Why is it that men are left out of the mental health discussion? Is it stigma or masculine pride? Maybe we’ve just overlooked the need? Even though women are diagnosed with depression and depressive disorders more than two times as often as men, men are more than FOUR times as likely to die by suicide!
Men are also two to three times more likely to misuse substances often as a means of self-medicating. This is a serious issue that needs to be addressed. To do that we need to understand how signs of depression in men may differ from that of women.
As women in these men’s lives, we also need to understand how depression and mental health issues not only affect men but the way they display symptoms. When we see anger or lashing out, we may just think, “God, he’s being such a jerk!” when really he is anxious or depressed. Not wanting to give in to those feelings, men will often go in the opposite direction (the ones that tend to be more masculine).
We, as women, need to recognize those signs as a cry for help. We need to understand that they aren’t going to be curling up on the couch with us and a pint of Ben & Jerry’s to discuss their feelings. Men are usually much more direct and practical, focused on fixing the situation not talking it through.
Instead of doing the same old thing (that doesn’t seem to be working), let them know that you’ve noticed a change, let them know that you are there, but don’t try to fix them. If they lash out, don’t respond by escalating the issue. Give them the time and space to work things out. Point them in the direction of help or possibly enlist a best friend for a guys night.
Being educated on the way men display signs of depression is a good starting point so we know not only that the men in our lives may be acting differently for reasons we didn’t think about, but so we can also be supportive of the situation.
Depression Doesn’t Look the Way We Might Think It Does
Though the statistics show that men consult with doctors and seek help for depression less than women, that doesn’t necessarily mean that men have better health than women. In fact, it has been suggested that we need different parameters to diagnose men with depression as it displays differently in men than in women. Where women are more likely to outwardly express feelings, men don’t tend to dive into their “feels” to discuss what might be going on with their lives.
Men tend to display signs of depression with actions or physical symptoms rather than what we consider to be the norm. They may not openly express feelings of sadness or despair. Men tend to lash out or appear angry or irritable. They may develop headaches or body pain, a tightening chest or racing heart, even digestive issues.
One of the major issues with depression in men is that they may not even realize that they are depressed. They may pass off any symptoms of depression because “men don’t get depressed”. Men are much more likely to go the doctor over the physical symptoms rather than any mental ones.
Educating not only men but physicians and family members on signs and symptoms that men experience is essential in recognizing depression and opening that dialog. Part of that is the stigma surrounding men and mental health. Men going undiagnosed is a big enough problem but, as a state, Washington needs to do better as well. As of 2014, Washington state has an average of 9.1 inpatient psychiatric beds per 100,000 people, which ranks Washington 46 out of 50 states for the capacity of inpatient beds.
Stigma Prevents Men from Receiving Help
Part of the issue that surrounds men getting appropriate care is the stigma that surrounds it. Some people view depression as a sign of weakness. Stigmas can imply character flaws or make men feel like their not worthy. Things like:
Not being able to “keep it together”
Not being able to provide for the family
Not being a “Man”
Men don’t want to appear weak or like they aren’t capable of taking care of their families. They don’t want to be the “pansy” that is showing and talking about his feelings.
Often even when they are in treatment, either because they were dragged in by family, attending couples therapy, or they finally just hit rock bottom, it is still treated as a deep, dark secret. They feel the need to sneak around so no one finds out. The constant fear of being “less than”.
This can be especially true for men that are involved in careers that have a high tendency for PTSD rates. Policemen, firefighters, military. These men often see and endure things that:
1) They don’t or can’t burden their families with what they saw, smelled, heard, or
2) They are uncomfortable talking with anyone about it because then they have to remember it.
For example, an EMT friend of mine had a 6-month-old baby die in his arms after being pulled out of a fire with the mom standing right there. That’s something you carry with you for a long time and is very hard to talk about.
“Exposure (direct or indirect) to death, grief, injury, pain, or loss, as well as direct exposure to threats to personal safety, long hours of work, frequent shifts and longer shift hours, poor sleep, physical hardships, and other negative experiences, can negatively impact their mental health. Leading to higher rates of stress, exhaustion, and substance use.”
This is especially unnerving because of the high rates of suicides in our military, EMS, Police officers, firefighters, first responders and other professions where mental fatigue often leads to PTSD.
There are all kinds of stigmas that surround men and mental health and these days you hear “toxic masculinity” as it applies to men’s behavior towards women. But what about how it applies to men’s behavior towards themselves?
The inability to seek help, the bro culture that ridicules men when they speak about their feelings, the constant pressure to succeed. These things can be emotionally crippling.
