Loneliness is killing men – and without proper support and intervention nothing will change

Many men have been raised to prioritize independence and stoicism, making it difficult for them to open up and form emotional connections.

Many men have been raised to prioritize independence and stoicism, making it difficult for them to open up and connect emotionally.

Last year I read Richard Reeves' book,About boys and men” In his research, Reeves describes the various factors that lead to boys and men feeling excluded from society and struggling to cope with systems, whether it's education or work. One section talks about how men struggle after a divorce or breakup, especially if they don't find a new partner. None of this is new information, but it made me pay attention to the growing number of men coming into my clinic each week.

Many men are raised to value strength, independence, and stoicism, making it difficult for them to open up and form emotional connections. Many aging men experience loneliness due to the loss of their partner and friendships. Below is a sample of the types of cases I often see in my clinic.

Colin* is a 49-year-old sales manager with bipolar disorder who presented to a mental health unit following a five-week hospitalisation for mania caused by non-adherence to his medication, alcohol abuse and a recent separation from his wife. During his most recent manic episode, he had an affair with a colleague and was subsequently suspended by his employer. Colin was facing significant stress at work due to deadlines. He cut back on his medication without discussing this with his doctor. He thought he would be more effective because the mood stabilisers and antipsychotics had a calming effect on him. Unfortunately, this led to poor sleep, increased hypersexuality, alcohol abuse, grandiose ideas to improve sales at work and increased arguments with his family. Colin's wife and children presented to mental health services, leading to an involuntary psychiatric hospitalisation where he was reinstated on his medication.

When we meet Colin, he lives alone in a short-term rental. His wife asked for a divorce after discovering the affair, and he was forced to leave the family home. Colin had had a previous affair, and this was his fifth manic episode in 30 years of marriage. His two adult children have sided with their mother, and Colin feels bereft of support. “I feel like I’ve been abandoned,” he says. “But I need their support now.”

His employer has been more lenient because he is one of the top employees, but the company wants him to see a psychiatrist and develop a return-to-work plan.

Colin is motivated by his children, who maintain contact with him, albeit at a distance. He agrees to attend regular Alcoholics Anonymous meetings and group therapy. He knows he should take his medication regularly, but he lives alone and has no one to help him with this. I advise him to take a month off, return part-time, and gradually increase his workload over several months.

I recommend reaching out to close friends. Colin chokes with laughter and says he has no close friends. The friends he has were made through his wife, and they drifted away after the affair. I ask about colleagues, and he says that despite years at the company, he has only superficial friendships. Colin’s eldest son, Adam*, comes to one of the meetings and provides more information about his father. He paints a picture of a man who, although loved, puts an undue strain on the family when he doesn’t take his medication. When I ask about Colin’s wife, Adam is not optimistic about their chances of getting back together. “She’s fed up with him.”

Despite all this, Colin is generally cheerful but seems lonely. He takes medication, attends group therapy, and his return to work has been initially awkward but successful. We agree that he will work part-time for a few months to minimize stress. Colin still lives alone, but talks to his wife and hopes for a reconciliation. We schedule a meeting in two months. Colin misses the meeting and emails an apology but no explanation or rescheduling. Two weeks later, a police officer calls me to tell me that Colin has taken his own life.

Adam comes into the clinic and thanks me for my support. He is grieving for his father, but also looking for answers. He admits that he feels he has let Colin down. Adam says he has come to pay for his father’s missed appointment. I tell him that there is no need. I assume that the real reason is that he wanted to talk to someone about his father, someone who knew him to the end. Adam has been tasked with organising the funeral because his younger sister and mother are too grief-stricken. Finding friends of his father to attend the funeral has been difficult. Adam says a hasty goodbye and apologises for wasting my time. I see a similarity between father and son – two men trying to keep their cool.

Mental health services are trying to engage lonely men using a variety of strategies. We know that most men do not call helplines when they are in crisis, many find it difficult to engage in individual therapy, and male-only group therapy is difficult to access. Governments are discussing intervention policies targeting boys in schools. Holistic practices such as exercise (gym, running or sport), healthy eating and good sleep hygiene also help, but they are not enough. I am optimistic that we will get there, but sometimes it feels like nothing is changing while men are struggling in their lives.

Most psychiatrists have had cases like Colin's. Age and mental illness may vary, but loneliness is too often a factor.

*These examples of patients are collective images of people who often come to psychiatrists.