GoodTherapy | The Stigma Around Men’s Mental Health June is a celebratory month for many reasons, most notably the start of summertime, but many don’t realize this time of year is also Men’s Mental Health Month. While discussing such an important topic shouldn’t be confined to one month out of the year, it offers a great opportunity to reflect on the progress and conversely, persistent barriers that men still face when it comes to seeking professional help.  

Men’s Mental Health Picture By the Numbers  

It’s no secret that men have a lower likelihood of seeking mental health therapy compared to women. In fact, according to an American Psychological Association survey, just 35% of men stated they’d seek help from a mental health professional, as opposed to 58% of women.    It should go without saying that men seek therapy not because they suffer from mental health conditions at lower rates. In fact, the opposite is true in many cases. According to Mental Health America, about six million men suffer from depression in the U.S. every year, and men are also more likely to suffer from substance abuse and experience much higher rates of suicide.   Studies have shown that men also express symptoms of depression that don’t necessarily follow traditional guidelines of the Diagnostic and Statistical Manual of Mental Disorder, or DSM. Rather than citing well-known effects, such as chronic fatigue, appetite changes, and lowered interest in hobbies, they often state external behaviors, such as alcohol consumption or aggression, which are often more difficult to associate with a clinical diagnosis.  

Ways to Reduce Stigma Around Men’s Mental Health  

 Societal discourse and norms continue to lend credence to the notion that masculinity involves appearing tough and independent at all times. According to psychologist Dr. Brad Brenner:    “Societal stigma and entrenched masculinity norms play pivotal roles in shaping men’s attitudes toward mental health problems and their willingness to seek help. The fear of being perceived as weak or vulnerable is a significant barrier. This is exacerbated by the traditional view of masculinity, which emphasizes strength, stoicism, and self-reliance, often at the expense of emotional expression and vulnerability.” 

Sharing therapy experiences publicly 

Myths fester when no individuals, or at least very few, are willing to criticize a long-held belief openly, and historically, that explains why many were embarrassed or ashamed to admit they went to therapy. But times have changed. Male therapy attendance still lags in the U.S. compared to women, though the strides made over the last decade are a testament to the heightened public discourse that is questioning these long-held beliefs about what it means to be “a man.”   Men are increasingly willing to discuss their mental health journey, whether that involves seeking therapy or seeking medication for depression or anxiety. And that only propagates healthier and more transparent approaches to mental health, whether via social media or public figures. 

 Creating and maintaining healthy community and relationships 

Hearing celebrities, advertisements or social media influencers talk about therapy is helpful, but penetrating deep-seated misconceptions must also involve one’s close relationships. Surrounding yourself with friends and family that allow you to authentically express yourself and show vulnerability is a big deterrent to depressive symptoms and can act as an antidote to some mental health side effects. Such an environment also allows us to feel more comfortable sharing our own struggles, which can help propel efforts to seek therapy.    

Normalizing men in mental health positions  

Men are more likely to feel indifferent about their therapists’ gender than women — who, on average, prefer a female therapist — but there are certainly benefits of men talking with a therapist of the same sex. Just like women may feel less shame and embarrassment talking to someone who has a firsthand understanding of female-specific challenges, men are also likely to feel that way about gender-related topics, whether societally imposed or otherwise.   But because the majority of therapists and psychologists are females, it can further fuel the idea that mental health discussions are a “feminine” endeavor, and by extension, diminish one’s masculinity. In fact, women comprise nearly three-quarters of all new psychology doctorates and more than half of the psychology workforce, according to the APA’s Center for Workforce Studies.   The more men go to therapy and discuss its benefits, however, the more other males will be encouraged to seek help, and eventually, they may also feel more motivated to enter the profession and provide much-needed representation.  

Making it convenient to find a compatible therapist  

Finding an available therapist who makes you feel comfortable, has availability that aligns with your schedule, and accepts your insurance can be difficult. Traditionally, the process was so cumbersome that it dissuaded many who were already apprehensive about therapy. But that’s no longer the case. Online directories, such as GoodTherapy, make the process seamless by allowing you to easily filter for the criteria you’re looking for, whether it’s by availability, price, insurance plan, or more.      

