He’s sitting in the office. Papers in shaky fingers. He’s got the list: the symptoms, both physical and mental, the treatment necessary, the resources. His heart is pounding in his throat and his legs are quivering. Pins and needles rush over his skin.
“I don’t know much about it,” his boss says.
Rusty swallows and exhales deeply. “I’ve got it all here. I can show you.”
“Oh, no, that’s fine.” The world seems to crystallize for a second. “It’s not really my thing.”
The words sends a shockwave through Rusty’s body. The crystalline world shatters in Rusty’s mind and gut, sending a million shards tearing through his inside.
I don’t matter. I don’t count. I want to be dead. I can’t do this. I have to go. I have to go.
Apart from being outright rude, this casual dismissal of a life-threatening illness is a symptom of how society treat men’s depression like it’s an optional interest, like being into shark-cage diving or reading Twilight.
A Man On Fire – The Emergency Flare
Rusty wasn’t just “sad” or “down”. His mind was at war with itself. Do you know what neurochemical collapse looks like? Let me show you.
- Serotonin: a neurotransmitter and hormone that affects mood, sleep, digestion, and other functions throughout the body. It stabilizes mood and plays a role in happiness, learning, and memory, while also influencing appetite, sleep-wake cycles, and bone health.
The smart, mouthy, charming engineer’s serotonin had plummeted between 40 & 60% below baseline.
When he told his boss “No, it’s fine, I’m fine” it was a lie his body chemistry could not back up.
- Dopamine: a neurotransmitter that primarily functions as part of the brain's reward and pleasure system, reinforcing behaviours and motivating you to repeat them. It also plays a crucial role in regulating motor control, memory, mood, attention, learning, and sleep.
Once an avid gamer running successful servers, Rusty barely looks at his PC. Anhedonia turned his favourite pastimes into ash.
- Norepinephrine: functions as both a neurotransmitter and a hormone, playing a key role in the "fight or flight" response by increasing alertness, arousal, and attention. It also constricts blood vessels to raise blood pressure, affects mood and sleep-wake cycles, and is used medically to treat life-threatening low blood pressure.
It’s spiking erratically. Rusty’s amygdala has been hijacked. Every movement of the pen over the paper sounds like a 1940s air-raid siren. His prefrontal cortex is offline. Suddenly, he has no words, cannot express himself, can barely hold his emotions back, can’t make a single logical decision or plan his next step, all the while every single thought is spinning like a washing machine’s spin cycle on crack.
DSM-5 Body Count
In a single scene, Rusty hit 7 out of the 9 criteria, as outlined in the DSM-5, for Major Depressive Disorder.
- Anhedonia – loss of interest in hobbies and pleasure
- Massive weight loss (20+ kgs)
- Insomnia – max 2 hours of uneasy sleep a night
- Psychomotor agitation – shaking fingers, twitching legs
- Feelings of despair and hopelessness – mind screaming I don’t matter over and over
- Suicidal ideation – I want to be dead. I have to go.
According to SADAG, South African men average 6.2 symptoms before seeking help. Rusty would fall under textbook late-stage.
All these complaints on social media about how people’s medical complaints are dismissed?
Four years previously, Rusty’s stomach issues – caused by excessive cortisol levels causing gut inflammation – and his chest pain was dismissed as “stress”. “You’re tired, it’s just stress.”
Let’s get more sensitive - libido crashes, because testosterone comes down by 25 %. He’s not having a midlife crisis and he’s still just as attracted to her as he was, but he’s been chemically castrated by Depression.
Heartburn? All those ENOs and Gaviscon you see them pounding? 68% of depressed SA men see a GP for physical symptoms before (if) they’re diagnosed (SADAG 2024). Rusty’s “heartburn” was his body screaming for help.
Do you see now, how this “downer” rips apart a man’s life, strips away everything and leaves him paralysed counting the blades on a ceiling fan? It’s not a choice, it’s not something he can “opt out of” because you feel uncomfortable. It’s a war of the mind and the rules of engagement are off, and maximum casualties. It is survivable – but only if someone stays in the room.
Rusty’s list wasn’t just a silly little PowerPoint, it was a distress flare. That dismissal? Snuffed it out.
The Culture of Dodgers
Apparently, we’ve built a Stoic operating system over the last how-many hundred years, with many delightful gems like “Man up” (because men don’t have feelings?), “Snap out of it” (like a toddler), “Don’t be a sissy” (y’all know that’s being paraphrased), “Men don’t cry” (tear ducts are just for aesthetics). This is the standard protocol, no matter where you go, from the braai to the boardroom to the workshop.
