This article may be triggering to some people. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
“Daddy is in the closet with a gun…” This was the welcome I received by a child after ringing the doorbell of a friend’s home. The wife had expressed to me that her husband was working more than he could mentally or emotionally keep up with. I know he survived that day, however, I lost touch and I’m unsure how things are today. I hope he found the help and life balance he needed for himself and his family.
My friend’s husband falls in the highest category of suicide rates: the middle aged white man.
- White males accounted for 69% of all suicides in 2019.
- Men are four times more likely to commit suicide than women.
- Six million men are affected by depression every year.
- Men die of alcohol abuse at a rate of 62,000 to 26,000 comparatively.
- Use more lethal means to attempt suicide than women, such as guns.
- Show fewer warning signs than women before a suicide attempt.
How can we reduce these statistics? First, let’s look at the warning signs.
Signs of Depression in Men
From a young age men are taught to “man up” and not cry; it follows that most men do not develop healthy coping mechanisms or the emotional vocabulary to address emotional pain. They are less likely to articulate their depression or need for help. Depression may be easy to recognize in some men with fatigue, sadness, or lack of interest, but other men may express depression differently. They may have:
- Escapist behavior, excessive time at work or sports
- Physical symptoms: headaches, digestive problems and pain
- Problems with alcohol or drug use
- Controlling, violent or abusive behavior
- Irritability or inappropriate anger
- Risky behavior, such as reckless driving
These risky behaviors can lead to relational and legal problems worsening the depression, so it’s important to recognize the signs as soon as possible.
Violence to others and self, Psychotropic Medications, and Mental Illness
We have established that men are not encouraged to express their feelings. Therapy is all about talking and expressing feelings, therefore, it’s not considered a manly coping mechanism. How about medications? I have frequently been told by friends and the media that medications only worsen the problem. But do they?
- Mental illness and psychotropic medications have not been adequately proven to be the cause violence.
- 1 in 112 individuals under the age of 24 are at an increased risk of suicidal ideas and attempts with antidepressants.
- People with mental illnesses account for only 3% – 5% of violent crimes.
- People with both substance use disorders and personality disorders were 240 percent more likely to commit violent acts than mentally ill patients without substance abuse issues.
- While some psychotropic drugs list irritability as a potential side effect, there are other notable medications that increase risk of aggression: anti-seizure medications, steroids, immunomodulatory drugs, antivirals, oxycodone, creatinine, marijuana, caffeine, and alcohol.
The fear of increasing the risk of suicide or violence combined with social stigmas create barriers to proper treatment. This lack of treatment increases the risk of violent acts rather than preventing them. When appropriately treated, those with mental illness do not pose increased risk of violence over the general population. The increased risk of suicide is more in individuals without fully developed brains (under 24 years old), not older men. Substance abuse dramatically increases violent acts; substance abuse is a treatable form of mental illness. Personality disorders also have a high rate of violence; there are no medications for personality disorders. The only treatment for personality disorders is therapy, though patients often have concurrent diagnoses. While some prescribed psychiatric drugs may increase hostility, there are many other substances that do this, so we should not attribute aggressive acts to one category of medications. We must work to end the stigma and fear of psychiatric care to best serve our society by increasing understanding and awareness of the facts.
Coping While Maintaining Masculinity
I have frequently participated in self-help Facebook groups, all women. I have never seen a social media post about self-care for men. Here are some ideas to cope without feeling less manly:
- Join a men’s bible study, health or support group.
- Get adequate rest, not just nightly sleep, but also restful activities that you enjoy such as: reading for pleasure, writing in a journal, watching an entertaining movie, taking a midday nap, or petting/playing with your pet.
- Take time for fun activities: fishing, cooking, playing an instrument, or going to a restaurant, concert, or sporting event.
- While it is important to go to family events and activities, do not miss out on regular date nights with your spouse/significant other.
- Moms often remind other moms that we have to take care of ourselves to be able to best take care of our families- the same goes for dads. Remember, that taking care of yourself is the most important thing the head of the household can do for the whole household.
We must be cognizant of the need for mental health care in men. The expression of depression in men can differ from women. While aggressive acts can be a sign of depression in men, many are afraid to become more aggressive by taking psychiatric medication. Studies have shown that there is a greater benefit to receiving mental health care than the risks associated with not getting professional treatment. We can alleviate these fears by normalizing the conversations about mental health care for men. This conversation should include ways men can cope without feeling less masculine; just as the foundation of a home should be strong so should the men in our society have solid foundations in their mental and emotional wellbeing.