Men Struggle with Mental Health in Silence


There are many biological and sociological gender differences between men and women, but some of the most primary distinctions include the prevalence, diagnosis, escalation and treatment of mental illnesses. Due to several millennia of male socialization and certain biological predispositions, many men around the world suffer from mental health difficulties in silence, leading to a host of other potential problems.

The Silent Crisis

There’s a tragic intersection of low rates of diagnosed depression and high rates of suicide and substance abuse among the U.S. male population. Men account for 75 percent of all suicide victims in the U.S., with one man taking his own life every 20 minutes.[1] Around the world, men are 3 – 7.5 times more likely than women to take their own lives.[2]

Infographic describing that three out of four U.S. suicide victims are men.

Researchers have come up with some theories for this.

Men are struggling to fill the breadwinner role:

Traditional societal norms position men to be the primary financial provider in the home. However, the decline in industries like manufacturing have left many men in certain regions unemployed, with women now as large a part of the national workforce as men.

Blurring of work and life:

So much of a man’s sense of self-worth is linked to how much money he earns. This, combined with advances in technology, has made it so some people never really escape the office. Over time, this can cause great stress and lead to depression.

Social media:

This is not only a problem that affects men, but it’s easy to feel as though others are doing better than we are because on social media we see everyone’s holiday celebrations, vacations and gourmet dinners. When a person feels something is lacking in his or her life, it could cause depression, as some research has shown.[3]

Some groups of men feel rejected:

There are very high rates of suicide among veterans and gay men. Some have attributed this to the fact that these groups of men may feel (whether it is real or not) rejected by society and mainstream media.

Because it’s impossible to know all of the factors that lead a person to attempt a suicide, it’s difficult to point to a common trend that would link them together and lead to prevention strategies. One study of the different rates of suicide among men and women focused on the different methods they use when attempting to take their own lives.

It has been well established that men are more likely to use suicide methods of high lethality, or methods with an increased risk of death. This is supported by the finding in a European study that 62 percent of males who attempt suicide use hanging or firearms, compared to 40 percent of women.[4]

While one could explain away the use of guns with men having more exposure to firearms, the same cannot be said about hanging. Some researchers have determined these suicide method tendencies indicate that compared with women, men who are at the point of suicidal thoughts are:[5]

  • More hopeless
  • More resigned to die
  • More likely to have a greater capacity to enact self-harm
  • More unconcerned with the consequences of their actions
  • More likely to be intoxicated
  • More willing to carry out actions that might leave them injured or disfigured

If these conclusions are correct, it would support the theory that men are less inclined to discuss difficulties in their lives than women. When difficulties with mental health are untreated, they only get worse, often leading people to abuse drugs and alcohol and eventually to suicide.

High Substance Abuse Prevalence Among Men

A series of infographics detailing the correlation between substance abuse, mental health and suicide.

Substance use disorders are three times more common among men than women. This has been historically accurate and may be reflective of the risk-taking tendencies caused by testosterone. Research has shown that substance use disorders are often accompanied by mental illness, and that alcohol and drug abuse are simply common yet flawed means of self-medication.

There is a strong correlation between substance abuse and suicide, which may partially explain why men commit suicide at far higher rates than women.[6]

While the common logic among substance abusers centers around using drugs or alcohol to drown out feelings of depression, alcohol has the opposite effect. Being intoxicated may actually increase the risk of suicide due to decreased inhibitions, and increased aggression and levels of depression.[7]

Unique Mental Health Difficulties for Each Gender

According to the World Health Organization, “gender differences in the rates of overall mental disorder, including rare disorders such as schizophrenia and bipolar disorders, are negligible. However, highly significant gender differences exist for depression, anxiety and somatic complaints that affect more than 20 percent of the population in established economies.”

The organization’s report, “Gender Disparities in Mental Health” highlights that global rates of depression are twice as high among women than men, and that gender stereotyping is a large reason for this disparity. Even when presenting the exact same symptoms, women are more likely to be diagnosed with depression and less likely to be diagnosed with a substance use disorder than men.[8]

“Many men quietly struggle with a mental health issue for long periods of time without any treatment.”

