This is the third in a six-part series on mental health and this issue, looks at men’s mental health. Men, much like women, face different health challenges and social pressures so even though they experience similar mental health disorders, they present differently.

Men of all ages are less likely to seek help and will downplay how bad they are feeling. They often don’t connect their symptoms with their emotional state such as feeling stressed, anxious or angry and they believe there is stigma in talking about mental health. Men tend to overuse alcohol to cope and are more likely to succeed when attempting suicide than women are, due to the methods they choose.

Loneliness is most closely linked with mental health issues, even more than loss of job, which suggests that sports clubs and ‘men’s sheds’ are not just good social outlets but are good for mental health. I’ll also touch on gambling as an example of how a behaviour which becomes an addiction, is associated with mental health decline and negative social consequences.

Common facts about mental health in men

–      25 per cent of men will experience depression in their lifetime

–     15 per cent will have a mental health issue in any one year

–     Loneliness is associated with depression and is more closely linked than loss of job or low socio-economic status

–     Men who are not lonely have significantly better mental health and less likely to experience depression, anxiety, suicidal thoughts.

–     25 per cent of men say they would not seek help for their mental health issue

–     Men with mental health disorders are more likely to drink alcohol excessively, engage in risk taking behaviours and abuse substances

–     Suicide is more common among Australian men than women with men making up more than three-quarters of suicidal deaths

–     Mental health issues in men might present as feeling stressed, anxious or angry

–     Relationship breakup or divorce are a high risk for mental health decline

–     Partner’s pregnancy and becoming a parent are a high risk time for men’s mental health

Men find it difficult to talk about mental health issues

Men generally find it more difficult to talk about how they are feeling. Generations of social behaviour and competitive norms have created an expectation that crying or even admitting to feeling sad, are signs of weakness in a male.

Even though up to 80 per cent of men with depression, anxiety and even suicidal thoughts will have seen a GP in the past year, very few will ever be diagnosed and even fewer will receive treatment for their mental health issue.

Making the connection between depression/anxiety and feeling tired, having bad sleep, being more irritable and quicker to anger or just not wanting to socialise, is not clear cut.

Signs and symptoms that things aren’t right

A few signs to watch out for in yourself and in others:

–     Increase irritability and being short tempered

–     Becoming socially withdrawn, not wanting to go out and just staying home

–     Feeling tired – often for no good reason

–     Feeling empty, sad, hopeless, lonely

–     Having difficulty sleeping or sleeping too much

–     Not getting pleasure from things and people around you

Masking mental health with maladaptive behaviours

There are the behaviours that men use to cover up how they are feeling such as:

–     Escapist behaviour, spending masses of time on work, sport or alone.

–     Physical symptoms such as headaches, abdominal pain, digestive issues

–     Drinking alcohol to excess

–     Controlling, abusive, violent behaviour

Irritability and inappropriate anger

Risky behaviour, risky driving

–     Addictions – illicit drugs, gambling

Gambling behaviour and harm

A long-time patient who attended over many years had issues around alcohol abuse, relationship tensions and work dissatisfaction. He then started having panic attacks which he thought were heart attacks.

He described symptoms of tension in the chest, palpitations, and sweating, which often got worse at night, causing him to go to hospital in the middle of the night several times. Each time, he was given the ‘all clear’ – it was not his heart.

The panic attacks continued to increase to the point they became so severe, that they caused him to stop driving the car. This was when he decided to talk to me about what he was going through.

He had a gambling addiction and was ashamed to admit this, despite knowing me for many years. It explained why he and his wife were constantly fighting, the alcohol abuse, his poor sleep and overall life and work dissatisfaction. He needed to make the connection between gambling and his life turning sour, but when he finally did, we could partner together to get him and his family some support.

The national longitudinal study on men called, Ten To Men looks at gaps in men’s health. It’s findings signalled out gambling as a significant social harm. Around 44 per cent of Australian men aged 18–63 years had gambled in the 12 month period (2021) and of these, more than 25 per cent were at risk of also experiencing financial stress.

This is very concerning because it is a socially accepted behaviour and is being promoted at most sporting events as just a bit of fun. However, for some this becomes addictive, and men with gambling problems are more likely to experience higher levels of anxiety and depression and lower levels of life satisfaction.

They were also much more likely to drink alcohol at harmful levels, use illicit drugs and smoke tobacco. Gambling losses can lead to a range of negative consequences, or gambling harms. These harms can range from financial, relationship or psychological issues to serious legal or health issues.

Gambling harms include:

–     Relationship harm – increased conflicts and relationship neglect

–     Health Harm- stress, depression, poor sleep

–     Emotional / psychological harm – feelings of regret, failure lack of worth

–     Financial harm – credit card debt, reduced spending on essentials

–     Work/study harm – absenteeism, poor performance at work

Seeking help

Most men end up in the GP room because their wife, partner, friend or mother has told them to go. Men generally don’t see the doctor for emotional reasons but will attend for backache, a repeat script, a sports injury or for a mandatory occupational health check. Generally, these sessions do not allow for a ‘mental health’ or an RUOK (‘Are you ok?’), chat but it’s important to let the doctor know that you’re not feeling good.

My advice is not to be ‘brave’ by avoiding talking about things going on in your head or heart. Just opening up makes the load lighter and GPs do like to listen. Or just tell a friend. There are useful resources at the end of this article which I hope are being shared and used.

When you see your general practitioner to discuss the physical, emotional and life situations you are finding difficult, your GP can arrange a mental health care plan for you to receive counselling with a psychologist and discuss treatment options. If you have addiction issues, or are feeling that you are having difficulties managing your anger, there is a risk of intimate partner violence. Speak with your GP who can support you and provide you with a referral to confidential support services.

Tips for good mental health

1.     Nurture intimate relationships.

2.     Seek social connection – some through work, some through hobbies.

3.     Exercise daily. Endorphins released, trigger happy feelings.

4.     Take time to relax and unwind – don’t use alcohol to relax.

5.     Delay making new decisions such as a new job, until your depression is managed

6.     Sleep well.

7.     Connect with nature – do things outdoors.

8.     Learn ways to cope with stress such as mediation or for those with a faith, use prayer.

9.     Social media – limit your use of this or take long breaks from it.

10. Purpose – we sometimes find this through doing service for others in need.

Resources and links

–     Head to Health:

–     Lifeline on 13 11 14

–     MensLine Australia on 1300 789 978

–     Suicide Call Back Service on 1300 659 467

–     Beyond Blue on 1300 224 636

–     Dad’s in distress helpline 1300 853 437

–     SANE


Associate Professor Magdalena Simonis AM is a General Practitioner, government health advisor, and primary care researcher with the University of Melbourne, and a leading health expert and advocate.