Michael Abrahams | Men and mental health challenges

The death of the popular American hip-hop dancer, actor, and television personality Stephen ‘tWitch’ Boss late last year surprised and shocked many, and over the past few weeks in Jamaica, I have heard of three men taking their own lives.

Both males and females die by suicide, but the gender differences are interesting. On the one hand, women are more likely to attempt suicide, but men are more likely to be successful in their endeavours to transition to the other side. Indeed, according to statistics from the World Health Organization (WHO), twice as many men than women end their lives. We are all at risk, but some factors affect men more than women. Stigma regarding mental illness is a global problem, more prevalent in some societies than in others, but the stigma affects men on another level.

Stereotypes and antiquated ideas about gender contribute to the stress men face. Don’t get me wrong. Women are faced with unrealistic expectations, too. For example, we expect women who work and are spouses and mothers to excel in all three areas, which is unreasonable. But we men have our societal pressures to deal with, too. We are expected to be strong ALL the time, even though, being human, we cannot be. We are supposed to be the breadwinners and heads of the households. And as for sex, we are shamed for erectile dysfunction, premature ejaculation, and not ‘measuring up’. Society frowns on men ridiculing women with capacious vaginas but tolerates women chiding men over their ‘shortcomings’.

RESTRICTS US

Women are permitted to exhibit a wide range of emotions, but society restricts us. We are allowed to be angry, hungry, and aroused; but being sad, afraid or insecure is less well tolerated. We are told to ‘be a man’ and to ‘man up’.

We are informed that men and boys are not supposed to cry, but the selective tolerance of men shedding tears is rather interesting. When we watch the World Cup, Olympics and other prestigious sporting events and we see men cry because their team got eliminated, or they miss out on a medal because of injury or disqualification, we do not bat an eye. But place us in certain other situations, and we risk harsh judgement or even ridicule. I recall an incident where American actor Will Smith was engaged in dialogue with his wife, Jada, about a relationship she had with another man during a turbulent time in their marriage. At one point during the conversation, Smith became teary-eyed, and that image became a meme used to poke fun at him. So we can cry when we pull a hamstring and drop out of a race, but we have to be mindful of shedding tears when a woman we love does something that hurts us.

This societal pressure contributes to the different ways men and women may display symptoms of mental illness. For example, regarding depression, women are more likely to show signs of low mood. Men may also display these symptoms, but are more likely to exhibit irritability, sudden anger and increased loss of control. These symptoms are more culturally acceptable. We are also more likely to go missing, or become dependent on alcohol and other drugs.

BOTTLE UP EMOTIONS

Because of societal expectations, many of us bottle up our emotions. As an obstetrician and gynaecologist, I can tell you that one of the commonest complaints I hear from my patients about men is that they do not talk or open up. But this repression of emotions and their expression is unhealthy. Far too many of us suffer in silence. We hurt, but suck it up because society tells us to. So when we are afflicted with mental illness, or when situational stressors such as relationship or financial issues overwhelm us, and we reach a breaking point, the risk of hurting others and/or ourselves, becomes a harsh and sometimes tragic reality.

In the United Kingdom, according to the government’s national well-being survey, men report lower levels of life satisfaction than women. Still, they are less likely than women to access psychological therapies, accounting for only 36 per cent of referrals to the National Health Service. In the United States, in 2022, a review of studies examining societal stigma surrounding mental illness published in the American Journal of Public Health found that men who internalised that stigma were less likely to get help and more likely to face challenges, and therefore at a heightened risk for severe mental illness. Research has also found that people who are treated for depression or suicidal thoughts are far less likely to contemplate or attempt suicide.

Efforts must therefore be made by those in positions of authority in the mental health field to not only destigmatise mental illness, but to normalise men talking about their issues and receiving therapy. The emotions surrounding mental health that stop many of us from seeking help is killing us. Literally.

Michael Abrahams is an obstetrician and gynaecologist, social commentator and human-rights advocate. Send feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or follow him on Twitter @mikeyabrahams.