Intro: Duly Noted, a Health and Care Podcast is the
official podcast series of Duly Health and Care. Each podcast features
physicians or team members discussing groundbreaking topics and innovations
that help listeners reimagine and better understand an extraordinary health and
care experience.

Joey Wahler (Host): In honor of Men's Health Month in
June, we're continuing our conversation about men's health. So we're discussing
the importance of men discussing their mental wellbeing and getting the right
treatment for it. Our guest, Dr. Steven Prinz, he's a Psychiatrist and Department
Chair of Behavioral and MentalH ealth for Duly Health and Care. This is Duly
Noted, a Health and Care podcast. Thanks for listening. I'm Joey Wahler. Hi,
Dr. Prinz. Thanks for joining us.

Steven Prinz, MD: Hi Joey. Good to be here. Thanks for
having me.

Host: Sure. Great to have you. So first, a Cleveland
Clinic survey says just over half of men say their health isn't something they
talk about. Now, from a mental health perspective, from your own experience,
why do you suppose that is?

Steven Prinz, MD: I think we have to take a look at
several different factors, and one is really to take a look at traditional
views in our society about men and masculinity. And so men, for instance, are
supposed to be strong, should be self-reliant, do not need to seek out healthcare
or care in general.

We also need to take a look at that men, because of this, will
often seek out healthcare when it's actually very extreme, when they have
severe symptoms. So they don't go for preventative kind of care. And then men
are often feeling very vulnerable when they go for a physical exam. So, you
know, a typical physical exam for a male adult involves having a rectal exam,
involves having a hernia exam where their private parts are touched, and men
feel very uncomfortable and vulnerable in this regard. So they often will not
seek out care.

Host: Gotcha. So in recent years, it seems to me whether
it's because of social media or whatever else may be at work, there is more
conversation publicly about mental health, the importance of talking about your
own, of seeking out treatment for it, if needed. Maybe even just talking to
someone that's not a professional to let someone know how you're feeling. Do
you think that's getting better in society recently?

Steven Prinz, MD: I really do. I think that our culture
is changing, even though there's still tremendous stigma about mental health,
both for men and women, more for men than women. But, I do think it's changing
in a positive direction, which is very good. I think, there's differences which
we'll talk about in a little bit between men and women with mental health
issues. And because of that, sometimes like depression may present differently
for a man where they're more fatigued, more irritable, and that doesn't look
like depression, what we think of typical depression. And so, that somewhat
prevents men from getting mental health as well.

I still think that it's improving, like you said, but there's
still the stigma. There's still social norms that say men should be strong and
not talk about the issues as much. They downplay symptoms more than women would
do. And you know, the, just these different triggers in our society for men
versus women. Men often again, responding to more social expectations, gender
role ideas. I was doing some research. I mean, I, love this statement. And it
says, men who understand that there's no shame in improving their health and
have the mindset that the real shame is having a need for mental health, having
access and choosing to not engage in getting help. We must recognize the
importance of positive mental health. So really, mental health is so much more
available. Still the stigma, but absolutely getting better. What helps a lot is
when we have men that have high profiles, that publicly announce that they had depression
or, that they're out there getting mental health and so for instance, like
having a Michael Phelps, say that he had mental health issues and it's okay to
seek out treatment. That really helps men in our society seek out care.

Host: And actually it so happens, that just before
beginning our conversation, I was reading a story that broke in the news about
Nick Curios, one of the top men's tennis players in the world, mentioning in an
interview that back in 2019 when he lost at Wimbledon, he was so distraught
that he considered suicide before eventually seeking out treatment. So to your
point, it can happen to anyone. So having said all the above, how important to
men's health and wellbeing is just normalizing that conversation, having men be
more comfortable with sharing those feelings?

Steven Prinz, MD: Yeah, it's so important. If we could
normalize that it's acceptable to get physical exams, and part of the physical
exam is to be screened for mental health, right? So, so many men, if they're
going to get mental health, it's actually a few factors. One is that we often
see family members pushing men to get health. Here's where women are smarter
and stronger than men. They seek out care more readily, but we also know that a
strong woman in someone's life, whether that be a mother or a sister, a wife,
often will push the important men in their life to seek out care.

And the more that that happens, it's going to be wonderful.
That will normalize mental health, care. I also think training. Like our
primary care physicians, which they do a very nice job, but they have some
screening tools, some simple screening tools that assess for mental health and
that's becoming more routine and part of physical exams and that will lead to a
man getting further mental health care that they so deserve. And just as you
said, I mean, just you reading that article. It's so interesting when we have
really public figures expressing different components of illness. I remember
when Ronald Reagan was giving a speech, a national speech, and he played around
with his little ear device in his ear, to be able to hear more effectively.

All of a sudden, the hearing business boomed in success because
it was acceptable. A man could say, I could get assessed for hearing loss, and,
and so I think we need to look at that as well. So it's very important. You
mentioned something really important too. Suicide is one of the leading causes
of death in young men.

And if we could get young men screened routinely for physical
health issues, and then we could screen them for mental health issues, we're
going to really help with mental health greatly. We know that the quicker we
could get mental health treatment, the better the prognosis. And so very
important to normalize this.

Host: So let me pick up on what you just mentioned
there, mental health screenings. I think it's safe to say, Doctor, that when we
think of health screenings nowadays, we still think more of mainly the
physical, not the mental. Yes? So when should that be done? How often and what does
that entail? If someone is getting a mental health screening, what's going to
happen?

Steven Prinz, MD: Yeah, so mental health screenings
really should occur at every visit to a primary care physician. So,
pediatricians should be screening, primary care docs should be screening. And
there's again, some tools right now that are really very simple. There's
primary care docs use something called a PHQ 2 or 3, which asks just some basic
questions about depression.

