Men’s Health: 6 Mental Health Struggles More Likely to Affect Men
Although depression and anxiety are the most common mental health struggles in the population overall, there are some other conditions that affect men at higher rates than women. In this article we will focus on the conditions that are disproportionately diagnosed among men.
Rates of mental illness have been growing among people of all genders, including men. Some research shows that about 1 in 7 males suffer from depression or anxiety during their lifetime.
Reported rates of depression and anxiety are lower in men compared to women. There might be a few explanations for this, but it could be damaging to assume that men need less support. Unfortunately, many men suffer in silence.
Why do fewer men seek help than women?
In many societies, both mental and physical “toughness” are typically considered masculine, while emotional sensitivity and empathy are considered feminine. While this perception may be rooted in evolutionary and biological bases, it is enhanced by social and cultural expectations and practices.
Throughout childhood, boys are often discouraged from overt displays of emotion, particularly sadness, while girls are more regularly spoken to about their feelings.
As a result, men may be less likely to be open about feelings of anxiety or depression due to a higher degree of perceived stigma and threat to their masculinity. In contrast, women are often encouraged to discuss such concerns. Therefore, it’s important to consider that males may be unrepresented in the reported prevalence rates of such conditions.
When men experience mental health challenges, they are more likely to externalize their emotions. This means that their struggles are more likely to manifest outwardly, sometimes as aggressive or disruptive behavior, whereas women are more likely to internalize their struggles as worry or self-blame. This is of course an oversimplification, but it may partially explain some differences in mental health experiences.
Although depression and anxiety are the most common mental health struggles in the population overall, there are some other conditions that affect males at higher rates than females. In this article we will focus on the conditions that are disproportionately diagnosed among males.
It is important for us to note that the differences we are discussing are broad patterns that can be seen over large populations, and that there is a lot of overlap. That is, no assumptions should be made about any one individual based on the information discussed here.
Here we are focusing on men’s mental health in comparison to women, but other identities across the gender spectrum may experience their own unique challenges, which we will cover elsewhere.
1. Attention deficit hyperactivity disorder (ADHD)
ADHD is diagnosed at least twice as often in males compared to females—this gender difference is even larger in some studies. The condition is usually diagnosed during childhood, although, more and more adults are now becoming aware of their previously undiagnosed ADHD.
ADHD involves patterns of inattention (difficulty staying focused, disorganization, forgetfulness etc.) or hyperactivity (fidgeting, restlessness, talkativeness, impulsivity, etc.). It can include difficulties in either of these areas, or a combination.
We don’t really know the cause(s) of ADHD, but there are several theories as to why the rates are higher in males. ADHD is an externalizing disorder, particularly the types that involve hyperactivity. This could be one explanation for why ADHD is identified more in males, given their higher tendency to externalize emotions.
There has also been some research to suggest that there are genetic components to ADHD, which may be more dominant among males. In addition to possible genetic and biological factors, ADHD often presents itself differently between boys and girls, and can be more recognizable in boys. This means the gender difference is likely a combination of actual higher rates in males and underdiagnosis in females.
2. Autism spectrum disorder (ASD)
About four times as many boys are diagnosed with ASD than girls. ASD involves a combination of difficulties in social communication (e.g., difficulties with reciprocal conversation, expressing or understanding nonverbal communication, making and maintaining friendships, etc.) and restricted, repetitive patterns of behavior (e.g., repetitive movements, strict routines, intense interests, sensory sensitivities, etc.).
ASD is believed to be made up of extremities of certain traits that are common in the population. For instance, we all have different degrees of social skill, but autistic individuals fall close to one end of the continuum.
Many ASD traits are aligned with traits that are considered typically “masculine”, such as a greater understanding of systems and mechanics, attention to detail, visuospatial skills, and reduced language and social abilities.
There is a theory called the extreme male brain theory of autism, which suggests that ASD is an extreme of typical male features and brain functioning. There is some research to support this idea, but it is somewhat controversial and not fully accepted in the scientific community.
