05 - The Silent Struggle - Men's Mental Health

Why is it still so hard for men to say, “I’m not okay”?

In this powerful and timely episode, Shazia and Dr Munita shine a light on men’s mental health - the unspoken pain, the societal pressure to stay silent, and the cultural narratives that still tell men to “man up” instead of open up.

We explore how masculinity has been shaped by outdated expectations, why emotional literacy is often denied to boys from a young age, and the ways depression, anxiety, and shame can manifest in men - often hidden beneath anger, overwork, or withdrawal.

From male identity collapse to loneliness after divorce, and from cultural stigma to the unique challenges faced by LGBTQ+ men, this episode unpacks it all with insight, empathy, and urgency. Plus, we offer practical ways to support the men in your life - and empower them to support themselves.

Whether you’re a man, love a man, or want to create a world where men are free to feel - this episode is for you.

Edited and produced by Mike at Making Digital Real 🎙️

Transcript

Hello, welcome to the Flawed and Fabulous podcast, a podcast that celebrates showing up as your real, raw and beautifully imperfect selves. We will explore topics that are commonly seen as flaws and help you turn them into another dimension of your fabulous self. We discuss personal stories together with myths around topics such as perfectionism, imposter syndrome, fear, and happiness, just to name a few.

I'm Shazia, co-host of the Flawed and Fabulous podcast. I'm a psychotherapist specialising in trauma and work with people struggling with issues such as anxiety, depression, PTSD, and childhood trauma, just to name a few. Hello, I'm Dr. Munita, and I'm also a co-host of the Flawed and Fabulous podcast.

I'm a certified life coach, but also I'm a doctor with two decades' experience as a consultant in intensive care medicine. This gives me a unique perspective to bring to our conversations about mindset, resilience, and personal growth. In my day job, I help patients through the most difficult challenges, and in my coaching practise, I help my clients break through their limitations to achieve their maximum potential.

So, on this podcast, we're going to cut through the noise, have heart-centred conversations to energise and nourish your mind. So whether you're looking to optimise your mindset, navigate life's critical moments, communicate with inspiring topics around human flaws, join us. Let's dive in.

I'm Shazia, and today we're talking about a topic that so many people feel, but few discuss openly, men's mental health, the silent struggle. Hello, I'm Munita, and it's Movember, formerly known as November, the month in which we raise awareness of men's health, and it's desperately needed. The statistics are sobering.

Across the world, around 75% of suicides are men, and in the UK, suicide remains the leading cause of death for men under 50. That is such a shocking number, Munita, and it's not that men are not struggling. It's that they often don't feel able to say so and express themselves.

Exactly. So, studies show that men are far less likely to seek help. A 2019 Frontiers in Psychology study found that men who strongly identify with the traditional masculine norms of stoicism, dominance, emotional control, are the least likely to access help or to talk to friends about their feelings.

Yeah, so even though the pain is there, the ability to express, the outlet, the safe space to talk about all this is just not there. Yeah. So, emotional literacy is part of the issue.

We often talk about emotional intelligence, but emotional intelligence comes from emotional literary and vocabulary that boys growing up are able to comprehend. So, boys actually grow up hearing messages like, come on, man up, and don't cry, and by adulthood, they don't even have the right vocabulary or the language for what they feel. Yeah.

The ability to express emotions is not taught. So, it's like the word hands them silence, you know, and calls it strength. So, the more you bury and just get on with it, it appears the stronger you are.

And you know, the real worry about all of this, of course, is that that silence can be fatal. And we've seen, you've just mentioned the statistics for it. So, I mean, I've seen that even in my practise, where men who I see often are at the brink because they've just not had the space and the outlet to share how they're feeling.

Yeah. And another big aspect is men who are recently divorced and don't have those networks, women surround themselves with networks, which we'll come in and talk about in a minute. But actually, I know firsthand of friends and colleagues who have been divorced and found themselves alone, essentially.

So yeah. So let's talk a little bit now about where that silence comes from. Historically, masculinity has been built on achievement.

You provide, you protect, you never falter. Right. And that definition hasn't evolved as far as society has evolved.

