Why more men than women take their own lives

Dear Doc

Is it true that men have higher suicide rates than women?

Dear reader,
While suicide rates vary between different groups of people, it is true that more males die from suicide than females. The World Health Organization puts the ratio at two males to one female dying from suicide, though these ratios vary from place to place.

In Kenya, men are three to four times more likely to die from suicide than women. The rate of suicide in men rises with advancing age, with a sharp rise in men over the age of 85 years possibly due to social isolation, loneliness, significant losses and chronic illness.

There are several reasons for this. For starters, most men are uncomfortable talking about their emotions, largely due to a cultural expectation for men to tough it out and deal with their emotions in private.

Men are also more likely to downplay symptoms and seek help early (or at all), and are therefore likely to end up experiencing severe symptoms. In addition, while depression affects both men and women, some of the symptoms in men may be different, leading to a lack of or delay in diagnosis.

Men experience symptoms of depression like low mood, sadness, low energy, hopelessness, changes in sleep and appetite, and lack of pleasure in activities previously enjoyed.

However, these symptoms may be masked by “externalising behaviours” like challenges getting along with others, social isolation, spending too much time on work or sports, irritability, anger, aggression, substance abuse, risky behaviour and unexplained physical symptoms.

Although women attempt suicide more than men, men are more likely to die from suicide because they tend to use more violent means of self-harm, are more likely to act on the spur of the moment and tend to have fewer warning signs. Also, men are more likely to take alcohol or other substances to cope, which increases suicide risk.

Depression can be treated with psychotherapy, or medication, or both. There are also brain stimulation treatments that may be used. Family and social support is vital for someone who has depression or someone who is thinking about suicide.

To support men, let them know you are there for them and they can freely express themselves. Look out for any mental health concerns, listen carefully and refer and support them to receive help.

Dear doctor,

I need your help! My wife has lost interest in sexual intercourse since she got a baby five months ago. Is there something I can do?
 

Toby

Dear Toby,

It is rare that partners have identical sexual drives, and everyone experiences ups and downs in the desire for sex over time. Many women have reduced sex drive during pregnancy and breastfeeding, with 40 to 83 per cent of women reporting one form of sexual dysfunction or other after giving birth. The possible contributors to the reduced sex drive are:

• Hormonal changes, specifically release of oxytocin (necessary for breastfeeding) and lowered androgens reduces desire for sex
• Discomfort and pain during sex due to reduced vaginal lubrication as a result of lower oestrogen levels and increased prolactin (necessary for breastfeeding)
• Reduced levels of sexual excitement and satisfaction, possibly also due to hormonal changes
• Change in routine, fatigue and sleep deprivation from caring for the baby
• Changes in body/self-image
• Fear of another pregnancy
• Relationship concerns
• Psychological concerns such as stress, anxiety, depression, including post-partum depression

To support your wife, it is best to have a conversation with her, focusing on what her experience and concerns are and addressing them. Having adequate help can reduce the fatigue and sleep deprivation.

There are personal lubricants readily available in pharmacies that can be used to address the concern of discomfort and pain due to reduced lubrication.

If there are any significant psychological concerns, then support from a mental health professional would be beneficial. It is also advisable for both of you to be reviewed by a gynaecologist in case the symptoms are causing significant distress.

Dear doctor,

I was diagnosed with scabies three days ago and I still cannot believe it. Isn’t it a disease that affects only dirty people?

Sophie

Dear Sophie,

Scabies is a skin disease that is caused by the human itch mite. It’s a small bug that burrows into the skin, producing thin lines, and it feeds and lays eggs there.

The skin reacts to the bug, causing an itchy rash. It may cause formation of scaly patches or thick crusts. Excessive scratching can cause wounds, which can get a secondary bacterial infection.

The mite can easily spread from person to person or through furniture, shared beddings or clothes. It can affect anyone, regardless of how clean they are.

Scabies is diagnosed from physical examination of the affected area and also from skin scrapings that may have the mite or the eggs. There are different medications that may be applied on the skin to treat scabies. Follow the instructions given on how to apply the medication.

Oral medication may be added to the treatment including anti-scabies tablets, medication to relieve the itching and antibiotics in case of additional bacterial infection.

Because the mite is very contagious, it is advisable for all exposed persons to be treated, even if they don’t have symptoms, but the mite does not spread to animals. 

In addition, clothes, beddings, furniture and carpets need to be thoroughly cleaned. Clothes, beddings and towels should be cleaned in hot water and properly dried. Another option is to place clothing and beddings in an air-tight plastic bag for a week and clean them thereafter.

Send your questions to [email protected]