You’re sitting in the car in the driveway with the engine off, and you can’t quite make yourself go inside. Nothing big happened today. You’ve been telling yourself you’ll deal with it after this busy patch at work, and that was eight months ago. If this sounds familiar, you’ve run into one of the most common patterns we see in men’s mental health: holding on for as long as possible, and only reaching out once things feel close to breaking point.

Every November, Movember gets Australia talking about this. The moustaches are the easy part, though. The harder part is picking up the phone while you can still tell yourself you’re fine.

In this post, we’ll cover:

  • why so many men wait, and the Australian data on it
  • how self-reliance can turn from a strength into a barrier
  • the signs in the lead-up to breaking point
  • how to approach therapy if it didn’t help last time
  • the treatments that help, and some small first steps

Men’s mental health: why do so many men wait?

Men often wait because the things that have always worked, like staying busy, staying useful and handling it alone, keep working for a long time. So the problem stays out of view until those strategies run out.

The gap shows up clearly in Australian men’s mental health data. In the national mental health study for 2020 to 2022, 36.4% of men with a recent mental health disorder had seen a health professional about their mental health in the past year, compared with 51.1% of women. In other words, roughly two in three of those men hadn’t seen anyone.

Those figures can’t tell us how long anyone waits. However, the pattern is familiar in practice. We often hear from men after a partner has said “you need to talk to someone”, or after a GP has asked one extra question. By then, you may have been carrying this for years.

Self-reliance: why does asking for help feel like failing?

Asking for help can feel like failing because many men learn early that coping alone is what a capable man does. Psychologists call these expectations masculine norms: the unwritten rules about how men should think, feel and behave.

These rules aren’t all harmful, and the research is more interesting than the usual “men need to open up” message. For example, a large review combining 78 samples found that the norm of self-reliance was consistently linked with poorer mental health. By contrast, putting a high priority on work wasn’t linked with mental health either way. So the difficulty seems to sit less in caring about work or family, and more in the belief that you have to manage everything by yourself.

A systematic review of men and depression points the same way. It found that these norms can shape how depression shows up, whether you seek help, and how you try to manage it in the meantime. Help seeking also changes with context. As a result, the same man may book a physio in a heartbeat and still put off seeing a psychologist for years.

Self-reliance has probably served you well. It may have got you through a hard childhood, a demanding job or a family crisis. The trouble starts when it becomes the only tool you’re allowed to use.

“Not bad enough yet”: why the goalposts keep moving

“Not bad enough yet” is the thought that keeps the wait going, because the line for what counts as bad enough tends to move as things get harder. When you’re still getting to work, it’s easy to decide therapy is for someone worse off.

You might recognise the shift. First, you’d get help if you stopped sleeping. Then you’d get help if it started affecting work. After that, it’s only if your relationship is in real trouble. Each time you reach the line, you cope, so you redraw it a little further out.

In men’s mental health, high-functioning men can stay in this loop for a long time. High-functioning depression can sit behind a full calendar and a good career, and from the outside nobody would guess. Yet you don’t need to reach a particular level of distress before a psychologist can help. If something has been bothering you for a while, that’s reason enough.

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Breaking point: what does the lead-up look like?

The lead-up to breaking point often looks less like sadness and more like irritability, numbness, drinking more, working longer or feeling constantly tired. That’s one reason it’s so easy to miss, including for you.

Researchers developing the Male Depression Risk Scale looked at this directly. Alongside the more familiar symptoms of depression, they measured emotional suppression, alcohol use, drug use, anger, physical symptoms and risk-taking. These patterns won’t apply to every man, but you might notice some of them:

  • Your fuse has got shorter, and people at home have started to tiptoe around you.
  • A couple of drinks has become the only way you switch off. If that’s worrying you, here’s how we can help with alcohol and substance use.
  • You’re staying later at work, or at the gym, to avoid being still.
  • Your body keeps complaining, with headaches, a sore gut or poor sleep that nothing seems to fix.
  • You feel flat about things you used to enjoy, including people you love.

None of these means you have a diagnosis, and only an in-person assessment can sort that out. Our guide to spotting the symptoms of depression is a good next read.

Men’s mental health in a crisis: when not to wait

If you’re having thoughts of suicide or you feel unsafe, please don’t wait. Call 000 in an emergency, Lifeline on 13 11 14, or MensLine Australia on 1300 78 99 78. All of these services can talk with you straight away, and you don’t need the right words.

