Why so many men avoid therapy even when struggling, according to doctors

Across age groups, men continue to avoid mental health support even when they are struggling. Experts explain why this happens and what needs to change to make help accessible

 

Even when they are overwhelmed, exhausted or clearly struggling, many men still hesitate to reach out for support. This behaviour is not accidental or just stubbornness. According to mental health experts, it is shaped by psychology, culture, upbringing and deeply embedded ideas of what men are supposed to be. Understanding this quiet resistance tells us far more about our society than we realise.

 

Doctors say the biggest barrier is that many men do not recognise their emotional distress as emotional distress. Dr Astik Joshi, Child, adolescent psychiatrist at Fortis Healthcare, Delhi, explains that a large number of men lack awareness of how psychological stress shows up in their bodies and behaviour. They often chalk up anxiety to “work pressure”, depression to “tiredness”, and trauma to “just a bad phase”.

 

 

Layer this with cultural messaging that men must “handle it themselves”, and seeking therapy feels, to many, like crossing a forbidden line.

 

Dr Gorav Gupta, Senior Psychiatrist & CEO, Tulasi Healthcare, Gurugram, adds that men are socialised from childhood to hide vulnerability and stay “in control”. This conditioning does not vanish easily. Even when the emotional load becomes unbearable, silence feels safer than admitting they need help.

 

Do men show mental health symptoms differently from women?

Instead of openly expressing sadness, fear or anxiety, many men display anger, irritability, withdrawal, risk-taking, overworking or substance use. These behaviours are easy to misread as personality traits rather than distress signals.

 

That means men often reach mental health services late, sometimes after a crisis, sometimes when symptoms have already hardened into patterns.

 

Dr Joshi notes that men also tend to under-report their struggles. If they do not articulate what is going on, doctors may diagnose late or inaccurately.  ALRO READ | The early prostate symptoms men ignore, and why they matter for health 

How does traditional masculinity shape men’s reluctance to seek help?

Generations of men have grown up believing that strength means silence, and that emotional expression is somehow “unmanly”.

 

Both experts agree the needle is shifting, slowly, with younger men showing more openness. But this change is still at a very early stage. The old expectations that men must be stoic, independent, problem-solving and emotionally contained remain deeply rooted.

 

What barriers do men face even after deciding to seek therapy?

After finally deciding to seek help, men continue to run into obstacles that push them away again:

 

• therapy costs too much
• rigid schedules clash with demanding work hours
• many therapeutic models are emotion-focused rather than solution-oriented
• difficulty finding a therapist who “gets” how men express distress
• fear of being judged or misunderstood

 

Dr Gupta says many men prefer practicality and action in sessions, but the system is not always aligned to that preference. This mismatch can make therapy feel irrelevant or uncomfortable.

 

What would a genuinely male-inclusive therapy environment look like?

According to both experts, it would look like this:

 

• therapists trained to understand male-specific distress patterns
• flexibility in scheduling
• action-oriented, practical approaches
• safe spaces that feel approachable rather than clinical
• practitioners who understand the cultural pressures men face
• group formats or telehealth options for those uncomfortable with in-person sessions

 

Dr Joshi highlights that culturally competent clinicians who truly understand gender-related issues are still rare. But where they exist, the impact can be life-changing.

 

Both doctors stress that men do not avoid therapy because they are indifferent to their pain. They avoid it because they have been conditioned to. The path forward lies in creating a society where men feel safe to be vulnerable, where therapy is seen as wisdom rather than weakness and where emotional expression is not gendered.   

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This content is for informational purposes only and is not a substitute for professional medical advice.