For many men, talking about their feelings is simply not something they ever do, which is big part of why the whole subject of men’s mental health is somewhat shrouded and something of a taboo. Often men’s silence is because they feel friends, family, colleagues and wider society expect them to be strong and dependable, and that somehow talking about things they struggle with is an admission of weakness and a failure to meet those expectations. Not being in the habit of speaking up inevitably makes it harder for them to seek help when they need it.

Growing evidence suggests that those that don’t or can’t speak about their emotions are less able to recognise them or be even aware they may be in a state of turmoil. Along with the resignation that ‘this is just how life is’, this is thought to be a key factor in the higher suicide rates among men compared with women, with those aged 40 – 49 the most vulnerable. Also, the NHS only refers men at a rate of 30%, meaning woman with mental health issues are three times more likely to be referred to a psychologist.

Another factor obscuring men’s true emotional state is that depression presents differently in men than women, often manifesting in reckless behaviour, short temperedness, drinking more frequently or taking drugs. This is an added reason why depression in men goes undetected as this is not sympathetic behaviour or what we might expect from someone who is struggling.

Men’s silence about their mental health is an issue that is insufficiently recognised or addressed. If that is to change, greater awareness is needed about the tell-tale signs that we ourselves or others are struggling. Men who feel there is no option but to suffer in silence can feel isolated and in turn suffer with loneliness, which is the theme of this year’s Mental Health Awareness week. There is a school of thought that, just as physical pain serves a purpose in teaching us to avoid things that are harmful, so loneliness serves as a social pain to protect us from the dangers of being isolated.

Symptoms of loneliness can include seeking social-interaction substitutes, such as excessive shopping and trying to find value in material things, or binge-watching television due to the connection felt with characters. Poor sleep can also be a symptom due to feeling socially insecure and there’s also a correlation between loneliness and taking long hot baths or showers to replicate the warmth one feels around others. As with any mental health issue, if left unaddressed loneliness can eventually affect physical health, with sufferers experiencing illness more frequently, commonly with colds or headaches.

As well as better recognising the symptoms, our concepts and understanding of loneliness need to be more informed. We can be lonely even in a crowd and loneliness is not related to the quantity of human interaction we experience, but the quality. Men may feel that wearing their vulnerability is seen as a sign of weakness but, for that reason, it is actually a sign of bravery and confidence. Those that venture to express their vulnerability often find it a great relief and confidence boosting to be completely real and to not be hiding anything. Frequently, men’s mental health struggles are similar to those of women, especially regarding the pressure they feel to perform certain roles and live up to societal expectations, yet they are much less willing to discuss them.

As mental health first aiders (MHFAs), we would wholeheartedly encourage men to speak to friends, family, colleagues or their company’s MHFAs rather than accept that suffering in silence is their only option. There are some great resources available online such as www.mentalhealth.org.uk and beyond that local GPs can also offer help, support and advice. There are, in addition, a growing number of initiatives such as Men’s Sheds, which started in Australia and has since come to the UK. This is where men can bring and exchange tools, share their knowledge and help others to build things and in doing so build a community of men who share their time and skills and enjoy camaraderie for collective and individual benefit.

Knowing and recognising the symptoms of loneliness either in ourselves or others enables us to consider if a change is needed. Choosing to speak to someone, whoever it may be, and not feeling weak for doing so is a hugely important step toward actively managing and improving our own mental health. Some may find it daunting, disingenuous even to offer help to someone they see struggling as they may feel they don’t have all the answers. Men can feel obliged to offer a solution when someone confides in them however, sometimes, often even, people just want empathy and a listening ear. If we can all take a little time to understand the subtle signs that signal distress, this could have a potentially profound effect on the lives of others, help reduce the suicide rate and alleviate the stigma and the needless anguish of men suffering in silence.

If you are experiencing symptoms of mental illness and/or having suicidal thoughts, help is available. Use the following support groups and lifelines to get the care you need.

• Seek advice from your GP
• Call NHS choices on 111
• Mind info line: 0300 123 3393
• Crisis Text Line – text shout to 85258
• Side by Side Mind’s supportive online community – join here: https://sidebyside.mind.org.uk/