In this culture of dodgers, whenever a difficult subject is raised – and it’s not only depression – you’re immediately dismissed with a “don’t be a downer” or “that’s not really my thing” response.
Rugby scores are more important than suicide notes. Because it’s a buzz kill and it spoils the party.
Here’s a wild concept though – no-one chooses depression, anxiety, autism, ADHD. Those other difficult topics, like sexual abuse and violence – they’re not chosen either. But they’re dismissed outright because it’s “not my thing”.
What exactly is “your thing” then?
Shallow Skips and Frightened Mirrors
I’ll hypothesise that there’s two reasons that response is so prevalent.
One, they are shallow, lacking in compassion and understanding, always chasing the next high and the next feel good. And not for a reason, but purely because they really are about as deep as a parking lot puddle. They’ve never suffered a day in their lives, the worst experience they’ve had was the drinks spilled at their last rugby braai or a taxi swerved in front of them and their sunglasses fell off.
Then there’s the other ones. They look exactly the same and they respond the same but they’re motivated to keep these conversations at arms length at all costs, not because they’re super shallow but because they’re terrified. They’re facing the same thing. There’s a tiny thread and if you pull on it, the flood gates will open and they’ll either collapse and they’re scared of the pain, or they’ll collapse and they’re scared of the stigma.
Neither of these is an excuse to dismiss, judge, or otherwise shut out people who are brave enough to talk about depression, mental health issues or suicide.
The Cost Of The Dodge
Every time this happens, a man suffering from depression is pushed a little closer to the edge. Each dismissal is one more nail in a coffin he shouldn’t be in. Globally there are 703 000 male suicides each year (WHO, 2024). In South Africa, 80% of suicides are men.
Those are the extreme cases, like Rusty. How about the faceless mass of men with what is amusingly called “functioning depression” – coping every day, looking 100% normal, but they’re completely empty inside and they’re slowly burning out – they also end in suicide, they just take a very long time to get there, but it hurts the whole time.
And those of us who care, who carry the weight because we love them and we want to see them smile again, have our own price to pay in the form of burnout, exhaustion, sadness, frustration. And we’ll carry that every single day, while the party-guys keep vibing and the scared ones stay septic.
Here’s a harsh fact: We lose our fathers, brothers, husbands, boyfriends, friends because comfort is more important than a life.
Flip the Script
It is hard. I’m not saying it’s not. Some of those conversations with Rusty had my heart breaking over and over. Some of the conversations about Rusty had me furious. So? I’m a capable, functioning adult with a firm grip on myself. So I can handle it.
If you claim you can’t, then you probably need some serious introspection or therapy yourself.
When Rusty’s mom was mean and dismissive, I smiled and offered to be there for her too, if she ever needs to talk about anything. And – nothing bad happened to me.
You can flip the script. Here’s some easy examples when someone tries to dodge the hard discussions:
- I know we normally don’t discuss this, but his life isn’t a joke.
- If this hits too close to home, we can talk about that too.
- Let’s talk about why this is so uncomfortable for you?
Kill these phrases immediately:
- Man up; snap out of it; toughen up; don’t be so weak/sensitive/girly
- Think positive; you’ll be fine; it’s all good
- You’re a buzzkill/downer; I’m not interested; this isn’t my thing
Set up a zero-tolerance policy towards people who dismiss it.
Use the multitude of resources (here and here) available to learn what depression is, what the effects are, what the symptoms are, and what you can do for support. Or subscribe to this blog and Rusty’s Youtube channel.
Rusty’s story is one millions of men face every single day. Why do they have to face it alone, when there is an army of able-bodied people who can help them fight – and win – this invisible war?
Is our comfort really so much more important than another human being’s life?
Are we so vain, and so superficial, that we can’t read a pamphlet or an X thread? Are we so scared of what’s hiding inside us, that we’d rather sacrifice a beautiful, strong, kind, generous man to the void of Depression than face it?
Or is it because you feel guilty, when you know what’s going on, that you’re not doing anything?
Are we that weak?
I know that I am not. I know that I will sit with Rusty in the dark, no matter how miserable or cold it is, until his light is strong again.
And I challenge you – you don’t have to go to this extreme. But you can listen. You can spread the word. You can engage, talk, reach out, check in – all of that counts for a lot more than you may think.
@ironicnotion
#OneMoreDay
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