By Adil Yurekli, LCSW, Relief Mental Health in Warren, New Jersey
When men experience emotional or psychological challenges, they often fear the stigma associated with seeking professional therapy. Stigma, in this context, means judgment – and that’s exactly what men don’t want. No one wants to be judged, of course. But the stigma men fear is deeply rooted in the male psyche, particularly among males in the United States.
Some men know they live by cultural norms that govern a large part of their behavior, others may think they’ve transcended the norms and expectations, while others are completely unaware that they follow a default man-code that influences how they speak, behave, interact with others, and even think of themselves.
Disclaimer: it’s very hard to recognize the social and cultural conditioning we all experience as we grow up. I’m not praising men who recognize their conditioning or criticizing men who are unaware of their conditioning. I’m simply describing the default conditions with regards to the majority of adult males in the U.S.
The man-code is real, although there’s no official resources or handbook: it’s all unspoken, and unofficial. The official unofficial man-code goes something like this.
I’m a Real Man: Checklist
- I’m strong, and don’t need any help solving any of my problems.
- Yes, I have emotions, but no one really cares about how I feel – they only care about what I do or can accomplish.
- Those emotions? Talking about them – and especially letting anyone know my emotions are challenging – is neither manly, nor strong, nor anything I would ever do voluntarily.
- Asking for help is a sign of weakness.
- Therefore, I never ask for help with anything – not changing the oil in my car, cleaning the gutters, or fixing the kitchen cabinets – and I most certainly won’t ask for help dealing with my emotions (about which no one cares anyway).
- Suck it up and don’t complain about anything, ever. Like asking for help, complaining is a sign of weakness.
Even for men who are aware of their cultural, social, and gender conditioning, some of these unofficial rules are incredibly hard to transcend. And that’s to their detriment, and the detriment of our society in general, because it keeps men with clinical mental health diagnoses, such as anxiety, depression, bipolar disorder, post-traumatic stress disorder, and others, from getting the treatment and support they need to live, grow, thrive, and have a healthy and productive life.
Mental Health and Men: Facts and Figures
When I look at the statistics on mental health, I always note that women report higher rates of diagnoses of certain disorders, such as depression. When I see these facts and figures, I often wonder: does the man-code I refer to above skew these results? Do men fear the stigma attached to therapy so they misrepresent themselves on anonymous surveys? Do the women report higher rates because of their gender, and men report lower rates because of their gender?
I don’t have answers to those two questions, but I encourage you to consider them as I review the data on men and mental health. Here’s the latest data on mental health from the 2021 National Survey on Drug Use and Health (2021 NSDUH) on several key mental health metrics: any mental illness (AMI), serious mental illness (SMI), major depressive episode (MDE), and MDE with severe impairment. I’ll include rates of treatment for those categories, and break down the data by gender, so we can compare rates of treatment for males and females, and learn why it’s important for more males to step up and ask for help when they need it.
Mental Health in the U.S.: Rates and Treatment, Males Compared to Females
Note: the phrase major depressive episode (MDE) serves as a proxy metric for diagnosis with major depressive disorder (MDD)
Any Mental Illness (AMI)
- Adults 18+: 22.8% (57.8 million)
- Males: 22.3 million (18%)
- Received treatment, males: 8.6 million (38%)
- Females: 35.4 million (27%)
- Received treatment, females: 17.8 million (50%)
- Males: 22.3 million (18%)
Serious Mental Illness (SMI)
- Adults 18+: 5.5% (14.1million)
- Men: 4.9 million (4%)
- Received treatment, males: 2.9 million (59%)
- Women: 9.1 million (7%)
- Received treatment, females: 6.1 million (67%)
- Men: 4.9 million (4%)
Major Depressive Episode (MDE)
- Adults 18+: 8.3% (21.0 million)
- Males: 7.6 million (6.2%)
- Females: 13.3 million (10.3%)
MDE With Severe Impairment
- Adults 18+: 5.7% (14.5 million)
- Males: 5.1 million (4.1%)
- Females: 9.3 million (7.2%)
Adults with MDE: Received Treatment
- Adults 18+ with MDE:
- 61.0% (12.6 million) received treatment for depression
- Males: 4.1 million (54.3%)
- Females: 8.4 million (64.9%)
- Adults 18+ with MDE with severe impairment:
- 64.8% received treatment (9.1 million)
- Males: 2.8 million (56.1%)
- Females: 6.3 million (69.5%)
- 64.8% received treatment (9.1 million)
- 61.0% (12.6 million) received treatment for depression
The data demonstrates the disparity in both rates of mental health diagnoses and rates of participating in treatment between males and females. With regards to diagnosis overall, females report mental illness and major depressive episodes at rates roughly 40-60 percent greater than males. With regards to treatment, females report treatment participation at rates that are roughly 15-40 percent greater than males.
Aside from the disparities, it’s important to note the raw numbers: 22.3 million men in the U.S. have some sort of mental illness, but less than half of them – 38 percent – engage in any sort of mental health treatment.
While I can’t speak for every male in the U.S. with a mental health diagnosis who doesn’t seek treatment, I suspect that many of them avoid treatment because they knowingly or unknowingly follow the unofficial man-code described above. That’s why part of my professional mission is to help men move past stigma and engage in therapy.
