June is men’s health month, and mental health is as important as physical health. So let’s take a look at men, depression, and suicide.
Some answers are facile. Men are more likely to use extreme methods, such as a gun, while women are more likely to swallow pills. But using a more fatal method simply shows a greater desire to die. It doesn’t explain why men are more likely to feel that way.
On the other hand, women report more suicidal thoughts than men do. But is it possible that men have as many (or more) suicidal thoughts but don’t report it?
Men aren’t supposed to need help. Recently I had to put air in my tires, but I couldn’t get the cap off one tire stem. I asked a fellow traveler if she had pliers. She grabbed a pair from her trunk and removed the cap. I thanked her, but her irritation with me was evident.
No big deal. But what if I needed help with something far bigger – with my emotional life disintegrating to the point where I felt suicidal?
There’s a reason men don’t ask for help.
Solid data on suicide attempts are hard to come by, but anecdotally women are more likely to attempt suicide. However, those attempting suicide often don’t want to die and instead are communicating their need for help. A cry for help means the person believes someone may actually help them.
But no one attempts suicide with a gun – they really want to die. Are men less likely to believe anyone will help them, leaving a final exit as the only perceived option?
Depression plays a large role in suicide, and here too we find a gender difference. Women are more likely than men to be diagnosed with depression. But if women suffer from depression more than men, why do men commit suicide at such higher rates?
Perhaps mental health professionals don’t recognize depression in men because there are differences in the way men and women experience depression. This is not a new idea: the evidence that men suffer from depression at similar rates as women goes back more than a quarter century.
Psychiatry’s manual of mental disorders, the DSM-5, lists symptoms of depression such as fatigue, loss of interest in fun stuff, feelings of guilt, sleeping too much or too little, and of course suicidal thoughts. But depressed men are more likely than depressed women to be more aggressive, to engage in risky behaviors, and abuse substances.
One problem is that there’s a shortage of men in the mental health field, and a consequence is treatment more geared toward women than men. Alternative approaches such as ManTherapy, which uses humor to engage men, have yet to catch on.
Though teen suicide is a big concern, middle age suicide is often overlooked. Alice G. Walton writes in Forbes that “there’s still a lot of pressure on men to fill out the masculine husband role, whatever socioeconomic class one is in, and the reality is that today this classic role may be somewhat unrealistic.” Somewhat?
Poor and divorced men are especially vulnerable for suicide because they have experienced a loss of the primary male role, which is to serve as a resource for women and children (specifically, to provide and protect). Divorced women don’t face a similar loss of the traditional female role (caring for children) because mothers are far more likely than fathers to get custody of the children. But most of all, women have greater social networks and social supports than men.
Let’s recap: Men experience depression as often as women but are less likely to be diagnosed. Women attempt suicide more because they believe their cry for help will be heeded. Men are much less likely to believe anyone will help, and men are more likely to be shamed for asking for help. Men are more socially isolated than women. And job losses and divorce have a far more negative impact on men because traditional gender role expectations are more rigid for men.
It’s not just about what men need to do differently. That men must take action is a 1950s ethos which no longer serves men’s interest. Were it more socially acceptable for men to ask for help, men would do so. But this isn’t just about men’s view of the male gender role: women must also change their perceptions (see Heather Gray’s Are We Really Ready For Emotionally Intelligent Men?).
Further, we must raise awareness that suicide is a gendered issue. This requires rowing against the zero sum current which says that any focus on men’s issues comes at the detriment of women’s issues. Mental health professionals, and especially substance abuse counselors, must be educated on how to spot depression and suicide risk in men. Finally, mental health treatment should consider unorthodox approaches such as the humor of ManTherapy to reach men who might otherwise avoid therapy.