Problem case “man”: how the “strong” sex deals with mental illnesses

UTired, overloaded, overwhelmed by accumulated stress and tormented by unresolved problems: many men in Germany have psychological problems, but ignore them and do not seek help, as experts point out.

“For many people, illnesses, especially mental illnesses, are not compatible with the classical ideal of masculinity,” reports Anne-Maria Möller-Leimkuhler of the board of directors of the Men’s Health Foundation. The orientation toward traditional norms of masculinity, “that is, being strong and successful, solving problems on your own, persevering, and not showing feelings,” is more pronounced among older men than among younger men. This attitude could be “very harmful to oneself”.

Many men have very limited access to their emotional world due to their socialization, notes the professor of social psychiatry at the University of Munich. “They suppress and trivialize their psychological problems.” Depression in particular is often misunderstood as an expression of weakness and personal failure. Some people try to compensate with “masculine strategies,” says Möller-Leimcooler. “So more aggression and anger, more alcohol, more social withdrawal, much more work, much more sport, more risky behavior and escape into the virtual world.”

Three times more suicides than women

In Germany, one in four adults suffers from a mental illness within a year: around one in three women and one in four to five men, as Anette Kersting from the Clinic for Psychosomatic Medicine at Leipzig University Hospital describes. “Men suffer more from substance abuse, that is, dependence or abuse of alcohol and drugs.” On the other hand, they are diagnosed with depression only about half as often as women. However, depression in men can sometimes be overlooked, explains the director of the clinic.

Möller-Leimcooler assumes that there is a high number of unreported and underdiagnosed cases, especially when it comes to depression. Unrecognized depression could have serious consequences: inability to work, social decline, isolation, anxiety disorders, diabetes, stroke and an overall increase in mortality. And: “The suicide rate among men is at least three times higher than that of women.”

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In general, mental disorders occur regardless of profession, experts say. However, Möller-Leimkuhler highlights high-risk occupational groups, with a high proportion of men, in which mental disorders occur more frequently than in the general population: the armed forces, the emergency services and even the police. The stress here can be extreme and traumatic, but at the same time the traditional norms of masculinity are quite strong. The most common disorders here are post-traumatic stress disorder and depression. In general, men are much more burdened by professional stress than women.

Men are less likely to use offers of help

It’s not just their ideals that often seem to hinder men. Women recognize and name symptoms better than men, says Anette Kersting, director of women’s and men’s health at the professional association of psychiatrists DGPPN. “We see clear gender differences in healthcare utilization. Offers of help are used much less often by men.” Among people with mental problems, only a minority receive therapeutic treatment, men even less often than women.

The lack of places is problematic, underlines psychologist Sebastian Jakobi, consultant to companies on workplace safety. “Those who need psychotherapy are in a weakened life situation and cannot wait many months for a place in therapy.” However, the fact that there are few male therapists is less important. In any case, this is not the reason why men rarely turn to a psychotherapeutic office.

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Overworked businessman

In recent decades the cliché “man does not know pain” has lost its meaning. This happens more often among young people than among older people, observes Jakobi, who is on the board of directors of the freelance section of the professional association of psychologists DGPPN. “Awareness, reflection, seeking and accepting help are important skills for health.” There are still “important construction sites” for a significant percentage of men.

Digital offers

Even in a modern society with equal opportunities, rights and responsibilities between men and women, there are many men who place burdensome demands on themselves, for example to provide for their family. At the same time, Jakobi sees a trend towards the destigmatization of mental illnesses. More attention is paid to psychological factors, diagnostics have improved and the medical profession is also much more aware.

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Woman suffering from insomnia.  Alone at home in the throes of depression, covered with a blanket in the bedroom

If men who are afraid of stigma and don’t seek help turn to mental health apps, “that’s fine, better than nothing,” Jakobi says. The advantages from their point of view could be: low threshold, anonymous offering, easy switching between multiple apps. But: “It is a mistake to think that such digital offers can replace real personal therapy with a psychotherapist.”

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