And if someone has an elevated score, then they should be
referred to a mental health specialist. I think families need to talk about
this more frequently, and do just check-ins with their family members and
children and anyone is noticing any significant change in sleep patterns and
energy patterns and grades dropping and difficulty with concentration, all of a
sudden withdrawing and isolating more from family and friends; these are
concerns that say, Hey, maybe we should screen a little bit more thoroughly.

Whether that's through a primary care physician initially, and
then refer to a behavioral health specialist. Duly has a behavioral health
specialty team. The majority of referrals really come through our primary care
docs. I would encourage anyone in the Duly system or outside the Duly system, talk
to ministry people, talk to teachers who are trained now more in mental health.
Talk to your doctor. We'll give out some numbers. There's some services that
are available that someone could call and seek out some assistance to get
referrals in your local community.

So it should be screened routinely, at least on physical exams
and talked about in schools and church and with family.

Host: So we've touched on the difference between men and
women with regard to all this, but to follow up on that, can men and women have
different symptoms for the same mental illness? And in a nutshell, how do we
distinguish between the two?

Steven Prinz, MD: Yeah, men and women absolutely could
have different symptoms and so I think one thing to look at is that sometimes
like the symptoms of depression or anxiety in a man is masked by unhealthy
coping behavior. So men, for instance, when they get depressed, they'll go into
some escapist behavior such as spending a great deal of time at work. So they
may work more hours or engage more heavily in sports, which sometimes is a good
thing cause you release endorphins. But these kind of things could be a sign of
depression, you know, sort of the isolation and withdrawal that may be socially
a little bit more accepted.

Men often will have more physical kinds of symptoms like
headaches or upset stomach, pain. And then men often will abuse substances more
often than women. So if you see like an increase in alcohol or drug use, that's
often a sign of mental health concerns for men more than women. Men express
anger more easily, and may express aggressive kinds of behavior, which are
often inappropriate, anger more frequently than women. Men engage in more risky
behavior, such as, reckless driving, more so than women. And, men will have often
changes, some physical changes more than women, like changes in appetite,
feeling more restless, having more difficulty with concentrating.

Now, those could occur in women as well, but those are more
characteristic of men. The typical signs of depression that we think about,
which could occur with men and women is the sadness, feelings that hopeless,
helpless kind of sense, feeling empty, not getting pleasure from activities.
That could occur in men and women, but those factors I mentioned, are more characteristic
of men.

Host: So you've touched on some of those factors that
make men at risk for mental health issues. In summary here, what are some tips
you have, whether it be for handling stress or otherwise, things men can do
tangibly on their own to try to manage whatever may be causing mental strife?

Steven Prinz, MD: We all need to take a look at how
could we reduce stress in our life, how do we manage this life work balance
better and take care of ourselves. So we say take some time for yourself to
carve out specific time. Could be listening to music, doing mindfulness
activities, meditating, getting a massage. Sometimes that touch, and the
pressure into the muscles could be wonderful release of stress. Eating balanced
meals, eating healthier snacks. We know there's a brain gut connection and what
we take in could help us feel better, limiting substances like alcohol or even
caffeine. Sometimes both those substances could interfere with feeling well.
Make sure we're getting enough sleep. The body, especially when it's stressed
needs more sleep. I sound like a, a, PCP, but exercise daily. Exercising
releases endorphins. Endorphins are these natural like opioid feel good
substances in our brain that help. Taking deep breaths, getting more oxygen
into our body. Sometimes just slowing down, counting to 10, before you would
react or respond to something. We know that when someone has a good sense of
humor or enjoys laughing, that releases endorphins too.

So, try and engage in some activities that give pleasure with
humor. Stay active, try and volunteer, look at your value system and do some
things within your values as far as volunteering. Sometimes we'll say keep a
journal, just to write down what your day's like, what stressed you. And that
could be helpful, as well. We know that if people have people, they function
better, so, trying to prevent that isolation. So, reach out to loved one, loved
one should stay in contact with someone. To get help, contact a minister or
spiritual leader, your doctor, consider joining a group or a men's group, could
be very helpful as far as preventing, depression. And then there's a whole
bunch of hotlines again. I mean, I, you know, if someone dials 988, it's a
suicide in crisis lifeline. So instead of 999, someone could dial 998 and talk
to someone. There's a disaster distressed hotline that's 1-800-985-5990.

And this line you could talk about different mental health
issues. If one's a veteran, there's a hotline, for mental health. It's
1-800-273-8255. There's a phenomenal organization called the National Alliance
of Mental Health, that's called NAMI, N A M I have tremendous resources for
mental health, and they're 800-950-6264.

And then there's even some, you know, sites. There's something
called Face It Foundation. Which, provides support resources for men with
depression. There's an organization called Heads Up Guys. It's an organization
that provides strategies to manage or prevent depression in men. So those are
just some help groups that could be very valuable for men.

Host: Well, great advice, pertinent information. Thanks
so much for those valuable phone numbers as well. Folks, we trust you are now
more familiar with discussing and treating men's mental health. Dr. Steven
Prinz, I feel less stressed already. Thanks so much again.

Steven Prinz, MD: Thank you Joey. Great to be here with
you guys.

Host: And again, great to have you with us. Now for more
information, please do visit dulyhealthandcare.com. As Dr. Prinz mentioned,
they've got a great mental health team there to help you. Again, it's
dulyhealthandcare.com. If you found this podcast helpful, please share it on
your social media, and thanks again for listening to Duly Noted, a Health and
Care podcast. Hoping your health is good health. I'm Joey Wahler.