Women are more likely to seek mental health treatment than men because of the stigma that it reflects a weak character. Depression and suicide are ranked as leading causes of death in men. In this episode, we explore:
- Why men avoid seeking help and how we can create a culture of acceptance so that we aren’t stigmatizing personal growth
- How men typically cope with emotional conflicts rather than get support
- How you can help the men in your life face their inner life so they can have better relationships and quality of life
This podcast represents the opinions of Debra Berndt Maldonado and Robert Maldonado, PhD. The content here should not be taken as medical/mental health advice. The content here is for informational purposes only, and because each person is so unique, please consult your mental healthcare professional for your mental health questions.
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Debra Maldonado 00:28
Hello, this is another episode of Soul Sessions. I’m Debra Maldonado, here with Robert Maldonado. Today we are talking about helping men get mental health. This is continuing our series on mental health. But before we begin, I’d like to remind you all to subscribe to our podcast, if you haven’t already, on Spotify, iTunes, and if you are listening to us on YouTube, there’s a link in the corner here that you can click and make sure you subscribe to our channel. Let’s talk about men and mental health.
Robert Maldonado 01:11
It’s a continuing series on mental health. We started with children, we went on to women mental health, and now men. The particular approach we’re going to take talking about men’s mental health issues is stigma. It’s a big issue for men, to seek out help, to simply acknowledge and admit, “I needed some help with my mental health. Where do I find it? How do I get it?” We’re going to discuss all those things.
Debra Maldonado 01:54
Let’s talk about stigma. Some women have a stigma about going to a therapist or talking about depression. But it seems to be more prevalent in men than women. If you go to any personal development workshop, there’s a load of women there and maybe five men out of 100. A lot of times they’re with one of the women there. You don’t see a lot of men at those events. When I was getting my book written, the very first one, Let Love In, they said 90% of self-help books are read by women. Men don’t buy self-help books. Maybe now that you can buy it incognito on Amazon and don’t need to go to the bookstore, but I could see that even making a choice to help yourself may be a stigma for men.
Robert Maldonado 02:54
We’re talking about different social and gender roles. Part of the culture, men in general, is to think in terms of strength, leadership, and power. Therefore, if you need help from any professional, especially a mental health professional, the implication is you’re weak. That goes against the whole gender role of masculinity. What is stigma? Mental health-related stigma is an umbrella term that includes social stigma, self-stigma, and cultural stigma. Social stigma is that social attitude that if you’re seeking help, you need help for your mental health, or your emotional wellbeing, for depression, for anxiety, for a personality disorder, there’s some weakness in you. Therefore people stay away from it. They don’t want to admit they need help, or they’re ashamed to be seen walking into a therapist’s office.
Debra Maldonado 04:26
There’s this idea that if you have a mental illness, there’s this stigma for men that you have a weak character, a character flaw.
Robert Maldonado 04:37
A moral failing on your part. But the whole idea in educating the public on mental health issues is this idea that if you had diabetes, for example, and you needed insulin, that’s not a moral failing. It’s just a medical issue that you need attention with. That’s where we need to get to, for people to see mental health services the same way as they do medical services, it is just something you do, something you need to take care of, and you take care of it. The self-stigma is the internalization of that social stigma, you believe there’s something wrong with you if you ask for help. There’s a weakness in you if you seek out mental health services.
Debra Maldonado 05:34
One is other people will see this as weak, the self-stigma is that you think there’s a shame around it, self-shame around seeking help.
Robert Maldonado 05:46
This is a big one, cultural stigma. A lot of us come from cultures that don’t even have a word for therapy or mental health services, it’s just denied.
Debra Maldonado 06:02
If you go to a therapist, it’s really for crazy people, it’s not for the average person, there must be something really wrong.
Robert Maldonado 06:14
I used to work with a lot of people from varying cultural backgrounds, almost across the board. It was particularly the men that had the problem with saying, “My child, my wife, my mother, the whole family needs mental health services.” They had a problem with it because it came from cultures where it was not acceptable to think of yourself as needing mental health assistance, to seek out a therapist. It was associated with people that were crazy. Only people that are crazy go to a psychologist or therapist.
Debra Maldonado 06:57
Initially, before the word “therapy” came about, no one talked about mental health.
