‘It Puts You at Odds With Society’: Masculinity and Men’s Experiences of Mental Illness Stigma

Data Collection

Following institutional ethical approval from the University of Otago Human Ethics Committee (Health), we recruited participants from the community by distributing flyers at public libraries, cafes, and community notice boards in a large urban city in the North Island of New Zealand inviting men living with depression and anxiety disorders to take part in the study. Potential participants contacted one of two researchers via email or telephone, and eligible men were then briefed about the study objectives and procedures. Participants, 18 years and over, English-speaking, and living with depression, anxiety disorders, or both, were asked to meet with the interviewer and take part in individual semi-structured interviews to share their perspectives about and experience of stigma. Participants provided informed written consent and completed a short demographic questionnaire prior to their involvement in the study. They received a NZ$50 honorarium to acknowledge their contribution to the study. Participants were free to withdraw from the study at any time. A total of 21 men ranging in age from 25 to 75 years (mean age = 46.6) participated in the study (see Table 1 for participant demographics). In terms of depression and anxiety disorders, participants reported depression only (n = 11), co-existing depression and anxiety (n = 4), depression and post-traumatic stress disorder (n = 1), anxiety only (n = 2), and bipolar disorder (which includes depressive episodes) (n = 3). All participants had previously or were currently receiving professional mental health care with three participants reporting short-term stays in a mental health unit. Seven of the men who took part were unemployed, in large part, due to their current mental illness and fifteen men described some degree of loneliness as measured by a three-item loneliness scale (Klein et al., 2021).

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Table 1.

Participant Demographic Characteristics

​	Participants (N = 21), n (%)
Age (range, years); mean	25–75; 46.6
Self-identified ethnicity
New Zealand European	17 (81.0)
Māori	3 (14.3)
European	1 (4.8)
Relationship status
Single	8 (38.1)
Living with a partner	3 (14.3)
Married	6 (28.6)
Divorced/separated	4 (19.0)
Employment status
Employed for wages	8 (38.1)
Self-employed	4 (19.0)
Unemployed	7 (33.3)
Retired	1 (4.8)
Student	1 (4.8)
Mental illness diagnoses
Depression	11 (52.4)
Depression and anxiety	4 (19.0)
Depression and post-traumatic stress disorder	1 (4.8)
Anxiety	2 (9.5)
Bipolar disorder	3 (14.3)
Mental health care (currently or previously)
Medication	13 (61.9)
Counselling	14 (66.7)
Psychiatrist	5 (23.8)
Cognitive behavioural therapy	5 (23.8)
Other talking therapies	11 (52.4)
In-patient stay	3 (14.3)
Loneliness
Not lonely	6 (28.6)
Lonely	15 (71.4)

Data collection occurred between August and December 2019 with interviews conducted by a female research assistant with lived experience of mental illness who was trained in qualitative interviewing. Given that researchers’ biographies can shape men’s ‘talk’ in interviews on sensitive topics including mental illness, reflexivity was embedded throughout data collection (Broom et al., 2009; Jepson et al., 2015). During this time, the interviewer kept a journal of reflexive field notes recording the mood and emotional reactions to the interview and recalling as much detail as possible about their interactions with each participant. Meetings between the interviewer and first author were held after each interview as further reflexive practice to support analyses and debrief reflexive insights. A fluid approach to interviewing was adopted to enable participants to narrate their experiences in their own words and time. The interviews started by asking each participant if they would ‘tell me about your experience or history of depression/anxiety?’. This allowed participants to choose the starting point of their story. The interviewer then drew from a brief interview guide which comprised questions including ‘What sort of beliefs or stereotypes do you think exist around men who experience mental health difficulties?’, ‘In your own words, tell me what stigma means to you?’, ‘Tell me about your own experience with stigma’, and ‘Tell me who you’ve spoken to about your depression/anxiety?’. At the end of the interview, participants had a further opportunity to provide additional information and/or ask the researcher questions about the study. Participants were provided a list of relevant health care and social service resources in their area following each interview. Interviews ranged between 60 and 150 min in duration, were digitally recorded, transcribed verbatim, and checked for accuracy. Each transcript was anonymised by removing all identifying information, and the participants were assigned pseudonyms.

Recognising that qualitative data are co-constructed through interviewer-participant interactions, the interviewer’s positionality as a young woman with lived experience of mental illness was understood as potentially shaping the participants accounts (Broom et al., 2009; Pini, 2005). Although the researcher’s illness experiences were not disclosed, it informed how the interviews were conducted, including sensitivity to non-verbal cues, pacing, the use of breaks, and responses to signs of distress or fatigue. Familiarity with mental illness symptoms and medication references enabled clear and responsive communication without requiring participants to clarify or translate their experiences. The interviewer’s gender also likely shaped perceptions of emotional safety and receptivity within the interview encounter given the gendered association of emotion work with woman (Holmes, 2015). Participants often contrasted their difficulty discussing emotional distress with other men with a relative ease in opening up to women, whom they perceived as more empathic and receptive. These gendered dynamics functioned as a ‘resource’ rather than a limitation (Broom et al., 2009), wherein the interviewer in the current study was likely viewed as unthreatening, facilitating disclosures that may not have otherwise occurred.

