Why do men refuse to get help?

Why is it that most American men refuse to get help when they suffer from depression? In their article “Why Won’t Men Get Help?” in Pacific Standard (July/August), David Freed and Betsy Bates Freed tell stories of specific men and point to alarming statistics about men who suffer from depression and other maladies.

In 1998, the Freeds write, “about 1.47 of every 100 men in the United States sought outpatient help for depression; by 2007, it was 2.12 men per 100, according to a study sponsored by the federal Agency for Healthcare Research and Quality.”

And most of those who do go for help prefer pharmaceuticals to “talk therapy.” In 1998, 56.2 percent of those who sought help used the latter treatment; in 2007, that percentage dropped to 42.5. And those who chose pills increased from 68.8 percent in 1998 to 73.3 percent in 2007.

This failure of the vast majority of men to seek help has dire consequences, especially since the economic recession. “Suicide overtook blood poisoning to become the 10th leading cause of death in the U.S. in 2009,” the Freeds write. And men account for nearly 80 percent of suicides in the United States today.

Those rates have been rising in the past 25 years, and the rise in recent years of overall male unemployment will likely send them higher, unless something changes.

Why are men so reluctant to seek help from professional therapists--or even from medical doctors for that matter? It’s something they learn growing up. 

But it turns out they aren’t born that way. “Studies show that most male babies actually start out more emotionally expressive than females,” the Freeds write. But by age 2, boys are less verbally expressive than girls.

Psychologists have a word for the “strong silent type” masculinity that many American men hold on to: “normative male alexithymia,” which literally translates as “without words for emotions.”

Another reality men face who do go for help, the Freeds write, is that “nearly three in every four licensed psychologists who hold doctorate degrees are female, as are almost 80 percent of master’s-level students in psychology-related fields of study.” This can pose both an advantage and a disadvantage for male patients.

On the one hand, men may regard a woman as “more nurturing, empathetic and less threatening.” On the other hand, “female psychotherapists … run the risk of alienating men by trying to counsel them, however subtly, to be like them.”

Once men do get into counseling, they tend to do better. In fact, research has shown that men benefit from talk therapy just as much, if not more, than women.

I mentioned this to some friends of mine who are therapists, and they thought this made sense, since most women are used to talking about their feelings, so therapy isn’t as new an experience as it is for most men.

Men with cancer also don’t usually ask for or get as much support as women. Betsy Bates Freed in her article “Did You Hear the One About the Guy with Prostate Cancer?” (in the same issue) compares breast cancer and prostate cancer, “two diseases that are diagnosed in almost equal numbers each year in the U.S., and take a similar emotional as well as physical toll. As of May, published, peer-reviewed studies on ‘breast cancer and support’ outnumbered those on ‘prostate cancer and support’ by 56,000.”

The macho mentality that we shouldn’t ask for help may be American, but it’s far from being Christian. "God helps those who help themselves" comes from Ben Franklin, not the Bible. 

There are some Christian writers in the field of male spirituality who complain about the "wimpy Jesus" others promulgate. They call men to be strong. I suggest these writers are not only wrong but dangerous. They reinforce a male stereotype many of us have grown up with that has caused much pain. 

I suggest it takes strength to admit when we are hurting. It also takes discernment, wisdom, to even recognize it sometimes. Many men carry great pain and anguish inside and feel unable to face it. Too often that inability leads to addictive, destructive behaviors, such as alcoholism and drug abuse, which not only hurts ourselves but others, particularly spouses.

We men need to encourage one another to talk about our problems and seek help when we need it. That is a truly countercultural, Christian response to the lies we've been told, such as, "Suck it up." "Be a man." "Don't cry." It is also true strength and needed wisdom to talk about our pain and seek help.