There are multiple influential factors at play. First, mental illness manifests itself differently in men than women. For example, depression in men often results in irritability, anger, hostility, risk taking and escaping behavior. However, depression in women is more commonly associated with sadness, crying, feelings of guilt and changes in appetite.[9] Another factor is the lack of willingness in men to seek treatment for any mental illnesses. This tendency frequently results in a situation in which many men quietly struggle with a mental health issue for long periods of time without any treatment. The longer the condition remains untreated, the more severe the problem potentially comes. This may help to explain the high rates of suicide among men.

Overcoming Gender Stereotypes

A mixture of gender and sex-based differences accounts for the different ways that men and women experience and respond to mental health difficulties. Before delving too deeply, it’s important to distinguish the difference between gender and sex. Gender relates to socially shaped behaviors and how we are expected to think and act as men or women. Sex refers to biologically determined characteristics.[10]

Biological factors inform sociological ones, just as sociological factors influence biological ones. This makes it difficult to determine what exactly causes men to act one way and women to act another, or in the case of this article, what causes men to be more or less predisposed to certain mental illnesses and why they choose to remain quiet about them.

Here are some of the common reasons why depression in men is undiagnosed so often:

  • Failure to recognize symptoms: Most people assume that feeling sad or emotional are the signs to look for when diagnosing depression. However, as discussed earlier, men and women experience depression differently.
  • Ignoring or minimizing symptoms and signs: Many men assume they will just get over whatever problems are plaguing them and downplay the impact they are having on their lives. When men are feeling depressed, many assume that the problem will go away on its own.
  • Reluctance to Talk About Problems: Men don’t generally discuss problems openly with close friends, so speaking to a mental health professional about them is even more unlikely.

A middle-aged male struggling with mental illness.

Through thousands of years of male socialization, certain definitions of what is and isn’t manly have been created. Rather than openly discuss problems, the more “manly” thing to do is “tough it out” on your own. This is something that is drilled into male psyches from birth. You can see these male depictions in literature, television, movies, advertisements and in sports. The athlete who “plays through the injury” is always considered tougher and stronger than the ones who aren’t able to do so. The term “man up” does not mean to go talk to people about your problems and ask for help.

Wanting to be like their male heroes and likely following the examples men in their lives set, boys are taught from an early age to suppress their emotions. By the time they become adults, many are unable to properly express any emotion other than anger.[11]

How to Solve the Problem

Given the extremely high rates of depression and substance abuse among men, it is clear that mental illness in the male population requires extra attention. More research into what would make men more likely to seek treatment for mental illnesses and other health issues is needed. However, perhaps the first step in the process involves changing the narrative about what it means to be a man.

“The stigma of asking for help must be eliminated.”

While it will take a considerable effort to undue several millennia of male socialization, boys need to have it impressed upon them that reaching out for help isn’t a sign of weakness. But this is difficult considering the myriad subliminal messages prevalent throughout our culture. How do we as a culture on one hand tell our sons that they should speak up and ask for help when the majority of the idealized fictional and real-life men in our culture are celebrated for not doing so? The stigma of asking for help must be eliminated.

Another step our society can take is to stop normalizing destructive behaviors in men by explaining it away as “boys being boys.” This age-old justification only serves to enable the behavior to continue.

The professionals at Unity Behavioral Health are committed to remaining at the forefront of addiction and mental health research. We are a comprehensive addiction recovery facility located in North Palm Beach, Fl. If you or someone you care for is struggling with addiction, mental illness or both, we encourage you to contact us at 561-708-5295 to learn more about our programs.

[1] https://www.psychologytoday.com/blog/talking-about-men/201702/mens-mental-health-silent-crisis
[2] Nock MK, Borges G, Bromet EJ, et al. Suicide and suicidal behavior. Epidemiol Rev 2008;30:133-154.
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183915/
[4] Varnik A, Kolves K, van der Feltz-Cornelis, et al. Suicide methods in Europe: A gender-specific analysis of countries participating in the “European Alliance Against Depression.” J Epidemiol Community Health 2008;62:545-551.
[5] http://www.bcmj.org/articles/silent-epidemic-male-suicide
[6] http://store.samhsa.gov/shin/content/SMA16-4935/SMA16-4935.pdf
[7] http://www.sciencedirect.com/science/article/pii/S0272735800000702
[8] http://www.who.int/mental_health/media/en/242.pdf
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4907547/
[10] https://sites.oxy.edu/clint/physio/article/Genderdifferencesinmentalhealth.pdf
[11] http://www.apa.org/monitor/jun05/helping.aspx