Psychiatrists are warning that many men delay seeking help for mental health conditions, often waiting until symptoms have reached crisis levels before accessing support.
According to the South African Society of Psychiatrists (SASOP), while women are more frequently diagnosed with conditions such as depression and anxiety, men are significantly less likely to seek professional help.
Research shows that one in eight men will experience depression and one in five will experience anxiety during their lifetime. However, mental health challenges in men often go unrecognised or untreated, frequently presenting through anger, withdrawal, substance abuse, aggression or risk-taking behaviour rather than more commonly recognised symptoms.
SASOP member Dr Gagu Matsebula said men are less likely to engage with healthcare services, including mental healthcare, even when these services are available.
“Men are less likely to attend preventative healthcare visits, less likely to seek help early and more likely to present when their condition has already progressed significantly,” he said.
He said this reluctance is often driven by social and cultural expectations that encourage men to appear strong, self-reliant and emotionally controlled.
According to Matsebula, many men experience what mental health professionals describe as “restrictive emotionality” – a tendency to suppress emotions because vulnerability is often viewed as incompatible with traditional ideas of masculinity.
As a result, mental health conditions may present differently in men.
“The tools traditionally used to diagnose depression and anxiety do not always account for how these conditions present in men,” he said.
Symptoms may include irritability, aggression, emotional withdrawal, substance abuse, reckless behaviour, poor impulse control and excessive work habits.
Untreated mental health conditions can affect relationships, work performance, parenting, physical health and overall quality of life. Men may also turn to unhealthy coping mechanisms such as alcohol abuse, gambling, drug use and social isolation.
Globally, men account for the majority of deaths linked to homicide, road traffic injuries and suicide, while consuming almost four times more pure alcohol than women.
Matsebula said these trends are closely linked to poor emotional regulation, untreated trauma, substance abuse, chronic stress and social isolation.
The economic impact is also significant. A 2023 analysis estimated that South Africa loses about R161 billion annually due to unaddressed mental health conditions through reduced productivity, absenteeism and lower workforce participation.
“Mental health is not only a healthcare issue. It is also a workplace issue, a family issue, and an economic issue,” he said.
Matsebula called for more open conversations about emotional wellbeing and encouraged families, workplaces, schools, sports clubs, faith-based organisations and communities to help reduce stigma around men’s mental health.
He advised loved ones to approach emotionally withdrawn men with empathy rather than judgment, noting that support often comes through listening, validating feelings and offering practical assistance.
He stressed that seeking help should not be viewed as a sign of weakness.
“Experiencing anxiety, depression, emotional distress or burnout does not make a man less resilient, less capable or less masculine. It simply means he is human,” he said.
Warning signs that may require professional support include persistent irritability, emotional withdrawal, changes in sleep or appetite, loss of interest in activities, increased substance use, hopelessness, anxiety, fatigue, difficulty concentrating and risk-taking behaviour.
Treatment options can include counselling, psychotherapy, cognitive behavioural therapy, support groups, lifestyle interventions and, where necessary, medication.
SASOP is also calling for greater investment in mental healthcare, public awareness campaigns and community-based support services. South Africa currently allocates about 5% of its public health budget to mental health services, below the 10% to 15% recommended for lower- and middle-income countries.
“The message men need to hear is simple: speaking up is not weakness. Reaching out is not failure. Mental health conditions are treatable, and seeking support early can change and save lives,” Matsebula said.
For mental health support, contact the South African Depression and Anxiety Group (SADAG) Suicide Crisis Helpline on 0800 567 567 or SMS 31393 for assistance.
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