"When I was a child, I could not understand the strange feeling in my body whenever an emotion would pop up,” says 27-year-old Shayan Kazmi. “Sometimes, I wanted to cry but at those times I would be disgusted with myself, because I was repeatedly told I am a man and I am not supposed to cry.”

Shayan tells Eos his anger issues began when he was 15.

“My body would go into defensive mode as soon as something unpleasant happened. I would scream loudly, throw things around and feel a weird peace as my sisters and mother tried to calm me down. It would make me feel important,” he says.

The attitude followed him into adulthood and even marriage, and the verbal abuse soon turned physical. “When I hit [my wife] and then apologised saying I can’t control it, she’d ask if I’d hit my boss just because I am angry,” he says, adding that her words rang a bell for him.

Shayan sought emotion-focused behavioural therapy, delving into thoughts’ impact on behaviour and emotions. This approach targets specific issues and addresses abnormal coping mechanisms developed under emotional strain.

Today is International Men’s Day. It provides an opportunity to break the stereotypes around men’s mental health

“In my first session with my therapist, I was told I am an attention-seeker because I am only heard when I am angry. It enraged me, I wanted to break everything in the room, just to prove to her how powerful I am, until I realised that she was right,” he says.

“I delved into my childhood, realising I gained attention only when angry. As a child, crying prompted my mother to urge me to ‘man up,’ and happiness evoked the same from my dad. The behaviour of not being told to ‘man up’ emerged solely in moments of anger, becoming ingrained,” he says.

Worldwide, there’s a stereotype that portrays men as tough and resilient, making them hesitant to openly discuss or address mental health issues, says Huda Meher, clinical psychologist at Subh-e-Nau, a high school in Karachi.

“The societal stigma surrounding mental health exacerbates the situation, putting men with mental illnesses at higher risk,” she says. “Rather than seeking help, many men turn to harmful practices, such as substance abuse, as an alternative.

“As a community, it’s crucial to dismantle stereotypes and extend support to those who are vulnerable,” she adds.

Men’s mental health is often overlooked all over the world.

Despite a higher suicide rate among men, societal norms discourage open emotional expression. Pakistan recorded 8.9 suicides per 100,000 in 2020 as per the World Health Organisation. A study published in February 2023 in Asian Journal of Psychiatry looked at press coverage of suicides between 2021 to 2022. They found that of the total 51 cases reported, 65 percent were men. Daily, 15-35 individuals, one per hour, end their lives in the country, underscoring the urgent need for nuanced discussions on men’s mental well-being.

“Looking back at why I attempted suicide is very painful,” says Murtaza Abbas, 28. “I don’t think I am strong enough to walk down that path. However I am open to narrate what happened after I attempted to kill myself.”

Murtaza narrates how he opened his eyes in a hospital after committing self-harm on his right arm and using a razor on his vein.

“When I looked at my mother, she started talking about how much I mean to them and ‘how could I do this to them’. My right hand was in so much pain and I kept thinking ‘how is this about them and not about me’,” he says, amidst heavy pauses in between.

“No one questioned why I did what I did, though I knew they cared. Despite their concern, my pain felt overwhelming, overshadowing reasons to live. Battling clinical depression, I craved help, but feared opening up. Even my best friend bullied me. My mother, advising distraction, dismissed my struggles.

“The deep loneliness still haunts me,” he adds. “I shiver at the memory.”

Murtaza broke down several times while narrating the aftermath of his suicide. In between, he stopped speaking for a whole 15 minutes. When he finally resumed, he said he wished he had someone he could have confided in then.

“I am in therapy for the last five years and it is strange to think that, back in 2017, I did not even want to exist. Whoever attempts suicide, they don’t necessarily want to die, they just want to stop existing,” he says.

“When I was suicidal, I was told by everyone that I was either thinking too much, or how much I meant to them and how they don’t want me to die because of ‘their’ reasons. Again, when I could not see the light at the end of my tunnel, how would I see the light in your world?” he says.

Similar to the country’s suicide rate, more men are afflicted with mental illnesses then women. According to the Pakistan Medical Association, 34 percent of individuals in Pakistan experience mental illnesses; 68 percent of them are men.

“Men also experience higher rates of substance-abuse disorders and anti-social behaviours,” says Auon Abbas, a behavioural therapist at Hilal-e-Ahmar. “For severe mental disorders like schizophrenia and bipolar disorder, there are no consistent differences in prevalence between genders. However, men usually develop schizophrenia earlier, whereas women are more likely to display severe forms of bipolar depression,” he adds.

“I was clinically depressed in university and, while I was surrounded by friends who would allow me to exist in my bubble, there were times when I’d meet them and they’d say ‘Aur bhai, zinda hai abhi tak?’ [Brother, are you still alive?] and I’d respond with a joke too,” says Hassan Mujtaba, a 24-year-old mural artist. He says that while humour was a coping mechanism, he realised he needed to confront his emotions and be vulnerable in safe spaces.

“The reason behind development of such complex diseases is the lack of accountability of actions and emotions both,” says therapist Abbas.

“Men in our society are told to be ‘tough’ and just keep it all inside. Most patients I have dealt with over the years were never given space to be vulnerable, because they confuse it with weakness and, as they grow up, their behaviours start affecting them and their families.” He adds: “This is why you see so much male toxicity around you.”

“Therapy is very important,” says Mujtaba. “In my individual capacity, whenever someone reaches out to me, I help them. However, I am not a professional. I can listen but, to develop healthy coping mechanisms, you need to opt for professional help.”

The writer is a member of staff.
X: @dalchawalorrone

Published in Dawn, EOS, November 19th, 2023