Man in red shirt leans on railing to look at cityMost people crave social connection. While social media, endless apps, and new technology promises to connect more people, many people feel lonelier than ever. While isolation can be a trigger for loneliness, loneliness and isolation are not identical. A person can feel lonely even when surrounded by others, especially if they don’t have deep connections that feel meaningful to them.

Loneliness doesn’t just feel bad. It can have profound implications for health. Some research even suggests that chronic loneliness can be as harmful to a person’s health as smoking 15 cigarettes per day.

Research on gender differences in loneliness is mixed. Some studies show that women are lonelier than men; others show the reverse. Most researchers, however, agree that single men tend to be especially lonely, and that certain social norms governing masculinity may increase the risk of loneliness in men. Some early research on loneliness also suggests men may be less likely than women to admit to feelings of loneliness.

Social Isolation in Men

Studies consistently find that women are more likely to have dense social networks than men. From childhood, women are socialized to value friendship, confide in their friends, and to foster deep intimacy with close friends. Even when men have many friends, they may feel uncomfortable sharing emotions or airing feelings of vulnerability.

A 2018 analysis of people living in rural regions found that 63 percent of men felt comfortable opening up to friends, compared to 74 percent of women. Women were also more likely to participate in activities, such as church gatherings, that foster friendship and a sense of community.

Although social isolation is a serious concern among single men, research suggests that emotional feelings of loneliness are even more important. A 2011 study tied social isolation to reduced life satisfaction, but the link was even stronger for emotional loneliness. Researchers also found that male university students were significantly more likely to report emotional feelings of loneliness than female students.

How Stigma Can Be a Cage

Masculine social norms teach men that vulnerability is weakness. Homophobia is also prevalent. Straight cisgender men may fear being labeled “gay.” These two forces can make it very difficult for men to reach out to others in friendship. Even when men have friends, they may fear judgment if they display weakness or ask for help.

Heterosexual male friendships often feature a boastful sort of masculinity, in which men brag about their sexual prowess, their financial success, or their independence. This culture can make it hard for men struggling in their relationships to share their challenges. It also shows men that the ideal man is one who uses others—not one who invests deeply in interdependent relationships.

This isolation can be a self-replicating intergenerational cycle. Men may discourage sons from showing weakness or emotion. Boys also witness their fathers modeling stoic behavior and may mimic it. In this way, the stigma of emotionally connecting to other men passes from one generation to the next.

The Marriage Effect

Men in most studies are more likely than women to have long-term partners. These partners can ease some loneliness. Indeed, many men rely on their partners as a primary or sole source of emotional support. This increases men’s vulnerability to loneliness when relationships end or partners die. A 2017 survey found women are more comfortable being single than men. Sixty-one percent of single women in the UK reported being happy, compared to just 49% of single men.

In addition to supporting their male partners, women in long-term heterosexual relationships may help them socialize by building and fostering social networks. Emotional labor like remembering birthdays, sending holiday cards, planning family get-togethers, and scheduling outings with friends has traditionally fallen to women. When a man loses his partner, he may lose an important social lubricant. That may mean losing friends and social opportunities.

How to Build Bromance

Building friendships with other men can be challenging, especially when a man is no longer in school. A few strategies may help:

Therapy can help many men practice and master new social skills. Men may also benefit from therapy when social anxiety impedes relationships or when loneliness is so severe that it leads to depression.

GoodTherapy connects people to caring, ethical therapists who can help with a range of challenges, including loneliness and making new friends. Find a therapist who can help you here.

References:

  1. Henning-Smith, C., Ecklund, A., Moscovice, I., & Kozhimannil, K. (2018). Gender differences in social isolation and social support among rural residents [Ebook]. University of Minnesota Rural Health Research Center. Retrieved from http://rhrc.umn.edu/wp-content/files_mf/1532458325UMNpolicybriefsocialisolationgenderdifferences.pdf
  2. Neville, S., Adams, J., Montayre, J., Larmer, P., Garrett, N., Stephens, C., & Alpass, F. (2018). Loneliness in men 60 years and over: the association with purpose in life. American Journal of Men’s Health, 12(4), 730-739. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131432
  3. Salimi, A. (2011). Social-emotional loneliness and life satisfaction. Procedia – Social and Behavioral Sciences, 29, 292-295. Retrieved from https://www.sciencedirect.com/science/article/pii/S1877042811027029
  4. Sex differences in loneliness: the role of masculinity and femininity. (1998). Sex Roles, 38(7-8). Retrieved from https://link.springer.com/article/10.1023%2FA%3A1018850711372#page-2
  5. Yarrow, A. (2017). All the single ladies: 61% of women in the UK are happy to be single, compared to 49% of men. Retrieved from https://www.mintel.com/press-centre/social-and-lifestyle/all-the-single-ladies-61-of-women-in-the-uk-are-happy-to-be-single-compared-to-49-of-men

