Why Is It So Hard To Ask For Help When Facing Psychological Distress?

Feb 23

And why is it even harder for men?

I was recently watching an online event organized by MAYDAY! M’AIDER!, a new French-Canadian online community that focuses on opening the dialogue on mental health and breaking the isolation. What was unique about this event called “Les Boys'' was the guest-speaker line-up which was solely composed of men. All middle aged (or so) entrepreneur businessmen openly sharing about their journey through mental health challenges, recovery and public disclosure. The format resembled sport commentators casually discussing during a hockey game intermission. One interesting question raised by the host JF Lacasse was: why is it so hard, especially for men, to talk about their psychological and emotional challenges, and ask for help?

So, I started wondering: is gender really influencing how close a person is to their emotions? How much is true? Why would men hide their psychological challenges more than women? A quick survey among the mental wellness online communities I’m involved with showed that, among all of their followers, about 75% are females. Why is that so? Where are the males? On the other hand, as a peer specialist, I have noticed that in hospital or peer support group settings, men are overrepresented. Are males much more afraid of disclosure than females, hence avoiding public platforms? Is this just the everlasting gender stereotype carrying on?

By collecting peers’ perspectives, looking at research and drawing from my personal and professional experience (and as a man), I wanted to share some findings on what could lead to one’s silence and isolation when faced with mental health challenges. Of course, everyone’s experience is unique and different, but these are the most common themes I have observed:

1.What the data is telling us about gender stereotypes

According to the World Health Organization (WHO)

“Only 2 in every 5 people (all genders) seek assistance in the year of the onset of their mental health struggles”. Despite gender, this is way too low! We must change that through awareness, education and stigma reduction.

“Women predominate in the rates of common conditions such as anxiety and depression (twice as much and more persistent than men). Socioeconomic determinants, violence, social position and inequality are among the drivers behind those higher rates”. This piece of data could support the much higher percentage of women joining online mental health support communities, for example.

“Doctors are more likely to diagnose depression in women compared with men. Female gender is a significant predictor of being prescribed mood-altering psychotropic drugs”. Unbelievable! What a sad stereotype that still lingers on. Asking questions, clarifications and justifications to your doctor about their diagnosis and proposed treatment path can help fighting this stereotype and getting proper support. Speak up, it is your experience, your health.

“Women are more likely to seek help from and disclose mental health problems to their primary health care physician while men are more likely to seek specialist mental health care and are the principal users of inpatient care”. This confirms what we - peer specialists - observe in the field. One explanation could be that men seem to wait longer than women to seek help and when they do, their condition has worsened, or they are in crisis. I’m a living example of that. The only two occasions I went to the hospital for my mental health challenges were 1) generalized anxiety with panic disorder and 2) severe depression with psychotic events and suicide attempt.

“Men are more likely than women to disclose problems with alcohol use to their health care provider”. There is light on the end of the tunnel. Keep opening up men!

“Gender stereotypes regarding proneness to emotional problems in women and alcohol problems in men, appear to reinforce social stigma and constrain help seeking along stereotypical lines. They are a barrier to the accurate identification and treatment of psychological conditions”. It is so important that we all fight the gender stereotypes and break the mental health stigma. Speak up about your experience, concerns and needs.

2. What our parents have been telling us: shake it off!

The way we’ve been raised and our role-models’ behavior definitely influenced our own perceptions, narrative and thinking patterns. One of the best examples is the anti-self-compassion/anti-empathy phrase: “stop whining, pull yourself together and carry on”. As a kid, when I would hurt myself running up the stairs, my father would tell me to go faster the next time. He wasn’t a bad father. Almost every peer I talk to can relate to that way of thinking and living. It is most likely a heritage from their parents, grand-parents and probably all the way back to the first human beings obliged to live in survival/doing mode. Focusing on duties, working hard from dusk until dawn, not asking themselves too many questions, praying, and repeating this pattern day after day seemed the way to go. Another similar saying is “boys and big girls don’t cry”. Wow, what a great way to invalidate and dismiss a kid’s feelings and experience. Just because we aren’t comfortable dealing with difficult emotions? Despite all efforts to push the “bad stuff” away, it always comes back at some point, psychologically and/or physically.

