6 steps to better mental health: What men need to know

While mental health conditions affect up to 25% of people, figures show that men often struggle to recognise issues or reach out for support[1]. There is no clear-cut cause or simple solution for the current crisis.

However, poor lifestyle choices, misconceptions about mental health and gaps in support are certainly contributing factors.

There is no clear-cut cause or simple solution for the current crisis, but poor lifestyle choices, misconceptions about mental health and gaps in support are certainly contributing factors.

In this month’s instalment in our Male Health series, we’re exploring men’s mental health and its complex causes, the role of lifestyle, and what you can do to protect your psychological well-being.

 

Mental health facts and statistics

One in four people in England experience a mental health problem each year, and one in eight men have poor mental health [2],[3]. However, while such conditions are more prevalent among women, men are only half as likely to access psychological therapies or tell friends and family. Evidence shows that men are more prone to using harmful coping measures, such as substance abuse [4],[5]. As a result, official data often do not show the full picture. However, other statistics provide a worrying overview of the state of men’s mental health:

• There were 6,507 suicides in the UK in 2018, three-quarters of which were men [6],[7].
• Men aged 40-49 have the highest suicide rates in the UK, and suicide is the biggest cause of death for men under 50 [8].
• Men are three times more likely than women to become alcohol dependent [9].
• Men are more likely to use and die from illegal drugs [10].
• Around 95% of prison inmates are men, and over 50% of all prisoners have significant mental health issues [11],[12].
• Over three-quarters of all individuals who go missing are men [13].

It is important to differentiate between common mental health problems, including anxiety, depression, or post-traumatic stress disorder (PTSD), and severe, chronic conditions, such as schizophrenia, borderline personality disorder, and bipolar [14].

Common mental health problems can often be treated with a combination of lifestyle changes and therapy options, but severe psychological conditions may require long-term, specialist care.

A person’s diagnosis may change over their lifetime, which may sometimes prove controversial due to the associated stigma of specific labels. However, with 63% of people reporting that they know someone with a mental health problem, psychological well-being is an issue that affects many of us [15].

Andy opens up about how he overcame crippling anxiety by getting a handle on his health and fitness and losing 26kg at Ultimate Performance.

 

What is driving the current crisis?

The causes of the gender gap in mental health are varied and complex. However, there appear to be several key themes that contribute to this disparity:

1. Men are more likely to have misconceptions about mental health

Recent YouGov survey data indicates that men are far more likely to believe common misconceptions around mental health, including:

• 14% of men believe that people with mental health issues can just stop feeling bad if they try hard enough.
• 12% of men think that it is ‘probably’ or ‘definitely’ true that people with mental health issues are violent and unpredictable.
• 11% of men believe that mental health problems are a sign of weakness [16].

Such beliefs could prevent men from reaching out when they do experience mental health issues.

 

2. A lack of support

Stats indicate that up to a quarter of men feel that they have no one to talk to. Up to 63% of men aged 18 to 29 say they have someone to confide in, but this is true for only 50% of those aged 30-44 and 42% of those 60 and over [17]. Gaps in support networks could explain why men are more likely to turn to unhealthy coping mechanisms such as drugs and alcohol [18].

 

3. Gender roles and perceived expectations

There are common cultural perceptions that men are expected to be the breadwinner, strong, dominant and in control. Data suggests that strong conformity to masculine norms, including risk-taking, the ‘playboy’ persona, self-reliance and violence, increases the risk of psychological distress [19]. Perceived cultural expectations could cause men to be less open about their emotions, impair their ability to recognise when they have a mental health problem and mean they struggle to reach out for support [20],[21].

 

4. Men express mental health issues differently than women

Women statistically are more likely to experience internalising conditions, such as depression and anxiety, whereas externalising symptoms, including violence and substance abuse, are more prevalent among men[22]. These disparities are often considered to be due to gender differences in socialisation, help-seeking and coping behaviours [23]. Our perceptions of what poor mental health ‘should’ look like often do not marry up with real-life, resulting in an underappreciation of the true extent of male mental health problems [24].

