The Silent Struggle: Men, Mental Health, and the Weight of Societal Expectations
The sterile environment of a clinic, often a place of diagnosis and treatment, can also be the stage for profound human struggle. At Hanoi’s Bach Mai Hospital, within the specialized Mood Disorder clinic, Dr. Vu Son Tung recently encountered a stark reminder of this reality. A 43-year-old man, identified here as Trong, was admitted after a suicide attempt, his body and mind bearing the heavy toll of unspoken distress.
Upon arrival, Trong presented a wall of defense. He averted his gaze, his arms rigidly crossed, offering a dismissive “I am fine” to Dr. Tung’s inquiries about his mental state. This initial resistance, however, began to crumble under persistent reassurance that he was in a safe and confidential space. Gradually, the carefully constructed facade fell away, revealing the immense burden he had been carrying for the past year.
Dr. Tung explained that Trong had faced a devastating “double blow” twelve months prior: the loss of his employment coupled with a significant financial loss of approximately VND1 billion ($38,000) on the stock market. The weight of these setbacks was compounded by his decision to conceal them from his family. Each morning, Trong would don his work attire and leave home at the usual time, but his destination was no longer his office. Instead, he would wander aimlessly through parks and city streets, a phantom of his former self, until nightfall. When his wife inquired about funds for daily expenses, he resorted to maxing out credit cards, desperately attempting to maintain the illusion of stability. “The patient described clinical symptoms such as chronic insomnia and anxiety about his debts,” Dr. Tung noted. “The contrast between reality and his pretend life gradually pushed him over the edge.”
This scenario is not an isolated incident. Dr. Nguyen Viet Chung, from the mental health department at Hospital E, shared a similar case. His patient, Dat, a 37-year-old proprietor of a small business, initially sought medical attention for physical symptoms – heart palpitations and breathing difficulties. Despite exhaustive cardiology tests yielding normal results, a deeper assessment uncovered a severe mental health crisis.
Dr. Chung described Dat’s daily ritual: he would retreat to the bathroom each morning, locking himself inside to engage in self-inflicted face slaps, a desperate attempt to stay awake after nights plagued by insomnia. While his business revenues dwindled and bank loans mounted, Dat remained silent, never confiding in his wife. When questioned about his pervasive fatigue, he consistently reassured his concerned family that all was well. “The patient was in a constant high-alert state and also experienced generalized anxiety disorder,” Dr. Chung stated. His panic attacks, he explained, were a direct consequence of the sustained effort to suppress his financial anxieties, a relentless battle to preserve his identity as the family’s sole provider.
The Pervasive Influence of Toxic Masculinity
The reluctance of men like Trong and Dat to openly discuss their struggles is deeply rooted in societal norms. It is a near-universal cultural expectation that masculinity is synonymous with stoic endurance. Boys are often admonished from an early age not to cry, as it is deemed “unmanly,” and to refrain from discussing their feelings, as “only the weak complain.” These ingrained gender stereotypes can fester into what is known as toxic masculinity, a harmful ideology that glorifies emotional repression as a sign of strength and stigmatizes any display of vulnerability.
The ramifications of this societal pressure are dire. Global statistics from the World Health Organization paint a grim picture, with an estimated 850,000 suicides occurring worldwide annually, depression being the most common underlying cause. A particularly concerning paradox, often referred to as “the gender paradox of suicide,” highlights that while women may be diagnosed with depression more frequently, men exhibit a significantly higher rate of suicide completion. This counterintuitive trend is widely believed to stem from men’s pervasive reluctance to seek clinical diagnoses, a behavior that often persists until the very brink of crisis. When faced with seemingly insurmountable circumstances, men may tragically resort to death as their only perceived escape.
Within Vietnam, approximately 15% of the population experiences some form of mental disorder. Alarmingly, depression and anxiety disorders constitute a substantial third of this figure. The innate human need to be acknowledged and understood is present in men, yet it is frequently suppressed.
Breaking the Silence: Pathways to Emotional Well-being
A 2022 survey conducted by VnExpress revealed a significant desire among Vietnamese men to discuss their pressures related to finances, work, and family with a specialist. However, a formidable barrier stood in their way: the pervasive fear of judgment. Dr. Tung observed that many men internalize the role of “the backbone of their family” by default, compelling them to endure hardships silently rather than voice their concerns.
Unlike women, who often find release through open communication and physiological expressions like tears, men frequently resort to bottling up their emotions or seeking superficial solace in alcohol and sports. These coping mechanisms offer only temporary respite, failing to address the underlying issues. Dr. Tung posits that prolonged emotional repression acts as a “ticking bomb,” not only exacerbating depression and increasing the risk of suicide but also contributing to a host of physiological problems and diminishing work efficacy.
These interconnected issues can ensnare individuals in a detrimental cycle of failure and self-recrimination. It is a common tragedy that many men only seek comprehensive medical intervention when their health has deteriorated to a perilous state, necessitating long-term care. Early intervention, however, through accessible psychotherapy, could have potentially averted such severe outcomes.
To initiate a liberation from the constraints of toxic masculinity, experts propose a fundamental redefinition of strength. True strength, they argue, must encompass both physical and emotional resilience. An individual who is truly strong is capable of acknowledging and processing their emotions. Men are encouraged to identify a trusted individual and begin opening up in informal, low-pressure settings – perhaps while cooking or watching television – rather than scheduling formal “therapy” sessions.
For those who serve as confidantes, the imperative is to listen without judgment, validating the speaker’s feelings rather than immediately offering unsolicited advice. Cultivating these simple, everyday interactions with such empathetic dynamics can gradually thaw the emotional ice that many men have encased themselves in, fostering genuine connections with both themselves and others.
