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MALTATODAY 28 November 2021

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maltatoday | SUNDAY • 28 NOVEMBER 2021 10 NEWS Why are men afraid to talk about mental health? Mental health issues are al- ways a challenge to face and to speak up about mainly due to the stigma surrounding them. The stigma has always been a complex and prevalent issue throughout the population, but this is noticeably more promi- nent in the male gender mainly due to social stigma. Only 1 in 4 men who suffer daily feelings of anxiety or de- pression actually speak up to mental health professionals. So- cial stigma is the culture of mas- culinity standards and norms that expect men to be domi- nant, powerful, self-sufficient, invulnerable and to always be in control. This is also affected by the expectation of men to display traditional gender roles such as being less forthcoming in opening up about their emo- tions and also to downplay their symptoms to take a stoic ap- proach. Toxic masculinity may negatively impact one's mental health and thus prevent men from reaching out for support and ultimately receiving treat- ment. All these factors compounded, lead to health disparities be- tween men and women as most men with mental health issues tend to suffer in silence, re- main undiagnosed with missed warning signs and with some unfortunate cases being only identified when it is too late. This may lead us to falsely be- lieve that mental health issues are less predominant in males compared to women. Is depression different for men? Depression is generally char- acterised by persistently low mood, lack of motivation, loss of pleasure, changes in appe- tite, sleep disturbances, hope- lessness and helplessness which impact one's daily living. Al- ternatively, symptomatology of depression in men may vary and men may display male-typ- ical depressive symptoms which include destructive and risk-taking behaviours such as violence or substance misuse, aggression, irritability, negative parental behaviours, escapism as well as somatic complaints. This difference in depression between genders may be due to biological sex and gender roles. Studies have shown that bio- logical sex differences influence the way depression manifests itself as well as the treatment response. Western society's tra- ditional gender roles and identi- ty effect the way people experi- ence and express their emotions and thus may lead men to exter- nalise depression as male-typi- cal behaviours. Many a times, men seek help when they are at a crisis point because tradi- tional symptoms of depression are at odds with the ideals of masculinity. Emphasis is made on the fact that most men with depression remain undiagnosed due to failure to seek help. What are the warning signs for men's mental health and who is the most at risk? Warning signs tend to be spe- cific to the mental health con- dition in question and thus can vary significantly. However, it is important to keep in mind that signs and symptoms of men- tal health conditions include a change in mood, energy levels, behaviour, appetite and sleeping habits. Others may include use of illicit substances or participa- tion in risky activities, non-sui- cidal self-injury and thoughts of or attempts of suicide, to name a few. It is thus fundamental to seek medical help if you think you or a loved one are experi- encing such symptoms because early treatment can prevent progression of the condition as well as lower the risk of compli- cations. While mental health issues tend to be more prevalent in vulnerable groups within the population, it is fundamental to keep in mind that mental health issues can affect people from all social strata. Vulnerable groups of men tend to be more predis- posed to suffering from mental health issues and these include men with previous history of trauma such as physical or emo- tional trauma, men who are ex- posed to social stressors such as unemployment, marital break- down and financial problems, men who misuse alcohol or il- licit drugs, men with a history of or family history of mental health issues including suicide. Why are men more likely to die by suicide than women? It is very unfortunate but al- so very true that men are more likely to die by suicide than women, in fact men are more than 3.5 times likely to die from suicide than women especial- ly in the less than 35-year age group. One of the reasons may be that men tend to be less open to seeking the appropriate help for their mental issues for fear of being ridiculed and are of- tentimes embarrassed to admit that they need help. Further- more, when mental health is- sues are identified in men, these tend to be more advanced and sometimes also too late. It is also well known that men tend to have different coping mechanisms to dealing with mental health issues. Men tend to choose more lethal means such as the use of weapons or self-destructive behaviours such as the use of alcohol and illicit substances as well as par- ticipation in risky activities. Other culprits for suicide being a commoner cause of death in men than women, include the unrealistic societal expectations for men which were alluded to before and the stigma sur- rounding mental health. These lead to negative feelings of men- tal health issues spiralling out of control, becoming overwhelm- ing and can lead to the unfortu- nate outcome of suicide. What can we do in terms of prevention and awareness to remove the stigma? The media can be a means to educate and provide the correct knowledge to the general popu- lation and also convey a message of hope to sufferers of mental health issues through sensitive and responsible reporting. The Maltese Association of Psychi- atry has released guidelines for reporting on such issues, which are accessible on their website. Additionally, the media can in- crease awareness of the current mental health services which can be used nationally and which include: national support line 179, Richmond Foundation 1770, psychiatry team at Acci- dent & Emergency Department within Mater Dei Hospital, and online resources such as www., amongst others. As an individual in society, one should be active in discus- sions about mental health and suicide in men. We should re- spect those who are passing through difficult moments and avoid shaming and blaming vulnerable individuals for their behaviour. Society should trash out-dated male stereotypes such as "real men don't cry" because in reality people who speak up and seek help are more likely to receive proper care and support. On an individual and personal level, it is fundamental to edu- cate ourselves on mental health issues so as to be more equipped to identify those who are in need and to provide help and support as needed. It is impor- tant to be there for each other, listen and understand and avoid being judgemental in any way. More importantly, it is essen- tial to value yourself, surround yourself with good people and always, be kind to yourself. Men's mental health: what affects it, and how to improve support Surveys from around the world show that men everywhere find it difficult to open up about mental health, though they are significantly more at risk of attempting suicide than women. Laura Calleja speaks to Amanda Farrugia, a medical doctor with special interest in psychiatry Amanda Farrugia is a medical doctor with special interest in psychiatry

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