By Joanna Audi, Mental Health Professional & Psychomotor therapist
Karim calls his brother on a Tuesday night for no particular reason. He asks about the kids, the car, their father’s doctor. “And you?” his brother asks. “ماشي الحال,” Karim says. Things are fine. They hang up after four minutes.
Karim is invented. You may still know him.
Nobody would call that a cry for help. Yet in a UK survey of 3,000 men, 35% said that if they wanted to talk to a friend about their mental health, they would ask how the friend was doing and hope the question came back.
Much of what we say about men’s mental health each Movember assumes that men are silent. What if some have been trying, in a language the rest of us never learned?
The silence we may be misreading
Globally, men die by suicide at more than twice the rate of women. In Lebanon, 81% of the 168 suicide deaths reported in 2023 were men, and stigma means the true figures are likely higher. No single cause explains these deaths, and none of this means men suffer more: depression and anxiety are more common among women.
But the familiar story, that men don’t talk, don’t seek help, and die as a result, is less tidy than it sounds. When researchers reviewed suicide deaths among middle-aged men in Britain, they expected isolation. Instead, most had recently been in contact with healthcare, the justice system, or another service.
Contact is not asking for help, and Britain is not Beirut or Riyadh. Still, many of these men were within reach of someone who may not have known what they were looking at.
Closer to home, the manager of Lebanon’s National Lifeline reports that men call almost as often as women. Some men clearly reach out when the door is free and open at 3 a.m. What do we offer them before it gets that far?
When pain doesn’t look like sadness
He is short with the children. He stays at the office until nine. He drives too fast, drinks more, stops answering his friends. At home, we call it temper, or say he’s just tired.
In some men, depression can look more like this than like sadness. Researchers still debate how far that goes, and women experience these signs too. The useful question is not whether he is depressed but what has changed. Is this new? How long has it lasted? Is it affecting his sleep, his work, the people at home?
And when he does say it plainly? In a Movember-commissioned survey, 41% of men had regretted opening up, often because the listener didn’t seem to care or take them seriously.
Most of us can hear the local version: شو ناقصك؟ What are you missing? You have a job, a family, a roof. It is usually said with love. It can close the subject for years. A better reply is smaller: من إيمتى حاسس هيك؟ Since when have you felt like this?
The cost of holding everything together
For many men here, being a good man and being a good provider have become hard to separate. In a UN Women and Promundo study across four Arab countries, including Lebanon, around half of men said they felt stressed or ashamed to face their families, whether over too little work and income or fear for their safety.
That research predates Lebanon’s financial collapse. Since then, crisis has stacked on crisis. Some men stayed and watched what they built disappear. Others work in the Gulf, send money home, and tell no one they are exhausted. Neither might call it a mental health problem. They might call it responsibility.
Responsibility itself is not the enemy. Research on masculine norms, correlational and largely American, points to self-reliance, not the importance of work, as the pattern tied to worse outcomes. The danger may lie less in carrying weight than in believing you must carry it alone. In practice, that can mean telling one person the real picture: what you owe, what you earn, what keeps you up at night. For a family, it can mean asking “What can I take off your plate?” instead of “What’s wrong with you?”
Research from our own region is still scarce, but in some communities people turn first to family, friends, or faith. Support can start there, as long as it doesn’t end there.
Available is not the same as reachable
In Lebanon, psychologists and psychiatrists are in short supply and concentrated around Greater Beirut. Cost matters, and so does fit: in one Australian survey, nearly half of men who had tried therapy had dropped out, most often because they felt no connection with the therapist.
That does not mean therapy doesn’t suit men. It means the first session matters, and it can be less mysterious. You can ask: How do you work? What will we actually do here? You can say you want tools, not only talk. If a waiting room feels like too much, an online session removes it. If the fit is wrong, you can say so or try someone else.
So who is responsible?
Not everyone equally. Responsibility should grow with the power to change something.
Consider what “reach out” asks. A man at his lowest must find the words, find a professional, find the money, and risk being dismissed. We have given the hardest task to the person least equipped for it that week.
That does not remove men’s part. Men can learn to notice when anger, overwork, or numbness has become a pattern, and say one honest sentence to one person. They are also fathers, brothers, friends, and managers, well placed to break rules of silence that pass from man to man.
Families and partners are not therapists, and many already carry too much. Their part is smaller and harder: not punishing honesty when it finally comes. Friends can notice when someone has gone quiet and go find him. Employers can train managers to notice change without diagnosing it, and say where to find support when they cut salaries or jobs. Professionals can ask about sleep, anger, and work, not only sadness, and explain plainly what therapy involves. Public institutions decide whether help is affordable, and placing Lebanon’s Lifeline among its emergency numbers shows what treating it as essential can look like.
What could change next week
If you are worried about someone, ask twice. “You said you’re fine. You haven’t seemed yourself lately. I’m not trying to fix anything.” If face to face feels like too much, try a drive or a walk. Then listen longer than feels comfortable. “Man up” shuts conversations down, and so does rushing to solutions. If you fear for his safety, ask him directly whether he is thinking about suicide. Asking does not appear to plant the idea.
If this is you, you don’t have to begin with feelings. Begin with facts: I’m not sleeping. I’m angry all the time. Nothing feels enjoyable. Say it to one person, or to a doctor you already trust. If the first person doesn’t get it, try another.
If you or someone you know is thinking about suicide, call Lebanon’s National Lifeline on 1564, free and around the clock. Outside Lebanon, contact local emergency services or a doctor you trust.
The second question
So, are we failing men? Sometimes, and rarely on purpose. We fail them when we ask for honesty and reward composure, when we read despair as bad temper, and when we build a door and blame those who can’t find it. That “we” includes men.
Think back to Karim. It is fair to ask why he didn’t say more. But his brother could also call back tomorrow and ask: “No, really. And you?”
Change may begin with who is willing to ask the second question, and whether the systems around us are ready for the answer.
When that answer feels easier to give to someone outside the family, Mindsome can connect you with a mental health specialist, whenever you feel ready.