The link between obesity and depression

As of 2020, 67% of men were classed as overweight, and 26% categorised as obese[25]. As waistlines have grown, so have cases of depression and other common mental health problems.

A body of research indicates clear links between depression and obesity, which increases the risk of chronic health conditions such as high blood pressure, coronary heart disease and increased risk of all-cause mortality [26]. One critical factor is the relationship between lifestyle habits and mental health.

Of course, it does not take a genius to appreciate that being overweight or obese may impact your mood. Ever-present pressures from social media and TV to fit with cultural ideals around body shape and size mean that body dissatisfaction and low self-esteem often go together with weight gain. As a result, psychological distress is often exacerbated by cultural perceptions and experiences of being overweight [27],[28].

There are also several physiological mechanisms behind the link between obesity and poor mental well-being. Of course, few of us want to eat a plate of vegetables when we feel down. But fibre intake through complex carbohydrates is crucial for producing short-chain fatty acids (SCFAs), the metabolites created via fermentation by our gut bacteria in the large intestine. These SCFAs play a vital role in our balance of neurotransmitters such as serotonin and dopamine, our respective happiness and pleasure responses [29]. Modern diets, high in saturated and trans fats and low in fibre and nutrients, increase the risk of weight gain and make you more likely to develop poor mental health.

How former drug addict Matt’s 28kg transformation made fitness his focus to overcome depression.

 

Obesity, at its core, is an inflammatory state. Inflammation is an independent risk factor for depression, anxiety and a host of other mental health conditions [30],[31],[32]. A key player in this relationship is the influence of the gut microbiome Increasing evidence shows that our gut bacteria play a crucial role in modulating brain function and mental health [33].

When this delicate ecosystem falls out of balance, it can upset how we regulate energy metabolism, increasing the risk of metabolic disorders such as insulin resistance and type 2 diabetes [34]. Physical and emotional stress can trigger gut permeability, allowing foreign substances to enter the body and increasing systemic inflammation [35].

One of the pathways through which stress affects gut health is via the hypothalamic-pituitary-adrenal axis (HPA axis), the part of the brain that acts as our central stress response system.

The HPA axis has a bidirectional relationship with the gut through the vagus nerve. It is responsible for our stress response’s neurological and hormonal effects. When we encounter stress, the HPA axis releases cortisol for several hours [36].

This process inhibits the secretion of insulin, the hormone that shuttles and stores glycose in cells throughout the body. In short bursts, this highly effective survival mechanism diverts energy away from storage for instantaneous use by our working muscles so we can evade a perceived stressor (such as a predator).

However, chronic stress has consistently been shown to impair insulin signalling, increasing the risk of health conditions such as type 2 diabetes[37]. Stress also negatively affects thyroid function and metabolism via the hypothalamic-pituitary-thyroid (HPT) axis, a closely connected part of the neuroendocrine system [38].

So, when you turn to high-calorie foods for a short-term boost, you’re more likely to store those calories as fat, triggering further weight gain, more inflammation, decreased mood, and so on. In this way, weight gain and depression form a vicious cycle that is hard to break.

The link between mental health and obesity is complex and does not have a simple or single association [39],[40]. However, we can say that the modern western lifestyle, which often correlates with inflammatory, calorie-dense foods, decreased physical activity and high stress, forms a perfect cocktail for obesity and poor mental health.