3. What culture and society are telling us about masculinity

Some say men have lost their masculinity, that “men aren’t men anymore”. Well, men won’t have much chance to be “real” men if they end up dead, not being able and comfortable to express their emotions and experience. I know, I was one of them: not macho but all the rest. Behind their beards, muscles, loud voices or nasty language, the highly insecure macho men are still holding on strong to their sole family provider and protector role. In addition, shame infiltrates their own narrative: “how can I even feel these emotions? I’m stronger than that. How can I show soft emotions like sadness or fear and still be the rock I must be for my wife, my family, my friends and for society? That whole cover up always made me sad and concerned for both women and men, as it shadows all the rest, the real stuff.

4. What we tell ourselves about our reality

I will always remember standing in the lobby of our house, my wife with the phone in her hands ready to call 911 and never felt that scared in my whole life. I was in full panic mode, seven months into a major depression, anxiety disorder and fighting for survival. I was absolutely convinced that if she made that called, the police would force my admission into a psychiatric hospital where I would be locked up for the rest of my life. Losing everything, including myself.

Another major fear many peers (men and women) have shared with me is making a career suicide the moment they disclose their mental health struggles or seek help. What would their boss, their organization, their employees think? How can they come back from this? And if they come back, will everyone be judgmental and doubting their ability to carry-on work as usual? Will their employer terminate their job? Will they be able to find work somewhere else or at all? Will they be labeled as weak, ill, unfit? While these are all legitimate questions and fears while mentally struggling, it is the depression and/or the anxiety talking. Most of the time, those apocalyptic scenarios don’t occur, on the contrary. That’s what happened to me i.e., colleagues and bosses showed compassion and support. Some even opened up and shared their own experience with mental health challenges.

5. What we are not taught to understand

Often my wife reminds me to express my emotions: “just say it, say what you’re feeling inside”. Many times, I am clueless about what the emotion is, what is the name of what I’m experiencing? It’s not that I’m ashamed or too proud, I just don’t know, and I don’t want to say the wrong thing that could scare off my wife or family. What I’ve learned is to at least say something, try and correct as needed. Sometimes the words coming out are too intense compared to what I’m really feeling but it’s a start, it opens up the conversation which is a major initial step toward getting help.

6. What we think when suffering “alone”

In both men and women, thinking that you must be the only one to feel this way, especially when working in a high performing environment, is very common. Thoughts like: “everybody else seems just fine, they are pushing through”, “no one is complaining”, “others have so much more responsibilities and bigger problems” are simply negative and unproductive. But then, as soon as you start sharing with people around you, you find out that you’re not alone, that most people are also struggling, and they truly understand what you are going through. That precise moment when you find your peers is a bliss and feels so liberating. Go and find peers within your friends, family members, colleagues or join a peer support group in your community or online. It will transform you and your recovery journey.

How to help ourselves and someone in need

Above stereotypes and whether you are a male, female, non binary, you are a human being that may need support. So please, do ask for help. And for family members, loved ones, friends, colleagues, please start the conversation by asking the person who struggles: “how are you feeling, really?”, “what are you thinking about?”, “what are your fears?”, “how can I help?”, “what kind of support do you need right now?”. I know it will sound counterintuitive but try not to find solutions, just listen actively, genuinely and fully. Just be there for the person. Keep in mind that for a person in crisis, any task may seem huge and impossible to achieve, especially finding resources and seeking for help. I remember that for me trying to find a therapist was so hard, complicated and exhausting. So, offering to accompany the person in their search or to attend a peer support group or professional therapy goes a long way. That is pure peer support. Anyone can do it and save a life.

Born and raised in Quebec City, Pat G (Patrice) spent several years in the medical industry, overcame burnout, then moved to Boston where he experienced severe mental health challenges that almost took his life. His recovery journey took him through self-discovery and a career shift. He became a Certified Peer Specialist and highly engaged in humanizing mental health through education and awareness.

Over a year ago, Pat pursued his dream to move to California where he joined the California Association for Mental Health Peer-Run Organizations (CAMHPRO) to take care of communications and to facilitate state advocacy workgroups and peer education webinars. He also volunteers with NAMI and participates in various writing and speaking engagements.

More recently, Pat founded and launched Human Experience Peer Consultant, a platform to share his own recovery journey, resources and offers a unique perspective when it comes to mental wellness education in the workplace. He loves to connect and collaborate with Peers doing unique, innovative and human-focused work in the mental wellness field.

Pat G Massicotte