We take this seriously because men make up about three in four suicide deaths in Australia. The most recent national summary recorded 2,419 deaths among men in 2023, and 795 among women. Behind those numbers are people who deserved support, and we want reaching out to feel possible well before that point.

Tried therapy before: what if it didn’t help?

If therapy didn’t help last time, that doesn’t mean therapy can’t help you. Often it means something in the fit or the approach wasn’t right, and that’s worth saying out loud.

You’d be in good company. In a men’s mental health survey of 1,907 Australian men who had been to therapy, 44.8% had dropped out at some stage. The most common reason, given by more than half of those men, was that they didn’t feel a connection with their therapist. About one in five felt therapy wasn’t getting anywhere.

That’s useful information, because both problems can be raised directly. You can tell a psychologist that you want more structure, more straight talking or a clearer sense of where this is heading. A good one won’t be offended. In fact, research on engaging men in therapy recommends exactly this kind of collaborative, transparent and goal-focused work.

First session: what would I even say?

You don’t need to know what to say. “My partner told me to come” or “I don’t really know why I’m here” are perfectly good opening lines, and your psychologist will take it from there.

Therapy also tends to look different from the stereotype. You’ll work out together what you’d like to change, and you can set the pace on what you talk about. Some men want practical strategies first, while others want to make sense of something they’ve never told anyone. Both are fine. If you’d like to know more, here’s what to expect when seeing a clinical psychologist for the first time.

Men’s mental health treatment: what actually helps?

What helps depends on what’s going on for you, so a good psychologist will start by understanding your experience before suggesting an approach. For depression, Australian clinical guidelines include psychological therapy among the main treatments, and these are some of the approaches our psychologists use:

Whichever approach you choose, the relationship matters. A review of 295 studies found a consistent link between the therapeutic alliance and how well therapy goes. That’s why we take the match between you and your psychologist seriously. If you have a preference, such as seeing a male psychologist, tell our Care Coordinator and we’ll take it into account.

There are practical options too. You can see us in person in Alexandria or by video, and we offer some evening appointments. If you have a Mental Health Treatment Plan from your GP, Medicare rebates are available for individual sessions.

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Small steps you can take this week

Good men’s mental health care can start small. These steps won’t replace treatment, but they can help you begin before things feel urgent.

  1. Book a long appointment with your GP and say, “I haven’t been myself for a while.” They can check your physical health too.
  2. Tell one person something true. For example, “I’ve been flat lately and I don’t really know why” is enough.
  3. Try talking side by side. A walk, a drive or a job in the shed can make a hard conversation feel easier.
  4. Track one thing for two weeks, such as sleep, drinks or how often you snap at someone, so you can see the pattern.
  5. Call MensLine Australia if a psychologist feels like too big a step right now. It’s free and open 24/7.

Worried about a man in your life?

Men’s mental health affects everyone at home, so it makes sense to be concerned. If you’re worried about a partner, brother, son or friend, start with what you’ve noticed rather than what you think is wrong. For instance, “You’ve seemed really tired lately, and I’ve missed you” often lands better than “I think you’re depressed”.

Then give it time, because the first answer may well be “I’m fine”. You can leave the door open and come back to it later. Meanwhile, you can offer something practical, like finding a number or going along to the GP. If you’re ever worried about his immediate safety, or your own, call 000.

Moving forward

If you’ve held on for a long time, there’s a reason for that. You were probably doing what you were taught, and it probably got you and other people through some hard times. Noticing that it’s no longer enough doesn’t undo any of that.

There’s also no rule that says you have to reach breaking point first. Men’s mental health deserves attention at the “something’s not right” stage, and you’re allowed to want more than just getting through the week. When you’re ready, we’re here to help you find your way through.

Book a free 15-minute call with our Care Coordinator to talk about what’s been happening and find the right psychologist for you.

References

Resources

  • MensLine Australia: free 24/7 phone and online counselling on 1300 78 99 78
  • Lifeline: 24/7 crisis support on 13 11 14
  • Beyond Blue: information and support for anxiety and depression
  • Healthy Male: Australian men’s health information, including mental health
  • Movember: men’s health information and the November campaign

Disclaimer: This article is for general informational purposes only and is not a substitute for individual psychological advice, assessment, or treatment. Reading this content does not establish a therapeutic relationship. If you have concerns about your mental health, please seek support from a registered health professional.