Features

Boys don't cry: young men and suicide

by Cassie White

Suicide is the leading cause of death in young men, yet figures suggest mental illness is more common in women. So what is going wrong?



[Image source: iStockPhoto | stphillips ]

Male suicide statistics in Australia are grim.

Men are three times more likely to kill themselves than women and suicide is the leading cause of death in men aged between 15 and 44. In 2011, almost double the number of young men died by suicide compared to fatal car accidents.

Yet although men are more likely to die by suicide, the incidence of mental illness is actually higher in women. Australian Bureau of Statistics figures suggest at some point in their lives one in five men experience anxiety and one in eight will have depression, whereas for women one in six experience depression and anxiety affects one in three.

But men are less likely to get the help they need, with other ABS data showing only 27 per cent of men seek professional help, compared to 40 per cent of women. In many cases men turn to drugs or alcohol instead of getting assistance, this is especially so with men under 25.

Substance abuse tends to compound mental health problems, and can cause many men's lives to spiral out of control. Often by the time young men are asking for help, health professionals only see a drug or alcohol problem, not the underlying illness.

Jack Heath, SANE Australia chief executive officer, says young men are often put off from seeking help because of stigma, embarrassment and the need to appear independent. Instead, they stick it out on their own, hoping the problem will go away.

"There are notions of masculinity and what it means to be a man that prevent them from getting help," he explains.

"There's a belief that the very idea of being a man is that you deal with stuff and you don't reach out or connect. Untreated, the problem snowballs. The combination of that and the notion of having to deal with it alone, is the reason behind high suicide rates."

Why men respond differently

Genetics, substance abuse, a traumatic childhood and relationship issues are the most common reasons people can develop a mental illness.

Although the causes are the same for everyone, Professor Ian Hickie, from the University of Sydney's Brain & Mind Research Institute, says experts still don't know exactly why men respond differently.

"There may be hormonal and brain developmental differences between men and women that we need to understand better, particularly during the teenage period when the rates of development of the brain are different," he says.

"And there are social reasons, like the extent to which young men are introduced to alcohol  at a young age in high volumes  as a way of socialising and coping with anxiety around sexual relationships and exploring life outside their family."

Irritable and angry

Someone who has a mental illness will often withdraw from friendship groups, have poor sleeping habits, struggle to concentrate and stop being productive at work or study.

But where women often feel sad and tearful, young men are more likely to be irritable, angry and frustrated, which causes them to lash out at people  especially if drugs or alcohol are involved, Hickie says

"These problems are seen by the rest of the world as an angry difficult person who's hard to get on with," he explains. "You don't see the mental health problems that lie behind that."

When men get older, they experience more classic signs of depression, such as sadness, guilt and turning against themselves, rather than others, Hickie says.

Jonathan Nicholas, chief executive officer of The Inspire Foundation, says young men also tend to isolate themselves by shutting out loved ones and refusing to confront their problems. They sometimes distract themselves for days and weeks playing video games or watching TV.

"If he's doing it to relax and still spending time with people and going to work or school, then that's fine," he says. "But if he's using it to avoid other things, then it's a problem, because he's effectively leaving the real world."

Behavioural changes that last longer than two weeks can be a red flag, and they often indicate a person is suffering from more than just a case of the blues, especially if there's no reason for their sharp drop in mood.

Tough conversations

When so many men won't accept or admit there is a problem in the first place, it can be difficult to convince them to find support. Converting feelings to numbers often helps guys open up, Nicholas says.

"Ask, 'On a scale of zero-10, where zero is 'as bad as life can be', and 10 is 'I'm so happy I'm the Dalai Lama', where do you sit?' If he's sitting around at four or less, you'll know he's feeling really bad."

But if he refuses to see a doctor, all is not lost; it just means you may need to approach the subject differently.

"Women generally want to understand more about depression, whereas guys just want to know what to do," Nicholas says.

"For a lot of men, the process of talking really puts them off. Moving straight to the practical steps they can take to help while learning about their illness, such as eating well, exercising and getting into a regular sleep pattern, is something many guys feel engaged with and empowered by."

While seeing a psychologist is an excellent form of support, there are many other options for men who are uncomfortable talking about their feelings.

"For guys, quite often it's about being connected, without actually talking. It's the reason why going to a sporting event with a mate is good," Nicholas says. "It gives you a sense of connection, without having to talk about your feelings."

Suicide red flags

Difficult life events can drive depressed men to suicide, especially if they've been using drugs or alcohol, Hickie warns.

"The situation that terrifies us is the young man who's isolated, depressed and drinking, then something else goes wrong as a consequence of that  they lose their job or their partner leaves," he says.

"When people are using substances to manage their distress, they're much more likely to do something impulsive and harmful."

And while it's normal for young guys to sometimes take physical risks, repeatedly jeopardising their own safety or that of others is a warning sign.

"You see issues in terms of drink driving, going out and jumping off things, and generally putting themselves in obvious harmful situations that appear to not be thought through," Hickie explains. "They're seeking pleasure or thrills or escape from distress."