Men’s Health Month: Masculinity and Mental Health

According to research, men are less likely to seek mental health services compared to their female counterparts. One of the factors that contribute to this underuse of seeking professional help is masculinity norms.

June is Men’s Health Month; a month dedicated to raising awareness of preventable health problems and encourages early detection and treatment of diseases among men and boys. It is well understood that men are less likely to focus on their physical and mental health due to toxic masculinity that has been ingrained in society for hundreds of years. As a result, men often suffer from depression and anxiety in silence and turn to illicit drugs and alcohol as negative coping mechanisms and ways to numb their pain.

The silent health crisis

  • There is a silent health crisis happening among men in the United States.
  • The Men’s Health Network reports that men die at higher rates than women due to these top 10 causes of death: heart disease, cancer, stroke, chronic obstructive pulmonary disease, accidents, pneumonia and influenza, diabetes, suicide, kidney disease, and chronic liver disease and cirrhosis.
  • Men are less likely than women to see a physician
  • Men are more likely to be uninsured compared to women
  • Approximately 30,0000 men in the United States die from prostate cancer each year
  • Prostate cancer and skin cancers are the most common types of cancer in men.
  • Sexual dysfunction is a common health problem in men that can lead to an array of psychological setbacks such as low self-esteem, depression, and anxiety.
  • Sexual dysfunction is usually caused by atherosclerosis, the same process that causes heart attacks and strokes.
  • Men also die at a younger age compared to women.
  • In 1920, women outlived men only by one year. Today, CDC figures show the life expectancy gap has widened: Today, on average, women survive men by over five years.
  • Many men believe that as long as they are working and feel good, there is no need to see a doctor.

Men’s mental health matters

Mental health is a major component of a man’s well-being, and unfortunately, men’s mental health is often silenced in society. There is a catastrophic intersection of low rates of diagnosed depression and high rates of suicide and substance abuse among the U.S. male population. Men are more likely to use substances, at greater quantities, and are two to five times more likely than women to develop a substance use disorder (SAMSHA). Heavy drinking and binge drinking are more prevalent in men (National Institute on Drug Abuse). Men chronically use nonmedical opioids at twice the rate of women (even though women are prescribed them more often), and more men die of prescription drug overdoses than women (CDC). Men are more likely to use external methods to cope with the inward turmoil and pain caused by depression. Men often deal with depression by over-working. They also self-medicate by turning to substances such as drugs and alcohol as a way to avoid dealing with depression and anxiety.

The connection between toxic masculinity and substance abuse

Toxic masculinity refers to actions that discourage displays of emotion, other than anger, in men while also encouraging behavior that will deem the male “dominant” in a given situation. Even as children, young boys who express feelings are compared to girls in a negative context. Common responses to young males who become emotional include:

  • Boys don’t cry!
  • Man up!
  • Don’t be such a baby!
  • Don’t cry like a girl!
  • Be a man, get over it!
  • You throw like a girl!

Displaying traits of toxic masculinity can lead to numerous negative outcomes and adherence to rigid masculine norms may lead to:

  • Problems with dating and interpersonal intimacy
  • Greater depression and anxiety
  • Abuse of substances
  • Problems with interpersonal violence (sexual assault, spousal abuse)
  • Greater health risk (high blood pressure)
  • Greater overall psychological distress

Recovering from toxic masculinity

All recovery is a lifelong process, whether you are recovering from drugs, alcohol, codependency, or toxic masculinity. In fact, beyond these specific issues, every human life is truly one long recovery process. Born into a world that conditions fear and separation, we emerge as adults who are disconnected from our power, from our goodness, from each other. Once we recognize that there is a truer way of being, beneath what we were taught, every day is a chance to restore a bit more of our perspective from fear to love. Every moment is a chance to remember the truth of who we are: Whole, sacred beings who inherently deserve love and care.

Breaking the stigma

As treatment professionals, it is our job to reach out to men who are struggling internally and who are using illicit substances and alcohol to number their pain. Men want to be respected, men want to provide for their family, men want to work hard, men want to stay healthy, and men want to be loyal to their friends. If you are a male and are struggling with a mental health or substance use disorder, we want to help you. We at Quest2Recovery, want to treat you, the individual, and not just your disorder. We want to break the mold, set the standard, and be role models for the rest of the addiction treatment industry. We want to invite you to seek help in a compassionate, non-judgmental environment.