Today, many men feel caught between old expectations, patriarchal norms and new realities. Psychologists term this role strain, the tension between traditional masculine roles and modern pressures. And when we talk about modern pressures, men are at the crossroads of these old expectations of success, control, stoicism, and the new demands of vulnerability, equality, self-awareness.

And when men can't live up to these expectations, they often feel ashamed. And shame and embarrassment are another huge emotion that has its own demons that sit within us. Yeah.

And the literature supports this. So a 2020 study in the Journal of Men's Studies found that men who felt disconnected from these roles, exactly as you say, were twice as likely to experience anxiety or depression. Yeah, it's a matter of, it becomes a matter of identity.

So it's a constant performance, be strong, be successful, but don't fail. And at the same time, be vulnerable, be self-aware. It's a lot of pressure that is suddenly being bombarded with.

Exactly. And, you know, it's not sustainable and we see this. That's what we call masculine identity collapse.

When men realise their sense of worth is built on external markers like their job, their car, their house, the school their children go to, what jewellery their wife is wearing, and what sort of societal circles they are part of. And when these markers, or if these markers disappear, the foundation cracks. It's like the rug is pulled out from under their feet.

So true. It's so true. Yeah.

As Bell Hooks said, the first act of violence that patriarchy demands of men is towards themselves to kill off the emotional parts of themselves. Yeah, that quote always hits me. It's tragic because it's these emotional parts that make life meaningful.

And you know, society compounds this. Society denies men the ability to talk about themselves emotionally and to be taken seriously or for them not to feel that they're discriminated against or, and you know, I say men are not given the permission to nurture themselves. Yes, this is true.

And it shows up in different ways, right, in men from women, actually. And if we were to delve a little bit deeper into how depression shows up in men, what do you think? Yeah, I mean, I think, you know, women are outwardly open about their sadness, their tears, they like to talk to lots of people. But in men, it might appear as irritability, anger, they stay at work a lot longer.

But actually, you know, nobody would really realise because people would say, it's got a really stressful job, or, you know, poor so and so. And the notion that they might be depressed or anxious or having a mental health problem, that never really enters the conversation. It's called male pattern depression.

That's the American Psychological Association has even termed it that. So it's not that men don't feel sadness. It's that they express it differently.

And in many cases, usually in the form of aggression or anger, because anger and aggression is one of the strongest defence mechanisms. It's a protector, actually. Yeah, that's so true.

And the Journal of the American Medical Association's psychiatry study found that those that included men who were externalising symptoms such as anger, irritability, and those studies included those numbers, that the rates nearly doubled from what they're expected to be otherwise in the standard studies. Yeah. And that makes so much sense.

You know, it's not less emotion. It's hidden emotion because expressing sadness equals vulnerability equals weakness. Yeah.

And because it doesn't conform to the stereotypes of depression, it often gets overlooked and bypassed. And that's where the danger lies. The appearance of functioning whilst internally drowning.

Yeah. I've heard men describe it as feeling nothing but pressure, pressure to perform. That numbness is its own kind of pain where somebody just the expectations, the weight, the burden on men is tremendous, I think, in today's society.

A lot of men talk about feeling lost, like they don't know who they are anymore. It's like an identity crisis. Yeah, I don't blame them, actually.

And I think because old definitions of manhood no longer fit. In the past, identity was for clear social roles, the provider, the leader, the protector, whether that was in the community or whether that was in your own home. But now those roles are fluid.

Women are doing a lot more and taking those roles on. It sort of creates an uncertainty and almost a redundancy for men. Yeah, yeah.

They don't know where their place is sort of thing. And when this men's society takes away the old rule book, it hasn't given a new one. And so men are left to guess what their role is.

And sometimes it's like walking on eggshells in a way. You're right. Actually, walking on eggshells is a brilliant way of thinking what it's like the dynamics in a home would be like, because, you know, something's wrong.

You're walking around it. You're not actually dealing with the problem at all. Some men evolve towards healthier forms of masculinity.

However, it's not all about toxic masculinity. So some men exhibit vulnerability, empathy, shared caregiving. Others retreat, however, into nostalgia of better times in the past or even anger.

Sociologist Michael Kimmel calls that a grieved entitlement, the sense that men have lost something that once defined them. Yeah, and that can show up in really destructive ways. Rage, withdrawal, even extremist movements promising to restore real men.