Signs of male mental health issues

While men and women both experience similar mental health conditions, men often present different symptoms, including:

• anger, irritability, or aggressiveness
• noticeable changes in mood, energy level, or appetite
• difficulty sleeping or sleeping too much
• difficulty concentrating, feeling restless, or on edge
• increased worry or feeling stressed
• misuse of alcohol or drugs
• sadness or hopelessness
• suicidal thoughts
• feeling flat or having trouble feeling positive emotions
• engaging in high-risk activities
• aches, headaches, digestive problems without a clear cause
• obsessive thinking or compulsive behaviour
• thoughts or behaviours that interfere with work, family, or social life
• unusual thinking or behaviours that concern other people.[41]

 

Reaching out

If you feel like you’re struggling with your mental health, the first thing you should do is seek help. Your healthcare provider or GP is best placed to do this as they can assess the severity of your mental health problems, organise support and discuss treatment options.

They may discuss various types of therapy available, including counselling, hypnotherapy or cognitive behaviour therapy (CBT). However, if you feel like you’re not being heard, do not be afraid to reach out to other sources of support, such as the list of resources at the end of this article. Likewise, you can also contact groups such as Men’s Sheds, which provide community spaces for men to connect.

If you cannot wait for an appointment or you are experiencing feelings of suicide, self-harm, extreme anxiety, paranoia or hallucinations, you could be having a mental health crisis. It is important to reach out to a mental health support service to help you through the immediate crisis and advise on further help.

Lifestyle changes to improve your mental health

While mental ill health can have multiple overlapping causes, and you certainly cannot simply ‘snap out of it’, there are some key steps you can take to increase your sense of well-being, including:

 

1. Be mindful of seasonal changes

Seasonal affective disorder (SAD) is a form of depression resulting from seasonal decreases in daylight exposure[42]. Indeed, vitamin D deficiency has consistently been linked with depression as well as numerous other chronic diseases [43]. While supplementation is always advisable, if you find your mood dips as the days shorten in autumn and winter, adding D3 Replenish is a simple step that can boost your mood. Investing in a daylight alarm clock or SAD lamp can also help to ease symptoms.

 

2. Get moving

Experts assert that as little as 60 minutes of exercise a week could cure 12% of all cases of depression and is as effective as the current medical standard of care for treating mild-to-moderate depression [44],[45]. Resistance training is particularly effective at improving depressive symptoms and improving our ability to adapt to stressors[46].

 

3. Clean up your diet

Lower intake of processed foods and higher fruit and vegetable intake is consistently associated with greater mental well-being through their beneficial effects on inflammation and gut health [47],[48]. Likewise, higher intakes of unsaturated fats, such as nuts, avocado and oily fish, positively affect hormonal balance, which can significantly improve mood [49],[50]. Ditching the booze will also help, as alcohol is a depressant that can lower mood and energy levels even in moderate doses [51],[52],[53].

 

4. Take a blood test

According to research, many mental health issues have strong links to nutrient deficiencies, including magnesium, zinc, and vitamin D, as well as hormonal imbalances [54],[55],[56],[57]. A blood test is the most accurate way to test for deficiencies and produce a targeted treatment plan.

 

5. Prioritise sleep and stress management

People who sleep fewer than six hours per night are over a third more likely to experience depression [58]. Equally, people who have insomnia are 10 times more likely to develop depression than the average [59]. Of course, while depression and insomnia often go together, focusing on sleep hygiene may go a long way to improving your recovery.

Likewise, it is important to recognise and react before stress builds up to an uncontrollable level. Tools like box breathing can help you calm anxious and stressful thoughts if you feel overwhelmed:

• While sitting, breathe in through your nose for a count of 4, taking the breath into your stomach.
• Hold your breath for a count of 4. Release your breath through your mouth with a whooshing sound for a count of 4.
• Without a break, breathe in again for a count of 4, repeating the entire technique 3-4 times in a row.

 

6. Supplement

While a healthy diet should always come first, supplements can provide a useful safety net for mental health. Products like UltraMag, and Zinc NT can help plug gaps in your diet, whereas Drive and Serotonin Support provide the precursors to the neurotransmitters dopamine and serotonin. A group of plants known as adaptogens, including ashwagandha and Rhodiola Rosea, have proven benefits for lowering cortisol. Both ingredients can be found in Inflammation Support.