I know many don’t want to – and that’s fine. Everyone is different and my job is to meet people where they are and find a way to support them in the manner they’ll accept.
Helping Men Transcend Stigma and Find Therapy: My Top Five Tips
In my experience supporting men with a variety of mental health issues, I’ve learned that a personal connection is important. Men will listen to male friends when they talk about these issues, and follow their advice, even if they won’t admit it in the moment and keep their emotional and psychological challenges to themselves.
In fact, I think the phrase “asking for a friend” probably originated with men seeking mental health support – but I could be wrong.
In any case, starting with someone you trust is the safest, quickest route to finding support for mental health issues: that’s why I put it at the top of the following list.
How Men Can Find Stigma-Free Therapy
1. Personal Referrals
Otherwise known as word-of-mouth, this is one of the best possible ways to find mental health treatment. However, it does require some degree of disclosure, meaning that you have to bring up the topic in order to engage in the topic. If you have a friend or family member you can trust – and won’t censure you for breaking the man-code – then I suggest asking them if they have any ideas about how and where to seek treatment and support. The best thing about this approach is that you only ask someone who knows you and whose opinion you trust implicitly: this increases your likelihood of receiving a practical and appropriate referral for someone who can offer you real help.
2. Professional Referrals
This is an excellent way to find appropriate professional support for mental health issues. A general care or family physician is bound by privacy laws to keep your medical information – including any information about mental health diagnoses and treatment – completely, one hundred percent private. Also, like a close friend or confidant, your general practitioner or family physician knows you, your medical history, and any medical factors that might contribute to your mental health challenges, and any medical factors a therapist should know about what might impact your treatment.
3. Educational Resources
While I recommend psychotherapy with a professional therapist and think this is the best option for anyone seeking support for mental health diagnoses, there are several educational resources available online that can help you learn more about your concerns. Whether you think you have symptoms of depression, anxiety, or something else, there’s something out there for you. The Depression Project is a good resource for men struggling with depression. Their blog, resource page, and YouTube channel are excellent resources for any mental health concern, not just depression. They address internal anxieties and helpful topics like meditation, among other things. There are also several podcasts for men’s mental health: this link reviews 15 podcasts specifically for men’s mental health. I find the Men’s Mental Health Show (MMHS) to be outstanding. Finally, I’ve found Rich Roll, a motivational speaker and athlete, to be helpful. He has a variety of guests, many of whom discuss mental health and motivation in general.
4. Online Therapist Locators
This is for men who’ve made the choice to engage in professional treatment and want to find a psychiatrist, therapist, or counselor. Treatment locators are available from:
American Psychological Association (APA)
Department of Health and Human Services (HHS)
National Association of Free and Charitable Clinics
Help When You Need It, a non-profit dedicated to helping people find support for a variety of needs, including mental health services
5. Self-Help/Mutual Aid Groups
Support groups are also an excellent way for men who fear stigma and want to remain mostly anonymous find other men in the same situation. By mostly anonymous, I mean you’ll attend a meeting with a group of other men to discuss specific topics relevant to men and mental health, so they’ll see you and hear you, but your participation will remain anonymous to anyone not in the group. To find a support group for men, I recommend consulting these resources:
Mental Health America (MHA). This resource has more than 20 links to appropriate support groups for men, including the Depression and Bipolar Support Alliance, Emotions Anonymous, Male Survivor (for men who’ve experienced abuse, violence, or trauma), and the National Center for PTSD.
Heads Up Guys operates an extensive website specifically for men and men’s issues, with a how-to guide on finding the right support group for your needs. Types of groups include general men’s issues – i.e., What Does it Mean to Be a Man? and similar topics – and specific groups for men with depression, men with anxiety, survivors of childhood trauma, combat veterans, and men dealing with difficult topics such as loss and grief.
Inclusive Therapists is a great resource – with a treatment locator – that enables you to find BIPOC and LGBTQ therapists that offer social justice oriented mental health care.
I’ll end this section with a quote from the Heads Up Guys website that I find to be true:
“Any men’s group that gives you space to explore who you are can be helpful.”
Final Thoughts: Men Can Overcome Stigma and Freely Engage in Therapy
I’d like to turn the man-code on its head and flip the script on all the real man stuff. I’ll do that with a simple, logical syllogism:
- Facing fear directly is courageous and manly.
- Men fear talking about emotions and mental health challenges.
- Therefore, when men face their fear and talk about emotions and mental health challenges, they’re acting in a courageous – and manly – manner.
I encourage all men to find the true courage it takes to open up, talk about their emotions, and address their mental health challenges. The man-code has been sending us all in the wrong direction: it’s time to reverse that trend, and recognize that seeking help takes courage, and talking about emotions and mental health is a sign of strength, rather than weakness.
When you realize this, you can learn to grow and heal. You also learn that courage and strength come in all shapes and sizes. Sometimes the hardest, most challenging step to take is simply realizing you need help and then asking for it. That’s the type of courage and strength I think men need to develop. When they do, then we may begin to see men seek treatment more often, and we’ll begin to close the significant gaps in mental health treatment between men and women.