Tip #111: Putting The Men In Mental Health

Before I begin this piece, I should disclose that as I am a woman, I have limited personal experience of what it is like to be a man who has anxiety. Therefore, I have based this piece on my own research into statistics as well as anecdotes, stories and interviews from the men in my life and beyond.

Since beginning my anxiety journey, I have heard many stories from many different people from many different backgrounds about their own experiences.

But when reflecting on the conversations I have had over the past two years, I have come to realise that there is something very important missing. I realise that almost everyone I have spoken to about mental health issues have been women.

Now, this was strange as I have many amazing men in my life; friends, relatives, co-workers, fellow students. But maybe only three or four out of the hundreds of people I have spoken to about anxiety has been a man.

I spent a lot of time wondering why this was. Could it really be the case that women are that much more likely to have anxiety than men? Could it be that mental health was a problem for one sex or gender and not another? Could it be that men were so much less prone to mental health issues than women?

After a considerable amount of research, the answer to all those questions buzzing around my brain turned out to be:

No. 

A friend challenged me on this conclusion for two reasons; firstly they said that there are more women who are diagnosed with a common mental health issue than men, and secondly, twice as many women in England have been diagnosed with anxiety than men.

In fact, within the age demographics of 16-40, men and women have fairly even rates of the four most common mental health issues, but as women often outlive their male partners, they are more prone to depression and anxiety in their older age, which can skew the statistics slightly.

Furthermore this picture didn’t quite square with the other horrifying statistics that I had found; that 76% of suicide victims are men, one in ten men reported experiencing severe and debilitating stress at work, and the majority of people who engage is some form of self-harm are men.

If it’s true that men are less likely to have a common mental health issue such as anxiety or depression, then why were so many men engaging in the most extreme manifestations of bad mental health? Even going so far as to take their own life?

But then I realised the keyword in all of this:

Diagnosed.

The conclusions found in the statistics my friend gave me are true, if you look at diagnosed patients. But given the rest of the evidence, it is highly likely that men appear to have lower instances of anxiety because they are less likely to talk about it openly.

I needed to begin asking a new set of questions: Is it the case that men are less likely to report mental health problems than women? Is it true that men are less likely to seek help with their mental health than women?

The answer to all these questions was:

Yes.

In fact, I found that only 36% of referrals to therapy comprised of men, significantly more men than women had not disclosed their mental health issue to a friend or relative, and significantly more men than women had not reported the last mental health issue they experienced to a doctor.

These statistics taken together painted a very tragic picture. That although men were almost just as likely to suffer from a mental health issue, they are far, far less likely to talk about it and seek help.

Now, there is pretty conclusive evidence that women are more prone to mental health issues, and I’m not an expert. What I’m disputing is the reason why the gap is as high as it is, and I do believe it’s largely due to underreporting.

This is something many of us can likely relate to; the fear of vocalising what you’re going through. You worry how people will react. You worry people will think you’re crazy. You worry people will think you’re weak.

There is already still such a stigma around mental health, but for men, I fear the problem is often even more complex, and certainly worse.

I wanted to know why the situation is the way it is, so spoke to some of my male friends about why they believed this was the case.

The responses I got were universal in their reasoning. Every guy I spoke to said almost exactly the same thing:

“Men are taught to be brave. Men are taught to be strong. Men are taught to be unemotional. Men are taught not to ask for help.”

“Speaking about your emotions meant being seen as weak, pathetic, unmanly.”

So many of the people I spoke to said that in the past if they had expressed sadness, they were told to man up and get over it.

Men aren’t allowed the space to express thier emotions, which means that they get bottled up. Bottled up to the extent that they can manifest themselves as a mental illness, as they have been suppressed without being dealt with or released for so long.

The pressure on men to always be strong, sturdy, never vulnerable, never needing help, can have debilitating or deadly consequences.

This is why is it so vital for all of us to do our part to smash the stigma surrounding men and mental health.

To help me with this, two of the most wonderfully brave men I know were willing to share their experiences and advice with me and with all of you, for which I am incredibly grateful.

The Early Begining

“When I was around thirteen or fourteen, I developed an overwhelming sensation of discomfort around my peers. It came with strong physical stimuli like my skin crawling and my blood turning to acid. The pain of having a burst appendix, which should have been debilitating to the point I shouldn’t have been able to walk was less in comparison. Not to suggest that I was strong, but to relate how inhibiting and painful the sense of anxiety could be. 

