For most people, opening up about mental health isn’t fun. It can feel vulnerable, uncomfortable and — let’s be real — terrifying, especially if you have any dark thoughts.
And while many people struggle to talk about their mental health, data shows men aren’t talking enough about it.
“Men, especially middle-aged and older men, are the groups with the highest rates of suicides,” says Dr. John K. Amory, a physician at the General Internal Medicine Center at UW Medical Center – Roosevelt.
In fact, people aged 65 and older are more likely to die by suicide than any other age group — for both men and women.
So, what needs to change? Well, both men and their loved ones need to try to break the silence and begin talking about mental health — before it becomes don’t-do-or-die.
Men’s (mental) health crisis
Let’s be honest: Fewer men generally access their healthcare options than other genders, not because there aren’t resources, but because many men opt out of their routine healthcare.
“Some of my male patients are very good health advocates for themselves. Others are certainly … less so. In those cases, I do think there’s a mental construct of ‘self-sufficiency’ for some men that prevents them from asking for help,” says Amory.
In 2021, the overall life expectancy for men dropped from 74.2 years to 73.2 years. And to bring this back to mental health, the rate of suicide was the third-most reason for this decline in life expectancy, only behind deaths from COVID-19 and unintentional injuries.
Out of these causes of death, only one is entirely preventable, and that’s suicide.
Knowing the facts can help give some perspective on why this out-of-sight, out-of-mind perspective isn’t helping men’s mental health.
How mental health conditions affect men
According to Mental Health America, these top mental health problems affect men:
- Depression: over 6 million men suffer from depression.
- Anxiety: 14.3% of men have a form of anxiety disorder.
- Bipolar disorder: 2.9% of men have bipolar disorder.
- Psychosis and schizophrenia: 90% of those diagnosed with schizophrenia by age 30 are men.
- Eating disorders: 10% of patients with anorexia or bulimia are men, and 35% of patients with binge-eating disorder are men.
While these are the general statistics, the truth is, many men who suffer from mental health conditions or eating disorders remain undiagnosed, leading to their conditions worsening. It’s thought that the perceptions around gender and the way men are socialized from a young age are part of the issue.
This could mean that men mask their feelings of depression or anxiety because of the stigma around men and their emotions. Needing help isn’t seen as “masculine,” but suffering in silence shouldn’t be the answer. Men of color are even less likely to seek or receive help.
“There’s an ethos that men should ‘tough it out’ and that getting mental health care isn’t ‘manly.’ Obviously, this approach is not working,” says Amory.
It’s also untrue that men don’t want to talk about their mental health or other struggles. Because of these gender socializations and, sometimes, personal preferences, it’s just about creating the right environment to talk to men about their mental health in a way that feels safe and organic.
How to start the conversation
If your loved one isn’t talking about his mental health issues, it can be hard to find a place to start. And while you might be coming from a place of worry, support and love, remember that this conversation isn’t about you or how you’re feeling. Steer clear of accusations around their actions or feelings, and instead, start with observations.
Tell them what you’ve been noticing. This can look like:
- I’ve noticed [behavior or feeling] lately and wanted to check in.
- When did you start feeling this way?
- How are you managing?
- Do you have anyone to talk to about this?
Validate how they’re feeling, but don’t offer advice. Instead, you can offer support and resources.
Suggest a trip to the doctor
Going to the doctor might not seem like mental health care, but it’s possible that a medical condition, such as low testosterone, could cause some symptoms of depression. Anxiety and other symptoms could also be side effects of medications or medical conditions, so a full workup is a great place to start.
If it’s his first appointment to talk about his mental health, offer to go with him. If he’d rather go alone, let him know you’re there for him when he needs support.
When patients come into Amory’s office with concerns, he says he tries to do a lot of the heavy work in facilitating the conversation to make his patients feel more comfortable.
“I often see men visibly relax after we start to discuss these issues openly,” says Amory.
But if the doctor doesn’t seem to be leading the conversation, encourage your loved one say something clear and honest like, “I’ve been having a lot of anxiety lately, and would like to know what my options are.”
Ask what he needs
Everyone opens up on their own terms and requires different methods of support. Don’t assume someone needs a specific type of help, such as medication or therapy. In addition, don’t be afraid to directly ask: Are you thinking about suicide? It’s a myth that the question will give them the idea. In fact, it could give them the much-needed opportunity to talk about their thoughts.
If he won’t open up
You can say and do all the right things, but at the end of the day, it’s up to your loved one to decide when they’re ready to open up and seek support for their mental health. Someone might not open up for a variety of reasons, from not knowing what to say, to shame or fear.
And while all of this might be frustrating, remember — this is about him, not how you’re feeling. Respect his decision to not open up, and in the meantime, you can continue to be a support by offering a safe space to talk when he’s ready, by spending quality time with him, or offering to help him with tasks.
Finally, if someone tells you they’re thinking about suicide, have an open and honest conversation. From there, you can work with them and their loved ones to decide the best course of action.
Your loved one can also call or text 988 if they are in crisis.
Talking about mental health is an extremely vulnerable act, but it can make a huge difference in someone’s life — it might even help save it.