Suffering in Silence: Men’s Mental Health in America Today

by Gabriel Nathan

Mid-way through my freshman year of college, the girl that I had longed to be with for years was nearly killed in a viscous, ice-slicked car wreck that claimed two other young lives. I sat, trembling, on my best friend’s bed, talking haltingly to her on the phone as she lay in a hospital bed, hundreds of miles away, nearly completely blitzed from painkillers and sedatives. I told her that I loved her, and she said it back. That’s what happens when you drug people, I guess.

I had been messed up for a long time — awash in anxiety and depression — but you need that tipping point, I guess, to motivate you to stand up and do something about it. I don’t know what I was hoping to find in that therapist’s office, under the couch cushions or in the tissue box or between the hands of the fifty-minute hour clock, but I knew something had to be there: answers, or at least different questions. The receptionist set me up with an appointment and she said to me, “You know, we do have a back entrance you can use.” I was puzzled.

“What’s wrong with the door I came in from just now?”

“Oh, nothing — nothing,” she sputtered, “We just offer it so students will feel more, well, comfortable.”

I walked out with my little appointment card thinking she must have hit her head on the kitchen counter that morning or something. What did it matter which door I used to go to the health center? At nineteen, I wasn’t smart enough to fully comprehend the stigma of mental illness, a stigma so powerful that even well-meaning mental health providers perpetuated it, by offering an anonymous entryway you could slink in through, concealed by hedges and secrecy.

Of course, I know now that there is a stigma surrounding mental illness and the stigma is far greater, in my opinion, if you’re a man. Think of all that the word “man” implies: strength, power, stoicism, assertiveness. Men aren’t supposed to have mental health problems. We are judged and pigeon-holed (in similar ways that women are). I think it’s possible that this stereotype was much more pervasive years ago, when it was more of a pull-yourself-up-by-your-bootstraps, boys-don’t-cry, be a man, quit yer bitchin’ kind of society, but sometimes I think that not much has changed.

I remember being in kindergarten, one story time, and being particularly unsettled by a picture of a large spider in a book. Logically, I went and hid under a nearby table. Mrs. Pearlman wasn’t having any of it. “Oh, Gabriel,” she said disapprovingly, “Don’t be such a sissy.” Now, I don’t mean to pick on Mrs. Pearlman, who was actually a wonderful teacher whom I loved very much, but those kinds of things, obviously, stay with you. I have a funny feeling that, had I been a Gabriella instead of a Gabriel, she wouldn’t have said that. “Gabriella,” she might have said, “you don’t have to be afraid—come back and sit with the rest of the class. And, the next time you see a picture of a spider: be more assertive.”

An art project I made in Mrs. Pearlman’s class.

I joke because, sometimes, I don’t know what else to do. Of course, the stigma against men’s mental health is not funny. When you are told that it is not appropriate to talk about your feelings, when you have limits placed on what is okay and what isn’t okay to talk about, when you are expected, or when you expect yourself, to just shut up and deal with it, the consequences can be deadly.

According to data from the American Foundation for Suicide Prevention, for years, four times as many American males killed themselves than their female counterparts. In the Jewish faith, when you go to sit shiva with the family of the deceased, you are supposed to offer the greeting, “We suffer in silence.” It is indeed disturbing to think about how many men throughout this country and this world went to their self-inflicted deaths suffering in their own stifling, suffocating silence.

In spite of being warned against the lifelong perils of Sissydom by the well-meaning Mrs. Pearlman, I grew up to be an introverted, emotionally delicate, eccentric adolescent, and the guy in his mid-thirties who’s typing these keys right now isn’t much different either. I’m still not crazy about spiders, (and flying, and math, and socializing, and drinking, and work, and money, and aging, and getting dementia, and dying), though I have amassed sufficient coping skills to avoid the necessity of cowering underneath tables. Most days.

And in spite of the fact that openly talking about your mental health problems as a man is still regarded as a big no-no, I am pretty garrulous about what goes on inside that fetid bird’s nest inside my head. It’s not because I’m some great mental health advocate or some kind of big deal, I think it’s because I know that I am not smart or capable enough to sort out everything that’s going on up there myself. I think it’s because my mental health scares me very badly, and when you’re scared very badly, the last thing you want is to be alone.

Talking to people — to my wife, to my friends, to my family — actually helps me gain a little bit of perspective sometimes. Talking to people helps me gain a greater awareness of my distorted thinking, my impulsiveness, my crippling fears and my, at times, consuming nihilism.

I’ve been seeing a therapist for around five years. Depression, anxiety, compulsive behaviors, obsessive thoughts — the words and the diagnoses and the labels really don’t matter. They change them all around every year anyway, so they can justify having a big swanky conference. In college, I went to therapy once a week for two-and-a-half years. I never once used the back entrance — again, not because I’m a “Mental Health Hero” but because there is no reason not to go through the front door, just like the kid who’s there for a sore throat.

As an editor for OC87 Recovery Diaries, I think a lot about the personal essays we publish here, and I was thinking about the authors who write those personal essays, and those authors, overwhelmingly, are women. And that’s fine, as far as that goes, and they are an extraordinary collection of authors, but I started wondering to myself, “Where the hell are all the men out there struggling with mental illness?” I spent five years working in an inpatient crisis psychiatric hospital, so I know that there are plenty of men dealing with mental illness and, after several years of running creative writing groups at that hospital, I know many of them can write, too.

