Understanding and supporting men’s mental health

One evening, Raj (name changed) , a 35-year-old IT professional, found himself inexplicably angry and frustrated after a minor disagreement with his colleague.

In fact, over the last many months he had been feeling much more irritable and overwhelmed.

He was working late nights, often numbing his feelings with alcohol, and felt increasingly disconnected from his family. Despite his outward success, Raj was struggling with an invisible adversary—depression and emotional turmoil that he was only faintly aware of.

Like many men, he was not even in touch with his deeper feelings of sadness, and hurt. When on occasion, he did become aware of these feelings, he suppressed and denied them. As with many men, to admit to his own sadness was to acknowledge a vulnerability that was unsettling and unfamiliar.

This denial of his own feelings only worsened his sense of emptiness, despair, and anger, alienated people around him prevented him from seeking the help that he needed, and tragically increased his risk of suicide

Raj is not alone in suffering from this vicious cycle of unexpressed sadness, anger, substance abuse, and isolation—a situation that obscures the reality of male depression

As a society, we are increasingly open about discussing anxiety, depression, and stress, which has helped many feel more comfortable talking about their mental well-being.

However, men’s mental health remains an overlooked area. In India, about 40% of men don’t openly discuss their mental health, due to stigma, misconceptions, including the mistaken belief that men should handle their emotions independently, and a mental health system that overlooks the symptoms of male depression.

Historically, social expectations have dictated that men embody strength, resilience, and emotional stoicism. There are also important biological differences in the way that men and women notice and process feelings. Hormonal influences, such as that of testosterone, also contribute to these different emotional responses in men.

Women are more likely to seek affiliation and emotional support when going through difficulties, whereas men are more likely to isolate themselves.

Current mental health diagnostic systems can easily miss depression in many men, who, rather than sadness, experience other symptoms such as physical pain, anger and numbness. These symptoms are well known to occur in affective disorders but are not necessary or sufficient for the diagnosis with current criteria.

Consequently, many men suffer in silence, become isolated, or resort to substance abuse, battling their internal struggles without the support they need. This explains the statistical paradox where research shows that women are diagnosed with depression twice as often as men, while the risk of death by suicide in men is far greater than women - more than 2.5 times the rate in women, according to a recent study.

Depression in men may manifest differently than in women. While classic symptoms such as sadness, loss of interest, and changes in sleep and appetite are common, men may also experience irritability, anger, substance abuse, and changes in libido. As men start suffering from depression, they often exhibit bouts of anger, irritability, and substance abuse. They may push people away and become less connected with loved ones.

When we think of depression, we often envision someone who is not working, staying at home, and lacking energy for daily tasks. However, many men cope by working more or distracting themselves with excessive work. In such cases, identifying a mental health issue is even more difficult as it often manifests as assertion, aggression, or competition. It is crucial to broaden awareness of these challenges and help men navigate both internal and systemic obstacles in seeking help.

If there’s a male figure in your life—brother, father, husband, boyfriend, partner—who is withdrawing from activities or excessively engaging in imbalanced activities, here are some ways to help:

* Encourage seeking professional help: If you notice signs of significant distress, encourage seeking professional help. Suggest therapy, counselling, or psychiatric support, and offer to assist in finding resources or accompany them if needed.

* Encourage open communication: Create a safe space for open and honest conversations. Encourage the expression of emotions without judgment. Engage in activities together that don’t feel confrontational, like going for a walk or having coffee.

* Stay connected: Maintain regular communication and check in on their well-being. Ensure a sense of connection to combat loneliness, which can exacerbate mental health issues. Recognise when to give them room to process their feelings and thoughts.

* Be mindful of stereotypes: Challenge traditional stereotypes associated with masculinity. Promote the idea that seeking help is a courageous and positive step toward better mental health.

* Educate yourself: Take the time to educate yourself about mental health issues, including common symptoms and available resources. This knowledge can help you better understand what your loved one might be experiencing and enable you to provide informed support.

As a man, taking proactive steps towards your mental health is crucial. Here are some ways you can help yourself:

• Acknowledge your feelings: Understand that it’s okay to have emotions and that acknowledging them is the first step towards healing. Try journalling as a regular practice to help you connect with yourself.
• Talk to someone: Share your feelings with a trusted friend or family member. Opening up can provide relief and support.
• Engage in healthy activities: Regular exercise, mindfulness practices, and hobbies can significantly improve your mental well-being.
• Educate yourself: Learn about mental health to better understand your own experiences and reduce stigma.
• Challenge stereotypes: Reject the notion that seeking help or expressing emotions makes you weak. Embrace vulnerability as a strength.
• Don’t hesitate to seek professional help when needed: Reach out to a therapist, counsellor, or mental health professional if you’re feeling overwhelmed.

Raj realised he couldn’t continue living in silence. He reached out to a close friend, who encouraged him to see a psychiatrist. With treatment and therapy, Raj learned to manage his emotions and develop healthier coping mechanisms. He reconnected with his family and found a renewed sense of purpose. In doing so, he realised that by acknowledging his own pain and healing it he was actually able to grow even more resilient and happy.

By fostering an environment where men are more aware of their feelings, comfortable expressing their emotions, and seeking support, we can create a healthier, supportive society.

Strength and vulnerability are not mutually exclusive. Men can discover that tapping into their empathy and connecting with their feelings makes them not weaker but stronger, more authentic, and resilient.

This article is authored by Dr Shyam Bhat, psychiatrist and chairperson, LiveLoveLaugh.