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To mark World Mental Health Day, our Newsletter Exclusive offers expert advice on what’s really going on with men’s mental health.
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Ahead of World Mental Health Day, we spoke to Dr Shyam Bhat about recognising the signs that you may be struggling and finding the courage to ask for help
By Arshita Kaur Suri
Ask an Indian man how he is and you'll almost always get the same reply: "Fine." It is a small word doing enormous work, covering the sleepless nights, the tightness in the chest, the temper that surfaces at home, the third drink that has become routine.
The cost is not abstract. Men account for nearly three in four suicides in India, according to 2024 data from the National Crime Records Bureau, and many more carry their distress for years without naming it, often because no one taught them how.
So, what is really going on with your mental health? On this World Mental Health Day, October 10, we spoke with Dr Shyam Bhat, psychiatrist, physician and founder of Integral Self Therapy, to help make sense of what you may be feeling, even if you don’t have the words for it, and what you can do when “fine” finally isn’t enough.
How would you describe the state of men's mental health in India today?
Several years ago, most men who saw a therapist or psychiatrist came because a family member or partner insisted. Over the last three to five years, I've seen more men come in on their own, recognising that something is wrong. What brings them in is usually a relationship difficulty, workplace stress or awareness that their mood has shifted. They rarely say “I'm anxious” or “I'm depressed.” Instead they describe symptoms like chest tightness, abdominal discomfort, back pain, fatigue, insomnia, irritability, emptiness or a gap between where they are and where they want to be.
Men often suffer without understanding what they are suffering from or seeking help, leaving their distress unrecognised and untreated. Consider this: men account for nearly three in four suicides in India.
What are the biggest pressures impacting men today, in your view?
Financial stress is a major factor, but the pressure runs through every income level. Family structures have changed: many men now carry the provider role in a nuclear household, without the support a joint family once offered, while often still responsible for parents and extended family. At the same time, men are still largely defined by what they earn, even as gender roles shift around them. Many men are caught between the old expectations and the new ones, without a clear sense of how to meet either.
How does a man recognise the signs that he's struggling with his mental health?
Many men notice changes in their body and behaviour before they become aware of a change in mood. Sleep gets worse, either too much or too little. Impatience and irritability increase. Drinking may escalate, as may time spent scrolling, or work expands to fill every hour. Sometimes motivation disappears, and questions of purpose and meaning emerge. There may be physical complaints, like the ones I mentioned earlier, but with no clear medical cause. Things that once gave pleasure start to feel like obligations. Some men feel empty or bored and constantly seek novelty. Many withdraw from people. When a man notices several of these changes together, he should consider that he may be experiencing emotional distress he hasn't fully recognised or addressed.
How much of this can be traced back to traditional ideas of masculinity?
Socialisation and traditional ideas of masculinity are part of it, but so is biology. Testosterone influences the brain in ways that shape competitiveness, status-seeking and how men respond to threat, and these tendencies interact with how boys are raised. Due to both socialisation and biology, most men grow up learning that strength means not showing distress, and that a real man solves his own problems. There is often less emotional processing and more problem-solving. Vulnerability and hurt are often expressed, and even felt, as anger. This can become a vicious cycle of distress, numbing, loneliness, anger and despair. Many men I see have spent years suffering without recognising it before they finally sought help.
Are younger men experiencing these pressures differently from older generations?
Men in their 20s have more language for mental health than any generation before them, but they face many challenges: an uncertain job market, constant comparison on social media, and a confusing dating culture, with a sense that they must perfect themselves in every way to matter. Men in their 30s and 40s carry heavy loads: careers, loans, a spouse, children and ageing parents, all at once, often with little time for friendships. Older men face a different set of losses: retirement, which for many is a loss of identity; declining health; and a loss of relevance. Younger men talk more openly. Older men often have more people around them but find it harder to share their feelings with them.
There's often a perception that men have plenty of friends but fewer people they can be emotionally vulnerable with. Can someone have an active social life and still be struggling?
Social contact and emotional intimacy are not the same thing. Men's friendships are often built around doing things together, like sport, drinks or other activities, and the conversation is rarely about feelings or vulnerabilities. These friendships are real, but they don't usually leave room for a man to let his guard down. So for many men, a spouse or partner is the only confidant. When that relationship is strained, they can feel completely alone. Research links loneliness to real effects on physical health and lifespan.
For a man who recognises that something isn't right, what are the first practical steps he can take?
First, say it to one person you trust: "I don't think I'm doing all right." That first step is the hardest, but it breaks the silence. Second, if speaking to a therapist feels like too big a step, start with a physician. A thorough check-up rules out physical causes, such as thyroid problems or sleep apnoea, and a good doctor will also ask about mood. Third, notice your patterns for two weeks: sleep, drinking, irritability. Don't hesitate to seek professional help. Therapy is not a sign of weakness; it is practical work on how you think, feel and relate.
If you are in crisis, Dr Bhat recommends calling Tele-MANAS, the government’s 24-hour free helpline, on 1800-891-4416
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