Men's Health - "Many Men Want to Be Heroes"
- Jul 6
- 5 min read
Men die younger, are less likely to seek help, and die by suicide at significantly higher rates than women—yet men's health often remains a neglected topic. Psychotherapist and researcher Andreas Walther explains why traditional concepts of masculinity can become dangerous and what healthcare professionals, therapists, and society can do to ensure that men receive support before it is too late.
Interview: Marita Fuchs, Freelance Journalist
Professor Walther, your research focuses on men's health, depression, and suicidality. What led you to this field?
Andreas Walther: My research initially focused on biological changes in men, such as the decline in testosterone levels during midlife. But it quickly became clear that physiology is only part of the picture—the psychological dimension is equally important. Men often seek professional help for mental health problems much later than women do. As a result, depression, anxiety disorders, and substance use disorders are frequently recognized only when the level of distress has become severe, even though many of these outcomes could have been prevented.
My research is also deeply personal. My father suffered from depression and died after a suicide attempt. Looking back, that experience was probably the starting point of my interest in this field. What support would he have needed? Who could have recognized how much he was struggling? Later, during my work in clinical psychology and research, I realized that psychological factors—particularly beliefs about masculinity—often explain more than biological variables alone. Traditional masculinity ideologies, meaning socially constructed expectations of how a man is supposed to behave, are consistently associated with depression, suicidality, substance use, and loneliness.
Many people believe these traditional ideas of masculinity are outdated. Aren't younger generations much more open today?
That is an easy assumption to make, especially if you live in an open, urban environment. Of course, there are many young men who speak openly about emotions and therapy. At the same time, research shows that traditional masculine norms remain deeply rooted.
In addition, the internet has given rise to what is known as the manosphere—online networks and influencers who promote highly dysfunctional concepts of masculinity. These are not fringe phenomena. When such content attracts millions of followers, it serves as a powerful indicator of broader societal trends.
Why are these ideals so harmful?
No one can fully live up to these ideals. If a man believes he must always be strong, dominant, successful, and invulnerable, those traits may even be rewarded for a while—in the workplace, in relationships, or by society in general.
But when life becomes difficult, that model begins to fall apart. Relationships end, children become distant, jobs are lost, or loneliness becomes impossible to ignore. At that point, many men have never learned how to ask for help or confide in someone else. What once appeared to be a strength can quickly become a serious risk factor.
Men die by suicide two to four times more often than women. Why doesn't this receive greater public attention?
That is exactly the problem. Because this pattern has existed for so long, many people have simply become accustomed to it. If these numbers affected another population group, we would immediately say that urgent action is needed. Men have a shorter life expectancy on average, higher suicide rates, and are less likely to seek professional help. These differences deserve much greater attention from a sex- and gender-specific perspective, especially when it comes to suicide prevention.
How does depression manifest itself in men?
The classic picture of depression – withdrawal, lack of drive, depressed mood – does not always apply at the beginning. Many men initially respond with tension, irritability, excessive work, intense exercise, or alcohol and substance use. They throw themselves into everything once again instead of admitting to themselves: I can't go on anymore.
Yet depression may still be present in the background. If healthcare professionals look only for the classic symptoms, they can easily overlook these men.
What role do general practitioners play?
A very important one. They are the gatekeepers. Many men are more likely to see their general practitioner than to go directly to a psychotherapist. That is why physicians need tools to recognize male-specific or externalizing symptoms of depression as well. For example, we translated and validated the Australian Male Depression Risk Scale into German. Combined with traditional depression questionnaires, it can help assess men more accurately – even during a short consultation.
Many men might be more willing to talk to AI than to a therapist. Is that an opportunity or a risk?
Both. AI can be a good starting point because it is anonymous and easily accessible. Many men are interested in technology and may ask questions there for the first time: Am I depressed? What can I do? These models can already provide a great deal of psychoeducation.
But depression cannot be treated through information alone. People need to take action, learn how to deal with setbacks, and continue to receive support. That requires people – healthcare professionals, relationships, and continuity of care. AI can open the door, but it cannot replace the journey through therapy.
Therapy is important, but don't pharmaceutical treatments also help? Earlier you mentioned testosterone.
My team and I at the University of Graz continue to work on male-specific pharmacological and psychotherapeutic approaches. When it comes to testosterone, we know that it can have an antidepressant effect, but it is not the whole solution.
We are also interested in social connectedness and its neurobiological foundations, such as oxytocin. We are planning clinical studies in which we will combine oxytocin with specific psychotherapy for men with depression.
At the same time, we are researching exercise and psychotherapy – for example, how physical activity can help people reintroduce more positive and motivating activities into their daily lives.
If you had to identify one blind spot in gender medicine, what would it be?
The social structures surrounding men. We still do not talk enough about them. We talk about hormones, diagnoses, and therapy – all of which are important. But when men are better socially connected, the risks of depression, substance use, anxiety, and suicidality decrease.
Many men want to be heroes. They take on too much and want to carry everything on their own. And in the end, they struggle in silence. My concern is that we recognize this without turning it into a competition. Women face their own challenges, and men face theirs. It is not a zero-sum game; it is about taking a closer look.
Assessment Questionnaire for Primary Care Physicians
Many men are more likely to see their family doctor than to go directly to a psychotherapy practice. The MDRS-22 (Male Depression Risk Scale) is a scientific questionnaire designed for the early detection of depression in men. Unlike traditional tests, the MDRS-22 pays particular attention to “male” warning signs such as anger, aggression, substance use, risky behavior, and emotional withdrawal. The team led by Andreas Walther has translated and validated the questionnaire into German. When combined with traditional depression questionnaires, it can help assess men more effectively—even during a brief consultation.
English Version of the Australian Male Depression Risk Scale.
German translation of the Australian Male Depression Risk Scale.
