Men might be the unhappiest they’ve ever been. Many causes have been cited for a recent slide in male satisfaction, evident in a number of social science data sets, everything from the 24-hour news cycle, to the economy, to the decline of sex, marriage, family, and religion respectively. The male crisis du jour, though, might have more to do with internalized attitudes than external factors. As traditional masculinity, which has historically normalized many unhealthy behaviors, demanded emotional avoidance, and stigmatized close relationships, has lost some traction, men have failed to take full advantage of new-found freedom. Instead, they have surrendered to a sort of lonely ennui, taking what was bound to be a difficult transition poorly.

“The current focus on toxic masculinity has many men feeling consciously and unconsciously that they are toxic as individuals,” psychotherapist Carla Manly explains. “This results is a sense of wariness and constant fear. This fear — much of it unprocessed — can lead to detachment from relationships. This, of course, can lead to a sense of loneliness that feeds a general sense of unhappiness.”

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The General Social Survey, a massive dataset meant to give researchers and policymakers a snapshot of how Americans are doing, shows male happiness has been curved over time. Until recently, men were the most unhappy when data was first collected in 1972, with 22 percent of men reporting that they were “very happy,” compared to 37 percent of women; 17 percent of men were “not too happy,” compared to 14 percent of women. In 2018, happiness levels bottomed out again, but men between the ages of 18 to 35 fell to an all-time low with only 22 percent of men reporting that they were “very happy” compared to 28 percent of women. Some 18 percent of men reported they were “not too happy” compared to 14 percent of women. Men in 2018 were about 9 percent less likely to describe themselves as “happy” than they were in 2012 and 8 percent more likely to describe themselves as “unhappy.” Manly suspects this decline in happiness has to do with men’s changing and precarious roles.

Toxic masculinity is often misunderstood as the notion that masculinity is inherently harmful, when the reality is that it’s inherently unstable. Unlike femininity, masculinity is regularly challenged, policed, and taken away. This causes more “toxic” men to behave badly and many other men to live unhappy lives.

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The anxiety Manly describes is not unique to progressive Twitter users. It appears to be almost universal among men. Experts at the American Psychological Association suspect that male sadness, specifically male sadness derivative of anxiety about masculinity works like a snare trap. Boys are caught in it when they’re young. They learn to “man up” or are told that “pain is just weakness leaving the body.” They are told successful and strength and value are all the same thing. This is internalized so that when men try to fight against it later on, it cuts into them.

In short, even men who recognize the need to change their attitudes may not succeed in doing so and men who are being forced to change their attitudes are unlikely to succeed in doing so. That’s a significant population: the shrinking of the middle class and traditionally male-dominated industries as well as the rise of dual-income family as a cultural norm has required men to pivot into unexpected roles and grapple with concepts at odds with internalized notions of manhood. Equally terrified of the #MeToo movement and being misconstrued as gay, men stumble down an untenably narrow middle path.

“Although these shifts are exceedingly positive, they can be daunting and intimidating for men,” Manly says. “This is a rather off-putting shift for those who have found safety in the left-brain, ‘logic is superior’ mentality.”

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The problem is not that the concept of positive masculinity has not been explored, it’s just been slow to catch on. The American Psychological Association recently identified a number of examples of positive masculinity including courage, respect for women, group orientation, self-reliance, and humor. Since men have been policed and punished more harshly for violating gender norms, those who want to deviate from traditional standards don’t always trust that it’s safe. So new expectations are piled on to old ones that they should be replacing. Dads are expected to be nurturing, but feel judged for making less money than their wives, crying when they’re sad, and seeking help when they’re depressed. This is clearly incoherent.

“The standards by which we judge what’s okay and what’s not okay for men are changing. The standards, many of which were inappropriate, used to be more clear,” psychologist John Moore told Fatherly.

In extreme cases, an inability to cope with changing expectations doesn’t just make men feel sad, it leads to death. Men are four times more likely to commit suicide than women and the numbers go way up in the wake of a shock to their identity, such as a divorce and job loss. Middle-aged men who buy into traditional ideas of masculinity have the highest suicide risk of all.

This is not a new problem, but an old and festering one. Men’s suicide rates have been significantly higher than women’s ever since scientists started tracking them, and yet men continue to be diagnosed with depression significantly less. This may not be because men are any less depressed, but because they tend to understand their symptoms in unemotional terms. Research shows that emotions like sadness manifest for men as physical pain. Men are much more likely to complain about back pain than sadness, and research shows that a majority of men who kill themselves visit their primary care doctor within a month of their death.

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When men don’t channel sadness into pain, they tend to convert it into aggression. Though some men lash out, more lash in, especially when they’re trying to protect their families from their worst qualities.

“It’s a sort of rotting from the inside out,” Manly warns. “When we don’t normalize and promote the healthy expression of all emotions, we create horrific psychological problems that result in anxiety, depression, and even suicide.”

There are some clear solutions and some fuzzier ones. The American Psychological Association is pushing for the adoption of “Positive Masculinity,” which is basically a collective move away from the old-school, lone wolf mentality.

Research suggests that group therapy experiences are especially effective for men because men are generally more responsive to advice from peers than advice from authorities.

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Universities like Brown, Duke, and North Carolina Chapel-Hill have launched successful men’s groups to talk about minding the gap between traditional and new masculinity. These groups don’t need to be that formal, but Manly and Moore agree that such groups can be far more casual and may attract more members if they are. A basketball league works as well as a talk session.

“Men are desperate to be a part of groups of other men,” Moore says. “The opportunities for men to bond with one another have become fewer and fewer, and so they feel more isolated and less connected, and in come cases become depressed.”

The solution for the male happiness crisis seems to be male. The question for the moment is whether men are equipped to ask for the help they need and to respond when their help is requested. Many are, but it’s possible many others are too busy tearing themselves apart.