And we know some of these. I don't want to name people and give any unnecessary people any air time here. But we've seen movies like adolescence and things that talk about this kind of a rage and extremist attraction from for young men today, because from a point of fitting into a place that no longer exists, actually.

Yeah, and it's a sense of belonging. I'll have to say, I don't think I've had as many conversations with my male colleagues and friends about things as I have about that programme adolescence. I think it really hit home.

It really it was it was heartbreaking, actually. And I think it really has brought to the to the surface things that were bubbling underneath with regards to men opening up about talking. But at its core, this aggrieved entitlement isn't anger.

It's actually grief, grief for themselves that they can no longer manifest. They can't show up to be that guy that they were in their 20s because they're somebody's dad. Maybe they have a child who has extra needs.

And this comes back to also their history, their family history, the role of patriarchy, whether the matriarch was dominant, whether the patriarch was dominant, maybe they, you know, and and how that permeates their family tree. And it's sort of redefining masculinity. It's not about taking something away, but it's about broadening it, you know, so.

So true masculinity isn't the absence of emotion. It's the integration of it, would you say? Yeah, 100 percent. Definitely.

So let's come a little bit, take this into relationships, because that's where identity and mental health collide most powerfully. Yeah, you're right. A 2021 YouGov study found that one in five men astonishingly have no close friends at all.

Yeah, I'm not surprised. That loneliness is devastating. Many men rely on their romantic partners for all their emotional support.

And so when relationships end, they are completely isolated. Yeah. And women tend to have these broader emotional networks, friends, family, community, you know, coffee mornings, lunch dates, girls trips, holidays, things like that.

And I, for one, really, really value my girlfriend time. It's my time to vent and rage and mourn and whatever I need to do. I don't think men, even in their boys groups, I don't think they use that space for that kind of expression.

Do you mean you don't think that they can be themselves? Do you think it's a facade? Do you think it's a performance or, you know, a stage show? Yeah, I think being vulnerable in those groups of their mates is very difficult. They don't want to bring the mood down. They want to be the lad, you know, or whatever.

So talking about difficult emotions and talking about feeling insecure in a job or financial insecurity or whatever it is, is very difficult amongst their friends. Yeah. And, you know, I think just going back to this, the situation of divorce, a Journal of Health and Social Behaviour study found men experience significantly higher emotional distress after divorce compared to women.

Precisely because of the loss of connection, the loss of the confidant, a change in life finances, a change in life, looking after children, which they've maybe not done in the past, being the primary caregiver and so forth. They are absolutely at sea. Yeah.

It's like emotional single point failure. One person goes and the whole system collapses and then they're at sea. They don't know what's going on.

Yeah. The house of cards phenomenon. Right.

You know, and chronic loneliness isn't just emotional. It's physical. Harvard Medical School research found that loneliness increases stress hormone and inflammation and can be as deadly as smoking 15 cigarettes a day, which I believe.

I mean, that's that is astonishing. And it is. Loneliness is one of the biggest causes for mental health problems in men, especially.

And I've seen an increase in men seeking therapy. Interestingly, not as much as women, of course. And loneliness is one of their primary reasons for coming to therapy, especially some of my NHS clients.

And often they just sit there and they just have no one to talk to. Yeah. So it's quite sad.

I think it's very sad. And society keeps still telling men that that needing connection is weak. Dominance is important.

You know, the people that we don't want to give any airtime to are examples of that behaviour pattern. You know, in private men, even as you say, quite rightly, they will have banter, but no depth of conversation is surface level. Yeah.

So the challenge is teaching men that intimacy isn't feminine. It's human. And, you know, for all people out there listening who have sons, it's really important to allow them or to allow them to feel sad and for them to know that it's OK to have these feelings and not say, brush it under the carpet, just get on with it.

There's no time to feel these difficult feelings. Yeah. And that whole notion of intimacy has been turned on its head because now with the internet and images that children as young as eight are watching and having put in front of their faces, even if they don't want to see it, the whole notion of intimacy as being anything other than purely physical has gone out the window.

So intimacy isn't just physical. It's emotional. And the two can be mutually exclusive.

They don't have to be all at the same time. But we are seeing positive change. OK, I don't want it all to be doom and gloom.

