Grandfather with grandson in a forest, pointing to something in the distanceMen may struggle with mental health issues including depression, suicidal thinking, and addictions, but they are far less likely to seek help than are women. This may be partially because men can often brush off or bottle up difficult emotions rather than process them. Another reason may be some men’s tendency to view discussion about therapy and mental health as a way to take away their masculinity. But in the same way masculinity may take many forms, the language we use to discuss mental health can also shift to engage a diverse range of people. 

Working with a therapist who uses a goal-oriented approach and who places therapeutic goals in the context of creating a better quality of life may help some men see the value in doing just that.

What Brings Men to Therapy?

In recent years, the role of men in the workplace, in relationships, and in society has changed to more strongly reflect equality. As this happens, some men begin to feel they have lost their traditional place or roles within society. This can cause stress and frustration as men seek to find a place through employment or within a relationship. Stress at one's job, in familial relationships, or as a result of one's pursuit of romantic relationships and intimacy may also lead men to seek therapy. 

One challenge men may face is the way symptoms of mental health conditions are experienced. For example, a man who is experiencing depression may be angry and irritable. Men in general have been shown to less often cry, discuss their feelings, or express thoughts of suicide. 

Posttraumatic stress may also lead to anger, as well as aggression, and men with PTSD may be somewhat more likely to cope with symptoms by using drugs or alcohol. Men may avoid seeking help until a point of crisis is reached, fearing that others will see them as weak, but treatment may become more complicated as a result. 

While there are no male-specific diagnoses in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), common issues reported by men seeking therapy include:

  • Anger
  • Stress, which may present with somatic pains, complaints, or feelings of irritation or frustration
  • Work adjustment issues such as procrastination, avoidance, anger, or success sabotage 
  • Substance dependency or addiction
  • Other dependency or addiction, such as internet, gaming, gambling, or sex
  • Body image issues
  • Bipolar
  • Depression, which might be experienced as boredom, lack of motivation, or feeling that one is blank or "stuck"
  • Relationship issues

Some men may experience fear and shame related to preconceived notions of their roles and responsibilities. For example, a man whose employment income is not sufficient to provide for the needs of his family may experience feelings of frustration or emasculation stemming from the belief that he should be able to provide for his family. This may especially be the case when a spouse or partner brings in more income or has a higher-paying job.

What Keeps Men from Going to Therapy?

Only about one third of all people in therapy are men. Research shows that men are less likely to seek help for mental health issues than women are, and studies also show that men may often delay getting help until there is a crisis. Men may tend to be more concerned about privacy, so they sometimes require greater reassurance that therapy will not adversely affect their image, position, or standing. 

Additionally, because men are often conditioned by social norms to refrain from showing certain emotions, such as emotional vulnerability, fear, sensitivity, or dependence, they may fear that expressing these emotions will lead them to be perceived as less masculine. However, keeping back these emotions may cause other emotional difficulties, and those who attempt to hold back their feelings may find their health and well-being are negatively affected by the practice. 

Some researchers have suggested reworking a description of therapy in order to make it more appealing to men. It is also believed that when men understand that many other men experience depression and other mental health concerns, they may be more encouraged to seek help when needed.

Therapy for Men

Men have been shown to be less likely than women to follow through with treatment recommendations. This behavior does not always characterize a resistance to treatment, however. “Real men solve their own problems” is a common stereotypical belief that may lead men to consider the act of asking for help to be shameful. Therapy generally requires open and honest communication about feelings, relationships, and other personal issues, and men may be more guarded and defensive when discussing these topics.

When therapists and other mental health professionals normalize the reluctance to share personal feelings and any defensive tendencies and address misconceptions regarding “typical male behavior,” men in therapy may be more willing to address their concerns. This may increase their likelihood of seeing results in therapy. Therapists are often able to help men explore aspects of “normal male behavior” that society has overlooked or encourage and help them to become better able to address feelings, get needs met, and achieve goals in an effective and healthy manner.

Couples Counseling and Men

Men who experience barriers to communication or other challenges in an intimate relationship may find couples counseling to be helpful. In couples counseling, both partners can:

  • Express their feelings and emotions
  • Explore reasons behind behavior that may be affecting the relationship
  • Discuss goals, whether related to the relationship or those of a personal nature

Many couples in therapy report concerns over differing communication styles, general communication issues, relationship goals, and concerns relating to intimacy both emotional and physical.