A couple of expecting parents both wake up with nauseaCouvade Syndrome: When Expectant Dads Get Pregnancy Symptoms

January 16, 2019 • By Zawn Villines

Couvade syndrome is a condition in which men with pregnant partners begin to experience symptoms of pregnancy. The causes of Couvade syndrome aren’t fully understood, though several theories exist. This condition has not been recognized as either a medical or mental health issue.

WHAT is Couvade Syndrome (SYMPATHY PREGNANCIES)?

Couvade syndrome or sympathy pregnancy occurs when a pregnant woman’s partner experiences pregnancy symptoms. Called Couvade syndrome when it occurs in men, it might also be referred to as pregnant dad syndrome, male pregnancy experience, or sympathetic pregnancy.

Though symptoms can vary, they usually involve some combination of the following:

Symptoms of this condition usually appear in the first trimester, around the third month of pregnancy. They improve temporarily during the second trimester, in most cases, and return in the third trimester. Once the baby is born, symptoms typically disappear.

SYMPATHY PREGNANCY VS. PHANTOM PREGNANCY

A similar condition called pseudocyesis, or phantom pregnancy, might be confused with Couvade syndrome. However, pseudocyesis has been recognized as a mental health issue. It’s listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a somatic symptom disorder.

Pseudocyesis, a somewhat rare condition, occurs more commonly in Africa than in Europe or America. Women with this condition become convinced they are pregnant when they are not. They may show pregnancy symptoms such as:

Research has suggested several potential causes for phantom pregnancies. Some cases may result from a strong desire to become pregnant, hence why it occurs more commonly among couples experiencing infertility. Other cases may occur due to an intense fear of becoming pregnant. Some studies have suggested pseudocyesis may develop within the context of depression and its accompanying endocrine changes.

WHAT CAUSES COUVADE SYNDROME?

A number of theories attempt to explain how Couvade syndrome develops. One or more of these factors may contribute to the occurrence of Couvade syndrome, though medical experts still don’t know why some men develop the condition.

Somatization

Somatic symptoms are real physical symptoms that result from emotional distress. It’s common for new parents to feel anxiety or stress about the birth of their child, no matter how excited or happy they feel. It’s believed that feelings of anxiety or stress may lead to somatic symptoms resembling those of pregnancy.

Becoming a parent also marks a change in an adult’s role in society. This can also lead to feelings of stress and anxiety, whether a person realizes it or not. Researchers have suggested some men manifest pregnancy symptoms as a way of unconsciously dealing with how they feel about their new responsibilities and the changes they’ll experience.

Changes in hormone levels

Some research has shown men whose partners are pregnant may experience hormone changes, such as decreased testosterone and increased estradiol. It’s possible these hormonal changes could contribute to many symptoms of Couvade syndrome.

Feelings of attachment

Men who are more involved with a partner’s pregnancy and have more fetal involvement (listening to the heartbeat, feeling movement, and so on) may be more likely to experience pregnancy symptoms. Participating in pregnancy-related events and being involved in childbirth preparations may lead some men to feel closer to their unborn child and identify more strongly with the role of father. This may lead to sympathy pregnancy symptoms, according to some experts.

Psychosocial causes

Some doctors believe Couvade syndrome relates to mental health. Common explanations for symptoms include:

However, these are only potential theories, and none have been proven through research.

HOW COMMON IS COUVADE SYNDROME?

Men all over the world experience Couvade syndrome. Studies have found varying rates in different parts of the world, but the most recent statistics suggest Couvade syndrome occurs in about 25% to 52% of men in the United States who have pregnant partners. Though Couvade syndrome appears fairly common, studies on the condition to date have focused on the male partners of women who are pregnant. Very little research has looked at Couvade syndrome in LGBTQ+ couples.

