Anxiety and Depression  |  Building Personal Resilience  |  Stigma and Discrimination

When Men Don’t Cry, But Are Hurting Inside…

29 March 2021  |   6 min read

“Man up!” Males of all ages hear these words all the time, from the four-year-old who has fallen and scraped his knee, to the businessman cracking from immense pressures at work.

It is a form of encouragement to stay strong and never cry. But such pep talks have created a gender gap between how men and women typically deal with problems.

Despite changing gender roles with more men now involved in the home while more women enter the workforce, social expectations have not caught up.

Men are still widely expected to be the strong, stoic and silent type – which stops them from reaching out for help.

It is not a big deal when they refuse to ask for directions. But it becomes a problem if they do not seek help for mental health issues and end up going the wrong way.

Male mental illness is not easy to detect

When men stay silent, no one can point them back to the right path as their symptoms are not as clear to family or friends.

Men typically show symptoms of anger, risk-taking and aggression, which are often viewed as behavioural problems rather than mental health issues.

“It is both a biological and social issue,” said Associate Professor Swapna Verma, a senior consultant at the Institute of Mental Health (IMH), who observes significant differences in how mental illness affects men and women.

In essence, women turn inwards while men do the opposite.

The difference starts from childhood. Studies show that girls are far more likely to suffer from depression and eating disorders, and engage more in suicidal thoughts and attempts.

Boys on the other hand experience more problems with anger, tend to engage more in high-risk behaviours, and are more likely to complete their suicide attempts.

“Boys who ‘act out’ are often just labelled as naughty, and what could be signs of early depression go undetected,” explained Prof Swapna, who is also Chairman Medical Board at IMH.

This continues into adulthood. Women suffer more from depression and anxiety, while men tend to have substance use disorders such as binge-drinking and antisocial behaviours.

Not “manly” to seek help

For those who are aware that they are suffering from mental illness, many could be too embarrassed to admit their vulnerabilities.

Men typically show symptoms of anger, risk-taking and aggression, which are often viewed as behavioural problems rather than mental health issues.

In the workplace, some men may find their ideals of masculinity being challenged in the presence of women bosses. To avoid being perceived as weak, they are less willing to share their struggles, noted Ms Lee Yi Ping, Programme Lead for IMH’s Community Health Assessment Team (CHAT).

She has observed this trend of male reticence among those who seek help through CHAT – a national outreach and mental health check programme for people aged 16 to 30 years old.

Only 30 per cent who reach out are men, and they are also more likely to drop out before their first session with CHAT. Men also generally take longer to open up about their feelings.

Prof Swapna saw one young man for eight months before he finally spoke. “He would come, take his medicine and leave without asking any questions. After months, he finally opened up about his trauma and losing control. He teared up while talking about it,” she shared.

This reluctance to seek help could also be leading more men to take their own lives.

More men die through suicide

Men are 2.5 times more likely to die by suicide than women here, according to data released by suicide prevention centre Samaritans of Singapore (SOS) in 2019.

The figures show that 283 men died by suicide, compared with 114 women.

This trend of higher male suicide is global, going by findings from the World Health Organization – nearly 40 per cent of countries have more than 15 suicide deaths per 100,000 men, with only 1.5 per cent showing a rate that high for women.

One reason, say experts, is that some men do not know they have a condition that is causing their distress and resort to desperate measures as they feel helpless.

Men also tend to attempt suicide in irreversible ways, making it more likely to be completed. “Research shows that men’s choice of suicide means is related to higher levels of suicidal intent.” said SOS chief executive Gasper Tan.

This has pushed SOS to step up efforts to normalise conversations about suicide and mental illness. It held a campaign titled #suicideseesnogender in 2020, and will be organising a virtual symposium on suicide with international experts this September.

Having suicidal thoughts does not make a person more or less of a man or woman, emphasised Mr Tan.

Breaking the silence

Fortunately, growing global awareness has shone the spotlight on male mental health, given more reports of social isolation and male unemployment caused by COVID-19.

However, youths and men are two groups of people still falling through the cracks, said Ms Lee, adding that CHAT will be expanding its pool of partner agencies to serve a greater range of people and needs.

“It will be important to have those, especially men, who have struggled with mental health to step forward to share their recovery journey. This will encourage those suffering in silence to reach out too,” she added.

Health messages all men (and women) need to hear

If someone confides in you about their mental health issues, what should you say or not say? Our three experts chime in:

“If someone approaches you with their problems, just listen. Or you could make the first move simply by asking ‘how are you?’,” said Mr Tan.

“If your children are acting out, it does not mean that they are naughty. Talk to them gently to find out if they are experiencing any underlying stress,” said Prof Swapna.

“Avoid using gendered language like ‘be a man’. Recognise and acknowledge their distress instead of reinforcing harmful gender stereotypes,” said Ms Lee.

If you are in distress and require urgent help, please call

  • IMH (24-hour Helpline) – Tel: 6389 2222
  • SOS (24-hour Hotline) – Tel: 1800-221 4444
  • Viriya Therapy Centre – Tel: 6256 13311
  • Singapore Association for Mental Health – Tel: 1800-283-7019