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Quick Facts:
Fort Smith
by Mercy's Mardi Taylor
Key points:
- Men’s mental health issues are often underdiagnosed. Conditions like depression, anxiety and PTSD frequently go unnoticed because they show up differently in men.
- Cultural expectations discourage men from seeking help. Traditional ideas of masculinity lead men to suppress feelings and avoid care.
- Delayed care can lead to serious consequences. Men are less likely to seek help and more likely to experience worsening symptoms and higher suicide rates.
- Reframing mental health care improves engagement. Approaches that are practical and goal-oriented resonate more with men.
For generations, men have been taught to equate strength with silence. Pushing through stress, suppressing emotion and handling problems alone are often seen as marks of resilience. But these same expectations can hide serious mental health struggles and delay life‑saving care.
Dr. Venkata Dalai, a psychiatrist with Mercy Behavioral Health – 74th Street in Fort Smith, sees firsthand how cultural norms shape the way men experience, express and seek help for mental health concerns. Understanding these differences is essential to improving outcomes and saving lives.
Many mental health conditions in men go undiagnosed not because they are rare, but because they look different than expected.
According to Dr. Dalai, mental health conditions commonly underdiagnosed in men include:
· Depression
· Anxiety disorders
· Substance use disorders
· Adult ADHD
· Sleep disorders such as insomnia or sleep apnea
· Post traumatic stress disorder (PTSD)
· Suicidality
Rather than sadness or worry, depression may show up as irritability, anger or withdrawal. Anxiety frequently appears through physical complaints like chest pain, fatigue or insomnia. Substance use, often viewed in isolation, may actually be a coping mechanism masking deeper distress.
“These issues are frequently overlooked because men are less likely to report emotional distress, tend to externalize symptoms and may present with behavioral or somatic complaints,” Dr. Dalai explains. The consequences can be serious: Men have significantly higher suicide completion rates, underscoring the need for earlier recognition and intervention.
Masculinity and Mental Health
Cultural ideas about masculinity play a powerful role in shaping how men deal with mental health challenges. Dr. Dalai notes that expectations emphasizing “strength, self‑reliance, emotional control and stoicism” often discourage men from expressing vulnerability or asking for help.
As a result, symptoms are often minimized or redirected. “Men may suppress or minimize emotional distress, avoid seeking help and instead express symptoms through irritability, anger, substance use or risk‑taking behaviors,” Dr. Dalai says.
In clinical settings, this reality is clear. Behavioral health services consistently see fewer male patients, not because the need is lower, but because stigma and expectations keep many men from walking through the door.
Men’s reluctance to seek care is often driven by multiple factors. “Cultural expectations of masculinity emphasize independence, emotional control and toughness,” Dr. Dalai says, reinforcing a mindset of, “I should be able to handle this myself.”
Fear of judgment also plays a role. Many men worry about being viewed as weak or labeled with a psychiatric diagnosis that could affect their work or relationships. Others are skeptical of therapy or medication, or struggle to articulate emotional pain.
Practical barriers further complicate access. Longer work hours, fewer routine medical visits and limited time all reduce opportunities for screening and intervention. Together, these factors contribute to delayed care, underdiagnosis and worse outcomes.
Certain phrases frequently signal internalized stigma. Dr. Dalai often hears statements such as:
- “I should be able to handle this myself.”
- “This is just stress, not a mental health issue.”
- “Therapy is not for me / talking won’t help.”
- “I don’t want to be dependent on medications.”
- “I can’t afford to look weak, especially at work or in my family.”
“These beliefs can lead to delayed engagement in treatment, limited disclosure of symptoms and increased risk of worsening symptoms and suicidality,” Dr. Dalai says. Recognizing these phrases early allows clinicians to normalize care and refocus treatment on practical goals like sleep, work performance and relationships.
Depression and anxiety in men often take a more externalized form. Rather than verbalizing sadness or fear, men may display anger, irritability or poor impulse control. Overworking, staying constantly busy or withdrawing emotionally can become ways to avoid confronting distress.
“Anxiety may present more through physical complaints rather than verbalized worry,” Dr. Dalai explains. These differences can make diagnosis more challenging and allow conditions to progress unchecked.
Certain life transitions increase risk, he says. Early adulthood brings pressures surrounding career, finances and relationships, while midlife can intensify stress as men juggle work demands, family responsibilities and financial strain.
Another high‑risk period is retirement, when loss of structure and professional identity can lead to isolation and depression. “Many men derive a significant part of their self‑worth from their work,” Dr. Dalai says, making these transitions especially destabilizing.
What Works in Treatment
Treatment approaches that resonate with men are often practical and goal‑oriented. Dr. Dalai notes that many men respond well to Cognitive Behavioral Therapy because it is “structured, problem‑focused and provides concrete strategies.”
Skills‑based interventions, psychoeducation and solution‑focused approaches tied to performance and daily functioning can also improve engagement. When appropriate, medications may be effective when framed as tools to restore functioning rather than symbols of weakness.
Making mental health care more appealing to men starts with reducing stigma and lowering barriers. Framing care around resilience, performance and responsibility can shift perceptions. Integrating services into primary care, workplaces and telehealth platforms increases access and privacy.
“Making care practical, discreet, accessible and aligned with personal goals is key,” Dr. Dalai says.
A Message of Strength
When asked what gives him hope, Dr. Dalai points to a growing cultural shift. Seeking help is increasingly viewed as strength, not failure, and care models are becoming more tailored to how men actually experience mental health.
If there is one message men should hear, Dr. Dalai is clear: “Taking care of your mental health is a core part of self‑care, and it is a sign of strength, not weakness.”