Supporting vs. Enabling Someone With PTSD

The biggest mistake and disservice we are doing to our first responders and military is putting a post traumatic stress disorder, also known as PTSD, label on any and all behaviors of someone struggling with PTSD. Not all behaviors we label as PTSD are actually PTSD. In fact, many of the behaviors we label as PTSD are beyond that diagnosis and fall under other categories of addiction, substance misuse, anxiety, depression, domestic violence, and even abuse. If we excuse or normalize behaviors based on a PTSD diagnosis, we can easily become enabling. Not all behaviors should be accepted with a PTSD diagnosis. We live in a time where so many resources are available that we should not be excusing any of it, but offering resources to those struggling. There is help available.

 

Examples of Enabling Someone with PTSD

I spent 15 years as a law enforcement wife. I saw the signs and symptoms of PTSD long before he accepted there were issues. Early intervention would have made all the difference. I would bring up the topic which would enrage him, so I would quickly back down. The children and I enabled his PTSD by not pressing the issue and not setting healthy boundaries for ourselves. When he had bouts of anger, we would hide in our bedrooms. When he isolated himself, we just let him isolate. We began doing all of our family activities without him. Instead of addressing the issues, we excused them. I would tell the kids, “Daddy doesn’t feel good today because he has PTSD.” I would tell the family, “His PTSD is bothering him so he didn’t come.” The problem was not addressed, it was simply excused by all of us. We felt that because PTSD was something that happened to him, we didn’t want to make him feel worse about it than he already did. Unfortunately, that enabled the PTSD instead of addressing it, and choosing to work through the diagnosis. The symptoms grew worse because he wasn’t getting the help he needed.

 

When Helping Turns Into Codependency 

Many spouses enmesh their self worth into “helping” their spouse. It becomes a codependent relationship very quickly when one person is battling PTSD. When we marry, we take on our spouse’s burdens as our own. We strive to help them and love them. Where do we set the boundary between helping versus enabling? It is natural for a spouse to desire to help their husband or wife. Most spouses want to help each other through their struggles. The problem is that we cannot fix a spouse’s PTSD. So instead, we try to fix everything around them. We try to make it easier for them. Unfortunately, that is the worst thing we can do with someone struggling with PTSD. Making everything around them easier for them is the very definition of enabling. Making life easier by taking over their responsibilities and allowing them to isolate actually makes PTSD worse instead of better. It enables them to sit in their issues without learning how to cope or work through it. How do we help them without enabling them?

Realizing When to Get Help

I deal with wives much like myself on a daily basis. We all have one thing in common. We are enablers and codependent. One wife we tried to help whose husband was an alcoholic didn’t want to press the issue with her husband. He had her convinced he was not an alcoholic. He agreed to go to counseling with her. We advised against it because we knew he needed more than just once a week counseling. Also, the marriage problems were a direct result of his alcoholism. He needed specific treatment for that as well as the untreated PTSD which was the beginning of the drinking problem. She was very codependent and didn’t want to upset him. She was so used to enabling him and being his rescuer that she wouldn’t let us intervene. She would not even let us speak to him. A year later, things fell apart in their home. He had not received the specified help he needed. He went to treatment, but the damage was too great at that point to repair the marriage.

I had another wife whose husband was using drugs. Instead of him getting professional help, the wife put an app on his phone to track him. She was trying to help him stop using. She had become his rescuer, but also his enabler. He didn’t need to be tracked by his wife. He needed professional help. I don’t judge her for it. I, myself, used to count pills to make sure that my husband wasn’t abusing them. There is no difference between myself and this wife. I know wives, myself included, who admitted to counting the beer in the fridge to monitor their spouse’s drinking. When you reach that point in any capacity, you are not helping your spouse. You are rescuing and enabling. Professional help and intervention is needed for both people. 

 

How to Support and Not Enable 

There are so many ways to support someone with PTSD. We can support them as they navigate the process of moving into post traumatic growth. We can encourage them as they go through the process of seeking help. We can choose activities that encourage them to get the exercise they need such as hiking, biking, swimming. We can understand that there will be rough days, but not to the point of enabling isolation for weeks at a time. We can set healthy boundaries, which is a lot harder than it sounds. We can get help for ourselves to learn how to stop enabling. We can work on ourselves to make sure that we don’t become enmeshed in an unhealthy balance. 

 

LGBTQ Pride Month

Stigma, Addiction, and Mental Health within the LGBTQ Community

“Like racism and all forms of prejudice, bigotry against LGBTQ people is a deadly carcinogen. We are pitted against each other in order to keep us from seeing each other as allies. Genuine bonds of solidarity can be forged between people who respect each other’s differences and are willing to fight their enemy together. We are the class that does the work of the world, and can revolutionize it. We can win true liberation.”

