The Most Depressed Man - This Is Us, episode 7

The Most Depressed Man - This Is Us, episode 7

So can I first say that $200 for the Will You Marry Me hoodies is quite a purchase?? But the proposal for the unconventional Kate & Toby was very sweet.  I may or may not have discovered a tear in my eye during that scene. I love how intuitive Toby was with Kate when he saw her difficulty imagining a milestone like a wedding without her father. Their storyline was some of the only light in an episode that was filled with pain. Even the legal recognition of Randall as a Pearson involved pain. But once again Rebecca comes up with creative ways to defend her family – this time by writing a letter to the judge who didn’t support transracial adoption, including a patched together family photo. I love how she said she would keep going to court until the judge “did his job” and then signed the letter “Randall’s mother.” Another small win for Rebecca came when the judge recused himself from the case – perhaps recognizing (but not resolving) his own bias. And of course, Randall wins all the points in Black Queendom for clarifying to Deja’s mother that he wakes up every morning to “a headscarf and coconut oil.” [salutes Randall]

This episode had a strong focus on men, and what seemed to me to be overwhelmed men. Toby is overwhelmed by marriage and fatherhood; the judges were overwhelmed and disillusioned by their jobs and life purpose; Randall is overwhelmed trying to protect Deja from any more pain than she’s already experienced. But there are two men who seem overwhelmed and unable to cope – Kevin and William. While others became frustrated or disappointed with their behaviors, all I could see was two men struggling with what could be unrecognized clinical depression. Depression often looks different in men, and we need to talk about it.

Depression in Men

We know that depression is one of the most commonly diagnosed disorders. It’s estimated over 16 million adults will have a depressive episode in a given year – that’s almost 7% of the adult population. We see many more women being diagnosed with depression, but we also know that many men who may be clinically depressed may not get diagnosed appropriately because they don’t fit the typical profile of a sad, mopey, slowed down person in despair. All humans go through pain, but we have socialized men to think they should have superhuman emotional strength to withstand it all. The worst part of this is that we teach men this from boyhood, which means they sometimes miss the chance to develop real coping skills to manage their emotional pain. So when the pain of life hits – and sometimes life hits hard – they are knocked down wondering how to get back up. This is what we see happening with Kevin and William. I love how the show let’s us see two men – one African American, one Caucasian, one rich, one poor – but both deeply in pain for similar reasons.

Common Causes of Depression

There is a long list of things that can potentially lead to depression. While we must acknowledge a biological/genetic aspect to depression, we must also consider the piling up of various painful social and psychological events that can overwhelm a person’s ability to cope. For example, the death of a loved one is a common factor in depression. Kevin lost his beloved father Jack in a very traumatic way during his adolescence and appears to still be stuck on how to process this grief. William lost his mother and then lost his wife to drugs. These situations alone – if not addressed – could easily result in depression. However, we also see Kevin dealing with the end of his marriage to his childhood sweetheart, not feeling accomplished or respected in his career, serious health concerns with the healing of his knee after the recent surgery – all of which can compound on one another to exponentially increase the risk of depression for men. William is dealing with the inner turmoil of giving away his only son, money problems, inconsistent employment – again, all events that would make a man more vulnerable to depression.

Risk Factors That Make Men More Vulnerable

Not enough can be said about the way we socialize men to deal with their emotions. We expect them to be emotionally (and physically) tough, we expect them to be able to resolve their own pain, we even expect them to keep themselves from crying as if tears give away an inner weakness they were supposed to hide. What this does is leave the male alone with his pain and without any support. We see William exhibiting what looks like a deep loneliness and isolation, as well as what appears to be a lack of support. While Kevin has two siblings, a mother and an ex-wife who still loves him, he too appears lonely and unable to access his support system.

Distinct Feature of Depression in Men:  Reckless Behavior

The way we socialize men also leaves them unable to manage their stress effectively – another risk factor making men more vulnerable to depression. Ineffective stress management leads to one of the biggest risk factors for depression: reckless behavior, many times in the form of substance use/abuse. 20-25% of depressed men also have an alcohol dependence. It makes it very difficult to treat the depression because the alcohol is masking some of the pain. If you remove the alcohol, the pain intensifies. But you can’t get to the pain unless you remove the alcohol. It’s a downward spiral of self-medication. Kevin has reached a point where alcohol does not mask enough of his pain, so he has added prescription opioid pain killers because they will kick up the chemicals in the brain that give him some euphoria. Similarly, William chose to manage his stress with heroin – also an opioid – to presumably self medicate his intense grief over the loss of three of the most valuable people in his life. Some men will also pursue dangerous activities like unsafe sex, compulsive gambling, driving recklessly or other escapist behavior. This is not always seen in the “typical” depression, but is a commonly overlooked sign of depression in men.

There are other distinct, often overlooked signs of depression in men like increased irritability and anger as well as an increase in physical pain. We can see an increase in restlessness, agitation and an increase in pushing people away or putting up emotional walls. It’ll be interesting to see if Kevin displays more and more of these symptoms as it seems the writers are trying to raise awareness of how much we don’t pay attention to male emotional suffering.  Even Kate, who usually is so emotionally attuned to Kevin, is only able to ask Toby “Did he seem a little off?” Later we hear a clearly intoxicated Kevin explain that he is not just “a little off,” but that he is an “empty shell” – a clear marker of depression.

Most Worrisome Impact

We have put men between a rock and a hard place. We have taught them their masculinity is everything. We have told them to be masculine means to be emotionally unbreakable. Admitting emotional brokenness means a loss of masculinity. So even if a man sees he is struggling emotionally, he would rather fight with quicksand rather than potentially lose his masculinity. They won’t admit their own suffering, they won’t ask for help. Men are notorious for not wanting to get psychotherapy and may not even be consistent if they begin. There is a stigma and a shame that may make this man feel worse because he feels forced to admit he may be emotionally broken and may not have been emotionally caring for himself in a healthy way. For men of color, we see this stigma and shame even stronger. (Not to mention many mental health professionals are less likely to take on African American male clients or African American working class men which makes seeking treatment even more of a hurdle!)

This is why we see men more likely to commit suicide more often than women – 3-4 times more likely. We push them into a corner where they feel they only have one way out. And sure enough, we see William in his apartment after receiving the news that his cancer cannot be treated. He had planned to use heroin again, and before Randall interrupts him, we are left wondering if he might have planned an overdose to end his life.

There is so much to be written about men and depression. I feel confident we will see this theme again in future episodes. We know that William was swept out of his pain and lonliness by his long lost son, and connected to emotional support, stability and joy in last days. We can only hope that Kevin’s support system will kick in soon for him as well.  He needs it.

What do you think is going to happen with Kevin?

Will he get worse before he gets better? 

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