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A wake up call for men’s mental health

Dr Sona Kaushal Gupta

Good mental health is as important as oxygen and we all need it to survive.  It includes emotional, psychological and social well-being. According to World Health Organisation, males commit suicide at twice the rate of females and countries in the higher income group have the highest suicide rates among males.

In USA for instance, according to the reports of Center for Disease Control  women are diagnosed with depression twice as much as men though males males are involved in 80 per cent of the deaths by suicide which is four times more than the females. In India, a review of Mental Health Disorders among Indians 2021 published in July 2023 stated that 33 per cent men had depression as compared to 31 per cent women during the same time. According to the non-profit Mental Health America (MHA), more than six million American men experience symptoms of depression annually — and most go undiagnosed. All women have men in their lives like their fathers, partners, sons, brothers, uncles and friends who are important to them and whose health is also important to them. We need to discuss the mental health issues in men because it affects the whole family. In the past one year, if you check it out, you will find that men are less likely to have received mental health treatment than women. I have found it to be true in my counselling practice.

The first step to resolve this issue is to be able to recognise the signs of mental illness in your own self or someone you love who may have a mental disorder. The earlier we start the treatment, the more effective it can be.

Some common symptoms of some common mental disorders in men and women include anger, irritability, or aggressiveness; noticeable changes in mood, energy level, or appetite; difficulty sleeping or sleeping too much; difficulty concentrating, feeling restless, or on edge; increased worry or feeling stressed; misuse of alcohol, drugs, or both; persistent sadness or feelings of hopelessness; engaging in high-risk activities; aches, headaches, or digestive problems without a clear cause; obsessive thinking or compulsive behaviour; thoughts or behaviour that interfere with work, family, or social life and thoughts of death or suicide or suicide attempts.

The same mental health issues can manifest differently in males and females. Males with depression may exhibit higher levels of anger, aggression and irritability. Females with depression may display signs of low mood sadness loss instead. Symptoms of depression in males can be physiological, such as a racing heart, digestive issues or headaches. Males may be “more likely to see their doctor about physical symptoms than emotional symptoms,” says the USA’s National Institute of Mental Health.

Due to stigma, societal expectations and stereotypes of masculinity, men often self-treat through addictive behaviours like substance abuse. Another unhealthy, risky behaviour men use to cope with their mental health issues is compulsive gambling. A study published in SSM – Qualitative Research in Health show correlations between mental illness and men’s intimate partner relationships, including a heightened risk of suicide.

Research has shown that mental health providers may miss or misdiagnose psychological problems in men because of their own gender biases. Since childhood men are told to ‘man up’ which means they are taught not to cry or express their mental health problems. So they bottle up their emotions and keep quiet in order to try to appear more ‘strong’ as associated with “masculine behavior”.  In 2022, the American Journal of Public Health published a review of studies dealing with the societal stigma surrounding mental illness. It found that men who internalised that stigma were less likely to get help for their psychological issues and more likely to face challenges and “a heightened risk for severe mental illness.” Situational stressors also play a major role in suicide deaths among males. These stressors can range from relationship troubles to arguments and indicate a need for “support during stressful times”.

Employment-related risk factors are also common. Decent work can improve mental health. Work promotes good mental health by providing a way to earn money, a feeling of self-assurance and a sense of purpose and accomplishment. On the other hand, poor working conditions that involve discrimination, inequality, heavy workloads, dangerous activities, lower wage earnings, low control and job insecurity or instability can jeopardise mental health. Depression in men can be caused by a combination of factors. His genes can play a role. Men who have a family history of depression are more likely to develop it than those who don’t. Environmental stress can trigger depression too. This includes financial problems, the loss of a loved one, work problems, a difficult relationship, a major life change, or a stressful situation. Also, depression can occur in men who have a serious medical condition like diabetes, heart disease, or cancer. Many men who have diagnosed mental health issues but do nothing about it because they think admitting it makes them weak. They don’t go to pick up an antidepressant because they are afraid they will be judged. They don’t want to go to a therapist because they don’t want to share with a stranger. They don’t talk about it, and it can be tough for friends or family members to know something is wrong. Men may appear angry or aggressive instead of sad or hopeless when they are depressed and this can make the doctors and loved ones miss the signs that something is wrong.

For improving mental health, the biggest challenge is getting men to actually accept help. Better mental health education is the first step in addressing mental health issues, by expanding general awareness and education around the topic itself. We need to talk openly about mental health. Suffering in silence isn’t a healthy option for anyone. Elevating men’s mental health is another key step in addressing increased feelings of isolation and despair in men. Check in with them. Look for changes in his behaviour and depression symptoms. If you think someone you love has depression, offer your support, listen and be patient. Encourage him to talk to his doctor or a mental health professional. Living with depression can feel overwhelming and isolating, so let him know he’s not alone.

Research says diet and nutrition can impact mental well-being. Prioritise self-care, which includes eating a balanced diet and also engaging in regular exercise and adequate sleep. Other strategies include meditation, mindfulness and becoming part of a social circle. Getting an accurate diagnosis and following it up with treatment is essential. Most people need professional help like therapy, medication, community interventions and family assistance to feel better.

However, ignoring mental health can impact relationships. For example, a depressive episode can cause stress and worry in a household, affecting spouses and children. It can become detrimental to his work life, including reduced motivation, lower productivity and poor performance. The impact of mental health issues can also extend to physical health. It can lead men to experience high blood pressureheart disease, and other chronic health conditions. Mental health conditions can make men feel isolated and frustrated, and men often struggle to find happiness and fulfillment in life. Family and friends may notice changes in behaviour, such as increased irritability, social withdrawal and decreased communication. Additionally, parents with mental health conditions may become easily irritable and difficult to be around, leading their children to distance themselves from them. As a consequence, this may create a sense of distance and isolation from a parent with a mental health condition. As American author Dan Milman states, “You don’t have to control your thoughts. You just have to stop letting them control you.”

(The author is a neuropsychologist, founder of a crisis helpline and designated CBSE counsellor. Views expressed are personal)

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