The hidden link between men’s mental health, trauma and dementia

Men’s mental health is in freefall. Despite increasing awareness, the stark reality remains: 74% of suicides in the UK are men (Office for National Statistics, 2023). Yet, we continue to overlook the long-term effects of this crisis. What if men’s mental health struggles today are silently altering their neurological futures, leading to an increased risk of dementia? What if the roots of this crisis are deeper than we ever imagined - interwoven with the psychological relationship model of attachment theory, neurobiology and intergenerational trauma?

Men’s mental health: A crisis we can no longer ignore

Mental illness in men constitutes a significant public health concern that requires immediate attention (Ogrodniczuk et al., 2016). Men experiencing mental health concerns often face compromised physical health, hindering their capacity to provide essential economic, social and emotional support to their families (Holden et al., 2012). Simultaneously, men demonstrate a notably low inclination to seek therapy, which is influenced by their reluctance to openly discuss emotions due to the apprehension of being perceived as weak or unmanly (Rice et al., 2020).

Traditional masculine norms exacerbate mental health issues in men by discouraging them from seeking help (King et al., 2017). It is imperative to tackle mental health stigma among men, as it prevents them from seeking coping strategies and support. Young men avoid seeking support due to fears of being judged as emotionally vulnerable, weak and unmasculine, which increases their risk of suicide (McKenzie et al., 2018). 

The issue of men's mental health has long been overlooked, resulting in significant disruptions to their overall well-being (Copeland, 2000). To effectively address this, we need to comprehend the complexities of their experiences and the societal factors that impact their mental health. This involves acknowledging the diverse pathways men take when seeking help for their mental health challenges, and identifying the restrictive and enabling aspects of masculinities in the process (Vickery, 2021). Men are less likely to seek professional help due to the fear of being stigmatised and perceived negatively.

Mental health concerns in men are often undiagnosed due to their reluctance to express emotions and seek professional assistance. It’s a vicious debilitating mental health cycle. It's crucial to foster environments that encourage men to seek help without fear of judgement. This phenomenon could be attributed to how men are conditioned to believe that seeking help is a sign of weakness, leading to a reluctance to seek help when they are struggling with mental health concerns (Hernandez et al., 2014). Promoting awareness about the importance of mental health for men can lead to early detection, intervention and prevention strategies. It is a form of emotional strength to seek therapy, and not a sign of weakness.

Dementia is now the leading cause of death in the UK (Office for National Statistics, 2023), with men experiencing faster cognitive decline than women. Could the way men are raised - rooted in biological differences and societal expectations - be fuelling a silent epidemic of mental and neurodegenerative illness? The evidence suggests yes. Masculine norms play a central role in how men experience and express anxiety, as well as their help-seeking and coping behaviours (Fisher et al., 2022). Factors such as economic hardship, lack of social support and societal expectations contribute to higher rates of mental health issues among men.

Mental health challenges are often exacerbated in men due to societal expectations and traditional gender roles. Cultural beliefs and stigma surrounding mental health contribute to the underreporting and lack of coping strategies among men. Despite the prevalence and impact of men’s anxiety, it remains largely overlooked in the field of men’s mental health (Fisher et al., 2022). It's essential to acknowledge the influence of gender roles on mental health and encourage men to seek assistance and support when necessary. 

How men’s unique biology shapes their mental health

From the moment of conception, male brains develop differently from female brains. The presence of XY chromosomes means that male fetuses are more vulnerable to environmental stressors in-utero. Research from Dr Howard Chilton, an Australian neonatologist, highlights that baby boys are born neurologically less mature than girls, making them more susceptible to early stressors that shape attachment patterns and emotional resilience (Chilton, 2003).

• Testosterone and attachment: High levels of testosterone in the womb can influence emotional regulation and attachment styles, making baby boys more sensitive to early relational disruptions (Chilton, 2003).
• Delayed neurological maturity: At birth, boys have a less developed corpus callosum, the bridge between the brain’s hemispheres, impacting emotional processing and communication (Tronick & Beeghly, 2011).
• Higher stress sensitivity: Studies suggest that male infants exhibit higher levels of cortisol in response to stress, yet they receive less physical comfort and emotional attunement than female infants (Tronick & Beeghly, 2011).

Biological differences make males more vulnerable than females from conception (Kraemer, 2000). Significant differences are seen between male and female social and emotional functions in the earliest stages of development, resulting from differences in sex hormones, social experiences and rates of brain maturation (Schore, 1994). Despite these biological vulnerabilities, boys are often raised with emotional suppression, leading to attachment wounds that carry into adulthood, increasing the risk of depression, addiction and suicide (Mansfield et al., 2003). Understanding these sex and gender differences may lead to sex-specific therapeutic interventions and preventative strategies for improving mental health. Acknowledging the role of these factors can help to improve help-seeking and mental health outcomes for men (Sullivan, Camic and Brown, 2014).

The neurobiological link: How trauma impacts the brain

Childhood trauma, often dismissed or unacknowledged in men, fundamentally alters brain development and function. Adverse childhood experiences are associated with increased risk of developing mental health concerns in adulthood. Men may develop chronic stress, anxiety, depression and substance abuse disorders due to trauma, which can lead to decreased cognitive function and increased risk of dementia (Dimitriadis et al., 2023).

Trauma changes the expression of genes involved in stress response, immune function and neuroplasticity (Ryan et al., 2016). Childhood trauma can lead to neuro-inflammation which can cause dysregulation of brain function. Men with dementia may struggle to articulate emotions linked to their experiences, which may lead to feelings of loss and isolation (Griffiths et al., 2020). 

