In spite of the fact that I myself have been diagnosed with pretty severe depression, I’m not entirely sure what advice to give you, so I’ll just relate to you as best as I can what it’s like, and what you’re likely to encounter from him.
First, people are coming to understand that male depression doesn’t generally manifest itself the way that it does in women. Suicide rates for men are roughly three times higher than for women, even though women are twice as likely to be diagnosed with depression. Some if this is due to a general reluctance that men have to seek medical treatement in general, but a lot of it is due to misdiagnosis. The symptoms just aren’t always the same in men as they are for women.
For men, it often includes:
- extreme dysphoria, irratibility
- violence / abuse
- risky or self-destructive behavior / behavior on the fringe of legality
- insomnia
- lack of emotional control
- lack of concentration
- lack of energy / motivation
The best way that I can help you see how these all tie in together and to explain what depression is like would be this – have you ever stayed awake for more than 24 hours straight? It’s a lot like that, only it’s all the time. You’re extremely fatigued, you can’t think straight, everything takes too much mental energy to process correctly, it takes too much mental energy to control your emotions and impulses, and everything pisses you off. You just want everyone to go away and leave you alone because dealing with other people is just more than you can handle, and you feel like you’re either going to break down or snap. Of course, withrdawing from everyone else is about the worst thing you can do, but it’s a very strong impulse. Be prepared for him to stonewall you and lash out at you if you try to dig into the problem.
The way I look at it is like this - the word “depression” is actually a pretty good description of what happens if you take it at face value. Your mind just slows down. Everything you do or think takes so much effort that, as I told a psychiatrist once, it feels like your thoughts are bullets going through molasses. It’s very stressful to just do ordinary things because it take so much effort. Eventually you start “shutting down” all the things that you don’t strictly speaking need to function, and that includes your usual emotional and impulse controls. The differences between male and female depression is just that we have different base impulses that are exposed by it. I guess what I’m saying is that you shouldn’t be surprised if your brother doesn’t act all mopey and sad like you might think, and don’t be surprised if he acts like a right bastard. I know I do when I’m off my meds. And he probably realizes that he’s doing it - that the anger isn’t reasonable and that there’s something not right - but he can’t seem to make it stop. And partly that feeds into the desire to drive people away so that you can withdraw in peace. That’s probably the hardest thing to deal with.
The risky behavior thing is a little harder to explain. It’s not like the mania cycle of bipolar disorder, you’re still quite thoroughly depressed. It’s more like a sense of abandon or resignation to your fate. It’s like the last meal of a death row inmate- you might as well eat all the things that’ll kill you anyway. You figure you might as well just do whatever the hell you want because your life is so totally f’ed-up that there’s no more point in even trying to make sense or to do things right. You just don’t care what happens to you anymore, so you do things that are obviously self-destructive without a second thought. It’s kind of a passive-agressive way to kill yourself, I guess.
Incidentally, most people aren’t aware that depression and ADD are very closely related, neurologically speaking. Most people immediately think of ADHD, so the connection isn’t obvious at first. But anti-depressents do somewhat alleviate the symptoms of ADD, and vice-versa. It’s one of the puzzle-pieces that might help you get a handle on what’s going on.
As for advice, well…that’s hard for me to say. I’m not doing an exceptional job of dealing with it all myself, so I might be the wrong person to ask, heh. I’m going to have to go with what seems like a contradictory game plan:
First of all, just act normal. It gets annoying and frankly kind of insulting when people treat you like you’re made of glass. In fact, in a morbid kind of way, it’s a little bit funny. I’m far more likely to say something that will hurt them, than they are to say something that could actually hurt me, in that state.
That said, you’re going to have to piss him off by intervening. Few depressed people actually seek the help they need by themselves. He’ll probably resent you for meddling in his life, but you can’t let that stop you. It’s mostly the depression talking - if he actually gets the treatment he needs, he’ll forget about it. Either way, him getting treatment is more important than a good relationship with you. Hopefully you won’t have to choose between those two things, but you need to be prepared if it comes down to that. It’s like anorexia - if all you’re doing is just hoping that it’ll get better, it won’t. Period. He’s got to seek treatment and follow through with it.