Exploring suicidal ideation in Men

"Suicidal feelings are not the same as giving up on life. Suicidal feelings often express a powerful and overwhelming need for a different life." – Will Hall. Suicide, one of the most terrifying acts in the human race, yet the 17th leading cause of death worldwide! According to the data collected by the World Health Organization (WHO), 1.3% of the number of deaths worldwide was due to suicide. Every year, globally, more than 700 000 people die due to suicide, i.e., one person every 40 seconds. These statistics speak only for the cases which were reported.

What do the numbers say?

It is reported that suicide rates among men are significantly higher than women. Globally, for every 100 000 per population, the suicide rate for females is 7.5%, whereas for males, it is almost twice as the female suicide rate, i.e., 13.7%. In India, according to the National Crime Records Bureau (NCRB), for every 100 deaths by suicide, 29.8 were female and 70.2 were male.

Research findings suggest that women are more likely to experience suicidal ideation, whereas men are much more likely to take their own lives. (Schimelpfening, 2020) According to a study by the UK British Medical Journal, it is found that general primary care consultation rates were 32% lower in men than women (Schumacher, 2021).

Are there any other associated factors?

Culturally, especially in India, creating awareness about mental health itself is a challenge. Since the beginning, traditional gender roles have always discouraged emotional expression among men. They have been told to 'man up and be strong, 'toughen up' as if men aren't supposed to be in touch with their gentle side. These societal norms in turn lead to men not being able to disclose their feelings resulting in underdiagnosed depression in men.

Not being aware of what one is feeling, men are often observed to misinterpret feelings of sadness, hopelessness under the tag of 'being stressed'. One of the factors which contribute to depression being underdiagnosed in men is that men are less likely to seek help for emotional problems as well as they have a sense of denial for the illness. Most of the men also have a tendency to self-treat themselves and not consult a professional. Alcohol and substance use are some of the common measures men resort to for self-treatment. According to one research article, males tend to resort to substance use and alcohol use nearly twice as likely as women would. These factors cause distress, emotional denial, and suppression of feelings, leading to depression and in turn to a high risk of suicide.

What is masked depression?

The societal norms of masculinity are also a huge threat to depression being underdiagnosed in men. Men are often over-represented in aggressive, violent, and risk-taking behaviors. Thus, the inability to express emotions finds its way to these kinds of behaviors which are socially acceptable when it comes to the notion of masculinity. Research conducted in 2005 suggests that these behaviors act as a coping mechanism in men which leads to hidden depression. This can be termed as 'the masked depression framework' (Brownhill et al., 2005). Research suggests that men may express their depression in terms of increased fatigue, anger, irritability, abusive behavior, etc., which can 'mask' the depression leading to difficulties in the diagnosis and treatment. National Institute of Mental Health (NIMH) conducted a campaign in 2003 'Real Men; Real Depression', which suggests that men may be unlikely to admit their depressive symptoms and seek help.

When it comes to attempting suicide, intent and lethality are two of the most major contributing factors. It is observed that the intent while attempting suicide among males and females is equal, but the methods to which males resort to are more lethal as compared to females, implying that the suicide mortality rate between males and females is affected more than method choice, rather than intent. (Poynton-Smith, 2015) Women tend to use non-violent methods such as drug overdose or self-poisoning whereas men tend to use methods such as firearms, hanging, suffocation, etc. (Schimelpfening, 2020)

How can we contribute to preventing this?

In an article by Zoromski (2018), he states that men comprehend and express emotions differently as they spend more time processing them. On average, it is observed that men take a longer time to understand what they are feeling and figuring out the cause of that emotion. Thus, creating a safe space to express and discuss emotions.

Thus, CAN WE

❖ Teach our young boys to healthy emotional expression??

❖ Encourage emotional expression in our men??

❖ Support and validate their feelings through their emotional roller-coasters??

❖ Be non-judgemental to their sharing??

❖ Open to the fact that they cry too??

❖ Let them freely express themselves baring the stigma??

On a concluding note, although suicide seems to be a challenging notion to understand and prevent completely, I feel that we as a society can do our bit. "Why not teach people to feel everything to the fullest, to be mild, to be gentle, to be kind. To show strength and accept vulnerability and take time to get over things or to heal at the rate they think is fine?" – Unknown.

References:

❖ Why more men than women die by suicide – Helene Schumacher (2019) https://www.bbc.com/future/article/20190313-why-more-men-kill-themselves-than-women

❖ Excessive Alcohol Use is a Risk to Men's Health – Centers for Disease Control and Prevention https://www.cdc.gov/alcohol/fact-sheets/mens-health.htm

❖ Differences in Suicide among Men and Women – Nancy Schimelpfening (2020) https://www.verywellmind.com/gender-differences-in-suicide-methods-1067508#suicide-methods

❖ Why is the suicide rate higher in men than in women? Emma Poynton-Smith https://www.psychology.nottingham.ac.uk/staff/ddc/c8cxpa/further/Dissertation_examples/Poynton-Smith_15.pdf

❖ Men: A Different Depression – American Psychological Association (APA) https://www.apa.org/research/action/men

Shriya Kulkarni

T.Y.B.A. Psychology Student

Intern, Vidula Psychological Consultancy, Pune.