Groups like Andy's Man Club in the UK are transforming lives. Started after one man's suicide, they now have over 100 clubs nationwide where men gather simply to talk. There's also Man On and the Man United clubs for mental health.

Actually, they seem to be affiliated with football clubs, but people are doing a lot nowadays compared to five years ago, I think, Shazi. Yeah, yeah, definitely, for sure. It's great that these clubs are coming about where men feel safe, to be honest.

And when that does happen, then everything shifts. A few months ago, I think about last year, I did a talk at a local gym on it on this very topic. And it was surprisingly well attended by the men.

And what came out of that was that they needed a safe space to talk. They did not want to burden their partners with whatever their emotional needs were. And they didn't feel comfortable sharing some of these difficult feelings with their mates because they don't want to bring the mood down.

You know, they just wanted to have a good time. But what they said was, there is no place for us to just go and talk to a group of random men and share things and have a place where they get me because they're probably going through the same things as me. So it's quite interesting.

And I'm glad some of these men's groups have formed. Interestingly, my husband started a business group about, I think, two years ago. And the idea of that was, you know, talk about their jobs and their careers and their business growth and things like that.

But now it has evolved into almost like a men's support group where they don't only talk about that, but they talk about health anxiety. They talk about relationships. They talk about their children.

And so it's evolved into like a support group, which is amazing. Yeah, that sounds amazing. Well done on him.

You know, and I do think when men realise vulnerability doesn't cost them respect, they will finally be a part of a group, a sense of belonging and allow healing to happen. Yeah. So how do we actually help men to heal? First, we have to say, look, it's OK to seek some help.

Go talk to your friend, find your friend, find your neighbour, find somebody, actually find somebody who's maybe your sister, maybe your auntie, maybe a female who's empathic to start with. That will be my advice. Peer groups, online forums, that kind of thing.

And for us as friends and partners, we too can create a sense of safety for the men in our lives, our brothers, our husbands, our sons, by simply asking the question, are you really OK? And meaning it. So we don't want just surface, but sit down over a cup of tea, even whilst you're watching TV and ask that question with some intent, you know? Yeah. And, you know, when we first decided we were going to do this topic, you know, I thought to myself, right, OK, probably the majority of our listeners are female.

OK, so that's OK too, because I recognise that going from this, our listeners will go and ask their boys, their brothers, their husbands, their partners, their best mates, their next door neighbours, are you OK? And certainly with their sons or their nephews, ask the boys when they're young. Teach them it's OK. Teach them the right vocabulary.

Be empathic and allow them a bit of time for self-reflection and space, you know? It's about giving them permission to feel before they're told not to. Yeah, you're so right. And reminding them that strength and sensitivity aren't opposites.

They're allies. They are the two halves that make a whole person. That's right.

Exactly. You know, I wanted to dive a bit deeper into something that often gets missed. How culture and sexuality influence men's mental health and their willingness to ask for help.

It's a very fascinating area and I think we should talk a little bit about this. I think we absolutely have to, you know, preferences and so forth. It's really important.

People will have, these are different segments of society. We can't really talk about men's health as though everybody experiences the same pressures. You know, culture, religion, class, sexuality all shape how men understand masculinity.

And that will directly affect whether they sort of hide away or whether they start to be open and honest about their feelings and maybe talk to somebody. So let's start with culture. What are your thoughts? Yeah, so non-Western culture is obviously what we're familiar with, right? South Asian, African, Middle Eastern societies.

Masculinity is tied to strength, stoicism and silence, okay? Familwana. A man's value is defined by how well he provides, protects, endures. Showing vulnerability is seen as a sign of weakness or even dishonour.

It's not nurtured. Yeah. And even if he's struggling, he may not have the language or, in fact, even the social permission to express it.

Yeah, exactly. So a UK study by the Mental Health Foundation that non-Caucasian men are four times more likely to be sectioned under the Mental Health Act and yet far less likely in the beginning to seek voluntary help before reaching that point of crisis. And that doesn't mean that they don't need it.

It just means because of stigma, they don't know who to trust, the family honours, they don't want to let the family down. They don't seek help, right? Yeah. The cultural expectations, you know? And obviously South Asian men, like you said, we're familiar with them.

