“Is manning up bringing men down?”, a panel discussion held on June 25, 2024, was a joint effort between Mental Health America (MHA) and Myriad Genetics to recognize Men’s Mental Health Month, dedicated to raising awareness about mental health issues affecting men and boys. It was moderated by Nathan Tatro, Vice President of Alliance Development at Mental Health America.

The panelists included:
Tyrone Quarterman, MPH – Senior Manager of Health Equity and Diversity at Myriad Genetics
Bernie Ranchero, MD, MS – Diplomate at ABFM & ABOM (Family & Obesity Medicine), Medical Director at the Coles County Public Health Dept., Medical Director at Leadwell (HSHS Medical Group), and Clinical Assistant Professor at Carle Illinois College of Medicine
Ryan Griggs, PhD – Senior Medical Science Liaison, Mental Health at Myriad Genetics

This post excerpts part of that conversation. Watch the full video or read the full transcript here.

Background: Importance of Men’s Mental Health

Nathan: Even before the pandemic, the United States was experiencing a significant mental health crisis, and the pandemic only exacerbated it… Today’s conversation is going to focus on how societal expectations and traditional gender roles often discourage men from expressing their emotions or seeking help, leading to significant mental health disparities. And statistics really do reveal the severity of the problem across a range of conditions:

• We know that men are less likely than women to seek treatment for depression, and studies do indicate that approximately 6 million men in the U.S. suffer from depression each year.
• For suicide, the suicide rate among men is very, very high. In the U.S., men die by suicide 3.85 times more often than women. And middle-aged men in particular, are at the highest risk, with men ages 35–64 representing 19 percent of the United States population but account for 40 percent of suicide deaths..
• Also, of course, we know that men are susceptible to other mental health conditions. So, men also face higher rates of substance use and substance abuse disorders, often as a coping mechanism for untreated mental health issues. And we know that conditions such as anxiety and PTSD may go also undiagnosed in men due to societal pressures to “tough it out” or “suck it up.”

The evolving definition of masculinity

Nathan: The traditional definition of masculinity has long emphasized stoicism, self-reliance, and emotional suppression. However, there is a growing movement toward redefining masculinity to include vulnerability, emotional expression, and seeking help when needed. This shift really is crucial in encouraging men to prioritize their mental health and wellbeing.

As we’ll discuss today, promoting a more inclusive and compassionate understanding and conceptualization of masculinity can help break down the barriers that prevent men from seeking mental health support. By challenging outdated stereotypes and fostering a culture of openness, society can better support men and their mental health and their overall mental health journeys.

Men’s Mental Health Month, which we have been observing throughout the month of June, serves as a vital platform to highlight all of these issues, advocate for change, and support men in leading healthier and more fulfilling lives.

…So, Panel, let’s kick this off: this event title asks the question “Is manning up bringing men down?” What we mean is that the traditional image of masculinity imposed on men seems to discourage men from showing any emotions, for a variety of reasons.

Yet we know men do struggle with their mental health, and recognizing the signs and communicating them is an important part of mental wellness.

Nathan: Part of the reason we’re having this conversation today and why Men’s Mental Health Month is so important is because it seems to be that conventional wisdom is that men don’t like to talk about their mental health. Now that could be due to stigma or other reasons. …Is that true for you and why? If so, why? Why do you think that’s the case?

Ryan Griggs: Yeah, that’s a good question. I would say yes, it’s true for me… I spent ten plus years in a rugby culture, playing rugby, which is “tough it out” from both a physical and a mental perspective. And that translates into personal lives and all the people I knew.

People did not talk about what was bothering them if they had depression, anxiety, if they had life trauma that impacted their wellbeing. It was always a culture of onward and being that masculine image.

…And for me personally, I definitely had some past trauma and experiences that impacted my mental health. And I was fortunate enough to be in a privileged space, being on a college campus, having a girlfriend at the time, now wife, that is a psychologist and very supportive of emotional vulnerability and talking to people about mental health issues.

And so, I was kind of able to, to break out of that stereotype and, and seek treatment. But not everybody can do that. And I think that’s an important part of what we’re talking about today.

Nathan: Tyrone, let’s bring this over to you. So, if you’re willing to share, have you personally experienced depression or anxiety or have you noticed family or friends, other men experiencing depression? And if you know you have, were the signs obvious or are they more subtle? How did you help them? What did you suggest to them? First, if you are willing to share your story, we are all ears.

Tyrone Quarterman: Absolutely. So, I’d like to think I’ve been pretty open about this thus far, and I’m always willing to share my experience. So, I’ve absolutely dealt with and still kind of deal with to this day, a level of depression, and more so anxiety. This is something that I discuss with my therapist and interactions on the best ways to, kind of, mitigate that.

I think that it’s  okay to accept that you’re dealing with these things and it’s okay to be upfront about them. And that’s something that I think we as men personally need to, need to feel more empowered. One of the ways to do that is to hear other people share their story. It absolutely manifests in different ways.

