Driven to Suicide: Why Men Don't Seek Help for Depression

It’s true: mental illness can be difficult to talk about. Unlike most physical ailments, mental illness bears the burden of stigma that prevents many from sharing their experiences. For men, the silence of stigma can be fatal: untreated depression leads men to complete suicide at alarming rates. Indeed, men complete suicide four times more than women do.

Despite the startling statistics, many men aren’t seeking help. One third of people with a mental illness look for help, and women seek help twice as often as men do. So why don’t some men suffering from mental illnesses like depression ask for help? Masculine stereotypes about stubborn, self-sufficient men lead to jokes about men refusing to ask for directions while going somewhere, painting a picture of a man who doesn’t look for outside help. Unfortunately for men, their reasons may go beyond not wanting to ask for help: they may not even know they’re lost.

 Recent research by Call and Shafer (2018) suggests that the assessment and diagnosis of depression in men may be flawed. The Diagnostic and Statistical Manual of Mental Disorders (DSM), a reference guide for psychologists, lists specific criteria for a diagnosis of depression. Many of us would recognize the symptoms: someone who experiences sadness that won’t go away, disinterest in activities they used to love, and low energy. Although this is a common portrayal of depression, for many men, it misses the mark. Rather than feeling sad, research suggests that men with depression are more likely to feel angry, aggressive, and irritated, and struggle with risky behaviour or substance abuse. This experience of depression isn’t captured in reference guides, or tests given by doctors and clinicians. Men may leave their doctor’s office undiagnosed, heading to Kansas when they’re looking for Disney.

The fault doesn’t rest with men: this one we get to blame on society. Those stereotypes that prompt us to think of men as tough guys who don’t need a map are the very reason men have a hard time asking for help. Instead of being told that really, it’s okay to cry, boys told to toughen up grow into men who struggle to express sadness and pain. Unable to express their more vulnerable feelings, men externalise their depression in ways more aligned with masculine stereotypes: with anger and violence. Sadly, the effects of men’s violent expressions of depression are more likely to receive attention for their impact on women and children than the suffering experienced by the man himself.

The more aligned men are with masculine stereotypes, the less likely they are to seek help for their depression. Men experiencing the more aggressive, stereotypically masculine aspects of depression are the least likely to seek help. Researchers have noted that the more depressive symptoms one has, the more likely they are to seek help. For men, as aggressive symptoms increase, help seeking decreases. This means that the men who need help the most aren’t getting it.

Furthermore, stigma contributes to many people slamming the breaks on opening up. Under pressure from masculine stereotypes, men feel that getting help or going to therapy makes them look weak. Men are much more likely to schedule a doctor’s visit for a physical symptom than they are to check in with a psychologist. Fears of Freudian couches and probing questions  drive men away from emotion focused strategies and lead men to underreport any depressive symptoms they may have.

What can we do for men struggling with depression? Talking about our own experiences with mental illness can encourage others to speak up. In order to help men in the long run, further research needs to be done on men’s unique symptoms of depression. Such research is important for evidence-based assessment tools that accurately evaluate men’s experience of mental illness. Better assessment tools mean fewer men leaving doctor’s or clinicians offices without a proper diagnosis or plan to get help. Moving forward, awareness campaigns can help men recognize their own symptoms of depression and reduce the stigma men face when asking for help. Most importantly, by giving proper care and attention to men struggling with depression, we can hopefully prevent those same men from dying by suicide.

Perceptions of masculinity are changing. We’re moving towards a society in which men can freely express their emotions, and aren’t burdened by the weight of restrictive masculine ideals. Our next step forward should be to help men ask for help, shaking off the shackles of stigma and stereotypes. In the near future men will have maps for their mental health thanks to a growing field of research and we, as a society, can proudly declare that we aren’t in Kansas anymore.

Call, J. B., & Shafer, K. (2018). Gendered manifestations of depression and help seeking among men. American Journal of Men's Health, 12(1), 41-51. doi:http://dx.doi.org.proxy1.lib.uwo.ca/10.1177/1557988315623993
Liddon, L., Kingerlee, R., & Barry, J. A. (2018). Gender differences in preferences for psychological treatment, coping strategies, and triggers to help‐seeking. British Journal of Clinical Psychology, 57(1), 42-58.