“Do we really have to use that term? It makes people uncomfortable.”

“Therapy? No, I don’t need therapy, that’s only for really unstable people.”

“It’s nothing. I’m fine.”

It can be hard to discuss mental health, especially among men, where it is often met with resistance.

The stigma surrounding mental health remains persistent in Malaysia, but we can’t run away from the facts.

Statistics paint a worrying picture, with data from 2015 estimating the prevalence of mental disorders at 29 per cent, a threefold increase from 1996, and 2023 data revealing around one million Malaysians aged 16 and above suffer from depression alone, a figure that is more than double what it was in 2019.

The truth is, the state of mental health among Malaysians is concerning, and it is even more so among men, owing to traditional mindsets about men’s role in society, how they should behave, and what is considered acceptable.

The mental health struggle in men

In many instances, women are more likely to acknowledge and share their feelings with friends. However, men are expected to be stoic, strong and unemotional.

These expectations are internalised and often reinforced through praise, with boys and young men being raised to think that it’s weak to show emotions or ask for help.

They may even be criticised or ridiculed for doing so. As a result, they often feel ashamed when they don’t live up to their own or others’ expectations.

When men feel stressed for not meeting these expectations, it is known as masculine discrepancy stress, which adds to the mental and emotional strain they are feeling, in addition to whatever is troubling them.

There is the additional burden of dealing with life’s daily struggles, such as long working hours, constant demands and responsibilities at work and at home.

Men are often the primary breadwinner and provider for the family, and financial difficulties can contribute to stress and feelings of being inadequate.

This, in turn, is often amplified by the impact of social media, which presents idealised, aspirational lifestyles.

Collectively, these elements can be overwhelming for anyone, but have a greater impact on men who are vulnerable to negativity, criticism, peer pressure and social expectations.

What mental health strain looks like

It is common to hear “I didn’t know what he was going through” until something happens.

This is because the signs are not always obvious; in many instances, mental health issues take time to develop, and the gradual progression may be easily overlooked.

In others, their inner struggles are concealed behind carefully cultivated behaviour; they are well-practised at behaving normally and know what to say and do, so that no one is the wiser.

Warning signs can manifest indirectly, in both men and women, and some of these are more commonly seen among men.

• Behavioural and emotional changes, including but not limited to:
  • Increased episodes of irritability or agitation, anger and aggression that show up as frequent or recurring angry outbursts that range from having a ‘short fuse’ to episodes of road rage.
  • Controlling and verbally or physically abusive behaviour.

• Risk-taking or escapist behaviour, which refers to activities that distract from having to deal with feelings, or self-medicating, such as:
  • Use of alcohol or drugs, or consuming more often or in greater amounts.
  • Reckless behaviour such as reckless driving, engaging in high-risk sports, excessive sexually-driven behaviour.
  • Addictive or compulsive behaviour such as gambling or substance abuse.
  • Obsessive behaviour such as being overly consumed by a single activity such as work, gaming or exercise to the point of excluding other aspects of daily life.

How to help

Family, friends and colleagues can play a role in being observant of such changes and offer support, both directly and indirectly. Dr Serena offers some suggestions:

• Listen carefully. It can be difficult for men to acknowledge their emotions and verbalise how they feel. They may use words or phrases like feeling low, always tired, numb or not being ‘in the mood’ to describe anxiety, depression or sadness.
• Be present. Spend time with them so they can talk when they are ready. Some men may feel more comfortable with activities so an invitation to go out for a drink or play a sport may be better received than an invitation to talk.
• Offer support. Many people are reluctant to seek help, especially men, who may need greater encouragement to do so. This could include help with making an appointment and driving them there, or suggesting virtual options if a face-to-face session feels too overwhelming.

Gaining a healthy perspective on mental health

It is important for everyone, and not just men, to understand this simple fact – anyone can struggle with mental health, and we all need help from time to time.

Having a mental health issue doesn’t always mean you have a disorder or that you need treatment. However, it is important for emotions to be acknowledged and processed in a healthy way, and to have an appropriate outlet. This can be achieved through simple measures like talking to a friend, getting regular exercise and enough rest, she explained.

In addition, she urges men to think of mental health in the same way as physical health.

Men need to take care of their minds just as they take care of their bodies. In the same way that you would see a doctor when feeling physically unwell, you should see a counsellor or therapist when you feel mentally or emotionally troubled.

-- BERNAMA

Dr Serena In is a Clinical Psychologist and Senior Lecturer at the International Medical University (IMU).