I work with a lot of men, both individually and in couples. It’s not unusual, often several weeks in, for a man to describe either a suicide attempt, a threat he’s made to take his own life, or a period of days, weeks or months when suicidal thoughts have been running around in his head. Often, he’s never shared this with anyone else before sharing it with me. It’s as if there’s nowhere for these thoughts to go. And even coming to therapy wasn’t specifically about suicide. It was much more about relationships, about how to be a man, about how to fit into the world that Western society has created for men.
In the UK, men account for around three-quarters of all suicide deaths. Middle-aged men are consistently the highest risk group. Suicide is the biggest killer of men under 50 in the UK. Around 15 men die every day, taking their own lives. Those numbers are shocking, but they don’t tell you what it actually feels like to be that man. This piece is about that.
What the culture teaches men
In white Western culture, men are discouraged from emotional language, particularly in connection with themselves. They’re permitted emotional expression around football, or in the currency of male banter, but the deeper register is closed off early. This does not mean they have no capacity for emotional language, just that they have not been encouraged to use it.
I turned eighteen, and my father invited me to the pub. Before we went in, he said: No sex, religion or politics. He went to the pub most nights and rarely talked about anything emotional. He’d raise his glass and say, ” Don’t let the bastards get you down”. It seemed he didn’t begin to have an emotional life he could actually talk about until he was retired, tending his garden, and several years sober. That was his generation, but I don’t think it’s as different now as we’d like to believe.
What that cultural shaping produces is something I see clearly in the men who sit across from me. It no longer surprises me that when a man begins talking about his relationships, the patterns, the reason he’s turned to alcohol or something else to numb the pain, we quickly arrive somewhere unexpected.
It’s like I’m talking with a seven-year-old boy who just wants to do his best but doesn’t know how he’s supposed to be or what he’s supposed to do. Without good guidance, he made some poor decisions, and those decisions are now making his life miserable. He didn’t fail. He was never taught.
When the performance becomes unsustainable
Male friendships and networks often function only while everyone’s performing a version of okayness. The pub, the workplace, the football: all of it is conditional on not needing anything real from each other. The moment genuine vulnerability appears, the network has nowhere to put it.
This became unsustainable for me in my twenties. I was drinking too much, driving cars too fast, writing one off, making poor choices in relationships, feeling like life was driving me somewhere I didn’t want to go, rather than me being in the driving seat. By great good fortune, I met my lifelong partner and moved away from the city. But it’s noticeable that I retained no friendships, no connections from that time. No one checked in on me once I’d moved away. Not one person.
That’s not unusual. It’s the ordinary texture of male isolation.
What happens in the body
When a man has spent decades learning it’s not safe to be seen as he really is, the people around him feel they don’t know him. They can’t predict his reactions. They sense a coldness or distance, even if they can’t name it.
I spent many years with what I can only describe as a limiter: something that stopped me from being fully seen. What that meant in practice was staying in jobs where I wasn’t fulfilled, resenting what I was doing, rather than speaking out and moving on to something better suited to me. I see versions of this constantly: men who can’t make decisions, men who feel like a disappointment to everyone, men who carry a secret conviction that something is broken about them that nobody must discover, or they’ll use it against them.
In the body, this shows up as tightness and reactivity. When those feelings become overwhelming, some survival action is taken: withdrawing, disappearing, or self-medicating. Sometimes something more final.
Why men don’t come to therapy
The cultural script says that need equals weakness. Asking for help is a confession of failure.
Many men arrive in therapy only when crisis forces them: a relationship ending, a breakdown, a moment that couldn’t be hidden any longer.
Some arrive earlier, if the framing feels right. What tends to work is an approach that’s practical and non-pathologising, that’s curious about experience rather than focused on diagnosis, that doesn’t require a man to already have the language for what he’s feeling before he walks through the door.
Therapy isn’t another set of rules or requirements to stick to. It’s a space where a man can begin to recognise his actual wants and desires, how to regulate his own emotions, and how to choose connection rather than push the people around him away. That connection begins with connecting with yourself. And in my experience, that’s what gives life its purpose and meaning.
If you’re reading this
If you’ve been holding something alone for a long time, it’s worth a conversation. You don’t need to know what to say or how to say it. You can make contact, and we can take it from there.
If you’re affected by anything in this article
If you’re struggling right now, you don’t have to manage it alone.
In the UK, you can contact the Samaritans any time, day or night, on 116 123 — calls are free.
CALM (Campaign Against Living Miserably) runs a helpline for men at 0800 58 58 58, open 5pm to midnight every day, and also offers a webchat if calling feels like too much.