For me, I’m a very hyper fixated person. I also played sports, like my colleague Ryan here did. I was a football player for the majority of my life. And, you know, when you have a craft or when you have an interest or you dedicate yourself to something, and especially when that goes away–right? We can’t play forever–it’s very easy to try to fill that void in other areas. Especially if you like to fixate on things as I do. So, for me, – and I’ll focus on the anxiety more so than the depression piece – but for me, I think it was consistently worrying about: “Am I doing enough?” or “Am I putting my time in the right places and seeing the physical, kind of manifestations of that?”

The nervousness, the heart rate, the mood swings, all of those things, those symptoms that come along with these conditions. And you don’t really know how to put your finger on it until you talk to someone. You talk to a professional, you talk to your support system, and they kind of let you know, you might be dealing with some depression or anxiety because this is not you.

Nathan: Part of what Mental Health America’s slogan is, that goes back to our founder is, “I must fight out in the open,” and sharing these stories about recognizing your signs and symptoms and the stigmatization and the validation of these experiences as contributing to your life.

Nathan: Dr. Ranchero, if you could respond to what Tyrone and Ryan talked about in terms of their own journey of self-recognition, in seeking help. Ryan just mentioned screening. You know, MHA has our national prevention screening research program. We’ve done over 26 million screens to date, 1.6 million for depression, 400,000 of those are screened positive for severe depression. As a primary care physician, is it part of your practice to give regular depression screens to your patients?

Dr. Ranchero: Absolutely. First off, let me just say for Tyrone and Ryan, it’s great to see strength and courage exhibited in both of them for recognizing, first of all, that they needed – and they wanted – to make positive changes in their lives. I think one thing in primary care that we emphasize, that I emphasize, is about prevention. It’s about asking the patient, yes, of course I want you to live a long time, but what kind of quality of life are you having?

…I think the big thing is when it comes to masculinity that you were talking about earlier, is that recognizing that, you know what? We as men, oftentimes in our society, believe that we have to have it all together all the time. And that’s not true. And it takes, I always tell my patients, we take better care of our cars, our trucks, our tractors or whatever than we do our own bodies sometimes.

We know when something’s going wrong with the car. It sounds funny. It’s driving differently. Well, shouldn’t we be even more attuned to our own bodies and our own mental status than a car? Than a pickup truck? And don’t our families deserve more than that?

…I also suffer from anxiety and depression, and being part of the LGBTQ+ community, there’s even more, if you will, pressure on masculinity and the roles you play. And so, you know, recognizing it, that is not a weakness. And asking for help is a strength.

Tyrone: Thank you, Dr. Ranchero, for that rundown, because I think a lot of people needed to hear that. And just going off the car analogy, you know, for those of us who care about our cars and care about a lot of things, you think about an oil change, you think about rotating your tires, you think about that general maintenance.

It very well could be that your car is in great shape, and you don’t really need to do anything, but you need to check it out, right? You need to make sure that, you know, I heard a little rumble, I heard a little wobble, and it just didn’t feel right. And for me, going through the screening process, you know, I think I’m in a pretty good space now, but when you have those screeners that you can at least see some of those core components.

Nathan: Do you notice a disparity in the way that men or women may react to: “Oh, you have a positive screen for depression?” …Is there a difference between men and women?

Dr. Ranchero: Absolutely. There’s a difference in it. Unfortunately, it’s the societal bias that we have of that we need to project this image of masculinity and strength. And unfortunately, oftentimes, when it comes up, it’s when that patient, that man, has hit that wall or hit rock bottom, they’ve done something where, you know, someone says, “Dr. Ranchero, I need your help because my family’s going to leave me” or “my relationships are in turmoil,” or “my irritability is affecting the people around me,” or “I can’t,” maybe they had a DUI. Maybe they had an outburst at work or something has happened.

And when it comes down to it, the other thing that I see is that I see high blood pressure. I see other things where depression, unfortunately, and anxiety is manifesting itself in physical ways, whether it be reflux, whether it be headaches, whether it be insomnia, all these things, whether it be obesity, alcoholism. So sometimes at the root of things is this anxiety and this depression and behavioral health, and it’s manifesting itself in physical ways.

Nathan: There are many paths forward for men as they begin, I think the term journey can be overused, but their own mental health journey, whether that be through psychotherapy or talk therapy or reaching out to family or friends or their support system or looking at medications. And then we do have this new conceptualization. …There have been incredible advancements into understanding how some medications can work. And it becomes especially important for something like a psychiatric or a mental health medication because sometimes people are started off on lots of different medications and seeing if they work after four to 6 to 8 weeks and then having to try something new. So, that does seem like something very promising, or as a tool in the toolbox.

Dr. Ranchero: I mean, masculinity for me is acting despite the fear and having the courage and the strength to say, I want to change. And if you don’t have that recognition that I always say this to my patients, “You are worthy of good care. You’re worthy of love.” And sometimes getting that patient to the point where they believe that. So, I can work on whatever physical ailments they have, that they’re worthy of it and that you’re worthy of good mental health. And that help is available.

Read more about men’s mental health:

https://genesight.com/blog/patient/the-relational-approach-to-talking-to-men-about-their-mental-health/

https://genesight.com/mental-health-monitor/is-manning-up-bringing-men-down/

https://genesight.com/blog/mental-health-and-south-asian-men/