There's that unspoken rule, right? Don't bring shame. Don't show struggle. It's taboo.

If you seek help, then there's something wrong with you. You're mentally unstable. So just brush it under the carpet, keep quiet and keep calm and carry on effectively.

Exactly. That's exactly right. And, you know, seeking help can seem like an admission of failure or even, you know, something that's a bit too westernised.

Mental health conversations are taboo, as you said. They happen behind closed doors, often with doors closed within the house, even, and people are whispering. And that's what I, you know, can imagine and I can sort of familiarise myself with.

Yeah. I've had a couple of male Asian clients, interestingly, and when I've asked, you know, does your family know that you are coming for therapy? They were like, absolutely not. We would not share this with anyone because it would just mean, you know, they would look at me like I'm mad.

And especially my dad, my dad would be really disappointed to think that I was going outside the family to share my, whatever, share my problems. And yeah, so it is still a very, it's changing. It is changing, but it's still got a long way to go where Asian men are allowing themselves to be vulnerable.

Yeah. And it's not just the Asian men. I think it's everybody, to be honest, you're quite right.

It's brushed under the carpet. Oh, I don't have to deal with this today. Tomorrow's another day.

I'll be fine. I'll just get some rest. I'll have a drink, that kind of thing.

It's been a heavy day. Then tomorrow comes and it's the same feelings again. But you know, yeah, it's a difficult one.

Yeah. And then there's sexuality, and that adds a whole different layer. Yeah.

The link between male sexuality and mental health is both profound and under-discussed. Heterosexual men are already socialised to equate self-worth with performance, control, stoicism. If you add in sexual identity, for example, LGBTQ+, the pressure multiplies.

For sure. Because now it's not just about being a man, it's about being the right kind of man. Now, can you imagine how much pressure that would add? Well, exactly.

And the pressure, the research shows that the LGBTQ plus men are between four and six times more likely to experience depression, anxiety, stigma, but within their own pool often shunned, discriminated against, rejected. And, you know, actually the biggest portrayal will be to be rejected from within your own community, the wide pool, the external, exactly that. And they're less likely to access support for this very reason.

Exactly that. Right. So studies from Stonewall UK and the Trevor Project found that while LGBTQ plus men experience higher distress, many delay seeking help because they just don't know how, don't want to.

And gay men, for example, often report feeling judged, stereotyped or misunderstood. And there's also a lot of fear and shame. And shame can start really early.

So if you grow up hearing that sensitivity or same-sex attraction is wrong, you internalise the idea and that needing help makes you feel weak and defective and you're consumed with shame. Yeah. So that internalised homophobia that you're talking about, it erodes self-esteem, fuels isolation, makes people feel as if they're wildly different or abnormal in some way.

Some men cope through overcompensation, overworking, substance abuse, addictive behaviour patterns to mask the vulnerability that they were never allowed to show. So sexuality shapes not just who men love, but how they love and whether they feel safe being seen. Yeah.

And that's why inclusive, culturally competent mental health care is vital. We need therapists trained to understand how masculinity, race and sexuality intersect to help men unpack not just the trauma, but the social rules that taught them to hide in the first place. Definitely.

And, you know, to tell every man, no matter who he is or who he loves, that seeking help isn't a weakness. It's part of being human. Oh, so lovely.

Shazi, you're absolutely spot on. Healing starts when men realise that vulnerability and masculinity aren't enemies, they're buddies, they're partners. Yes, most definitely.

I love this discussion, Monita. It really brings home that men's mental health isn't just one story. It's a thousand stories shaped by culture, by identity and love.

You're right. And every man has a different history, a different family tree, a different patriarchal setup. And I don't discount the role of patriarchy in this conversation.

I think it's hugely significant and perhaps for another time. But remembering the need for connection and understanding is universal. For every thousand mile journey, you have to take the first step.

Yeah. I mean, you know, as human beings, as we are social animals and connection is absolutely vital. So, you know, I hope the men, the women listening to this get something from it.

So before we close, let's give our listeners something practical. How can men start supporting their mental health right now? Not just men, actually, how can we as a society support men with their mental health? OK, so let's start off with the men themselves. Let's say, why don't you name what you feel? Do you feel sad? Do you feel desperate? Do you feel lonely? Name it.