Intergenerational trauma: The hidden epidemic in men’s mental health

Trauma isn’t just psychological - it’s biological. Studies in epigenetics reveal that trauma can alter gene expression, passing the physiological effects of stress and adversity from one generation to the next (Yehuda et al., 2014). 

• Men inherit more trauma-linked epigenetic markers: Research suggests that male offspring are more likely to inherit trauma-related genetic modifications from their fathers, particularly in genes linked to stress regulation and emotional processing (Yehuda et al., 2014).
• War, abuse and emotional neglect: Generations of men who lived through the war, economic hardship, or abusive upbringings unknowingly pass down these altered stress responses to their sons (Bowers & Yehuda, 2015).
• Attachment disruptions in father-son relationships: When fathers struggle with unresolved trauma, they may be emotionally unavailable, setting the stage for disordered attachment styles in their children - contributing to lifelong struggles with emotional regulation and relationships (Schore, 2017).

The result? A continuous cycle where boys grow up emotionally disconnected, internalising distress and later developing depression, anxiety, or cognitive decline (Sapolsky, 1996). There is an urgent need for increased awareness, early intervention and accessible mental health support tailored to men's needs.

In recent years, there has been a notable increase in interest in men's mental health, with researchers and activists successfully advocating for increased attention to men's issues and well-being (Affleck, Carmichael and Whitley, 2018). However, despite this progress, significant gaps remain in our understanding of the unique challenges men face, and in the provision of effective and accessible mental health support tailored to their specific needs. Acknowledging these differences is crucial for tailoring effective coping and self-soothing strategies to improve help-seeking behaviours and mental health outcomes for men (Cleary et al., 2023).

Social connections and support networks are essential for mental health and well-being, acting as a buffer against negative experiences and increasing the likelihood of seeking help (McKenzie et al., 2018). Acknowledging the multifaceted nature of mental health and the importance of understanding the specific needs of men is crucial for adopting positive change. Cultural values, such as placing a high value on family, may also influence coping strategies and care-seeking behaviours within certain communities (Giebel et al., 2014). 

Men, often socialised to be stoic and suppress emotions, may unknowingly carry intergenerational trauma, which manifests as: 

• Heightened anxiety and hypervigilance: Descendants of traumatised individuals often exhibit increased sensitivity to stress, anxiety and a constant state of alertness.
• Difficulty with emotional regulation: Epigenetic changes can impair the ability to manage emotions, leading to outbursts of anger, difficulty with empathy and strained relationships.
• Increased risk of addiction: Men with intergenerational trauma may turn to substance abuse as a means of coping with unresolved pain.

Men's mental health is significantly impacted by trauma experienced during their grade school years, potentially leading to anxiety disorders that might later transform into depressive states and concerns (Marshall, 2015). Early life stressors or trauma, such as physical or sexual abuse, decrease serotonergic neurotransmission, which is associated with increased impulsivity and aggressive behaviour in adults (Baharikhoob and Kolla, 2020). Traumatic experiences during childhood are a potential risk factor for developing depressive symptoms later in life, especially when facing additional stressful events (Vaiserman and Koliada, 2017; Yang and Oh, 2024). 

From silent suffering to cognitive decline: The dementia connection

The chronic suppression of emotions doesn’t just affect mental health - it rewires the brain, increasing the risk of neurodegenerative diseases. Early-life trauma increases dementia risk by 80% (Eagle, 2022).

• Chronic stress shrinks the hippocampus: The hippocampus, crucial for memory and learning, is significantly smaller in individuals exposed to prolonged emotional distress (Sapolsky, 1996).
• Emotional suppression and brain inflammation: Bottled-up emotions increase neuro-inflammation, a key driver in dementia and Alzheimer’s disease (Farrell, 2012).
• Men experience faster cognitive decline: Men’s brains appear to age differently, with more significant atrophy in areas linked to executive function and memory (Farrell, 2012).

This all paints a disturbing picture: the very emotional suppression forced on men from childhood could be accelerating cognitive decline and dementia risk in their adult lives.

Breaking the cycle: A call to action

If we continue to ignore the unique ways in which men’s biology, attachment and trauma responses shape their mental health, we will fail not just this generation - but also the next.

What needs to change?

1. Rethinking boys’ emotional development: We must raise boys differently - acknowledging their heightened vulnerability to stress and providing more secure, emotionally attuned caregiving from infancy.
2. Challenging emotional suppression in men: From childhood to adulthood, we must shift away from toxic masculinity narratives that equate emotional expression with weakness.
3. Early mental health intervention: Given men’s reluctance to seek help, we need more male-focused mental health initiatives - particularly in workplaces, schools and community spaces.
4. Trauma specialist therapy for men: Therapists must recognise male-specific attachment patterns and tailor approaches that acknowledge how men process trauma and seek support.
5. Intergenerational healing practices: Addressing the trauma passed down through generations requires individual therapy where they can learn to practice neurobiological interventions that help men regulate their emotions and re-establish secure attachments within themselves.

The evidence is clear: men’s mental health isn’t just a crisis - it’s a public health emergency.

If we fail to recognise how biology, attachment and trauma intersect in men’s lives, we risk condemning future generations to the same cycles of emotional neglect, serious mental health concerns and neurodegenerative disease.

It’s time for all of us to rewrite the narrative. We needn't think we have to work on ourselves alone, that's why therapy is an incredibly valuable and supportive process. We're all in this together. Who’s ready to start the conversation?

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