“There is nothing wrong with being afraid – but there is nothing more wrong than allowing that to be your master.” — Bobby Darin
Mental health is quite a huge uproar in the modern world, although it’s still in its infancy age but the awareness regarding its impact and importance is increasing day by day. Yet it couldn’t reach where it should be able to tackle the mass mental crisis among Indians.
The World Health Organization (WHO) conceptualizes mental health as a “state of well- being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.
According to an article of Times of India, India ranks 61st in global mental health report of 2024, while The Economic Times reports 60-70 million people in India suffer from common mental disorders; stigmatization, financial barriers prevent timely treatment. In an article published in India Today, another survey, conducted with more than four lakh people across 71 countries (46,982 in India), found that 30.4 per cent of Indians are distressed and struggling with their mental health, compared to 27.1 per cent globally .The statistics get even worse when it comes to men’s mental health . The traditional idea where men are praised for their resilience and the expectations of them to be stoic warriors often make us overlook the mental health struggles faced by them.
The traditional phrase ” boys don’t cry “ imbedded in our society so deep from childhood that men often don’t know how to react or cope with stressful situations leading them to adapt maladaptive coping mechanisms like social isolation, emotional castration, substance abuse or catharsis (the process of releasing repressed emotions )through anger outbursts . Men who express their emotions openly are often judged ,shamed and labelled as weak while a popular cultural acceptance of anger expression in a maladaptive way by displaying aggression reinforce it as their primary defence mechanism for men to hide their vulnerability and their real emotions. Research has consistently found that women experience anger as frequently and as intensely as men. But men who feel angry are more likely to display aggression. The prevalence of anti-social behaviour in men is 3: 1comparing women, although it could also point out to the major criticism of the research structure where most subjects are men under study. In adolescent case, boys are more likely to have anger issues than girls, engage in high risk behaviors and commit suicide.
According to a recent NCRB (National Crime Records Bureau) report, the suicidal death rate per lakh (SDR) among men stood at 20.6, compared to women’s 8.1 in the year 2021. Dr. Lakshmi Vijay Kumar, founder of Sneha, an NGO in Chennai for the prevention of suicide, says, “There’s an anomaly, a paradox. Worldwide, women have a higher prevalence of depression, but its men whose suicide rates are higher. It goes to show that men have difficulty in expressing their emotional needs and distress, which leads to issues like substance abuse and hence higher rates of suicide. “The findings of a National Institutes of Health (NIH) study of men’s willingness to seek help for their mental health concerns pointed to a stark reality: men are significantly less likely to seek help than women, often downplaying their symptoms of mental illness. NIH have founded several key reasons which dominates this reality like mental health stigma, societal expectations, toxic masculinity, gender roles etc.
Another major issue is identification of mental illness among men population is how emotional discord varies in expression compared to their counterparts. Let’s consider the example of depression, where men are often underdiagnosed because of the way symptoms are exhibited. Particularly in the early stages, it often manifests as irritability, anger, hostility, aggressiveness, risk taking, and escaping behaviour. Such expression of feelings, influenced by many contextual factors including gender socialization, can mask more typical symptoms of depression like sadness, crying, feelings of guilt, and changes in appetite.
Warning signs to look out for:
The signs and symptoms of a mental health condition varies according to its nature but there are some common ones which we can look out for
- Aggressiveness, anger and irritability
- Changes in appetite and sleeping habits
- Difficulty focusing
- High consumption of alcohol
- Participating in risky activities
- Having aches, pains or other physical symptoms without a clear cause
Common mental health conditions in men:
Depression:
Depression is characterized by a persistent low mood that interferes with everyday functioning. Worldwide, it is one of the most common mental health conditions. Yet research suggests that men’s are often underdiagnosed.
Anxiety disorders:
Anxiety disorders are characterized by intense and uncontrollable feelings of fear and worry. Social anxiety disorder causes intense anxiety and fear in social situations, while OCD causes the continuous repetition of specific thoughts (obsessions) or a compulsive need to perform specific routines repeatedly (compulsions).
Schizophrenia:
Schizophrenia is a severe mental health condition wherein people do not interpret reality as it is. They experience hallucinations, delusions, and other forms of disordered thinking. Schizophrenia can have a significant impact on quality of life and relationships. Of those who receive a schizophrenia diagnosis by the age of 30 years, 90% are men.
Post–traumatic stress disorder:
PTSD is a condition characterized by symptoms of reliving a traumatic experience, avoidance, and hyper arousal. Research indicates that around 60% of men experience at least one traumatic event in their lifetime.
Substance abuse:
Across most age groups, men have higher prevalence in use and dependence of illegal drugs and alcohol than women. They are also more likely to require an emergency department visit and die from overdose. According to the National Institute on Alcohol Abuse and Alcoholism, 68,000 men die annually from alcohol-related causes, compared with 27,000 women.
Treatment:
Psychotherapy: Therapy can help people work through issues that have triggered mental health conditions. It helps individuals by teaching them how to manage their symptoms, change their negative thoughts and unhelpful behaviours and learn new coping skills
Medication: A doctor may prescribe medication to treat various mental health conditions or symptoms associated with those illnesses. For example, they may prescribe: Antidepressants, Antianxiety medications, Antipsychotic drugs, Sleep aids. Typically, doctors will recommend that people use medications in combination with psychotherapy.
Lifestyle changes : Adapting positive lifestyle can hugely impact and improve mental well- being. For example, it is important to: Eat a balanced diet, Get enough sleep, Exercise on most days, Manage stress through meditation or yoga, Limit or avoid the use of alcohol and drugs.
Peer support: Attending a support group or group counselling can be beneficial in the recovery of mental health condition. Knowing that you are not alone in this journey and there are people who will make men feel more vulnerable and open to their emotions which could enhance acceptance of true self in them.
Other measures
- We need to change how men traditionally think about depression and suicide by breaking down the stigma that surrounds these topics. Rather than having men think that they are weak, flawed or different, make them aware that all occasionally have struggles and something like depression is pretty common among men too.
- Reframing men’s perspective regarding health services and how asking help is not a sign of weakness rather it’s a show of strength, of taking control of their situation to get things back on track.
- Changing the landscape of services available for men . Often men hesitate to seek help because of the lack of male mental health professional in the therapeutics setting, believing current mental health services are set up mainly to serve women. While this is not completely true, there are aspects of how services are delivered, and even the language that is used, that fail to resonate with men.
In the end, communication and expression of emotions in a healthy way is the Achilles heel of any mental health condition, unlike popular myth, continuous talking doesn’t necessarily mean communication, and sometimes silences can also play a huge role in meaningful communication to build a good relationship. Acceptance and willingness to seek help can also pave a way for a healthy mental condition.
Authors
1. Mr M Abdulla is pursuing his graduation degree in Psychology, Yenepoya (deemed to be university), Mangalore. His intresets include dancing, drama and singing
2. Dr Deepa Rasquinha, Associate Professor, Department of Clinical psychology, Yenepoya (deemed to be university), Mangalore. With 20 years’experience in the academic field she is very passionate about creating awareness on mental health among general public