So then I started thinking: if just being a man with a mental health challenge is taboo — being a man with a mental health challenge — and writing about it publicly — must be even worse. Is there some kind of understood “we don’t talk about it” code amongst men with mental illness? What are we trying to protect ourselves from, and why? Well, we’ve been doing it this way for years and years and years; quietly biting our fingernails off in the corners of our offices with the door closed, staring at the twirling and the whirling of the bedroom ceiling fan at 3:51am, and I think enough is enough already. It’s time to try something else. It’s time to write. It’s time to talk. It’s time to make it okay, or, trust me: it won’t be.

I have not been doing well recently. It’s not easy for me to say that, but, if I’m bothering to write a personal essay, why not make it personal? I’ve changed jobs twice in two months, and my anxiety is raging out-of-control in spite of efforts to medicate it and rationalize with it. My therapist, God bless him, tries his best to challenge my cognitive distortions, but I am very persistent — chronically negative, and relentlessly self-flagellating. I obsess over my failures, and I have lots to choose from, and fret compulsively over failures yet to materialize.

While I readily accepted the notion that I needed therapy many years ago, there was another hurdle to my recovery that I wasn’t ready to leap and bound over quite so energetically; and that was medication. I shouldn’t need that, I told my therapist. If I’m depressed, I reasoned, I wanted to feel depressed, because that’s obviously what I’m supposed to be feeling if that’s what I’m feeling. I became obsessed with trying to come to terms with what did it mean that I needed medication.

In my mind, needing therapy just means you’re neurotic. Needing medication means you’re sick. Men can’t get sick: they have to go to work. As a kid, I can remember my father going to work when he had a temperature of 104. He went to work immediately after having a major dental procedure, only to pass out in the bathroom from blood loss.

I don’t want to be sick.

My mother has become increasingly interested in my mental health lately. Maybe she always has been, but she was too afraid to talk to me about it, or maybe my issues were relatively benign years ago and didn’t necessarily warrant questioning or conversation. Lately, though, as I have been doing worse, she is spontaneously bringing it up more. I guess there’s a cause-and-effect there somewhere. I have to say, though: it’s nice. Even if I don’t always want to talk about it, it’s comforting and validating to know that she does, and she is respectful and backs off if I’m not in the mood to go there. I often said to her as a little boy, “Mommy, I think I should be in therapy.” And I should have been.

If my eight-year-old son called me into the living room to watch him ghoulishly re-enact the Pan-Am 103 bombing using rows of Playmobil men wrapped in Kleenex death shrouds, I’d sure as hell have been on the phone with somebody, but her response was always, “Therapy? Oh, Gabriel, wouldn’t you just love that?” I couldn’t believe my rotten luck: I was born into the only upper-middle class Jewish family in the country that didn’t believe in therapy.

She’s much different now, even if her only son isn’t so much. Now she is inquisitive and thoughtful, she really listens when I talk to her about therapy or medications, about how I’m doing at work and at home. It may very well be that talking to my mother isn’t going to change anything, but the dialogue is so desperately important, for both of us, I think.

So many times, mental illness tells us, “Go — run, hide! Shut everybody out. Go run down to the basement and throw a wool blanket over your head and stay there for about thirteen years. Tell them to leave you alone.” But mental illness tells you that because it wants to be your only bedfellow, your one true confidant — mental illness wants to be your mommy and your lover and your confessor and, of course, your undertaker, too.

That’s its ultimate goal, and isolating you from people who care is one of its most insidious tools. As someone who typically eschews forms of human contact other than his immediate family, my mental illness has a pretty easy time luring me away from others. When I’m not doing well, I’m perfectly happy to draw the shades and slide the chain across the front door’s lock at 7:30pm as I ignore emails from old, dear friends that have grown stale and unanswered in my inbox for another day. Or week. And when I’m not doing well, I have to work especially hard to remind myself that I need these people desperately.

Because while I’m not good at much, I have done a particularly impressive job at surrounding myself with some pretty wonderful friends — they are sensitive and empathic, intelligent and insightful, and beautiful in every possible way. And I’ll bet you have people like that in your pocket, too. People who are tuned in and available, non-judgmental and supportive. Maybe we just need someone to let us know that it’s okay. And I don’t think that message can be effective coming from a public awareness campaign or from a crisis line poster — I think it has to come from a person. A warm hand, a kind heart, an open mind.

This can be a nasty little world we live in, full of plane bombings and car wrecks, and spiders, too, and it doesn’t take all that much to tip the scales from manageable to just too much. Trusting your gut and paying attention may save someone’s life some day, or it may just make a certain man in your life at ease enough in his own skin to tell you even a fraction of what’s on his mind. And it may surprise you or haunt you or move you, but you’ll have performed one of the truest kindnesses one human being can offer another: availability.

That availability you give to another human being might just give him the courage he needs to seek the help and guidance of a mental health professional — walking through the front door.

EDITOR IN CHIEF: Bud Clayman | EDITOR: Glenn Holsten | DESIGN & LAYOUT: Leah Alexandra Goldstein

See Related Recovery Stories: Anxiety, Depression, Mental Health First Person Essays, OCD