The other day, scrolling through social media, I came across a quote, which read: ‘You don’t fake depression. You fake being OK.’ The quote stopped me in my scroll and made me think about all the people we encounter – men and boys in this case – that might look outwardly fine but who may be suffering the many mental health concerns that so many experience these days.
Brisbane-based Psychologist Michael Duhig explains why mental health issues affect both sexes. National data reveals that “males are more likely to experience a mental health disorder during their lifetime than females (48 per cent versus 43 per cent)”.
“Similarly, males are more likely to be diagnosed with a severe mental health disorder (e.g., psychosis and/or schizophrenia) compared to females,” he said, adding that “child and adolescent data mirrored that of adults.
“Boys are more likely to experience a mental [health] disorder compared to girls (16 per cent versus 12 per cent),” Mr Duhig said.
“While males are less likely to experience an affective disorder such as anxiety and depression, they are three times more likely to commit suicide compared to females with rates of 19.8 and 6.3 deaths per 100,00, respectively.”
These worrying statistics, he says, are because males “are less likely to seek support compared to females”.
What triggers mental health concerns?
Mr Duhig says that, in general, no one thing triggers mental health concerns.
“They’re more the interplay between environmental and personal stressors and a depleted support system,” he said.
“In men, we know that mental ill-health can often develop from societal expectations such that men must:
- “Be the breadwinner of the family and bear the brunt of financial stress;
- “Display masculine traits such as strength and control;
- “Reply on oneself and not seek help from others;
- “Not discuss or show emotions.”
While most men will know that achieving these perceived expectations is near-impossible, mainly if someone is vulnerable, not meeting these expectations can trigger mental health concerns.
Interestingly, while often associated with females, Mr Duhig adds that “recent trends have also revealed a sharp increase in rates of body dissatisfaction in adolescent and young males”.
“While these rates are well behind that of females, this increase may leave these groups vulnerable to body image and mental health concerns,” he said.
Matt Defina, Head of Programs and Registered Psychologist at The Man Cave, says that another contributor to mental health issues among men and boys are the beliefs around “rigid gender roles”, which traditionally depict males as needing to be “tough and to show no emotion; to be heterosexual and homophobic; always in control; athletic and fit”.
“Some of that is healthy,” Mr Defina said. “But when boys [and men] believe they need to be all those things, it worsens their mental health outcomes [and] how they behave towards others.”
“What we’re seeing now is, if men [and boys] believe in this rigid gender role and how they are allowed to be, then they feel constrained about what they can be, and they can’t be their authentic selves.
“So really, what it comes down to is this: this concept of needing to be strong and in control. And it’s not [their] fault, but there is now an opportunity for us to change that,” Mr Defina said.
Tell-tale signs
Regarding the warning signs that someone may be experiencing issues with their mental health, Mr Duhig lists the following tell-tale signs to look out for.
For boys, he says the common warning signs are:
- “Spontaneous tantrums or meltdowns;
- “Avoiding previously enjoyable situations;
- “A decline in their academic functioning;
- “Changes in temperament.”
For men, he says the common warning signs are:
- “Withdrawing from social networks;
- “Initiating or increased alcohol and/or substance abuse;
- “Changes to dietary habits;
- “A decline in activities of daily living (e.g., grooming, self-care etc.);
- “Being late or unexplained absences at work;
- “Being preoccupied with one’s thoughts.”
Mr Defina adds that at a basic level if men or boys aren’t “seeing much joy in life”, that’s often a tell-tale sign that there may be an issue.
“If they’re not smiling, laughing, making eye contact and engaging with you, there’s a chance that they are disengaged and withdrawn,” he said.
“If they don’t see much optimism in their lives, and they don’t have much hope for their future, that’s another tell-tale sign that someone is moving towards signs of depression,” Mr Defina added.
Broaching a challenging topic
Being on the frontline of healthcare, pharmacy assistants may find themselves confronted with men, boys (their parents) who may be facing mental health issues.
And it’s not just customers – knowing how to speak with colleagues who may be struggling is equally as important.
However, broaching the topic of mental health may be daunting.
“Choosing a time and place to broach this topic is challenging, and in most cases, the person in need is the last person to realise they need support,” Mr Duhig said.
“When approaching these conversations, one should avoid using directive language [and instead] delicately explain that they’ve noticed a change in the person’s behaviour potentially using some salient examples (e.g., getting up later, missing the gym etc.). And inquire if they are alright,” he said.