Data Analysis

The data were analysed using Braun and Clarke’s (2022) reflexive thematic analysis. In line with this approach, researcher subjectivity was treated as an analytic resource rather than a source of bias, with reflexivity embedded throughout the analytical process to support rigour and credibility (Braun & Clarke, 2021). The first author, a postdoctoral researcher who identifies as a woman, conducted the analysis and undertook the coding and theme development. The remaining authors contributed to the analysis through conceptual and theoretical discussion, critical engagement with interpretations, and manuscript development but were not involved in coding. These interpretations are therefore presented as one situated and theoretically informed reading of the data, shaped through continual reflection on her positionality rather than as a singular or definitive account of men’s experiences (Kingsman & Davis, 2024).

Analysis followed Braun and Clarke’s (2022) six-phase analytical process which includes data familiarisation, generation of initial codes, development of initial themes, review, refinement and naming of themes, and producing the report. The analysis was conducted as a recursive and iterative process, requiring the lead author to move flexibly between the phases and maintain sustained, reflexive engagement with the dataset throughout (Braun & Clarke, 2022). In the first phase, the interview transcripts were read and re-read by two researchers to familiarise themselves with the data. Potential meanings and patterns were considered, and reflective analytical notes were made using the ‘comments’ function in Word within each transcript. Corresponding field notes written by the interviewer were read alongside to give further context and meaning to each interview. Second, the transcripts were subsequently imported into NVivo version 15 (Lumivero, 2024), where a combination of deductive and inductive coding (Braun et al., 2022; Byrne, 2022) was used in which concepts from the stigma literature (i.e., social stigma, structural stigma, and self-stigma) were brought to the dataset as well as codes inductively derived from the dataset. Working systematically through the entire dataset, initial codes were kept brief and further familiarity with the data was developed. A number of iterations of deductive coding were done at this early stage to ensure rigour, as well as making reflexive notes using the memo function in NVivo. The lead author then worked inductively with the data, generating descriptive codes based on repeated readings of the transcripts and corresponding reflexive journal entries. Moving back and forth between the interviewer’s field notes and the transcripts, the coding was refined through multiple rounds to ensure rigour. This combined coding approach allowed for a robust analysis, balancing conceptualisations of stigma (Corrigan, 2018; Sheehan et al., 2022) with participant-data-driven insights. Third, after all the transcripts were coded in NVivo, the codes and matching data extracts were exported into Microsoft Word and collated into initial ‘theme piles’ along with initial interpretations of data segments (Braun & Clarke, 2022). Thematic mapping was conducted manually on paper to visually organise and explore these theme piles and generate initial themes, with consideration given to the recurrence of codes and the ‘meaningfulness’ of each potential theme idea in relation to our research question (Byrne, 2022). In the fourth phase, the first author moved backwards and forwards between the full dataset, thematic mapping, and the developing analysis to ensure potential themes addressed the research question. In further developing the themes, Connell’s (2005) theory of masculinities was drawn on to support theme refinement and interpretation, particularly by attending to how men’s accounts of experiencing and negotiating mental illness stigma were positioned in relation to masculinities. Finally, multiple rounds of theme refinement occurred through the writing of the current article.

Fearing Discrimination

Participants most often described anticipating stigma within employment settings, where overt acts of discrimination or prejudice were infrequent, but fears of exclusion, reputational harm, and diminished career opportunities remained persistent. Workplace norms that framed mental illness as a liability contributed to a culture of silence, compelling participants to conceal their marginalised masculine identities. This concealment was often a strategic response for safeguarding employment, maintaining credibility, and passing as a mentally well man. Participants described work environments as psychologically unsafe spaces for disclosing mental illness. They spoke of prevailing cultures in which employees with mental illness were viewed as unreliable, unstable, and too volatile for leadership roles. These discriminatory attitudes were seen to contribute to unfair treatment, workplace harassment, and, in some cases, even job loss. Consequently, most participants chose to conceal their condition, aiming to protect their employment status, professional credibility, and masculine status. Importantly, these workplace practices did not simply stigmatise mental illness as a health condition but positioned it as incompatible with masculine ideals of reliability, productivity, and self-sufficiency. In this way, employment institutions functioned as gendered sites where stigma operated structurally to regulate and assign idealised, marginalised, and subordinate forms of masculinity.