Forging a regular exercise habit, like resistance training, can help lay the foundation for good physical and mental health for men.

 

The take-home message.

Statistics show that increasing numbers of men struggle with their emotional well-being and often cannot recognise problems or reach out for support. While social factors are important, it is also clear that modern lifestyles contribute to poor mental health. There are no quick-fix solutions to this complex issue. However, there are simple changes that can go a long way to supporting mental well-being. If you are struggling, the most important thing is to reach out for support.

 

Key takeaways

• Women are statistically more likely than men to experience mental health issues, although gaps in diagnosis and treatment mean that the data may not paint an accurate picture.
• Figures fail to account for men being less likely to seek support for their mental health and often presenting different symptoms.
• The relationship between obesity and depression is complex and creates a vicious cycle that is difficult to break.
• While you should always reach out for support if you are struggling with your mental health, there are lifestyle changes you can make now to improve your well-being.
• If you are worried about your mental health, do not be afraid to reach out for help.
• Below is a list of external service providers you can contact in a time of crisis:

1. The Samaritans – To talk about anything upsetting you, you can contact Samaritans 24 hours a day, 365 days a year. You can call 116 123 (free from any phone), email [email protected] or visit some branches in person. You can also call the Welsh Language Line on 0300 123 3011 (7 pm–11 pm every day).
2. SANEline – If you are experiencing a mental health problem or supporting someone else, you can call SANEline on 0300 304 7000 (4.30 pm–10.30 pm every day).
3. The Mix – If you’re under 25, you can call The Mix on 0808 808 4994 (Sunday-Friday 2 pm–11 pm), request support by email using this form on The Mix website or use their crisis text messenger service.
4. Papyrus HOPELINEUK – If you’re under 35 and struggling with suicidal feelings or concerned about a young person who might be struggling, you can call Papyrus HOPELINEUK on 0800 068 4141 (weekdays 10 am-10 pm, weekends 2 pm-10 pm and bank holidays 2 pm–10 pm), email [email protected] or text 07786 209 697.
5. Additional resources
6. Men’s Health Forum
7. CALM – Campaign Against Living Miserably
8. Movember -Supporting Men’s Health
9. Father’s Reaching Out, Father’s Mental Health
10. Men’s Sheds UK – Support for Lonely Older Men
11. Mind

 

References

[1] McManus, S., et al. (2009). Adult Psychiatric Morbidity In England, 2007: Results Of A Household Survey. The Health and Social Care Information Centre, Social Care Statistics.

[2] McManus, S., et al. (2009). Adult Psychiatric Morbidity In England, 2007: Results Of A Household Survey.

[3] McManus, S., et al. (eds.) (2016) Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. http://content.digital.nhs.uk/catalogue/PUB21748/apms-2014-full-rpt.pdf

[4] MHFA. (2021) Mental health statistics. MHFA. https://mhfaengland.org/mhfa-centre/research-and-evaluation/mental-health-statistics/ [Accessed 27.10.2021].

[5] Mental Health Foundation (2021). Survey of people with lived experience of mental health problems reveals men less likely to seek medical support. https://www.mentalhealth.org.uk/news/survey-people-lived-experience-mental-health-problems-reveals-men-less-likely-seek-medical [Accessed 26.10.2021].

[6] ONS. (2019). Suicides in the UK: 2018 registrations. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2018registrations

[7] ONS. (2020). Suicides in England and Wales: 2019 registrations. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2019registrations

[8] MHFA. (2021) Mental health statistics. MHFA.

[9] Men’s Health Forum (2021). Men’s Health Week 2021 – Mental Health – Mental Health & Wellbeing Show, https://www.mhwshow.co.uk/mens-health-week-2020-mental-health/ [Accessed 26.10.2021].

[10] Men’s Health Forum (2021). Men’s Health Week 2021 – Mental Health – Mental Health & Wellbeing Show.