Robert Maldonado 07:13
That’s the stigma element of it. If we look at the stats, we see the effects of that stigma, what it’s doing to the population of men. Take, for example, depression. Over 6 million men suffer from depression per year. This is a US study from an organization called Mental Health America. It’s a nonprofit organization that gathers data to do their work. Male depression often goes undiagnosed. Out of 6 million people that experienced depression per year, men primarily go undiagnosed. Men are more likely to report fatigue, irritability, loss of interest in work or hobbies, rather than feelings of sadness or worthlessness.
Debra Maldonado 08:17
They can’t connect that the fatigue or the lack of motivation really is depression, they think it’s just a quirk, or they don’t know what’s wrong, but they wouldn’t label it as “I need to get help”, it’s just “I’m just irritable right now.”
Robert Maldonado 08:36
I’m just bummed out, I’m just blue, I’m tired, fatigued, etc. They often don’t get or seek out treatment. 2.3 million Americans are affected by bipolar disorder, an equal amount of men and women develop the illness. The age of onset for men is between 16 and 25 years old, very young. You have these young men developing bipolar disorder, often not seeking treatment and not getting diagnosed. We all have a picture of depression. In bipolar disorder, the person goes from that depression to a state of mania, a high euphoric state of mind, where they’re highly energized, full of ideas. They talk really fast and add a million ideas going on at once. They’re very excited about new relationships, new job opportunities. Then they crash again, go back to that depressive state. The cycles vary. Some people may cycle in a week, going from high to low, others might take longer or shorter. But in general, that’s the pattern.
Debra Maldonado 10:06
If you think about it, it not only affects the person, but think about the relationships, how hard it is to be in a relationship with someone who has bipolar, because you don’t know what to expect, because it’s basically having a relationship with two different people, someone who’s down and someone who’s really high. Right now it’s treated with medication primarily.
Robert Maldonado 10:29
Primarily medication, but also psychotherapy works really well, as well as depression, very treatable. There’s pretty good depression treatments.
Debra Maldonado 10:41
But that’s interesting that the onset is 16 to 25. There’s a lot of talk about men at that young age, getting more and more isolated. If they have these feelings of depression, and there’s stigma around it, staying more isolated and not having relationships.
Robert Maldonado 11:03
A lot of people are able to function even with these very serious mental health problems. They’re able to get through the day and to hold down jobs. Often people go undiagnosed, even with bipolar disorder. Now psychosis and schizophrenia, these are more serious mental health issues. But approximately 3.5 million people in the US are diagnosed with schizophrenia. It is one of the leading causes of disability. 90% of people who are diagnosed with schizophrenia by age 30 are men.
Debra Maldonado 12:39
I didn’t know it was so prevalent in men. Again, before age 30. When you talk about schizophrenia, can you explain what that is to people that don’t know?
Robert Maldonado 12:51
This is the mother of all mental health issues. If you think of a person that needs to be hospitalized, medicated, attended to because of a mental health crisis, it’s schizophrenia. The person might have hallucinations, delusions, they might think that people are out to get them, the FBI is surveilling them.
Debra Maldonado 13:28
Beautiful Mind with Russell Crow was about schizophrenia. You see the stigma behind it. I’m not crazy, I’m smart. A lot of times they’re intelligent, it’s not a sign of lack of intelligence. You also mentioned eating disorders.
Robert Maldonado 13:50
Eating disorders are often missed in men because most people think of eating disorders as a women’s issue. But males account for an estimated 10% of patients with anorexia and bulimia, and an estimated 35% of those with binge eating disorder.
Debra Maldonado 14:09
You always hear about women dealing with that. A lot of times people think of eating disorder as you want to look beautiful, you’re using a disordered way of eating to stay thin. But it’s more than that. It’s a psychological self-concept that you’re dealing with with eating disorders.
Robert Maldonado 14:30
It could be body dysmorphic problem, they look at the mirror and don’t see reality. They see themselves as horribly fat, or horribly thin or something like that.
Debra Maldonado 14:41
One of my friends from school early on, 20 years ago, her son had it, he was only eight or nine years old, he was afraid of food. The thing that helped was hypnosis, she decided to be a hypnotherapist because of it. But it’s not what we think it is. She had mentioned it was very rare in men than women.
Robert Maldonado 15:07
Men with eating disorders are less likely to seek professional help than women. Again, the stigma of mental health. Then we have alcohol and drug dependency. Gay and bisexual men have experienced more traumas, so often there’s more problems with their mental health, and again, they fall prey to the stigma as well. Military veterans don’t get treated. Male veterans, regardless of their form of service, experience nearly twice the rate of alcohol and drug use than women.