Men all over the world experience Couvade syndrome.

While it’s possible to experience severe symptoms, many have only a few mild symptoms. Since symptoms disappear after childbirth in nearly all cases, this condition could go mostly unnoticed. But some men may feel confused, concerned, or otherwise distressed about their symptoms. Health care professionals have found it can help to briefly explain the condition to men who experience distress and let them know Couvade syndrome isn’t unusual. It may also be reassuring to know Couvade syndrome is often described as a reaction to the changes pregnancy and parenthood bring, not a sign of a mental health issue or other concern.

CAN COUVADE SYNDROME BE TREATED?

Because symptoms resolve on their own and don’t generally pose a threat or cause harm, there’s no specific treatment recommended for men who have Couvade syndrome. However, there are several strategies that can help ease symptoms.

Some men find meditation, yoga, and similar approaches help them feel more relaxed. Therapy may help people who experience depression or anxiety symptoms as part of Couvade syndrome. It can also treat preexisting diagnoses which have been exacerbated by stress.

Medication, including herbal remedies, can help treat physical symptoms like nausea or pain. Some men might experience sympathy labor pains, which medication can also help with.

Remember that you aren’t alone. If you’re struggling with your feelings about parenthood, or experiencing symptoms you don’t understand, a trained therapist can help you work through them. Reach out today!

Couvade Syndrome and Sympethic Pregnacies FAQS

References:

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association. 327.
  2. Brennan, A., Ayers, S., Ahmed, H., & Marshall-Lucette, S. (2007). A critical review of the Couvade syndrome: The pregnant male. Journal of Reproductive and Infant Psychology, 25(3), 173-189. Retrieved from http://psycnet.apa.org/record/2007-11728-002
  3. Devi, A. M., & Chanu, M. P. (2015). Couvade syndrome. International Journal of Nursing Education and Research, 3(3). Retrieved from https://www.researchgate.net/profile/Akoijam_Devi2/publication/286313694_7_IJNER_165_–28-05-2015DE/links/5667b26c08aea62726ee986a/7-IJNER-165–28-05-2015DE.pdf
  4. Hall-Flavin, D. K. (2016, August 25). What can you tell me about couvade? Can men really experience sympathetic pregnancy symptoms? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/couvade-syndrome/faq-20058047
  5. Ibekwe, P. C., & Achor, J. U. (2008). Psychosocial and cultural aspects of pseudocyesis. Indian Journal of Psychiatry, 50(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738334
  6. Klein, H. (1991). Couvade syndrome: Male counterpart to pregnancy. International Journal of Psychiatry in Medicine, 21(1), 57-69. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/2066258
  7. Piechowski-Jozwiak, B., & Bogousslavsky, J. (2018). Couvade syndrome – custom, behavior, or disease? Frontiers of Neurology and Neuroscience, 42(1), 51-58. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29151091
  8. Tarín, J. J., Hermenegildo, C., García-Pérez, M. A., & Cano, A. (2013). Endocrinology and physiology of pseudocyesis. Reproductive Biology and Endocrinology, 11(39). Retrieved from https://rbej.biomedcentral.com/articles/10.1186/1477-7827-11-39

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A grown man is passed out on the yard next to a kiddie pool.In Peter Pan, the eponymous protagonist occupies a mythical placed called Never-Never Land, where children never grow up. While people with Peter Pan syndrome can and do become adults, they are stubbornly resistant to taking on the responsibilities of adulthood and adopting social norms associated with growing older.

Peter Pan syndrome, which is sometimes called failure to launch, is not a clinical diagnosis. Indeed, it may apply to a wide range of people and symptoms, from the 40-year-old woman who chooses not to work and instead lives with her mother, to the 30-year-old man who keeps having children for whom he provides little support.

Therapy can help people who feel uncomfortable growing up understand the root of their difficulties. With patience and hard work, they can transition toward happy adulthood and establish lasting relationships.

What is Peter Pan Syndrome?

Psychologist Dan Kiley coined the term Peter Pan syndrome in his 1983 book, Peter Pan Syndrome: Men Who Have Never Grown Up. Kiley worked with troubled teenage boys. He found that many grew into adult men who struggled to accept adult responsibilities.

