Men and mental health

Mental health has never been more top of mind than it has in the last two years.

Since early 2020, the COVID-19 pandemic and subsequent restrictions of movement, physical distancing measures, lockdowns, loss of employment, social isolation and the added stressors of remote work and schooling have heightened psychological distress and impacted the mental health of many Australians^[1]. However, this period has also seen more investment^[2] and increased uptake^[3] in mental health services than ever before.

From the top of the news bulletins to the topic of group chats — there’s greater awareness of an issue that touches most people in their lifetime, whether it’s battles with their own mental health, their family members’ or their mates’. Clinical psychologist and men’s mental health researcher, Dr Zac Seidler, has seen the effect this has had on his clients.

 “So many men have been given the okay to say, ‘no, not coping’ and that's the greatest benefit, if anything, of COVID, that it's the great equaliser,” Dr Seidler says. “Everyone has had a rough time, one way or another, and has been able to complain about it and hopefully, been able to seek help as well. But the camaraderie, the togetherness, the compassion, and love that I see amongst so many of these guys, doesn't go reported.”

Although mental health and illness are more widely discussed, there’s still significant stigma around the issue and room for improvement when it comes to our understanding this complex topic — particularly when it comes to symptoms, diagnosis and treatment of men’s mental illness and the role of masculinity. So here are the basics of what’s going on in your brain and how to recognise when you, or someone you know, needs a hand with their mental health.

The spectrum of mental health

It can help to think about mental health and mental illness as existing on a continuum or spectrum. At one end is mental health, defined by the World Health Organisation as, “A state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” It influences how we think, feel and act. There are ways to maintain your mental health and build resilience to cope with life’s unexpected challenges and these include regular physical activity, good sleep, creating strong connections, drinking sensibly and limiting other drugs, eating well, making time to do things you enjoy, being open and honest about how you’re feeling, and seeking help when you need it. 

Even when your mental health is optimal, it’s normal to feel sad, angry, lonely, stressed and anxious at times, and there will be periods in life when your mood and motivation isn’t as good as you’d like. This can change day-to-day and week-to-week, often in response to life’s stressors. When these feelings become persistent and interfere with your ability to lead and enjoy everyday life, that’s when you might be dealing with a mental health problem that requires medical attention.

These parts of the spectrum range from ‘coping’ — feeling some pressure but managing — to ‘struggling’ — feeling like you’re not doing ok. If mental health problems aren’t dealt with, they may develop into a mental illness.

Mental illness — at the opposite end of the spectrum to mental health — refers to all diagnosable mental disorders or conditions that significantly affect how a person feels, thinks, behaves and interacts with other people. There are different types of mental illnesses including depression, anxiety, schizophrenia, bipolar mood disorder, personality disorders and eating disorders, and these range in severity. Mental illness can affect anyone, regardless of factors like age, gender, geography or income. In fact, around 45% of Australians aged 16 to 85 have experienced mental illness at some point in their lives^[4]. Some people may experience one episode of mental illness and fully recover, while for others it may recur throughout their lives.

There is usually no singular cause of mental illness. A number of overlapping factors increase your risk. These include biology (mental health is affected by your genes and related to your family history of mental illness), your current circumstances (whether that’s stress at work, money problems or isolation), life experiences (such as trauma, abuse or grief), and individual coping styles.

Mental illnesses are medical conditions and they’re treatable. Recognising the early symptoms and getting effective treatment is important. If you need non-urgent help, contact your doctor and ask for a long appointment. A doctor can assess and treat many common mental health concerns and provide referrals to psychologists, psychiatrists and other mental healthcare professionals.

The state of men’s mental health

“When it comes to your basic markers of how men are doing, the gender paradox of suicide explains it really well,” Dr Seidler says. “Women experience suicidal thoughts, suicidal planning, suicidal attempts, much more often than men do, their depression and anxiety rates are much higher, their help-seeking rates are much higher, and yet, men account for three quarters of all suicides in Australia.”

But these statistics around gender and mental health difficulties don’t paint the whole picture.

“If you include irritability, frustration, drug-taking, aggression, those things that we actually think are representative of male depression, you end up with parity in prevalence rates,” Dr Seidler says.

Rather than “boys being boys”, problematic behaviour can be a cry for help that isn’t always recognised.

More on masculinities

There is a complex and diverse range of factors that impact mental health, which can be influenced by how men experience masculine social norms. Masculinity — the set of attributes, behaviours and roles associated with men and boys — has received a bad rap in recent years with critique of its “toxic” nature.

“The term ‘toxic masculinity' is fundamentally flawed. It has no basis in science and it's really problematic,” Dr Seidler says. “There are many facets of manhood that, when applied incorrectly, are toxic, but they are toxic behaviours, not toxic traits.”

Boys and men are taught, implicitly and explicitly, to embody traditionally masculine traits of stoicism, strength, independence and self-reliance. These are positive traits in many parts of life but become a problem when they’re practised rigidly in all contexts, particularly when it comes to looking after mental wellbeing.

“A fireman needs to be stoic, self-reliant, strong, and powerful in the face of the fire, but when he comes down, he needs to be vulnerable and emotionally communicative to overcome trauma,” Dr Seidler says. “If we just have a one-size-fits-all, ‘I am this bloke in all set settings’ approach, it really ends very badly and that's what we witness all the time.” Men who more strictly conform to these masculine norms report worse mental health outcomes and reduced help seeking^[5]. Exploring and celebrating healthier masculinities is critical for improving men’s mental health.

“We use the term ‘masculinities’ because within each man is a constantly evolving, changing, contradictory experience of masculinity that, depending on where you are, who you're talking to, who you're relating with, will shift,” Dr Seidler says. “It’s really important people start to embrace that, because it's when they rebel against that other version of themself, the tension comes about, and the feelings of being deficient, or broken, or not living up to something is really problematic. If we keep striving for one way of being, everybody will fail.”

Signs your mental wellbeing might need attention

• Persistent and pervasive feelings of sadness, elation, anxiety, fear or irritability

• Changes in sleep patterns

• Changes in appetite

• Loss of interest in things that were previously enjoyable

• Withdrawal from friends and activities

• Difficulty thinking and concentrating

• Excessive worries, fear or guilt

• Changes in use of alcohol and other drugs

• Thoughts and feelings that are out of the ordinary or difficult to understand, such as paranoia

• Experiencing sensations (seeing, hearing, smelling, tasting something) that others can’t identify

Social and emotional wellbeing

Many Aboriginal and Torres Strait Islander people prefer to use the term social and emotional wellbeing (SEWB) to describe the holistic range of factors that make up and influence health. It recognises their connection to land, sea, culture, spirituality, family and community, as well as the influence of policies and past events.