The male suicide crisis: a matter of nature or nurture?

It might appear to anyone reading the news that we are suffering from an epidemic of mental illness. Hardly a day goes by without a new statistic – or the repetition of the scary fact that suicide levels among men are now three times those for women.

Why might the suicide rate in men be so high, and are men more at-risk due to their biology or their environment? Is it nature, or nurture?

To begin to answer that question, we need to understand that men's mental health problems are often the result of stress – either workplace or other forms. Men don’t “cope” well with stress. As well as being more likely to commit suicide, they are also less likely to seek help for their condition. Biological research suggests this is because many men have an increased response to cortisol, the stress hormone, compared to women. Men appear to overreact to their bodies' cortisol production, intensifying the ill-effects of this natural hormone.

Why do men have this aggravated response? Surely, with the obvious negative consequences of it, wouldn’t our evolution have altered men’s biology to rid them of this heightened response to cortisol, thus reducing levels of depression and suicide?

It goes back to nature. When human existence began, we lived in small groups of 100 to 150 nomads, wandering planes and forests, seeking out water, food and shelter. We were always on the look-out for danger, always on edge. If our tribe were attacked by other tribes or wild animals, we would be dependent on those among us who would be the first to take on the attackers, even if they knew they were likely to die as a result. Without these “volunteers” willing to risk their lives, the whole tribe could be at risk. Those that did volunteer would be willing to give their lives to save the tribe. In other words, to them, their life was “worth less” than that of their tribe.

And who were these volunteers? Most likely, they were young adult men, and probably, those with a more pronounced cortisol response. To them, fighting a foe (human or animal) was their way to receive a social “reward” to “offset” the stress they felt, even if this meant they might die saving their tribe. Thus, the pronounced cortisol response was established in our biology to safeguard our genes, through the preservation of our tribe.

We can speculate that men with a pronounced cortisol response are those who, in the modern world, are more likely to join the armed forces or enter other professions where there are high levels of risk, high levels of stress, and also high rewards. It's as though a natural response is kicking in, compelling them to play roulette.

But nurture is also at play here. We want our men to be brave soldiers, not vulnerable and weak. During wartime, we teach them to be fighters. In previous generations, as during the First World War, young men willfully joined up, in part to get away from their bleak, depressing lives at home, but also because if they died in their endeavours, they did so for a greater cause, for the ultimate reward of dying for their country. For many of these volunteers, their lives were “worth less” than that of the greater good: their country. It's not a huge leap of logic from here to the mindset often articulated by people with depression, who see their lives as “worthless.”

There are undoubtedly many reasons why we still have predispositions to poor mental health. Men, in particular, get into trouble when they don’t have an outlet, a means to counteract the cortisol response when there is no recognisable reward in sight.

There's no clear cut reason why men have that high stress response – it's a combination of nature and nurture. Men are predisposed towards a greater stress response because it’s in their genes, but their inability to cope with that response is often due to environment and lifestyle. A poor environment and lifestyle is far more likely to result in poor mental health.

“What men do when they can’t manage stress and become mentally ill can often be inappropriate. As well as higher rates of suicide, we see behaviours such as addictions to drugs, alcohol, gambling, and sometimes ugly behaviour towards women. These behaviours can’t be excused, but they may occur to distract the mind from the pain of the stress. The mind is bent on seeking a reward, even though it could be an improper reward. So, while some men might be able to seek solace in their families, communities and their work, putting in longer hours for a “good cause,” doing good deeds and building secure loving attachments, others may fall into bad habits and seek unsuitable alternatives.

Today we have the means to assess and improve our mental health in the workplace, or any other setting, using digital cognitive assessments and training programmes that can be accessed on smartphones and tablets through apps. The assessments have been clinically validated and are based on nearly 200 years of neuropsychiatric research using paper and pen tests (puzzles) to measure the five key cognitive fitness domains: executive function; working memory; episodic memory; attention; and processing speed. They take as little as 15 minutes to do, and offer access to a range of tailored, personalised interventions, which help to reset the brain, building resilience to the stress responses.

The accessibility of these programmes means that any man concerned about his mental health, or that of a friend, family member or colleague, can regularly assess and keep a cognitive fitness check on his mental health. He can, if he wishes, use his results to have a discussion with a health professional or counsellor and get additional help. He can work to improve his lifestyle, reducing his chances of falling off the edge.

If we can encourage men to do this, we might see fewer of them struggling with mental health issues, and see less inappropriate behaviour. Furthermore, because good cognitive fitness can lead to a brighter outlook, we will see men with better control, management and leadership skills. And they don’t have to die to achieve this.

Keiron Sparrowhawk is the author of Executive Function: Cognitive Fitness for Business. Lid Publishing, £12.99