Mental illness isn’t something people like to talk about, in general. While it’s true that society has become more comfortable discussing these issues – especially as we come to better understand them – they’re still not exactly pleasant topics of conversation. Discussing mental illness can be difficult and discomforting, and we tend to avoid talking about things that we find difficult and discomforting. Unfortunately, this often causes us to sweep our issues under the rug when what we really need to do is drag them out into the light of day. This can be especially true for men. We are taught to be macho and strong, which often prevents us from seeking the help we desperately need.

I know these things not only from research, but from the lived experience I have detailed in a separate blog post. I will attempt to give a somewhat abridged accounting here, tailored to the subject matter at hand. My story begins with childhood sexual abuse. That abuse, perpetuated by the teenage son of a family friend (who was himself a victim of similar abuse at the hands of a member of his own family), tormented me for decades. As a child, I showed symptoms of depression and anxiety. I lacked confidence and remained withdrawn much of the time, opting to keep to myself in my room with a book or a video game. I was nerdy, skinny and unathletic, all of which made me a prime target for bullying. I tried fighting back at first, but when I showed no talent for it, I withdrew even further. 

My lack of self-confidence turned into self-loathing in my teen years. As my peers experienced romantic and sexual awakenings in predictable ways, I struggled to reckon with my abuse. I told no one, out of fear of what they might think of me. I tried to handle everything myself, because I thought that’s what boys were supposed to do. I worried that what had happened to me had made me less than a man, that it was the reason I was so easy to pick on and make fun of, and that it was the reason girls didn’t like me. I lived in fear that I was some kind of freak. Worse than that, I worried everyone could tell something was wrong with me. I left home at age 17, fleeing to California to attend college, where I made real friends and had some wonderful times. Deep down, though, I still hated myself. I’d only learned to hide my shame a little better.  

In college, I used alcohol and drugs to mask my pain and self-medicate my issues. This only made things worse, of course. I nearly flunked out of school on two separate occasions. I tried once to see a campus counselor during a major depressive episode, but never returned for another session. I felt uncomfortable talking about my feelings, especially with a total stranger. My internalized toxic masculinity caused me to carry my issues all the way through my 20s, with many ill-advised and dysfunctional cries for help along the way. I went on & off various medications because I felt weak for having to take them in the first place. After all, shouldn’t I be able to handle everything myself? 

If we can unlearn the cultural programming of toxic, fragile masculinity, then we can quiet the voice that keeps us trapped in our own misery, afraid to ask for help. We can learn to recognize the symptoms of mental illness and seek healthy, productive, professional solutions that really work. We don’t have to stay locked up in the dark. We don’t have to fight for our lives all alone. 

It wasn’t until well after my 30th birthday that I finally sought the help I needed my whole life. I had to get all the way to death’s doorstep to finally open up and allow myself to accept the necessary treatment for my mental illness. The cultural myths of manhood ran hard in me. I spent my childhood, my teens, my 20s, and even some of my early 30s in deep, awful pain. I suffered so unnecessarily because I was terrified of what people would think of me. I was worried about appearing weak. I thought needing help made me less of a man. Too often, this is the story of men with mental illness, but it doesn’t have to be. If we can unlearn the cultural programming of toxic, fragile masculinity, then we can quiet the voice that keeps us trapped in our own misery, afraid to ask for help. We can learn to recognize the symptoms of mental illness and seek healthy, productive, professional solutions that really work. We don’t have to stay locked up in the dark. We don’t have to fight for our lives all alone.

We believe this is because men are also statistically less likely to seek professional help for their issues than women. The stigmas surrounding male mental health are quite literally killing men. This has to stop. We have to start talking about these problems. 

Many of the issues men face when dealing with mental illness are stigmas related to the concept of toxic masculinity. Our culture teaches men never to show weakness, that Real Men™ don’t need help dealing with their problems, and Real Men™ definitely never cry when they are sad or overwhelmed. Because of this cultural toxicity, men often worry they will be perceived as burdensome if they attempt to talk to others about their issues. All of these stigmas coalesce to keep men from seeking help when they need it the most. Though we may not talk about it, there are millions of non-neurotypical men in America. Six million of us live with depression, 19 million have anxiety, more than one million men are diagnosed with bipolar, and 90% of the schizophrenia diagnoses by the age of 30 are American men. Additionally, while it is hard to get exact numbers on eating disorders among men due to under-reporting; it is estimated that 10% of anorexia and 35% of bulimia cases in America are men.

When these numbers meet the aforementioned stigmas, the results can be catastrophic. Suicide, for example, is on the rise among men, and four times as many men as women succumb to suicide every year. Put another way, we lose an American man to suicide every 20 minutes. Furthermore, men are three times more likely to develop substance abuse issues than their female counterparts. We believe this is because men are also statistically less likely to seek professional help for their issues than women. The stigmas surrounding male mental health are quite literally killing men. This has to stop. We have to start talking about these problems.

