This Men's Mental Health Awareness Week, it is crucial that we focus on some of the critical issues that impact men at large. There are certain mental health indicators that point to a persistent problem in this domain — including higher rates of suicide, greater reported levels of substance use, and a lower utilization of mental health resources among men. What are some of the factors that are causing this “silent epidemic” for 50.4% of the world’s population?
The majority of existing research on this tends to focus on differences in how mental health issues manifest in men and women, arguing that while men tend to experience more “externalizing” symptomatology such as substance use, aggression, violence, antisocial personality disorder, etc., women tend to experience more “internalizing” disorders such as depression and anxiety. However, researchers are increasingly arguing that this excessive focus on gendered differences: (i) underestimates the rates of depression and anxiety among men and (ii) ignores differences within the male population themselves (Smith, Mouzon, and Elliott, 2016). In the same vein, although research suggests that reported depression rates among men are half that of women, this could be because of a plethora of reasons, including but not limited to: (i) men being socialized to avoid the expression any depressivesymptoms, and (ii) men experiencing depression in a complex and distinct way that might not align with the existing standard criteria for depression, which focuses on internalizing symptoms.
The impacts of gender roles on mens’ expression of mental health
Research suggests that the typical ways in which men tend to cope with psychological distress are likely to lead to lower levels of diagnoses and an increased risk of suicide. Stereotypical expectations of masculinity make men susceptible to avoid addressing their pain, value hyper-independence and self-reliance, abstain from utilizing mental health resources, socially isolate and withdraw from relationships, depend on substances to numb their distress, and engage in risky behaviors. This is not to say that these coping strategies are inherently negative, but that utilizing these strategies rigidly and in all contexts is likely to lead to negative consequences. Hence, men often tend to behave in ways that are expected of them, which makes it incredibly difficult to recognize signs of distress and intervene at the optimal moment.
Existing measurement bias
Figure 1. Pathways and potential bias in detecting major depressive disorder among men in clinical settings.
The Diagnostic and Statistical Manual of Mental Disorders-V focuses on particular manifestations of depression such as a depressed mood, diminished interest in activities, weight loss, fatigue, etc. that might not completely be applicable to men. To be diagnosed with Major Depressive Disorder, it is also necessary for the individual to meet all Criterion A symptoms and four additional symptoms for most of the day, nearly every day, for at least 2 weeks. Although the existence of such a standardized tool of measurement is useful in several ways, it can also be extremely limiting, particularly for populations that might experience depression differently, whether this is because of their gender, cultural background, or any other factors. The mental health struggles of such people are then more likely to be sidelined, invalidated, and left undiagnosed and untreated.
The mental health difficulties that men deal with are complex and multifaceted. Only focusingon men’s externalizing symptoms, following narrow conceptualizations of what certain disorders should look like, and our implicit biases regarding how men “should” act sidelines the fact that men are also likely to experience significant mental health struggles. In order to create sustainable solutions on this front, it is necessary for us to focus on campaigns that increase public awareness, rethink our ways of conceptualizing and diagnosing mental health concerns, create focused healthcare strategies and policies that recognize men as vulnerable populations with distinct concerns and needs, and increase existing research in this domain.
Bilsker, D., Fogarty, A. S., & Wakefield, M. A. (2018). Critical Issues in Men’s Mental Health. The Canadian Journal of Psychiatry, 63(9), 590–596. https://doi.org/10.1177/0706743718766052
Smith, D. T., Mouzon, D. M., & Elliott, M. (2018). Reviewing the Assumptions About Men’s Mental Health: An Exploration of the Gender Binary. American Journal of Men’s Health, 78–89. https://doi.org/10.1177/1557988316630953
Mental Health Counselor Intern