[11] MHFA. (2021) Mental health statistics.

[12] Mental Health Foundation. (2021). “Jail can be scary”… mental health in prison. https://www.mentalhealth.org.uk/blog/jail-can-be-scary-mental-health-prison [Accessed 27.10.21].

[13] Men’s Health Forum. (2021) Key data: mental health.

[14] Mind (2020). Mental health facts and statistics. https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/ [Accessed 26.10.2021].

[15] Mind (2020). Mental health facts and statistics.

[16] YouGov (2021). Mental Health Attitudes Survey 2021. https://yougov.co.uk/topics/health/articles-reports/2021/10/10/men-are-much-more-likely-women-have-misconceptions [Accessed 26.10.2021].

[17] YouGov (2019). One In Five Britons Have Nobody to Open Up to About Problems. https://yougov.co.uk/topics/relationships/articles-reports/2019/04/19/one-five-britons-have-nobody-open-about-problems [Accessed 26.10.2021].

[18] Men’s Health Forum (2021). Men’s Health Week 2021 – Mental Health – Mental Health & Wellbeing Show.

[19] Wong, Y. J., et al. (2017). Meta-analyses of the relationship between conformity to masculine norms and mental health-related outcomes. Journal Of Counseling Psychology, 64 (1).

[20] Smith, D. T., Mouzon, D. M., & Elliott, M. (2018). Reviewing the Assumptions About Men’s Mental Health: An Exploration of the Gender Binary. American Journal Of Men’s Health, 12 (1), pp. 78–89.

[21] Mental Health Foundation (2021). Men and Mental Health, https://www.mentalhealth.org.uk/a-to-z/m/men-and-mental-health [Accessed 26.10.2021].

[22] Smith, D. T., Mouzon, D. M., & Elliott, M. (2018). Reviewing the Assumptions About Men’s Mental Health: An Exploration of the Gender Binary.

[23] Smith, D. T., Mouzon, D. M., Elliott, M. (2018). Reviewing the Assumptions About Men’s Mental Health: An Exploration of the Gender Binary.

[24] Affleck, W., Carmichael, V., Whitley, R., (2018). Men’s Mental Health: Social Determinants and Implications for Services. The Canadian Journal of Psychiatry, 63(9).

[25] NHS Digital (2020). Statistics on Obesity, Physical Activity and Diet, England, 2020. https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/england-2020 [Accessed 20.08.2021].

[26] Faith, M.S., et al. (2002). Obesity–depression associations in the population, Journal of Psychosomatic Research, 53 (4). pp. 935-942.

[27] Atlantis, E., Ball, K., (2008). Association between weight perception and psychological distress. International Journal of Obesity 32 (4), pp. 715-721.

[28] Derenne, J.L., Beresin, E.V., (2006). Body image, media, and eating disorders. Academic Psychiatry. 30 (3), pp. 257-261.

[29] Dalile, B., et al. (2019). The role of short-chain fatty acids in microbiota–gut–brain communication. Nature Reviews Gastroenterology & Hepatology, 16, pp. 461–478.

[30] Vaccarino, V., et al. (2007). National Heart, Lung, and Blood Institute. Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: the National Heart, Lung, and Blood Institute: Sponsored WISE study. Journal of the American College of Cardiology, 50 (21), pp. 2044-2050.

[31] Bremmer, M.A., et al. (2008). Inflammatory markers in late-life depression: results from a population-based study. Journal of Affective Disorders, 106 (3), pp. 249-255.

[32] Milaneschi, Y., et al. (2009). Interleukin-1 receptor antagonist and incident depressive symptoms over 6 years in older persons: the InCHIANTI Study. Biological Psychiatry. 65 (11), pp. 973-978.

[33] Peirce, J.M. and Alviña, K., (2019). The role of inflammation and the gut microbiome in depression and anxiety. Journal Of Neuroscience Research, 97 (10), pp.1223-1241.