For example, Shawn from Seattle had issues surrounding his mental health and he had trouble talking about it with some of his guy friends. They acted “grossed out” or uninterested and it made him question his masculinity. Shawn said:
“I enjoy things and experience emotions that are described in society as feminine, but they’re big parts of my personality,” he continues. “If I suppress those things, does that make me more of a man?”
When we look at the rates of depression and suicide in men and women, especially those in careers seen as more “masculine” you can find your answer. There are too many men that aren’t seeking the help that they need. When the reason for not seeking help is because it isn’t “manly” is when it becomes toxic behavior.
We need a new way of approaching men’s mental health. And, here’s the kicker, it shouldn’t look like support for women’s mental health. The mistake often made in our culture is that to be more emotionally healthy men should talk about their feelings like women.
But most men aren’t raised that way and aren’t comfortable with that kind of touchy-feely disclosure. Talking about things can help for sure, but rather than sitting around in a circle, many men often find benefit in going for hikes, going hunting, or going camping with a similar group of guys.
For those whose faith is a big part of their lives, Bible study and prayer groups often serve as a strong support function. For the less religious, it might be a dad’s leadership group, or a bunch of guys getting together to play basketball and then staying to talk about life.
The Silent Crisis
For the most part, men’s depression and mental health, along with the consequences, have been a silent crisis. Today we see our suicide rates are 75% men even though they are less frequently seeking out mental health services. Suicide rates in Washington State are even worse than the national average. We see an average of 12.58-14.23 deaths per 100,000 compared with other states that are as low as 6.19-11.40 per 100,000.
People are just now starting to realize that men need more options and more help when resolving their mental health issues. We need to work on making it okay to discuss mental health. A study done in Canada showed that 28% of men believe that they will lose their jobs if they discuss their mental health at work! Now that’s toxic.
That is almost a third of all men, and that’s not OK. We need to do something about it... Everyone should be okay talking about their mental health and other concerns.
‘And the numbers don’t end there… The same study showed that more than 33% worried about being passed over for a promotion if they mentioned a mental health disorder and 42% felt like coworkers would make negative comments behind their back.
Just recently, Andrew Luck, a quarterback for the Indianapolis Colts, made a decision to resign due to mental health. He was booed off the field by fans. This was a man that had been revered by many, who had fame and money, that had a “manly” job.
Fortunately for Luck, he has a big support system and he had a team that stood behind him. The average man doesn’t have access to that kind of support system and, when they see actions like that, it makes them even less likely to tell anyone about their problems.
We need to start with ourselves and shut down negative talk about men having mental health issues. We need to open the dialogue and really listen to what these men need in the forms of help and support. They may not want to talk about feeling but maybe would love to come over to play Halo or watch the game. We can’t make the discussion about what WE think men’s mental health should be, we need to let them lead the way.
Speaking Out and Changing the Dialogue
We have to start speaking out and include men in this dialogue about mental health, depression, and suicide. It can’t be a silent epidemic anymore and men shouldn’t have to suffer quietly to make others feel more comfortable.
We need to educate our communities on the dangers of leaving mental health untreated. We need to educate communities, men especially, about the signs and symptoms that men display when they are experiencing mental health issues so that they know when they need to seek help, and families and friends know when to push someone towards help.
We need to let men know that they are not alone. They don’t have to talk or cry on your shoulder, but let them know that we’re there. Be that friend they can come to when they are in a tight spot. Men tend toward isolation when feeling depressed and this can be especially dangerous for young, single men.
There are programs like Bring Change 2 Mind, in partnership with Brandon Marshall’s Project 375 that uses inspirational male figures to start raising awareness about the unique challenges that men face. More and more athletes have recently come out to speak about their mental health and that is helping to change the way we look at men with mental illnesses.
Ending the Stigma - What Can Families Do to Help?
The most important thing families can do is be there. You’re not a therapist and it’s not your job to diagnose him and tell him he has a problem. This could actually have the opposite effect that you want and push him further away. However, friends and family are the ones that know these men best.
Opening that dialogue can be hard, but, often, it’s even harder for the man in your life to admit he might need help. Bring up some differences in behavior or mood that you’ve noticed and encourage them to find someone to talk to whether that is you, a best friend, a battle buddy, or a therapist.
Having that network and knowing that they have support is a very important first step. You also have to be receptive to what they are telling you. Let them know that you’re not there to judge. They could be having issues over any number of things and it might be embarrassing for them. Additional judgment is the last thing that they need.
Help point them towards resources where they can learn more about depression and how it affects men. There are many government sites that can point them in the right direction such as, https://www.nimh.nih.gov/health/topics/men-and-mental-health/index.shtml.
And lastly, encourage them to seek out the help of a professional if nothing else just to get a better idea of what he is going through. If he doesn’t have a family doctor that can provide a referral (if needed), help him find a local clinic that will work with him.