It was another Monday morning and my first patient of the day walked in. He was a man in his mid-30s who came to see me for stress and anxiety. He appeared nervous and had trouble getting his words out. And the thing I remember most — which I see again and again with many of the men I treat — was his inability to maintain eye contact with me. It’s a telltale sign of fear and shame.
Many men recently have become better at taking control of their physical health, being more heart healthy and getting preventive screenings such as colonoscopies as they get older, but when it comes to their mental health, too many men still struggle, lagging way behind women.
According to the National Institute of Mental Health (NIMH), the prevalence of mental illnesses in men is often lower than women. The NIMH also says that men with mental illnesses are less likely to have received mental health treatment than women. This poses interesting questions: Are men truly experiencing fewer mental health problems, or are they more likely to ignore them and hope they go away?
My career in mental health spans 25 years as a social worker, therapist, hospital administrator, adjunct faculty member at the University of Southern California, and presently the executive director of a facility that specializes in comprehensive mental health and substance abuse treatment programs. I have worked with thousands of men in both one-on-one and group settings. I am convinced the statistics are skewed and the number of men who struggle and fail to get help is much greater than we have been led to believe.
I have watched mothers and wives literally drag the men they love into my office. I often struggle with some male patients to pull information about their emotional issues out of them because they are so reluctant to speak. Others simply downplay their problems saying things like, “It’s not really a big deal,” or “My wife is blowing this out of proportion.” Then there are the men who are simply embarrassed and ask, “Nobody will ever know I was here, right?”
Too many men think they are supposed to be strong or macho all the time — even when in pain. For many, it would be unimaginable, intolerable for anyone to know they were battling anxiety, depression, or were bogged down by their emotions. Many of my male patients also seem to believe that because they are not physically ill they are not truly sick.
These incorrect beliefs keep many men from getting the help they need for their mental health. In 2021, for anyone, men or women, to believe that mental health is something to be ignored or that it is not real is both unfathomable and dangerous. It adds to the stigma, can push a patient who is already struggling with a diagnosis deeper into denial and prevent him from getting treatment.
In addition, it can condemn the sufferer to unnecessary emotional pain that can harm their quality of life, their health and their ability to work.
When it comes to mental health, there are some important facts that all men need to know:
Never be embarrassed
I had a male patient who was terrified to drive on the highway. His recovery with therapy was going well, and he got to the point that he could drive small distances on the highway. But one day, 10 miles between highway exits, he had a major panic attack and pulled over to the side of the road. Almost an hour later, a state trooper pulled behind him to see if he needed assistance. My patient, feeling embarrassed and shaken up, explained his phobia to the trooper, who thankfully was able to empathize. The trooper’s wife also suffered with a driving phobia. The trooper safely escorted my patient to the next exit.
The point of the story: We all have our struggles in life. Never be embarrassed to ask for help. Conditions such as anxiety and depression are much more common than you realize, and they don’t discriminate. They are often deeply rooted in brain chemistry and chemical imbalances. The pandemic hasn’t helped. These conditions can take a toll on anyone regardless of sex, race, religion, geographical location or anything else.
You can't see it, but it is very real
If you were experiencing chest pains, you would call an ambulance or go to the emergency room. If you broke your arm or leg, you would have a cast and walk around in crutches. But mental illness is usually not visible. Just because you can’t see it doesn’t mean it’s not real. It is real, and it can be dangerous if not properly treated. Anxiety, depression and other mental health problems can lead to high blood pressure, weaker immune systems, stomach issues, chronic fatigue, changes in weight, substance abuse and even suicide. If you think your mental health problems are just going to vanish on their own or go away like the common cold, you are very mistaken.
You can recover
These days, there are some amazing treatment options when it comes to mental health, including different forms of psychotherapy, different classes of medications and alternative methods such as yoga, acupuncture, meditation and mindfulness. No matter how bad your condition is and even if you feel extremely lost and hopeless right now, I promise you that you can get better. I have seen men severely consumed by mental illness and even housebound who — with help — have been able to take control of their lives and recover.
Signs something is wrong
Many men will make excuses when things aren’t going well, but there are some signs that should not be ignored. These include changes in mood, including anger outbursts or long periods of sadness that don’t pass, changes in appetite, gaining or losing weight, feeling hopeless and losing interest in activities that are usually enjoyable, feeling overly stressed and anxious, being unable to leave the house or avoiding situations in which being able to leave might be difficult, no longer wanting to socialize, having thoughts of harming yourself or taking your life, experiencing a decline in concentration and job performance, turning to substance abuse, and having unexplained physical symptoms such as stomach aches and headaches. It should be pointed out that these signs that help is needed apply to women as well as men.
Ways to get help
Whatever you do, just do something. Talk to someone, be it a close friend, family member, professional in the mental health field or family doctor. Online resources, such as those offered by the NIMH and the Anxiety and Depression Association of America can provide detailed information about mental health for patients and their families. Many men feel more comfortable doing online therapy sessions. Look into websites such as TalkSpace.com and BetterHealth.
In-person and online support groups are also helpful. You can check with the national organization for your particular mental health condition to find one. I also recommend Support Groups Central, which can point you in the direction of an online support group for your particular condition. Focus on self-help such as meditation, stress relief, muscle relaxation and physical activity — all of which have been shown to help reduce anxiety and depression. In an emergency, don’t forget the National Suicide Prevention Lifeline at 800-273-8255.
Educating men about the importance of mental health is not just a priority. According to the American Foundation for Suicide Prevention, men died by suicide 3.63 times more often than women, with middle-aged White men having been particularly vulnerable. The good news is when mental health intervention begins early — in other words when you just begin to notice symptoms and before they severely limit your ability to function or engage in your day-to-day activities — and the right combination of treatments are put in place, men will feel better and suicide ideation is dramatically decreased. The key is encouraging men who may not naturally reach out to get the help they need when they need it.
Joseph Harper is the executive director of Comprehensive Behavioral Health Center in East St. Louis, Ill. He is an adjunct faculty member in social work at the University of Southern California and an advocate for men’s mental health.