Manning up? Why men have a harder time talking about mental health issues
Man up.
It’s a commonly heard refrain in many contexts, but what, exactly, are its implications? What, physiology aside, does it mean to be a ‘man’?
Is it knowing how to change a tyre, or fix a leaking tap? Does it mean being the head of a household, and its primary breadwinner? Or are the associations less tangible, and more values-based – manliness and ‘manning up’ involve displays of strength and dominance, stoicism and control, a mindset and approach to life in which showing emotion or asking for help are viewed as signs of weakness?
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The ‘silent’ crisis: men, emotions and stigma
The stigma around men opening up about their emotions is one that remains deeply rooted in many societies around the world (not to mention through still too many media portrayals). And while there’s no question that traditional expectations around gender roles are continuing to evolve, some research suggests that these stereotypical ideals – which remain pervasive in patriarchal societies such as Hong Kong – can negatively impact men’s mental health, specifically, through episodes of depression and anxiety.
In addition to the regressive stereotypes around masculinity, there is also a body of research showing that men have more trouble forging social connections. When combined with the idea that being a ‘man’ means displaying strength and stoicism, the vicious cycle becomes pretty self-evident – asking for help, or opening up about emotions, can seem emasculating to many men, especially when you’re taught that being a ‘man’ means handling things on one’s own.
The perverse irony that stems from this model of masculinity is that men are more likely to under-report symptoms of depression – and it’s why depression and anxiety in men are often referred to as a ‘silent crisis’. (It should be noted that there’s also a relative ‘silence’ academically when it comes to men and depression – in my research for this article, I was met with a dearth of Google Scholar results related to our topic at hand.) While women are more likely than men to develop depression in their lifetimes, a 2011 Harvard University study showed that a not insignificant figure of up to 17 percent of men ‘develop major depression at some point in their lives’.
Depression is also a key risk factor for suicide: annual men’s suicide rates in Hong Kong are consistently higher than women’s, and the same also applies on a global scale. While this is perhaps a morbid way to look at it, the numbers speak for themselves, and not exactly silently.
Towards a more holistic understanding of mental health
The ideas that have led to men’s mental health being seen as a silent crisis, however, do not fully align with how mental health is now understood. Where depression and anxiety were once perceived as personal issues that signified a lack of mental fortitude, research has now come to recognise the impact that chemical changes and imbalances in the brain, and how these can interplay with external factors to impact a person’s mental health.
But too many parts of society still have a way to go when it comes to this more holistic understanding. Hong Kong’s numbers certainly leave much to be desired – research conducted last year by Mind HK in collaboration with the University of Hong Kong and King’s College London showed that 40 percent of Hong Kongers would be ‘unwilling to live nearby someone with mental health problems’, while the same amount ‘felt that one of the main causes of mental illness is a lack of self-discipline and willpower’.
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Incidentally, research by the Chinese University of Hong Kong and commissioned by the Mental Health Month Organising Committee showed that in 2019 the city’s mental health had hit its worst level in nearly a decade. This result was attributed in part to the pro-democracy protests that swept much of the city over the back half of the year, a vivid illustration of the impact societal factors can also have on mental wellbeing. While this research was not exclusively about men’s mental health, the fact that Hong Kong is in many ways a traditionally patriarchal society means it’s not a stretch to extrapolate these findings to a context where it’s probably that much more difficult for men to open up about their mental wellbeing.
Breaking the cycle
It’s not all bad news though: the past decade has seen a significant improvement in the way that men’s health is talked about at a societal level. The global initiative Movember has shone a light on the issue of men not speaking up about their health, while men’s-specific organisations in countries such as Australia create safe spaces for men to start conversations around their wellbeing and that of others.
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Continuing awareness and education around men’s health issues will go a long way to further breaking down some of the long-held stigmas that remain deeply rooted in many societies around the world. But there’s nothing unmanly about speaking up about how you’re feeling – because ultimately, what’s more empowering than taking control of your own story?
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Sources:
Seidler, Zac E., et al. “The Role of Masculinity in Men's Help-Seeking for Depression: A Systematic Review.” Clinical Psychology Review, Pergamon, 10 Sept. 2016, www.sciencedirect.com/science/article/abs/pii/S027273581630004.
McKenzie, Sarah K, et al. “Masculinity, Social Connectedness, and Mental Health: Men's Diverse Patterns of Practice.” American Journal of Men's Health, SAGE Publications, Sept. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6142169/.
Abramson, et al. “Gender Differences in Self-Reports of Depression: The Response Bias Hypothesis Revisited.” Sex Roles, Kluwer Academic Publishers-Plenum Publishers, 1 Jan. 1978, link.springer.com/article/10.1007/s11199-005-6762-3.
Harvard Health Publishing. “Recognizing Depression in Men.” Harvard Health, www.health.harvard.edu/newsletter_article/recognizing-depression-in-men.
HKJC Centre for Suicide Research and Prevention, HKU, csrp.hku.hk/statistics/.
“Suicide Rates (per 100 000 Population).” World Health Organization, World Health Organization, 21 Aug. 2018, www.who.int/gho/mental_health/suicide_rates_male_female/en/.
Harvard Health Publishing. “What Causes Depression?” Harvard Health, www.health.harvard.edu/mind-and-mood/what-causes-depression.
Digital Candy Hong Kong Limited. “PRESS RELEASE: Not My Problem? Hong Kong's Attitude toward Mental Health Is Changing, but There's Plenty of Room for Improvement.” Mind HK, 20 Mar. 2019, www.mind.org.hk/press-releases/pressreleasettcresearch/.
“Mental Health in Hong Kong at Its Worst Level in Eight Years: Survey.” South China Morning Post, 10 Oct. 2019, www.scmp.com/news/hong-kong/health-environment/article/3032234/mental-health-hong-kong-its-worst-level-eight.