More accepted is the idea that there may be a bias in how ASD is recognized and diagnosed among males and females. ASD tends to look a bit different in females and may be harder to detect. Research suggests that girls are better able to “mask” their symptoms, meaning that they are better able to mimic typical behaviors and fly under the radar. So again, the gender difference may be a combination of actual higher rates of ASD in males, as well as underdiagnosis among females.
3. Schizophrenia
Research does show that males are more likely to be diagnosed with schizophrenia at younger ages. Males are more commonly diagnosed with schizophrenia in their late adolescents and early adulthood compared to females of the same age.
What’s more, men with schizophrenia have lower chances of remission than women and are more likely to experience more severe outcomes, including reduced cognitive functioning, and higher risks of homelessness and suicide.
Experts have speculated about the reasons for these differences—most likely an interaction between biological and environmental factors. It’s possible that higher rates of substance abuse among men could also play a role, but ultimately, there are still many unknowns in this area.
4. Substance use disorders
Overall, men use recreational drugs and alcohol more than women. However, substance use does not imply addiction, and the relationship between addiction and gender is complex.
More men present to emergency rooms due to the effects of a substance and overdose—probably because of the higher rates of substance use among men and because they tend to use larger amounts.
There are also more men in treatment for substance use disorders than women, which could reflect higher rates of addiction among men. However, other studies show that the rates of addiction are equal between the genders, so this could suggest that there are unique barriers for women with addiction to receiving care.
Substance abuse is related to externalizing behaviors, meaning that people who express their mental suffering outwardly are more likely to abuse substances. As we know, men tend to externalize more than women, and therefore may be more at risk of turning towards substances. Substance use can also lead to aggression and violence in anyone, but men are more susceptible to this effect.
5. Suicide
Sadly, men die by suicide about three times as frequently as women. Overall, women present to emergency rooms and report suicide attempts more frequently than men, but men are more likely to complete suicide.
There are a couple of reasons for this—first, as we discussed, men may be less likely to reach out for help when they are experiencing depression or hardship, and therefore are less likely to have support systems in place.
Another reason is that men are more likely to use quicker and more lethal methods than women, meaning there is less opportunity for intervention and a higher likelihood of fatality.
If you have thoughts of ending your life, we strongly encourage you to contact your local emergency services or support hotlines.
6. Antisocial personality disorder
Externalization of emotional pain can sometimes manifest as aggressive and defiant behaviors. This is particularly common among boys who have experienced physical abuse or other extreme adverse conditions in early childhood. Left untreated, such behaviors can, in some cases, develop into antisocial personality disorder (APD) in adulthood.
APD is characterized by a disregard for rules, exploitation of others, impulsive and destructive behaviors, and a lack of remorse. Men with APD outnumber women with the same diagnosis by about 3 to 1. This is likely due to the externalizing features of the disorder, as well as a potential bias among diagnosing clinicians to interpret aggressive behaviors in different ways between men and women.
Getting help: Tips for men
As males tend to struggle more with finding support, it might be helpful to try to build a support network by finding like-minded people. For instance, joining groups (in-person or online) focused on topics or activities that you are interested in—it doesn’t have to be about mental health, but having more connections with people in general can protect against mental health challenges.
It is hard for anyone to reach out and talk about mental health, but it might be especially hard for men who have grown up believing that vulnerability reflects weakness. While getting support can be important, it also helps to try and not put too much pressure on yourself—take it one step at a time, starting with approaching things in a way that feels less vulnerable to you. For instance, men often prefer a more problem-solving approach to their challenges, rather than an emotion-focused approach, which is fine!
It can also help to keep in mind that there are many positive aspects of traditional masculinity. Reflect on how you can embody these positive qualities while leaving behind other aspects that might be damaging to yourself or others.
It’s okay to ask for help, and it takes a lot of strength to do so. Remember that, whatever challenges you face, you deserve to be cared for.
If speaking to others is difficult, you could learn about managing mental health using the Mind Ease app.