Some characteristics of Peter Pan syndrome might include:

Kiley claimed the refusal to grow up is a primarily male affliction. He also believed women who “mother” their male partners—a complex he dubbed the Wendy dilemma—may enable these men to continue avoiding adult responsibilities. While both men and women can refuse to grow up, most literature on Peter Pan syndrome continues to focus on men.

What Causes Peter Pan Syndrome?

Peter Pan syndrome is not a clinically recognized diagnosis, and it is a newly identified syndrome. For these reasons, little research has explored the phenomenon. Some factors that may play a role in Peter Pan syndrome include:

Having “childish” interests—such as dolls or comic books—does not cause Peter Pan syndrome. Instead, this syndrome is about a refusal to take on responsibility and form reciprocal relationships.

What Maturity Means in a Cultural Context

The meaning of adulthood and maturity varies significantly across cultures. In some cultures, people live with their families for a lifetime and show their adulthood by marrying or having children.  In others, the hallmark of adulthood is the ability to live independently and away from one’s parents. Yet other cultures would consider living separately from one’s parents a sign of abandoning one’s duties to their family. In other words, the hallmark of this syndrome is not necessarily any single symptom, but instead a failure to adopt common norms of adulthood.

Some young people who appear to have Peter Pan syndrome may simply be taking longer to grow up due to forces outside their control.That said, the inability to leave home or find a spouse is not always proof that someone has Peter Pan syndrome. A person with a serious mobility impairment may need help from a caregiver to tend to daily tasks. The same level of help for someone who is not disabled would be inappropriate.

Complex sociological and economic factors can also delay when an individual reaches certain milestones. A 2013 people found young Americans are becoming financially independent at later ages than previous generations did. This is due in part to a shifting job market, increasing costs of education, rising rent prices, and many other factors. Financial dependency can in turn affect other milestones such as finding a spouse.

Some young people who appear to have Peter Pan syndrome may simply be taking longer to grow up due to forces outside their control. Financial status alone does not determine one’s maturity. Rather, adulthood is shown through a person’s willingness to work toward milestones and take responsibility for their actions.

Therapy for Peter Pan Syndrome

In many cases, an individual’s failure to grow up harms the people around them. The individual’s partner may feel overwhelmed and exhausted by taking on all household responsibilities. The person’s parents may take money from their retirement savings to continue providing material support.

Individuals with Peter Pan syndrome may not see their symptoms as problematic. Many only seek help when they lose a source of support or when their symptoms endanger their relationship. Loved ones struggling with someone else’s Peter Pan syndrome should know that drawing clear boundaries may encourage their loved one to seek help.

Family therapy or couples counseling can help an entire family understand their current dynamic. In therapy, they can address their own contributions and work toward healthier, more balanced relationships.

In individual counseling, a therapist can help a person understand their reluctance to grow up, tackle underlying factors such as trauma, and make a plan for transitioning to adulthood. Getting a job, forming a relationship, and becoming independent can feel like monumental tasks. The right therapist can break these tasks down into manageable steps, helping a person steadily improve their life.

References:

  1. Arnett, J. J., & Galambos, N. L. (2003). Culture and conceptions of adulthood. New Directions for Child and Adolescent Development, 100, 91-98. Retrieved from https://pdfs.semanticscholar.org/1dd8/8dfff10bb9d61fdfa5aef2997a6c7fabbbe8.pdf
  2. Carnevale, A. P., Hanson, A. R., & Gulish, A. (2013). Failure to launch: Structural shift and the new lost generation. Retrieved from https://eric.ed.gov/?id=ED558185
  3. Overprotecting parents can lead children to develop ‘Peter Pan Syndrome’. (2007, May 03). ScienceDaily. Retrieved from https://www.sciencedaily.com/releases/2007/05/070501112023.htm
  4. Quadrio, C. (1982). The Peter Pan and Wendy syndrome: A marital dynamic. Australian & New Zealand Journal of Psychiatry, 16(2), 23-28. Retrieved from https://www.tandfonline.com/doi/abs/10.3109/00048678209161187?journalCode=ianp20
  5. Thomas, R. M., Jr. (1996, February 27). Dan Kiley, 54, dies; wrote ‘Peter Pan syndrome’. New York Times. Retrieved from https://www.nytimes.com/1996/02/27/us/dan-kiley-54-dies-wrote-peter-pan-syndrome.html
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