Group Therapy for Men

Research shows that men may be more likely to succeed in therapy when assigned realistic and achievable tasks, such as homework assignments and specific behavioral goals. Therapy groups may also be helpful, and some men may find that joining a therapy group is an easier first step than seeking either individual or couples counseling. 

In a therapy group, men may receive support and encouragement from other men who identify with them and are experiencing similar issues. Issues that are often experienced by men may be normalized in a group therapy session, and men may find themselves more readily able to take advice from men with whom they can identify.

Online Mental Health Resources for Men

Some men may want to pursue mental health care or a supportive community or learn more about their own mental health online before choosing to connect with a therapist. Here are some mental health resources that can be found online and that are built with men’s mental health in mind.

  • HeadsUpGuys: This resource exists to help men with depression. It educates men about depression, shares tips for dealing with depression, provides ideas for reaching out for support, and allows men to build their own personal action plan for managing depression. HeadsUpGuys also offers a “self-check,” which helps men determine if they have symptoms of depression that other men often report.
  • Young Men’s Health: Young Men’s Health provides a holistic set of health resources for young men, including an extensive section on emotional health. This resource provides information on a number of mental health topics relevant to young men and includes a section on questions asked anonymously by young men and answered by site staff.
  • Men’s Health Resource Center: At the Men’s Health Resource Center, men can explore their mental health and learn more about issues such as anxiety, depression, posttraumatic stress (PTSD), and stress. The site also lists external resources for men dealing with specific mental health issues.
  • Campaign Against Living Miserably (CALM): A leading campaign to combat and prevent male suicide in the UK, CALM offers a helpline for men located in the UK as well as online help and a webchat. This resource allows men to find help and support for a variety of mental health issues by location.

Case Example: Men in Therapy

Anger as a symptom of depression: Marco, 42, enters therapy in conjunction with anger management classes as a condition of continued employment after his outbursts at work become problematic. He tells the therapist that he feels like nothing is going right for him lately. He has been passed up for a promotion by a newer employee, his wife frequently expresses dissatisfaction with their relationship, and his finances are not quite what he had hoped they would be in his current stage of life. The therapist helps Marco explore each of these issues, and in the process, Marco's loneliness also surfaces. He reveals that his best friend since high school died by suicide four years earlier and since then, he has found that areas of concern in his life have become harder to handle. Communicating with his wife is difficult, as he does not want to admit to her the extent of his sadness and low spirits, and his reluctance to express emotion has created distance between them. He also tells the therapist that he drinks more than he would like to, and gaining several pounds has further lowered his spirits. The therapist helps Marco realize that the anger he is experiencing is likely a symptom of depression. At first Marco brushes off this suggestion, but as the therapist further describes the condition of depression, he begins to accept the diagnosis. Once he does, the therapist helps him address his feelings and gives him small daily tasks to improve self-care, improve his communication with his wife, and express his dissatisfaction in the workplace in a more constructive manner. Marco begins to see small improvements early on, and over time, he finds his mood much improved. Reaching out at work both enables him to build new friendly relationships and to succeed in achieving the next promotion he tries for. Discussing his low spirits with his wife also greatly strengthens their relationship, and they are able to renew their intimacy with a little work. 

References:

  1. Frazier, L. (2016, June 15). Talk like a man: The language of male mental health. Retrieved from https://intermountainhealthcare.org/blogs/topics/live-well/2016/06/talk-like-a-man-the-language-of-male-mental-health  
  2. National Institute of Mental Health. (n.d.). Use of mental health services and treatment among adults. Retrieved from http://www.nimh.nih.gov/health/statistics/prevalence/use-of-mental-health-services-and-treatment-among-adults.shtml
  3. Rabinowitz, F. (2016, September 14). The benefits of men’s groups. Society for the Psychological Study of Men and Masculinity. Retrieved from http://division51.net/homepage-slider/the-benefits-of-mens-groups 
  4. Winerman, L. (2005). Helping men to help themselves. Retrieved from http://www.apa.org/monitor/jun05/helping.aspx