Debra Maldonado 15:48
Instead of getting mental health treatment, many of them self-medicate with alcohol and drug abuse. Some get aggressive. Some people deal with stress in different ways, like working harder, being obsessed with creating success. They displace the feelings they have, they get obsessed, intensifying their hunger for power. It can also turn into anything, that addiction.
Robert Maldonado 16:24
One of the possible solutions is to have sports celebrities come out and talk more about their mental health issues. This paper presents some of the people that have done so. Terry Bradshaw — we’re not outing people, these’re people that self-identified as having a mental health issue and were open about it. Brandon Marshall, during his time as a wide receiver for Miami Dolphins, announced his diagnosis of borderline personality disorder. Jim Piersol played 20 years of professional baseball. During his rookie season in 1952, he suffered a breakdown leading to a diagnosis of bipolar disorder. NBA player Keyon Dooling in 2012 broke down, it was his lowest point, prompted his recovery process. He suffered from post-traumatic stress disorder from years of repressed memories of sexual abuse as a child.
Debra Maldonado 17:49
That’s a big thing too. If you think about it, women have such a hard time speaking about sexual abuse or abuse of a family member, someone in their life, in dating. But for a man, the stigma is even stronger, where they don’t mention they have been abused, they’re even less likely to get help. They end up a lot of times acting out toward someone else and become an abuser. Not all the times, other times it’s depression or other PTSD they haven’t coped with. That shame around, they don’t want to mention it to anyone. What’s the solution? What can we do to help empower, to have mentors come out, have more men come out and share their stories? Ted Lasso, that show on Apple is really great. He was talking about anxiety and panic attacks. He said, “We need to come out more with mental health of our players in the sports community,” but even in all different areas, we should be speaking up about that.
Robert Maldonado 19:04
Like most social problems, education is the key. We need to start educating the kids from early on, what the mind is, how we suffer when the mind has problems. Thinking about nutrition. This is an interesting line of research that’s recently been developing. We’re thinking, not only do these traumatic events in our life or difficult emotional experiences cause us suffering. The foods we’re eating, if they’re not providing proper nutrition for our mind bodies, may cause anxiety and depression, mental health issues from the foods we’re eating.
Debra Maldonado 19:55
Abuse of any kind of substance, alcohol and drugs, affects the brain. It hurts the brain’s ability to process. A lot of people get used to escaping from their problems instead of dealing with them and facing them head on, it just perpetuates the symptoms. If you know someone, you have a family member, brother, uncle, cousin, male friend, or even a coworker that you notice, maybe they need some help, how can you help normalize that? What would you say to them? How do you suggest approaching it, knowing there’s a stigma around it? How do you approach that so they can get help?
Robert Maldonado 20:44
You hit the target right there. Talking about it, normalizing the fact that there is a stigma but that one should still seek out help is a good conversation to have. You understand there’s a stigma around this and the person might feel uncomfortable seeking help. But that’s what they need to do in order to feel better, in order to treat their problem. That’s the good approach. Of course, you notice we’re talking about social stigma, not only individually, so that addresses the individual, but what about the social level? We need to educate the public, these kinds of podcasts where we can talk about mental health problems in an open way, discuss what that looks like, what it means. Does it mean I’m stuck with this forever? No, there are really good treatments. There’s CBT, which is a talk therapy, you don’t have to take medication. The research shows CBT is just as effective as antidepressants.
Debra Maldonado 22:05
What’s the cause of these mental illnesses? Obviously, a PTSD is some traumatic event. But if you can go back, what causes depression? What’s the cause of bipolar, schizophrenia? Is it genetic? Is it situational? Is it the toxins in the environment?
Robert Maldonado 22:30
Most human affairs are very complex. Almost all mental health disorders are considered to be multifactorial, there’s a lot of factors that go into it. There’s a genetic component, some mental health disorders have more of a genetic component than others. But then there’s the history of abuse, history of chaotic environments, history of learning disorders, history of head injuries. People that have had injuries tend to experience more mental health issues in their life. Any of those factors, combined with prejudice, genetic predisposition, add to the likelihood of a mental health problem arising.
