Why Depressed Men Won't Ask For Help

Medical Reviewer

How many times have you heard, "I don't want to talk about it"? It's a typical male response and one that fits very neatly into the male strong-and-silent stereotype. A feature of masculinity is that it equates to mastery over the emotions. Most men will tell you that listening to another man openly express their emotions is an uncomfortable experience. It's easier if they can talk in a controlled and measured fashion, but tears and tantrums are a real problem. Some men will simply walk away. They've categorized the emotional male as weak, thin-skinned and effeminate.

The idea that real men don't express emotions is something of a fallacy. For a start there is no evidence I'm aware of to say men don't feel emotions any differently to women. So if there is a difference it's in the way men learn not to express emotions. Actually, I need to qualify that last point, because there are certain emotional expressions considered particularly male. I'm thinking here of positive expressions like cheering and laughing, but also of negative emotions such as possessiveness, jealousy and anger. Oh yes, the emotions are in there, but there are times when the real-man stereotype serves to cause particular difficulties for men.

Men have a way of viewing emotional problems with the kind of logic that corresponds to their notions of independence. It can result in a kind of obstinacy - the sort that stops men asking for directions or for assistance in a shop - and this can extend to a lack of acknowledgment that they are experiencing emotional distress. Men are much less likely to seek professional counseling or help, and those who do are less satisfied with the service they receive. In many respects some of the talking therapies haven't done themselves too many favors. Anything that relies on relinquishing control, verbal expression of emotions and admission of emotional vulnerability is hardly going to tick most men's boxes.

I don't mean to clump all men into a category of emotionally incapable individuals. Clearly there are many differences between men but I know from my own and others experiences that the traditional male role is alive and well. There already exists a good amount of literature on the specific needs of particular groups such as African American and gay men. This is good news but we do have to come to grips with the way traditional men view the world and their preferred ways of seeking help.

So perhaps the issue is twofold? First, men are certainly capable of expressing emotions but they do seem to have greater difficulties in untangling and then expressing the emotions they feel inside. Secondly, and related to the first, it seems to me that we need an approach with men that promotes this process while leaving men feeling empowered. Whether this can be achieved by varying existing techniques or by developing new therapies is something we need to explore.