SUICIDE AMONG MEN – STIGMA PREVENTS SEEKING HELP

Suicide is one of the leading causes of death globally and the prevalence amongst men is considerably higher than for women.

South Africa is ranked number 10 on the list of countries with the most suicides with 23,5 per 100 000 population.[1] Of the 13 774 suicides reported in South Africa, 10 861 were men whilst 2 913 were women – translating to a rate of 37,6 per 100 000 for men and 9,8 per 100 000 for women.

South Africa is not unique in this statistic: worldwide, men’s suicide is ranked higher. Among the 703 000 people dying every year, the suicide rate for men - 12.6 per 100 000- is considerably higher than that for women - 5.4 per 100 000.[2]

During Men’s Health Month noted in June, the South African Society of Psychiatrists (SASOP) urges men to speak up before it’s too late, and break the stigma that it’s ‘unmanly’ and a sign of weakness should men reach out for help.

“Men are five times more likely to die by suicide than women[3] and often use more aggressive methods. Although surveys reveal that women are diagnosed more than men with mental health conditions such as depression and anxiety, men don’t speak about their feelings until it is too late.”

“Instead, they underplay the distress caused by these symptoms drowning their depression and anxiety with poor coping behaviours, increasing their risk of the anxiety or depression to go unrecognised and untreated.”

Dr Talatala says the risk factors for suicide include unemployment and occupational issues, divorce and adverse childhood experiences[4] and that the symptoms of depression and anxiety are not in keeping with the perception men have of masculinity.

“The tools used for surveys for depression and for diagnosis of depression are not designed to pick up “male depression” as men are likely to present with substance abuse, risk-taking behaviour, poor impulse control, anger, and irritability. Yet even though not reported in surveys, many of those men dying by suicide are due to depression.”

 

“Men don’t seek help due to the ‘macho male stereotype’ in society expecting men to ‘man up’ and adopt the ‘boys don’t cry’ mentality. It’s this attitude of men portrayed as being brave and fearless that leads to men considering themselves in a negative light if they suffer from mental health conditions. And for this very reason, they see it as putting themselves in a vulnerable position when seeking help."

Dr Talatala says society expects a lot from men, expecting them to be seen as confident, in control, the decision-makers, and the decisive voice of reason and rationale. They are many times portrayed as the rock with a steady hand and mind in times of trouble or uncertainty. They are stereotyped as the provider, protector, dependable, confident, and fearless.”

 

“However, these very traits that society has labelled men with, could lead men to feel inadequate and emasculated. It’s not realistic to expect men to be the stronger sex that always lives by society’s motto of ‘what makes a man’ and to simply find a way to ‘pull yourself together.”

 

The consequences of not speaking out, says Dr Talatala, can aggravate the mental health condition as men find inappropriate coping strategies that might very well dull the symptoms temporarily but could develop into a dependency that eventually spins out of control.

 

“Abuse, gambling, drugs and alcohol, and reckless behaviour are some of the coping mechanisms embraced by men. If left untreated, anxiety and depression can trigger anger in men with violence, outbursts, bullying, abusiveness, explosive quick temper bursts, irritability, being edgy, touchy, cranky or impatient, as well as feelings of hopelessness and helplessness.”

The symptoms of depression include:

  • Feelings of hopelessness and pessimism

  • Loss of interest or pleasure in hobbies and activities that were once enjoyed

  • Persistent sad, or empty mood

  • Feelings of guilt, worthlessness, helplessness, and self-reproach

  • Insomnia or hypersomnia, early morning awakening, or oversleeping

  • Appetite and/or weight loss or overeating and weight gain

  • Decreased energy, fatigue and feeling run down

  • Increased use of alcohol and drugs

  • Thoughts of death or suicide, and suicide attempts

  • Restlessness, irritability, and hostility

  • Difficulty concentrating, remembering, and making decisions

  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

  • Deterioration of social relationships

 

The symptoms of anxiety include:

Physical

  • Pounding or racing heart

  • Excessive sweating

  • Muscle tension or aches

  • Restlessness or agitation

  • Dizziness or vertigo

  • Shortness of breath or sensation of choking

  • Insomnia

  • Panic attacks

  • Fatigue

  • Nausea, diarrhoea or irritable bowel syndrome

 

Emotional

  • Constant worry about what could go wrong

  • Perceiving situations and events as threatening when they are not

  • Indecisiveness and fear of making the wrong decision

  • Difficulty concentrating

  • Feelings of dread

  • Concentration problems

  • Avoidance

  • Catastrophic thinking

  • Irritability and edginess

  • Nightmares or intrusive thoughts in which traumatic scenes are replayed in the mind

  • Mood swings

  • Being overly vigilant towards danger

  • Absentmindedness

  • Fear of losing control

 

To get help for yourself or those dear to you, contact the South African Depression and Anxiety Group on 0800 121 314, or send an SMS to 32312 and a counsellor will call you back.

REFERENCES

 

[1] https://worldpopulationreview.com/country-rankings/suicide-rate-by-country

[2] Suicide worldwide in 2019 Global Health Estimates, World Health Organisation (WHO), published 16 June 2021.  https://www.who.int/publications/i/item/9789240026643

[3] https://www.iol.co.za/lifestyle/health/mind/suicide-crisis-soars-in-sa-a-look-at-men-in-the-entertainment-industry-who-lost-their-lives-to-suicide-63e0db0a-536e-4fe8-9d69-ff4ebb82a6ff

 

[4] Affleck, W., Carmichael V., Whitley R. (2018). Men’s Mental Health: Social Determinants and Implications for Services. The Canadian Journal of Psychiatry Vol. 63(9) 581-589