Pressure. We literally couldn't live without it. Pressure keeps us on the ground, keeps our tyres inflated, allows us to fly in the fuselage of aircraft and, given enough time, even creates precious jewels. But pressure on our emotions and our minds, from internal and external sources, can be deadly, unless we find ways to relieve it.
Almost all of us are under pressure, experiencing various stresses each and every day, and there is little difference in the kinds endured by men and women. But the ways both sexes deal with them vary wildly. I can speak from 46 years of experience of being a man, and admit that for far too long I have “bottled up” emotions, avoided processing certain traumatic experiences, compartmentalised my mind and shut away memories that I should have faced head-on and dealt with. And I am not alone – these are traits shared by the majority of men.
Women, on the other hand, tend to be much more open about things of an emotional nature, able to talk to one another about the issues they face or have been through, and are much more proactive in helping one another. Men? We are different – but the physical impact of sustained stress and pressure on our emotions should not be underestimated. It is killing us.
"Men are under huge pressures, especially in the Middle East," says Dr Saliha Afridi, director of LightHouse Arabia in Dubai, where I attend my own therapy sessions. "Work, being a parent, being far from home without their normal support networks, relationship issues and the constant drain on finances – these things are faced by more people than you might realise, and it's vitally important that men are honest in their self-appraisals and seek help when it's needed."
For me, a failed marriage, being forced to live apart from my son, long-standing money troubles and intense feelings of guilt caused by my religious upbringing took their toll in a way I was not expecting. Just when I felt life had finally settled down and all those problems were but distant memories, I began having panic attacks. After they became bad and regular, I made the first steps to get professional help.
The ways in which men deal (or not, as the case may be) with stress can be as unique as the individuals undergoing it. And the Gulf can be a veritable pressure cooker, where a particular set of circumstances provide a breeding ground for anxiety disorders and depression. These, if left unchecked, often result in devastating physical conditions – heart attacks, cancers, self-harm and the effects of substance abuse. But help is out there.
A maelstrom of thoughts and feelings rushed around my mind as I drove to that first appointment. Even then, I was still deeply sceptical about the benefits of therapy. I felt ridiculous, as though I was an attention-seeker who wasn’t “man enough” to deal with these things myself. Because that’s what we men do, isn’t it? We deal with things. Actually, no, we don’t.
My therapist was nominated following a telephone interview during which I explained what I was going through and a bit about my background, and from the second I met her, I have never felt anything other than at ease opening up about every aspect of my life. As we have unravelled my personal history, explored my upbringing and dissected past relationships, I have been at times devastated and elated – it can be a terribly painful experience, but ultimately it is something that needs to be done.
The net result of this process is that I am now a better husband and father, and the panic attacks, which are never pleasant to experience, have long since abated. I have learnt how to meditate and achieve an inner calm, which until now has always eluded me, and I would like to think it isn’t a coincidence that I feel better physically, with fewer aches and pains. As a result, who knows, perhaps I will get to live a bit longer, too?
What we as men must face is the reality that our mental well-being does greatly impact our physical state. It has been proven that people suffering from depression, which often results from repeated exposure to stress, genuinely feel bad physically. When your computer's CPU malfunctions or your car's on-board electronic control units need replacing, you know that you need to turn to a specialist for help. And our heads are no different – sometimes they need reprogramming, rewiring, cleaning out and getting rid of the rubbish that we have allowed to accumulate in there over the decades. And that is exactly what I did, although it isn't just middle-aged men who are beginning to seek help from counsellors, therapists and psychiatrists. Maartje Suijskens is a psychologist at Dubai's Priory Wellbeing Centre, and she says that youngsters are also turning to them in ever greater numbers. The reason might come as a surprise.
“The pressures young people can face at school are enormous,” she says. “The constant pressure to perform, to meet expectations. It’s too much for a number of them and we have to be very careful in the way we treat them, so as not to offend parents who might be culturally unready to accept this kind of support.”
She adds that here, where schooling is paid for directly by parents, without even knowing it, they can often end up making unfair or unrealistic demands on their children and their teachers. “When you’re paying a lot of money for something, it’s natural to expect the very best, but that can, in certain circumstances, translate to pressure on vulnerable youngsters who can easily feel like nothing they do is ever good enough,” Suijskens says. “There are so many factors in this region that affect people differently, compared to other parts of the world, but we’re doing what we can to help.”
Something else she says rings true with me. "When patients turn to us for the first time, we try to rule out physical problems that might have been misdiagnosed, or missed entirely. For instance, a parent might come in and say their child is dyslexic, but they haven't thought to have their eyes tested. We need to know what we're dealing with to give the right treatment. For the best possible outcome, collaboration between physical- and mental-health-care professionals is needed."
When I had my initial panic attacks, I saw a cardiologist to rule out heart problems, because at the time I genuinely believed I was having a heart attack. As he questioned me about my lifestyle, there was scant interest in the levels of stress I was under, and his only advice was to take certain medication and do more exercise. When I suggested it might be beneficial to see a therapist, he ignored me. So it is to be applauded that organisations such as LightHouse Arabia and Priory are trying to increase the dialogue between various medical practitioners so that the right treatment can be given at the right time.
“People tend to see all the medical specialities before they see a psychiatrist,” adds Dr Walid Abdul-Hamid, clinical director and consultant psychiatrist at the Priory, “and usually at a late stage, which can complicate the problem further. In the UK, the Nice [National Institute for Health and Care Excellence] guidelines suggest using exercise as a treatment for mild depression, but people rarely present early enough to have this put in place, and often come for psychiatric assessment after developing severe depression, which requires a combination of medication and psychotherapy.”
There is no escaping it: we need to talk more openly about our emotions, especially men. To facilitate this, it is incumbent on us to stop associating mental-health problems with weakness or an inability to cope with normality – we have to remove the stigma. None of us are immune, but we can all do good by bringing these issues out into the open, and talking about something that is as real and as damaging as any physical ailment.
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Read more:
The numbers: why we pay the price for a good night’s sleep
The UAE has made great strides in addressing mental health problems
Tackling post-natal depression: the baby blues can strike men
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