-Leslie Feinberg

 

Individuals who identify as LGBTQ are more at risk for substance use and mental health disorders compared to the heterosexual cis community. As we dive deep into LGBTQ Pride Month, it is important to honor this minority community and gain a deeper understanding of why these individuals are at a higher risk for addiction and mental health concerns. We want to eliminate the stigma associated with addiction and mental health in this special community, and we want to break down the barriers to entering treatment.

 

LGBTQ Pride Month is celebrated every June in honor of the 1969 Stonewall riots. The Stonewall riots took place in New York after the NYPD raided the Stonewall Inn, a gay club located in Greenwich Village. This raid sparked a six-day violent protest between the community and law enforcement and catalyzed gay rights across the globe. As with many minorities, the LGBTQ community is marginalized and stigmatized and often discriminated against, causing this community stress and anxiety. In recent years, we have made giant steps forward in terms of equal rights for the LGBTQ population, but there is still enormous progress to be made as we move forward and eliminate the stigma.

 

Taking a look at the statistics

  • Among all U.S. adults aged 18 and over, 96.6% identify as straight, 1.6% as gay or lesbian, 0.7% as bisexual, and the remaining 1.1% as “something else.”
  • 38-65% of transgender individuals experience suicidal ideation.
  • An estimated 20-30% of LGBT individuals abuse substances, compared to about 9% of the general population. 25% of LGBT individuals abuse alcohol, compared to 5-10% of the general population.
  • Approximately 8 percent of LGBT individuals and nearly 27 percent of transgender individuals report being denied needed health care outright.
  • More than 1 in 5 LGBT individuals reported withholding information about their sexual practices from their doctor or another health care professional.
  • LGBT youth are four times more likely to attempt suicide, experience suicidal thoughts, and engage in self-harm than straight youths.
  • LGBTQ individuals are almost three times more likely than others to experience a mental health condition such as major depression or generalized anxiety disorder.
  • The LGBTQ community is at a higher risk for suicide because they lack peer support and face harassment, mental health conditions, and substance abuse.
  • Compared with heterosexual men, gay and bisexual men had a significantly higher prevalence of lifetime full syndrome bulimia, subclinical bulimia, and any subclinical eating disorder.
  • 25% of LGBT people abuse alcohol, compared to 5-10% of the general population.
  • An estimated 20-30% of LGBTQ people abuse substances, compared to about 9% of the general population.
  • The LGBT community is at a higher risk of bullying and has even been the center points for violent attacks.

 

Why are substance abuse and mental health disorders so much higher in the LGBTQ population?

 

  • Stress: The LGBTQ community and other minority communities are under constant stress and tension. Our society does not view them as equal, and as a result, they are continuously enduring social prejudice. Whether it is in public, in the workplace, in relationships, in their family, or within the political system, the LGBTQ community struggles with being seen and heard. Often, their family members and close friends will disown them because of their sexual orientation. This community is at risk of loneliness, stress, and discrimination, and as a result, they are more likely to use alcohol and drugs as a way to cope with their feelings. Drowning out rejection, sorrow, and depression with alcohol or heroin can be a temporary unhealthy Band-Aid to relieve their internal pain. With increasing use, this can turn into a habit, which can quickly snowball into an addiction.
  • Stigma: The stigma associated with identifying, as LGBTQ, is unfortunately still very real and powerful. This community is often brutalized, isolated, and harmed simply because of how they choose to identify with their sexuality. The stigma associated with addiction and mental illness is still prominent today. When a member of the LGBTQ community is struggling with depression or an opioid use disorder, the stigma rises exponentially, putting this community at risk of even more rejection, isolation, low self-esteem, and physical threats of violence.
  • Limited access to treatment: Unfortunately, many therapists and treatment centers are not aware of the specific issues that the LGBTQ community faces. Nor can they relate to this community for the following reasons: their cultural norms conflict with this community, they do not recognize this community is a high risk, and fail to look past the client’s gender and sexual orientation. As a result, members of the LGBTQ community are less likely to seek out treatment for their substance use and mental health disorders out of fear that they will experience discrimination, worsening stigma, and lack of being understood by their providers.

 

Resources for the LGBTQ community 

 

Breaking the mold

As treatment providers and mental health specialists, we can do better. We can educate ourselves about the LGBTQ community and try to understand their views, opinions, and internal struggles. We can learn the proper vocabulary and erase the hateful jargon that is often used to stigmatize this population. We can create LGBTQ, specialized treatment programs that are inclusive, empowering, and educational for this population.

 

If you are part of the LGBTQ community and are struggling with a mental health or substance use disorder, we want to help you. We at Quest2Recovery, want to treat you, the individual, and not just your disorder. We want to break the mold, set the standard, and be role models for the rest of the addiction treatment industry. We want to invite you to seek help in a compassionate, non-judgmental environment.