Call it something. Create that vocabulary of emotional awareness. And like any bit of our body, if we don't go to the gym and use it, we lose it.

So keep thinking, keep talking, do a daily check in. How am I feeling? What am I, why am I tense in my shoulders when I walk into the office? Journaling, voice notes, saying it out loud helps translate emotion into a language. Yes.

Reach out. I think it's really important for men to know that they must reach out before they hit crisis levels. You don't have to wait until everything falls apart to ask for help.

Whether it's your partner, whether it's your sister or brother or family member, GP, friend, therapist, anyone, vulnerability early prevents breakdown later. Yeah. And, you know, everybody talks about, oh, you've got to get therapy these days, especially, you know, the US people go for therapy rather than confide in their friendship groups.

I would say start with small peer groups. You know, an example of which is Andy's Man Club, the Calm Campaign Against Living Miserably or online spaces like Blot Talk and the Mankind Project. Yeah.

These spaces normalise what we've been talking about, open, honest connection. Yeah. And for the LGBTQ plus men, organisations like Switchboard, MindOut and the Trevor Project provide safe, affirming support.

Yeah, it's really important. But we must also not underestimate the basics. Sleep, exercise, nutrition.

These are not just lifestyle tips. They are pillars of mental health. Exercise releases endorphins and improves mood as effectively as mild antidepressants in some studies.

So let's not. It's all very well to, you know, talk about seeking support and things like that, which, of course, is crucial. But start with the basics for yourself.

Self-care through all these ways of sleeping well, exercising and eating well. Yeah, that's a really good shout. I mean, I think when we talk about mental health, we can go off into all sorts of tangents.

But actually, body health is hugely important and is complementary. So, you know, just again, microbiome, your gut microbiome and the nutrition for that really, really has a very big impact on your mental health and more science emerging about that. So you could do mindfulness, meditation, helping people cope with emotional regulation.

Headspace is a great little app and Insight Timer. Actually, there's Headspace for Men as well, which have sessions focussing on anger, stress and self-compassion. And I'd also add, you know, redefine what it means to be strong.

Real strength isn't how much you endure, actually. And I think it's how much you share. So thinking about what is the concept of being strong, if we start thinking about that, then we're able to almost change how we view it and what is strength? Yeah, and I think some of this is almost infectious.

If you are expressing your own vulnerability to a bunch of people, we see it all the time, don't we? The standout one is what's that women programme, Loose Women? You know, somebody says something, then they all start talking about the same thing and it becomes permission to talk about something that you wouldn't probably do otherwise. So I think when men model vulnerability, especially to other men, it gives permission for others to do the same. You know, somebody says, listen, I'm really feeling down at the moment.

I'm finding it really hard. I've got a lot of financial burdens. I've got lots of things.

I can't sleep at night. And somebody says, yeah, you know what? We've got this thing coming up. My friend wants to go on a holiday and I just don't know.

And it becomes a big group conversation rather than a single on one shoulder. And I just want to just pause here just to define this word vulnerability. You know, Brini Brown, who talks a lot about vulnerability, she says it is the feeling when we get, when we are up against uncertainty, risk and emotional exposure.

Yeah. Love Brini Brown. That's great.

And you know, that thing I was talking about earlier, that's the rickle effect. One conversation can save another person's life. Healing doesn't always look dramatic.

It often starts with a quiet sentence. Mate, I'm struggling here. And that's all it takes to open up that conversation.

So if you are listening to this and struggling, please do reach out. In the UK, call Samaritans on 116 123. If you're in the US, you can dial 988 for the Suicide and Crisis Lifeline.

And remember, wherever you are, you're not alone. It's never too late to talk to somebody. So take care of yourselves.

And each other. And each other. Yeah.

Until next time, keep the conversation going. Thank you for joining us on Flawed and Fabulous, where we embrace our imperfections and our potential. Remember, growth happens in the space between who we are and who we're becoming.

Until next time, be kind, stay curious, and have no fear of discovering yourself. Knowing that wherever you are right now is where you're exactly meant to be. This is me, Munita.

And this is me, Shazia, reminding you to stay flawed. And stay fabulous. And allow yourselves to be beautifully imperfect.

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