Dealing with depression

A couple of days before New Year’s, right after Toronto finally got its first major snowfall of winter, my friend Andrew organized a tobogganing party at Riverdale Park. It was a beautiful afternoon for sledding, and every kid in the neighbourhood showed up to tackle the hill. Our small group was surrounded by smiling and laughter.

Still, I hated every minute of it. As I observed all the joy around me, including on the faces of the friends I was with, all I could think about was how miserable I felt. On an afternoon that was producing so much happiness, I was consumed by unhappiness. Seeing how much fun everyone else was having only made it worse.

But I also realized, for the first time ever, how absurd my feelings were. How could I not be enjoying this afternoon? There must be something wrong with me. It felt like my mind had been poisoned by negative thoughts and I couldn’t force them out, as if the cartoon devil in my head had defeated the angel. Then I finally acknowledged to myself that I was depressed.

For me, that moment was like coming out. For years, I had experienced — on and off — the same feelings as I was having that day. But even though my depression often lasted for weeks at a time, I had always been able to deny it and make it go away for a while. Now I realized it was always going to come back, a bit worse each time, unless I found a way to break the cycle.

Depression isn’t something that hits only gay men. But it’s a mental health issue that seems to strike us harder than the broader community. When I started doing a bit of research, I discovered one study after another showing that adult gay men experience depression, reach out for mental health services, and commit suicide at a rate at least three times higher than straight men. Yet this issue is rarely written about or discussed. Perhaps we don’t want to ruin our well-earned rep for being “out and proud,” but in some cases, depression is killing us. Just last year, The New York Times published a disturbing feature about a 49-year-old gay motivational speaker in Manhattan — attractive, popular and financially successful — who surprised all his friends one day by killing himself. His name was Bob Bergeron and he was just weeks away from publishing a book called The Right Side of Forty: The Complete Guide to Happiness for Gay Men at Midlife and Beyond.

I had just turned 39. In 10 years, I didn’t want that to happen to me. So, a couple of weeks after the tobogganing party I went to see a psychiatrist at Sunnybrook Hospital. After quizzing me for 20 minutes about my symptoms — sleepless nights; self-hating, suicidal thoughts; lack of motivation; constant attempts to escape unhappiness by quitting jobs, ending relationships and changing cities — he diagnosed me with depression. Then the psychiatrist said the most hopeful words I’d been able to hear in a long time: “If you get the help you need, you will be amazed at how happy you can feel and how much more you can accomplish.”

Ever since I started “coming out” with depression I’ve been wondering what makes gay men more prone to experiencing it than straight men. I talked to a few therapists who see gay patients and, according to them, there’s one issue that keeps coming up: self-esteem. “That’s a huge issue for gay men that can lead to depression and anxiety,” says Scott Duggan, a gay psychologist in Toronto who has been counselling patients for 10 years. “Many gay men feel ‘less than’ because of societal expectations and norms, and that can cause internalized homophobia,” he says. “They feel like they somehow failed, even though they didn’t.”

Being gay means resisting the traditional heterosexual expectations of life, and some guys have a harder time doing it than others.

Since my trip to Sunnybrook, I’ve started seeing a therapist. So far I don’t feel like my “issue” is self-esteem. Then again, Duggan says most other guys don’t realize it at first, either. A friend of mine said he started going to see a therapist a few years ago because he wanted to unpack his relationship with his mother. But over the next few months, he discovered his real problem was a feeling of low self-worth. This kind of anecdote is not surprising to Phillip Banks, a guy I met recently who works as a manager at the AIDS Committee of Simcoe County. Banks believes that many gay men suffer from “minority stress,” meaning that — as outsiders — we often feel the effects of social exclusion more than others.

“A lifetime of homophobia and heterosexism can be deep and hard to address,” he says. There’s no shortage of gay men looking for help. Banks points to a recent survey of nearly 8,000 gay men across Canada in which half of all respondents said they had sought out psychological services. Depression was stated as the most common reason. Currently, Banks is developing a program to address gay men’s mental health issues in Barrie.