The first step to taking on mental illness is figuring out how to recognize the symptoms so we can categorize them as such. These symptoms are signs of mental illness, not signs of weakness of some lack of manhood. Would we blame ourselves for being weak if we had cancer? High blood pressure? Diabetes? Of course not. Mental illness is no different, and getting past these stigmas will help us assess and understand the signs that we need help. Once we are able to deprogram some of the enduring cultural beliefs around what makes us Real Men™, we can start better identifying the very real symptoms of mental illness. 

Some of the symptoms of depression are not specific to men. Many symptoms of depression affect people regardless of gender. While it is true that everyone feels down from time to time, depression symptoms can belie larger issues that need addressing. Feeling deeply sad for long stretches of time is a hallmark of clinical depression, and depressed people also report feeling hopelessness or emptiness as well. Beyond the emotional hardships, symptoms of depression can also present as physical issues. Exhaustion is one of the most commonly reported issues. Depression can throw off a person’s sleep cycle, causing difficulty sleeping. On the other end of the spectrum, some people report sleeping far more than the recommended eight hours per night and still feeling too tired to function when they awake. Almost all depressed people report that activities they used to enjoy no longer bring them any pleasure at all. If you’re experiencing one or more of these symptoms, it might be time to speak to a professional about getting some help. 

While some symptoms are fairly obvious, not all symptoms fit the mold of what we think of when we talk about depression. Unfortunately, myriad depression symptoms exist, and many are difficult to spot because they don’t fit the cultural stereotype of a depressed person. This is especially true for men, as many of our unhealthy coping mechanisms have been codified into accepted and sometimes even expected behaviors. For example, escapist behavior can be a symptom of depression, and men often escape into activities like work and sports. While there is nothing wrong with being a hard worker or a dedicated athlete, these behaviors can also be used to mask larger issues. It can also manifest itself in physical symptoms like headaches, digestive issues, and other pains that men may attempt to power through and remain silent about in order to avoid looking like a “sissy.” Additionally, depression can lead to drug and alcohol abuse. Drug use, of course, isn’t the sort of thing society just glosses over, but heavy drinking among men is so common it is sometimes worn as a badge of honor, especially among younger men. 

There are other problematic symptoms that sadly have been normalized by the “boys will be boys” narrative in our culture. Risky behaviors such as reckless driving, excessive thrill-seeking, and promiscuity can be spun into positives for men. Behind closed doors, these wild men we laud and applaud may be suffering in silence. Irritability and inappropriate anger can also signal depression, and all too often we excuse these issues in men, ascribing bad behavior to “a short fuse” or “a bit of a temper.” This is especially dangerous because these issues can lead to controlling, violent, and abusive behaviors that can wind up hurting the people closest to the men who exhibit them. How many instances of abuse could we prevent if men sought and received the help they needed without fear of shame or emasculation?

Understanding symptoms and knowing we need help is a big step, but there is still the issue of actually getting the help we need. First and foremost, if you’re feeling suicidal, go to your local emergency room. Be honest. Medical professionals can provide the safety and supervision needed in these vulnerable moments. Don’t worry about the optics. Don’t worry about the cost. Anyone who thinks less of you for doing whatever it takes to keep yourself alive is just plain wrong, and you can’t put a price tag on living to fight another day. Don’t succumb to machismo. If that’s the help you need, then seek it out without embarrassment. The National Suicide Prevention Lifeline (1-800-273-8255) is also always available, 24/7/365. They’re great. I know. I’ve called them in some of my darkest moments of deep, immediate need. 

If you don’t feel you’re an immediate danger to yourself, but you’re still struggling, there are other avenues of help that you can investigate. Hard as it may be to talk about our feelings, sometimes reaching out to a trusted friend or loved one can be a great first step. If that feels too vulnerable and exposed, or if you’re far from friends and family, a counselor is another option. Counselors are widely available and can be trusted to keep confidentiality. For those more religiously inclined, the spiritual leader in your faith community is also a great option. These men and women can often make time for an appointment sooner than a counselor or therapist, as the in-demand nature of therapy and counseling services can sometimes lead to extensive waitlists for a first session. If one-on-one therapy sounds too daunting, you may prefer men’s group therapy as an approach. Many men find comfort in the support of a group focused around their shared needs. Of course, all of this can seem overwhelming at first, or perhaps the idea of actually leaving your house to speak to anyone seems impossible. In that case, the Crisis Text Line (text CONNECT to 741741) is always available. 

No matter what you decide, if you’re having mental health issues, please don’t hesitate to call your primary care physician. They can refer you to a therapist if you need one, and referrals generally get seen faster than people who call in on their own. Your primary care physician can also discuss other potential treatment options based on your specific symptoms. The most important thing is that you don’t just put your head down and attempt to get through everything alone. None of us are equipped for that. No one should expect that of anyone. And the sooner we reject all the societal lies about what makes us Real Men™, the sooner we can get to the real work of healing and feeling better. 

If you have any questions or need help locating services, you can contact Sanctuary Centers at (805)-569-2785. We’d be glad to walk you through the treatment options and plans we have available to help you.