A word of warning, though: Mr Duhig says that it’s not uncommon for the other person to “refute these observations initially”, only coming “back to you when they are ready to chat”.
“Often, when one continues the questioning, it deteriorates from a discussion to an argument with poor outcomes for all,” Mr Duhig warned.
One of the keys when broaching the topic of mental health concerns, according to Mr Defina, is to give the person “space to just start talking without giving them advice [straight away] or rescuing them”.
He also advises that it’s essential not to take any responses they might have personally. Not taking things said to heart means you can “hold space for the other person”, giving them the room to speak.
How to build resilience
“There are no gender differences in the ability to build resilience,” Mr Duhig said, “but men may find it more difficult to do as they typically seek support later than females.”
However, Mr Duhig says that the steps required to build resilience are the same for both sexes.
“Know your strengths and play to them; increase your self-esteem by having confidence in your abilities; establish and foster healthy relationships; manage stress and anxiety levels; focus on problem-solving strategies; and most important of all, know when to ask for help,” Mr Duhig said.
Mr Defina adds that it’s also important to get the basics right in building resilience – “it’s looking after themselves”.
“It’s doing the basics really well. It’s getting enough sleep, eating well, having good friends, exercising and doing things that bring you joy and happiness,” he said.
“The next step beyond that is having someone you can talk to, that you feel like you can say whatever is on your mind to,” Mr Defina added.
“And if you don’t have that, then even to just start journaling these things or taking voice notes … just to start expressing [your feelings].”
Mr Defina continued: “The other thing is, don’t fall into the happiness trap. You’re allowed to feel bad; you’re allowed to, it’s totally human to experience positive and negative emotions.”
He says that the goal isn’t to “always feel good”; it’s about recognising the triggers and then healthily handling those triggers – “being able to be with all of the emotions that arise and pass through us”.
Role of diet and lifestyle in mental health
Mr Duhig says that diet and lifestyle play a “massive” role in mental health.
“Several recent studies have outlined the bi-directional nature of the gut-brain link, meaning that what we eat and the process of breaking down food impacts our mental health and, of course, our brain impacts what we eat,” he said, adding that, likewise, the benefits of an active lifestyle also have positive effects on mental health.
“Clinically, when treating mental health disorders, despite the diagnosis, I will always encourage clients to take care of their foundation for good health, such as getting adequate sleep, eating well and being active,” Mr Duhig said.
“ This gives us the energy needed to overcome negative thoughts during the therapeutic process and day-to-day life.”
The importance of mental health awareness among males
“Historically speaking, we tended to tell boys to “get on with it” if they were upset, in turn not validating their feelings and leaving them to pull themselves out of this distress,” Mr Duhig said.
“Fast forward to today, these young boys are now men and in-line with that mindset, trying to tackle their mental ill-health and finding it extremely difficult to ask for support.”
Mr Duhig says that “thankfully, this rhetoric is changing with more support being focused on men’s mental health”, which is vital for “reducing the stigma about mental ill-health and fostering a sense of vulnerability among our boys and male youth”.
“This transition has been bolstered by several athletic and sports stars speaking about their mental ill-health, which normalises this behaviour for our kids and teens,” he continued.
“While we have a long way to go in this regard, starting a conversation and acknowledging that ‘it ain’t weak to speak’ are great starting points.”
How pharmacy assistants can help
Mr Duhig suggests that the first step for pharmacy assistants is to “take the time to move the customer to a more private setting” if they confess mental health concerns.
He says that this, along with “letting the customer know that it is courageous to voice their concerns”, will be beneficial to gaining trust, enabling the customer to open up about their mental health issues.
“If the pharmacy assistant suspects imminent danger to the customer or others, then it would be best to speak with a supervisor and identify how to get that customer to a safe place, which may involve calling an ambulance,” Mr Duhig advised.
“If the pharmacy assistant identifies that there is no immediate danger, then it is best to direct that customer to their GP for their treatment options.”
For more information around mental health, access the following websites:
If you, or someone you know, are suffering from mental health concerns, visit the above websites or speak with your healthcare professional. In an emergency, contact triple zero (000) or visit your nearest Emergency Department.
To read the full feature as it appears in this month’s issue of Retail Pharmacy Assistants e-magazine, visit: rpassistants.com.au/magazines/retail-pharmacy-assistants-november-december-2021/
