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Depression in men: the silent killer we need to talk about

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Boys don’t cry. It’s an odd bit of advice I have been getting ever since my brain started forming memories. In the heady days of my youth, the phrase was doled out almost every time I found myself in extreme pain. There was that one time some game ended in me landing, chest first, on a badly placed thorn bush. Then there was the time I got bitten by a dog, and that time it seemed like a good idea to sit on an electric fence.

What’s common through each of these moments of exquisite pain is that I was told, “Big boys don’t cry”. Over the years the words have changed (one now gets told to “man up” or “take it like a man”), but the sentiment remains the same — if you have a sliver of flesh dangling between your legs, it’s best to stuff your emotions into a secret cabinet until you die. It doesn’t take Dr Phil to recognise that this is an impressively unhealthy way to go about your life, but it does go a long way toward explaining why South African men — especially black men — are getting their asses kicked in the battle against depression. 

Speaking to the South African College of Applied Psychology, operations director at the South African Depression and Anxiety Group (Sadag) Cassey Chambers said: “Stigmas surrounding mental health pose a major stumbling block when it comes to treating the disease in South Africa. In isiZulu, there is not even a word for ‘depression’ —it’s basically not deemed a real illness in the African culture.” Often, admitting that you are depressed is seen as an acknowledgement that you are less of a man. According to Sadag: “Instead of acknowledging their feelings, asking for help, or seeking the appropriate treatment, men with depression may be more likely to turn to alcohol, drugs, or become frustrated, irritable, and angry”.

The patriarchal nature of South African society,especially when one has been blessed with generous amounts of melanin, means that a great deal of cultural effort has been invested in wrapping the male ego around the idea of strength. Men are supposed to be strong, unbreakable ports, able to deal with whatever storms life throws at them. If someone close to you passes away, the women may wail and go into hysterics but as a human infused with all of the superpowers of masculinity, you are required to take the loss with stoic manliness.

“Qina (be strong)” is often the advice one hears in lieu of having an emotional reaction. This tendency to bottle their feelings is probably why South African men seem to drink more than most. In August, Businesstech published an article quoting a World Health Organisation study showing how South Africans are some of the heaviest binge drinkers in the world with, “59% of the drinking population consuming more than 60 grams or more of pure alcohol on at least one occasion over a 30-day period”. That number places us 5th in the world in the binge-drinking stakes.

Part of the problem is our history. A number of recent studies have suggested that trauma can be passed on genetically. Given our ugly past, we are likely saddled with accumulated trauma of hundreds of years of systemic violence and fear. Couple that with high crime rates and our country’s stark economic inequalities, and it becomes easy to see where some of these problems with depression stem from.

In a statement launching its campaign aimed at assisting men suffering from depression, Sadag noted that, “Studies have shown that there are certain factors that can predispose someone to developing depression, such as high amounts of environmental stress and a lower socioeconomic level. Although there are a number of other factors implicated, these two alone could account for much of the elevated prevalence of depression in the black community.”

Yolisa Mkele

Systemic oppression, economic or otherwise, adds another layer. When everyone is struggling beneath the weight of the same boot on their neck, it becomes normalised. If everyone in your neighbourhood is poor, complaining about the toll that not having money takes on your peace of mind can feel pointless. After all, everyone is in the same boat, “Ukukalaakusizi (crying doesn’t help)”.

The workplace can also be an incubator for burnout and depression. For most of us, the idea of asking our boss for a few days off because we are “sad” or struggling with our mental health is laughable. By boxing ourselves into the role of provider or chief breadwinner, men often feel obligated to soldier through their workplace burdens with little regard for their mental health. Sadly, most employers are more than happy to let them do it. Many companies place a higher value on the employee who grinds themselves to dust in service of the company goals than on a well-adjusted and happy workforce, despite the latter having been shown to be better for productivity.

Having come from fathers who endured police dogs, hoses, and all manner of terrors, black South African men have developed an interesting quirk in their psychology. Fuelled in part by patriarchy— and all the toxicity that comes with it — we’ve come to believe that the gold standard of what a man should be is some kind of magic mix between Superman and Steve Biko. Real men don’t cry, show pain, or get hurt. Real men don’t complain. They shoulder their burdens with implacable, tireless resolve. The thing we often forget is that real men are also real human beings: prone to failure, physical injury, and most importantly, mental fatigue. Sweeping our emotions under the rug only creates a tripping hazard, and given how fragile we know the male ego to be, allowing all that emotional buildup seems like a recipe for disaster.

This article first appeared in print in the Sowetan S Mag September 2019 edition.