What Are Men’s Issues in Therapy? Understanding Common Barriers

In the United States, nearly 40,000 men die by suicide each year, accounting for about 80% of all suicides and highlighting the impact of untreated mental health problems in men, such as depression, anxiety, bipolar disorder, trauma, and substance abuse [1].  

Traditional masculine norms often discourage men from seeking help and being vulnerable. Many fear judgment, stigma, or view seeking support as a sign of weakness. However, seeking help is essential for yourself, your family, and your communities. 

Specialized therapy for men and male support groups can improve problems like emotional regulation and aggression, and early intervention has been found to reduce the suicide risk by up to 50% [2]. Read on to understand the importance of recognizing men’s mental health problems and common barriers to accessing therapy.   

Understanding Men’s Mental Health

About one in five men struggles with a common mental health condition at any given time, but most do not seek professional help. In the past year, only 17% of men received mental health treatment, and nearly half report never talking to anyone about their mental health struggles [3].

Men’s mental health awareness is important because ignoring it leads to several consequences, including increased risk of violence, aggression, substance abuse, financial and occupational problems, and suicide.   

Mental health issues in men go unnoticed for a variety of reasons. Some of the most common include:  

• Mental health conditions in men, such as depression and anxiety, often present as headaches, digestive problems, fatigue, chronic pain, isolation, or escapism (work, videogames) rather than sadness.​

• Men commonly downplay or hide symptoms, using work, substance use, or distraction to cope, which worsens underlying conditions.​ They typically withdraw from relationships but label it as “busy,” “focused,” or “locked in.” 

• Social norms around masculinity and values based on strength, independence, and stoicism make many men reluctant to talk about their feelings or seek help, perceiving it as weak.​

How Masculine Norms Shape Emotional Struggles 

Masculine norms in the US are often rooted in traditional expectations of stoicism, self-reliance, and emotional control, impacting men’s emotional struggles by discouraging vulnerability and help-seeking. 

• Emotional Repression/Stoicism: Men are taught “boys don’t cry” or to “man up,” suppressing sadness, fear, or vulnerability, which manifests as depression, anxiety, irritability, and chronic disease as emotions remain unprocessed.​

• Self-Reliance: Encourages handling problems alone and viewing asking for help as a weakness. Often results in social isolation, avoidance of therapy, and broken relationships or marriages.​

• Toughness and Control: Expectations of constant strength and dominance lead to poor emotional regulation, outbursts of anger, and strained relationships due to the inability to form intimate bonds.​

• Anti-Femininity: Discouraging traits seen as “feminine” like emotional expression, reinforces rigid roles, increasing suicide risk, bullying, and barriers to mental health services.

Silent Signs of Depression and Anxiety in Men

Depression and anxiety affect 1 in 10 men, although this number is thought to be higher and is impacted by underdiagnosis, as many men do not seek care [4]. 

For example, the symptoms of depression in men often manifest differently, rather than as sadness or crying, men often show silent signs such as:   

• Irritability, anger​, aggression, or violence 
• Increased alcohol or drug use as self-medication 
• Social withdrawal, avoiding family or friends while appearing to “keep busy.”​
• Risk-taking and reckless behavior (driving fast, aggressive acts) mask internal distress
• Headaches, stomach problems, constipation, diarrhea, trouble sleeping, frequent colds 
• Workaholism or overcontrol, burying emotions in work or perfectionism to avoid vulnerability.​
• Emotional numbness or flat affect, always saying things like “I’m fine” or “I’m good” when asked

The Link Between Mental Health Struggles and Addiction 

One of the most well-documented consequences of unresolved mental health challenges is addiction. Many men turn to alcohol or drugs to cope with uncomfortable feelings, and have high rates of co-occurring mental health disorders when they enter addiction treatment. 

According to the 2021 National Survey on Drug Use and Health, of the 44 million adults in the US with a substance use disorder, around 19 million also struggled with a mental health disorder [5].

Breaking Barriers: Making Therapy Accessible for Men

Men’s experiences with their mental health and therapy often differ from women’s, and conventional therapy spaces may appear unapplicable or irrelevant to their needs. Evidence has found that men are more likely to engage in therapy when it is tailored to their needs.

Specialized therapies for men focus on practicing genuine empathy, respecting masculine norms while gently challenging harmful stereotypes, and using relatable humor or cultural references to foster trust and openness.

How Men Benefit from Specialized Therapy at Holdfast Recovery

We help men build strength through vulnerability, Christ-centered care, and strategies that encourage self-transformation.

Cognitive Behavioral Therapy (CBT): Tailored for men, CBT identifies and reframes “tough guy” thought patterns that mask vulnerability or sadness using practical, action-oriented tools that align with masculine problem-solving styles, reducing depression and anxiety while building emotional resilience without requiring overt emotional display.

Internal Family Systems (IFS): ​​IFS helps men access and integrate “disconnected” parts of the self (e.g., buried pain or shame from trauma) through a structured process that fosters self-compassion and reduces internal conflict. 

Group Therapy: Men-only groups normalize vulnerability by sharing stories of strength in a brotherhood setting, reducing stigma around help-seeking.

Equine-Assisted Therapy: Horses can mirror unexpressed emotions without judgment, providing non-verbal feedback and helping men build trust with these healing animals. 

Seeking Support Is A Sign of Strength at Holdfast Recovery

Seeking help is about restoring your power, rebuilding your spirit, and reclaiming your life with proven therapies designed for men who want real, lasting change. At Holdfast Recovery, we help men address unprocessed emotions and find support for their mental health through Christ-centered care and personalized programs. 

We combine strength training, outdoor recreation, horseback riding, and emotional skill-building to help clients break deep-rooted trauma and develop positive coping strategies to overcome addiction. Take the first step toward self-transformation today.

Sources 

[1] Simon, R. et al. (2022). Suicide Among Males Across the Lifespan: An Analysis of Differences by Known Mental Health Status. American journal of preventive medicine, 63(3), 419–422.
[2] Bennett, S. et al. 2024. “Male suicide and barriers to accessing professional support: a qualitative thematic analysis”. Curr Psychol 43, 15125–15145. 
[3] Brown, L. (2025). Why do young men not seek help for affective mental health issues? A systematic review of perceived barriers and facilitators among adolescent boys and young men. European child & adolescent psychiatry, 34(2), 565–583.[4]ADAA. 2025. Men’s Mental Health. 
[5] SAMHSA. 2021. National Survey on Drug Use.