Debra Maldonado 23:26
Just because men and women don’t go to workshops together, it doesn’t mean men aren’t suffering as much as women are. It’s just that women have a social agreement that it’s okay to talk about our problems and be open for the most part, where men have to be strong, can’t show any weakness. We’re generalizing here, but that’s the point. Before we finish up, there’s not only mental health with disorders where you’d have to get therapy. There’s also general every day “How do I cope with my life?” for men. Coaching really is a great way, more preventative to help people work with their mind, help people wrestle with anxiety or stress in their life, understand where their thoughts are getting in touch with their feelings. It doesn’t have to get to the point where they need a therapist. Of course, those disorders would definitely need a therapist, but there’s a lot of men out there that are not considered to be mentally ill in the DSM4, or DSM6. There’s also men that have everyday coping issues with life.
Robert Maldonado 24:49
Any medical problem, any physical problem, if you can prevent it, that’s a much better way to work with that. To prevent mental health problems, one of the biggest factors that we can apply today is to reduce stress. Chronic stress adds to those multifactorial elements, the genetics and history of chaotic families or abuse. Just reducing your everyday level of stress, through yoga, meditation, exercise, better sleep, better diets. Even the foods we’re eating contribute to that. You can start to think about improving your life by reducing your stress, being more connected to people, having social connections. It doesn’t have to be a lot of people, you don’t have to change from being an introvert to being the life of the party. Just making one or two really strong connections, with old friends, with work buddies, with people in your environment. Even just talking to your spouse, your girlfriend, your best friend in a deeper way. Talking about your emotions, your experiences in a deeper way. All those things contribute to mental wellness.
Debra Maldonado 26:42
If you know someone who you feel could use some help, just talk to them, share your experiences of your own growth, your own work, give them a book to read, ask them how they’re feeling, ask them if they’re getting support. Even coaching would be a good entry point to start the conversation. The coach can decide if it’s more serious, but we don’t want to be diagnosing everyone like everyone does, giving labels. When something’s off with someone, we notice they’re not functioning the way they should, they are pulling away, they’re being depressed, acting out a lot. That’s a really good indicator it’s probably a cry for help, but they don’t know how to ask for help. The hardest ones are the ones that withdraw because you can’t reach them, or the ones that push you away because they fly off the handle, maybe emotionally upset, and getting defensive. How do you approach that? Be compassionate, don’t react to what they’re doing. Have compassion and say “There’s something deeper going on with this person.”
Robert Maldonado 28:05
One of the general rules to follow is, when you see changes in yourself or others, you’re not eating as you used to, or you’re not sleeping well, or sleeping too much, or eating too much, or not eating enough, you’re not motivated to exercise like you used to, you’re not finding joy in the things that used to bring you joy. All those are signs of depression or anxiety. You want to keep an eye out. The basic idea is to look out for each other. We’re social creatures, we’re always surrounded by people. We just need to ask people, “How are you doing?” In a true sense, not just “I’m doing fine”, and forget about it, but really talk to people, really observe how they’re doing. Are they doing okay? Observe them to make sure they’re not overstressed. Chronic stress is very preventable. It doesn’t have to be there. People can learn stress management techniques, meditation, yoga, exercise that are very beneficial.
Debra Maldonado 29:21
If you’re a man and you’ve done personal growth, share it. Be open, be transparent, share your experience, be vulnerable. By you stepping out and admitting that this is a normal process, it’s nothing to be stigmatized around, it reduces the stigma for all the men, so definitely keep that in mind if you’re a man listening. You don’t have to go and do a whole post or a social media outing, but tell your friend, see if there’s a friend that you could talk to and share your experience. Maybe you can change one person at a time.
Robert Maldonado 30:02
Most people talk to their family physician. If you have a family physician, you can always ask them, “I’m feeling this way, what do you recommend?” There’s always help available. Next time we’ll talk a lot more about what we can do to better our societies, to make mental health more acceptable, so that everyone or anyone that needs help, can have access to services.
Debra Maldonado 30:38
It’s going to be great. The future of mental health will be our next session. Thank you all for joining us, please don’t forget to subscribe to our channel here, click on the button. If you are listening to our podcast, subscribe to us on iTunes, Spotify or wherever you listen to our podcast. Click subscribe and you’ll reach every episode. You don’t want to miss the next one. Take care, everyone. Hope you’re having a great day. Be vulnerable and help others today.
Robert Maldonado 31:10
See you soon.