There’s already a lot of free short-term counselling available for gay men in Toronto. The problem is finding it. “For sure you can find resources,” confirms Marco Posadas, a psychotherapist with the AIDS Committee of Toronto, “but you have to know the system.” Guess where you’ll find Posadas? The bathhouse. He’s in charge of a roving counselling service in the city’s spas called TowelTalk. There, he meets guys and, if they want to continue talking beyond the baths, he invites them into his office at ACT for up to eight free sessions (whether they’re HIV-positive or not).

Realistically, though, Posadas says it takes longer than that to get at the root causes of mental health problems. “There’s no such thing as a quick fix,” he says.

The good news is, therapy can work — and Posadas speaks from experience as a patient. “One of the things I loved about my training is that I had to go through the analytic process myself. It made a huge difference in my own personal journey.” Then he laughs. “My family is very happy about it, too!”

Of course, gay men are just as complex as every other type of human. So the issues I need to overcome to help with my own depression might have very little to do with my homosexuality, or my self-esteem for that matter. I might have a chemical imbalance in my brain that I need to fix with medication, too. But everyone I interviewed said it’s important for therapists to consider what happens to us as a result of living in a heterocentric (and for some, homophobic) world. Which, by the way, doesn’t mean your therapist needs to be gay. “The best therapist is one who will listen,” says Posadas. “That’s way more important than the sexual orientation of a therapist.”

The therapist I picked is a heterosexual woman my psychiatrist recommended. So far, I’m finding her to be thoughtful and conscientious. I’m already feeling better, but she’s not the reason. I think it’s because, for the first time ever, I’m identifying and tackling my mental health problem.

Where you can get help in Toronto:

Private therapy can cost as much as $200 per session, but there is also plenty of free counselling available for Toronto’s queer community. Here are some of the options:

Family Service Toronto has an LGBT and HIV/AIDS counselling service. The HIV/AIDS service is free, while the LGBT option operates on a sliding scale; the lowest rate is $5 per session. Both services have a three- or four-month waiting list and offer up to 15 sessions of counselling for individuals, couples or families. To make an appointment, call 416-595-9618.

The 519 Community Centre has volunteer counsellors who will see patients up to six times each. After that, they’ll refer you to longer-term counselling or a group. The wait time for the first appointment is usually one to two months. To reserve a spot, call 416-392-6878 x4000.

The AIDS Committee of Toronto has the TowelTalk program, but if you’re not a bathhouse-goer you can still see a counsellor at the ACT office. Just check out the walk-in calendar on the ACT website or book an appointment by calling 416-340-2437. At ACT, counselling is seen as a form of HIV prevention, so you don’t need to be HIV-positive to get help.

Mount Sinai Hospital has a clinic for HIV-related concerns, for couples and individuals who are affected or infected by HIV. In most cases, patients must be referred by a family doctor. The wait time for a psychiatric assessment is about one month. Treatment usually begins a few weeks or months after that. For more information, call 416-586-4800 x 8714.

Where you can get help in Ottawa:

If you’re looking for affordable counselling services in Ottawa, just head to Cooper Street. There are two community organizations there that can help you.

The Centretown Community Health Centre, at 420 Cooper St, offers up to 20 free sessions with an LGBT-friendly mental health counsellor. To apply, just call 613-233-4443 x 2109. The current wait time for a counsellor is about one month. In case of emergency, the agency also has a walk-in counselling service every weekday from 1 to 4pm. Ottawa’s other community health centres, located across the city, offer counselling programs, too.

Pink Triangle Services, at 331 Cooper St, also offers up to eight sessions of counselling. Clients are charged according to their ability to pay, but the sliding scale doesn’t exceed $95 per session. To sign up for counselling at PTS, call 613-563-4818 or e-mail celebrating.self@ptsottawa.org.