[34] Nagpal, R., et al. (2016). Gut microbiota in health and disease: an overview focused on metabolic inflammation. Beneficial Microbes, 7 (2), pp.181-194.

[35] Nagpal, R., et al. (2016). Gut microbiota in health and disease: an overview focused on metabolic inflammation.

[36] Luppino, F.S., et al. (2010). Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives Of General Psychiatry, 67 (3), pp.220-229.

[37] Woo, H., Hong, C.J., Jung, S. et al. (2018). Chronic restraint stress induces hippocampal memory deficits by impairing insulin signaling. Molecular Brain, 11, 37.

[38] Helmreich, D. L., & Tylee, D. (2011). Thyroid hormone regulation by stress and behavioral differences in adult male rats. Hormones And Behavior, 60 (3), pp. 284–291.

[39] Luppino, F.S., et al. (2010). Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives Of General Psychiatry, 67 (3), pp. 220-229.

[40] Faith, M.S., et al. (2002). Obesity-depression associations in the population.

[41] NIMH. (2021). Men and Mental Health. https://www.nimh.nih.gov/health/topics/men-and-mental-health [Accessed 11.10.21].

[42] NHS. (2021). Seasonal affective disorder (SAD). https://www.nhs.uk/mental-health/conditions/seasonal-affective-disorder-sad [Accessed 11.10.21].

[43] Penckofer, S., et al. (2010). Vitamin D and depression: where is all the sunshine? Issues In Mental Health Nursing, 31(6), pp. 385-393.

[44] WHO. (2021). WHO: Motion for your mind. https://www.euro.who.int/en/health-topics/disease-prevention/physical-activity/publications/2019/motion-for-your-mind-physical-activity-for-mental-health-promotion,-protection-and-care-2019 [Accessed 27.10.2021].

[45] Krogh, J., et al. (2017). Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis. BMJ Open, 7 (9).

[46] Strickland, J. C., Smith, M. A. (2014). The anxiolytic effects of resistance exercise. Frontiers in Psychology, 5 (753).

[47] Phillips, C.M., et al. (2018). Dietary inflammatory index and mental health: a cross-sectional analysis of the relationship with depressive symptoms, anxiety and well-being in adults. Clinical Nutrition, 37 (5).

[48] Saghafian, F., et al. (2018). Fruit and vegetable consumption and risk of depression: accumulative evidence from an updated systematic review and meta-analysis of epidemiological studies. British Journal Of Nutrition, 119 (10).

[49] Whittaker, J., Wu, K., (2021). Low-fat diets and testosterone in men: Systematic review and meta-analysis of intervention studies. The Journal of Steroid Biochemistry and Molecular Biology. 210.

[50] Hämäläinen E, et al. (1984). Diet and serum sex hormones in healthy men. Journal of Steroid Biochemistry and Molecular Biology, 20 (1), pp. 459-64.

[51] Brust, J.C.M., (2010). Ethanol and cognition: Indirect effects, neurotoxicity and neuroprotection: A review. International Journal of Environmental Research and Public Health, 7.

[52] Oscar-Berman, M., Marinkovic, K., (2003). Alcoholism and the brain: An overview. Alcohol Research and Health, 27 (2).

[53] Ende, G., et al. (2005). Monitoring the effects of chronic alcohol consumption and abstinence on brain metabolism: A longitudinal proton magnetic resonance spectroscopy study. Biological Psychiatry, 58.

[54] Barragán-Rodríguez, L., et al. (2008). Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial. Magnesium Research, 21 (4).

[55] Sawada, T., Yokoi, K. (2010). Effect of zinc supplementation on mood states in young women: a pilot study. European Journal Of Clinical Nutrition, 64 (3).

[56] Di Gessa, G., et al. (2021). Changes in vitamin D levels and depressive symptoms in later life in England. Scientific Reports, 11 (1).

,