Because of this, I primarily isolated myself throughout my teen years. Throughout the day I’d attempt to act as normally as possible, but upon coming home I would usually be weeping, I’d lock my door, and disappear into the worlds provided by books and televisions. Utterly losing my sense of self in the process. Gaining a sense of numbness, as if I didn’t exist which felt absolutely liberating.

Of course, not dealing with these problems made things worse. It felt like there was a well of depression coursing through my body, draining me of energy and pushing out against my skull, I wasn’t able to develop or grow.

Over time, these sensations decreased in strength and in regularity, until I could function as a normal-ish person. However, these experiences have had a strong impact on me. I’ve been fearful of experiencing any form of intense emotion because it may have similar effects to what I have experienced before, although I’m trying to open myself up to intimacy, I’m afraid that I might be fundamentally malformed in a way that I don’t fully understand, and that this makes it difficult for me to have strong friendships or relationships which I have avoided in the past.

To my surprise, most of the people around me had no clue of how badly I was suffering despite daily contact, mostly just being seen as a quiet kid in class. Even my own sister didn’t realise the extent to which I was being affected. If there is a message to this, it’s that people can go through periods of time where they need help and support from others. Unfortunately, such people are also the least able to accept it and are often very reticent. If possible, please do drag these people out kicking and screaming. In the long-run, they will benefit from it hugely and be saved years of pain. Moreover, the amount of gratitude you gain in return is overwhelming. I had a friend with similar experiences who was helped by a classmate. He now considers him as a brother and has said with utter sincerity that he would die for him. Although this is in no way the goal, helping people reach their potential when they are at their nadir is both hugely rewarding and can have a great return in a loyal friend.

For those who are suffering, seek help, my own problems would have certainly been resolved far more quickly if I was able to see a therapist. Whilst the support of friends and family is hugely beneficial, in the end, even if it doesn’t feel like it we can take control of our own lives. The information you need is out there, even if you don’t have the social structure to support you, or the money for therapy, there are a huge amount of free or cheap resources which can be accessed. I personally found the books Mindset (Carol Dweck) and the Power of Habit (Charles Duhigg) particularly useful. If you don’t have a particular place you to start, maybe try starting there.”

On Seeking Help

“I have always been quiet, reserved and not very confident but I only realised that I could see a better version of myself when I was made aware of the similar issues a friend was having and that he had sought help.

I would always accept just being average and not speaking out of line to people. Quite often I appeared rude however there was just this crippling fear rendering me unable to not just talk to people, sometimes friends, but also attend classes or see friends and just have a general lack of motivation. I find it very difficult to approach someone or speak to someone for the first time but I appear to be ok chatting after the initial opening.

After I sought help, I was encouraged to just try and speak to people more often. It was very valuable to know that someone else I knew was experiencing similar troubles and despite initially feeling worse after realising what I was facing, I think that talking to friends and professionals has helped me start to lose some of the anxiety. One major problem is that many feel as though no one else experiences these emotions, some are worse than others but by talking to people I have started to improve with the occasional slump.”

Although these are just two of the many stories that must exist out there, I hope that they make any men who are out there reading this, feeling like they are going through it alone, realise that it does not make you weak to have a mental health issue. It does not make you weak to seek help.

In fact, I would argue that taking the steps to get yourself better, speaking out and standing up and breaking the stigma is a phenomenally brave and hard thing to do.

Obviously, there isn’t a general ‘men’ experience of mental health. For different groups there will be different pressures, different problems, different cultural attitudes, different circumstances, different triggers. However, what seems to be a common theme to all demographics is the idea of an archetypal male; being a constant strong presence and the socialisation to repress emotions.

This can be particularly problematic when dealing with anxiety; the mental illness most associated with fear. Men are told they must be brave and fearless, so admitting you are experiencing a constant terror at even the smallest of things can seem too difficult.

So, how can we be good mental health allies to our fathers, brothers, male friends and co-workers?

The first thing we can do is really and truly ask them how they are doing. Not just a quick “how are you” or an assumption that they are okay; really ask them how things are.

The second thing we can do is to change the way we view the men in our lives, and the way we speak about them. We should allow them the space to express their emotions, and not judge them when they do. We should stop using phrases like ‘man up’ or expecting them to always be okay or to always be strong.

The third thing we can do is to be fully supportive to anyone who speaks out about their experiences with mental health; man, woman, somewhere in between or neither.

Together, if we are always kind and compassionate, we can break the stigma.

Together, we can put the men back in mental health.

As a side note, I am planning to run a series of posts on this topic, so if anyone out there has any experiences with this, please do get in touch either in the comments or anonymously via the contact section of my website.

Love as always,

Ruth

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