likely to suffer from depression and anxiety while men are more likely to have “substance abuse disorder. … Depression is more common in women but men have it, too.

The men who suffer from depression tend to be “chronically out of work, have poor self-image and unable to provide for themselves and their families.”

The members of both sexes who see her tend to be overweight or obese but “I have better luck with male patients in making behavioral modifications,” Burger relates. Men seem to “fit exercise into their schedules better,” she says. They are more willing to walk or go to the gym and have an easier time letting go of sweets,” Burger says.

Diet and sleep are closely related, Burger says noting, “Mental health and [symptoms of] chronic pain improve when they sleep and eat better.”

Modifications in one’s diet often are all that’s needed. “People don’t realize what [how much] they’re eating,” the psychologist says. “Patients get discouraged because they think they need a complete overhaul when small steps will get them to their goal.”

As for quitting smoking, “There’s no difference in gender about their ability to quit … and few quit successfully.”

Joe Simons, who works with veterans at the Veterans Administration outpatient clinic on Belmont Avenue finds that all veterans, but especially male veterans, believe, “I should be able to handle this on my own.”

Most discuss their situations with other veterans who have been through their experiences before they go to the VA, Simons says. Referrals from veterans the VA has helped direct many his way.

Re-entry into civilian life after a military or naval career of two to three decades often poses a challenge. The values and mindsets developed over those 20 to 30 years – Simons mentions “brotherhood, commitment, honor, the chain of command” – are different in civilian life.

Civilian life has less structure and time can hang heavy on someone with no job. Some want to go back to school, Simons says, to prepare for the jobs they want. (Jaronski works with the Veterans Center on the YSU campus to help former members of the armed forces develop a new routine.)

Others consider apprenticeships in the building trades. “They think, ‘I can be an electrician,’ “ Simons offers as an example.

“Redefining yourself is the key,” Simons says. “Once people realize the services available to help them, that makes a difference” and their anxiety is greatly reduced.

This carries over into relationships with their families, especially spouses, and their family life improves, Simons says.

At PsyCare, Loren D’Amore says, women see female therapists and men see male therapists about depression and anxieties that include panic disorders, obsessive-compulsive disorders, bipolar illness and PTSD, post-traumatic stress disorder.

“Men wait until their problem is severe,” D’Amore says. “Men are stubborn” about denying both that they have a problem or its severity. “Usually it’s an accident or an argument at work or with their spouse” before they schedule an appointment. Once they begin therapy, however, “they ask, ‘Why did I wait?’ ” D’Amore says.

Job-related stress is more common with men, the licensed social worker says. “Your boss has power over you and you put more pressure on yourself.” A toxic workplace induces even more stress.

Self-medicating through alcohol or drugs “is about numbing the problem,” D’Amore points out. “It doesn’t fix the problem.” PsyCare psychiatrists, psychologists and counselors see patients “at all stages of addiction, early, middle and late-stage,” D’Amore says, and weaning people from drugs and alcohol is “getting people to learn new habits. “There’s no gender difference. …

“I talk to everyone about exercise,” D’Amore continues. “I promote walking. Outdoors, not on a treadmill. But as long as you’re active doing something, your mental outlook is going to improve. And your motivation must be internal. Do your best and don’t put yourself down. Don’t self-sabotage.”

Pictured: Dr. Carl Ansevin is a neurologist treating sleep disorders, including insomnia.

Copyright 2024 The Business Journal, Youngstown, Ohio.