The Silent Struggle: Men, Mental Health, and the Weight of Expectation
The corridors of Hanoi’s Bach Mai hospital, specifically within Dr. Vu Son Tung’s Mood Disorder clinic, recently bore witness to a stark reality: a 43-year-old man, having survived a suicide attempt, was brought in by his distraught family. Known only as Trong, he presented as a picture of exhaustion, both physically and mentally. Initially, his demeanor was one of guarded defiance, avoiding all eye contact and crossing his arms, offering a perfunctory “I am fine” whenever Dr. Tung inquired about his well-being.
However, with persistent reassurance that he was in a safe and confidential space, Trong’s defenses began to crumble. He eventually opened up, recounting the harrowing experiences of the past year. Twelve months prior, Trong had faced a devastating double blow: the loss of his job and a staggering VND1 billion (approximately $38,000) wiped out in the stock market. The weight of these losses was compounded by his decision to conceal them from everyone, maintaining a façade of normalcy.
Each day, Trong would don his work attire and depart at his usual hour. Yet, instead of heading to his office, he would wander aimlessly through parks and along city streets, his days punctuated by a profound sense of displacement until nightfall. When his wife broached the subject of finances for their daily needs, Trong resorted to maxing out his credit cards, a desperate attempt to sustain the illusion of stability. Dr. Tung noted the patient’s symptoms, which included chronic insomnia and overwhelming anxiety surrounding his mounting debts. “The stark contrast between his lived reality and the life he was pretending to lead gradually pushed him over the edge,” Dr. Tung explained.
The Unseen Burden: Business Stress and Emotional Suppression
The challenges faced by Trong are not isolated. Dr. Nguyen Viet Chung, from the mental health department at Hospital E, encountered a similar case with a 37-year-old small business owner named Dat. Dat initially sought medical attention for physical complaints, including heart palpitations and breathing difficulties. Despite a battery of cardiology tests yielding normal results, further evaluation revealed that Dat was in the throes of a severe mental health crisis.
Dr. Chung described Dat’s unsettling morning ritual: he would lock himself in the bathroom, slapping his face to combat the persistent wakefulness that plagued him after sleepless nights. While his business revenues dwindled and his bank loans accumulated, Dat remained silent, never confiding in his wife about the immense pressure he was under. When questioned about his profound fatigue, Dat consistently reassured his concerned family that everything was perfectly fine.
“The patient was in a constant state of high alert and also experienced generalized anxiety disorder,” Dr. Chung stated. The doctor elaborated that Dat’s panic attacks were triggered by the immense, sustained effort required to suppress his financial anxieties, all in a desperate bid to uphold his identity as the family’s sole breadwinner.
The Cultural Tapestry of Masculinity and Emotional Repression
Across many cultures, there exists a pervasive societal expectation for men to exhibit stoic resilience. Boys are often conditioned from a young age to suppress emotions, with crying deemed “unmanly” and discussing feelings discouraged as a sign of weakness. This ingrained societal conditioning can inadvertently foster what is known as toxic masculinity, a construct that glorifies emotional repression as a form of strength and stigmatizes vulnerability.
The consequences of this cultural narrative are far-reaching and, at times, tragic. Global health statistics from the World Health Organization reveal an alarming figure of 850,000 suicide deaths annually worldwide, with depression being the most prevalent underlying cause. Intriguingly, despite women being more frequently diagnosed with depression, men exhibit a significantly higher rate of suicide completion. This counterintuitive phenomenon, often referred to as “the gender paradox of suicide,” is believed to stem from men’s profound reluctance to seek clinical diagnosis and treatment, a pattern that often persists until the very end. When men feel cornered with no apparent escape, the ultimate recourse can tragically become death.
In Vietnam, a significant portion of the population, approximately 15%, suffers from some form of mental disorder. Alarmingly, depression and anxiety disorders account for a substantial third of this share. The innate human need to be acknowledged and understood is a universal one, yet for many men, this need is frequently suppressed.
Breaking the Silence: The Fear of Judgment and the Path Forward
A 2022 survey conducted by VnExpress highlighted a compelling statistic: 27% of male respondents expressed a desire to discuss their pressures related to finances, work, and family with a specialist. However, a significant barrier prevented them from reaching out: the pervasive fear of being judged.
Dr. Tung observes that many men default to viewing themselves as the unwavering “backbone of their family,” a perception that compels them to endure hardships silently rather than articulate their struggles. While women often find outlets for emotional release through active communication and physiological expressions like crying, men frequently resort to internalizing their feelings or seeking superficial relief through alcohol and sports. These coping mechanisms offer transient solace but fail to address the root cause of their distress.
Dr. Tung posits that prolonged emotional repression acts as a ticking time bomb, not only exacerbating the severity of depression and increasing the risk of suicide but also leading to a cascade of physiological health problems and diminishing professional efficacy. These interconnected issues can trap individuals in a debilitating cycle of perceived failure and self-recrimination. Consequently, many men only seek intensive medical intervention when their health has deteriorated to a critical point, requiring prolonged treatment, whereas earlier intervention through psychotherapy might have offered a less arduous path to recovery.
To initiate a liberation from the constraints of toxic masculinity, experts advocate for a fundamental redefinition of strength. This redefined strength should encompass not only physical prowess but also emotional resilience and the capacity to acknowledge and process feelings. A truly strong individual, they argue, is one who can permit themselves to experience emotions and actively address them.
The journey toward emotional well-being for men can begin with small, low-pressure steps. Choosing a trusted individual and initiating conversations in informal settings, such as during shared activities like cooking or watching television, can be more effective than setting up formal, potentially intimidating, appointments. For those on the receiving end of these confidences, the role is crucial: to listen without judgment, to validate the speaker’s feelings, and to refrain from immediately offering unsolicited advice. Through these consistent, supportive everyday interactions, the emotional ice that often encases many men can begin to thaw, fostering genuine connection with oneself and with others.