This fear of discrimination often began during the job application and interview process, where participants were required to answer health-related questions and disclose psychiatric conditions. This practice was widely perceived as stigmatising, reinforcing concerns about being judged or excluded based on their mental health status. Participants reasoned that having a history of mental illness did not determine their ability to work; hence, it was not necessary for potential employers to know this information, especially during the recruitment processes. Although many men felt compelled to respond truthfully, the requirement to do so was experienced as stigmatising and justifiably averted. As Callum, 29, explained:

There’s a job question ‘have you ever had any mental or physical impairments?’ and there’s no way in hell I’m ever writing depression. That is precisely the standard, that stigma. My perception is I’ll be treated atypically, and I don’t want it. I fear there are ramifications – that I’m less likely to get employed. I think the opinion today is ‘sick days galore, you’re going to be troublesome’. What they want is an easy vanilla person that just cracks on and does the job.

Callum’s account reflected his deep mistrust for how employers respond to employee’s mental illness, viewing it as a disclosure that could jeopardise his employability. Here, the stigma was embedded in the question and rather than allowing for accommodations, such disclosure would further expose him to bias and discrimination. Callum’s reference to employers wanting an ‘easy vanilla person’ underscores his belief that workplaces value hegemonic masculinity and ideals of self-reliance and stoicism that prioritise men’s performance and productivity without disruption. Mental illness, by contrast, is positioned as unhealthy, risky, and transgressing masculine ideals in the workplace. His reluctance to be perceived as ‘atypical’ speaks to the broader stigma in which mental illness is associated with excessive absenteeism and disruptive forces for otherwise (idealised) collegial workplaces. Paid work, and the sense of purpose and status men seek and construct as masculine capital through their careers, is often assumed to be unattainable and out of reach for those with mental illness. Bryan, 55, similarly spoke to the necessity for being silent about his depression:

You’d never mention this at a job interview. In an employment situation they’d be thinking you would be taking time off to go to doctor’s appointments but also that you might embarrass them professionally. I made damn sure I didn’t tell anyone when I was in a new job, that would’ve been suicide.

At the time of the interview, Bryan was unemployed, and he firmly believed that disclosing his depression would jeopardise his chances of securing work again. Referencing the need for companies to reduce and manage risk, he explained his omission as affording him a chance to prove himself as a worker rather than a liability. Again, Bryan and many men bought into the corporate hegemonic code that they must perform at work and ideally outperform others both in terms of their outward masculine demeanour and productivity. Fearing discrimination and sceptical about employers’ capacity for empathy, Bryan narrated a workplace tale in which he’d witnessed a male colleague endure the humiliation of an enforced reduction in work hours following a mental health crisis. For some participants, this structural stigma extended beyond the workplace, shaping broader institutional interactions and opportunities. Rob, 48, explained:

When I applied for my Master’s at university, I didn’t disclose [my mental illness] because I feared I wouldn’t be accepted on the basis of it. I didn’t want to convey anything that was going to threaten my ability to get the position. Similarly, whenever I applied for a house, I never admitted that I live with mental illness. Same with previous job applications. You learn how to lie basically, or you omit stuff to present a certain picture. It’s [mental illness] like a factor that counts against you.

Fearing discrimination might preclude him from an education, housing, and paid work, Rob deliberately concealed and denied his depression to avert the potential costs of his disqualifying trait. Having previously lost out on a job after disclosing he suffered depression, Rob worked steadfastly to present himself as capable, consciously conforming to masculine ideals to pass as a self-reliant and assured career man. Concealment thus operated as a form of gendered labour, through which men actively protected their masculine capital by passing as mentally well, displaying emotional control, and being productive in settings where vulnerability risked exclusion. While participants acknowledged that New Zealand law prohibits discrimination in employment on the grounds of mental illness, they also knew first-hand that workplace structures, with their emphasis on productivity and profit, could still limit genuine inclusion in practice. Denis, 54, echoed this concern:

I know that employers can’t discriminate against you, but they obviously do. If you start a job and then you go ‘oh, I’m having an anxiety attack’, they could probably use that against you to get rid of you.

Denis, who was also unemployed at the time of the interview, spoke about the risks of termination if his mental illness became known, recalling how his recent redundancy was officially explained as part of a company restructure, though he suspected otherwise. Denis noted the timing of his ‘mental breakdown’ and subsequent dismissal felt ‘too coincidental’ to ignore, leaving him doubtful about his chances of finding paid work again. Work and career as highly valued masculine arenas were in effect off limits for Denis, invoking significant triggers for his depression. Fearing discrimination was particularly heightened in male-dominated work environments. At a structural level, theses settings operated as intensely gendered arenas in which narrow performances of hegemonic masculinity were normed and rewarded, while mental illness signalled a deviation from expected masculine competence. Participants described these settings as places where men needed to embody ideals denoting success, capability, and resilience as necessary manly virtues and values. In addition, emotional restraint and self-assuredness were emphasised, censoring vulnerabilities including, and perhaps especially, mental illness. Stuart, a 69-year-old retired man with long-standing depression, reflected on his career within such an environment:

In that context – highly competitive, highly left brain, logical, rationale – I felt I was at risk of an arbitrary programme of getting rid of people. To have admitted to that kind of incapacity, because that’s how it would be treated, would have been to show a contemptible weakness and it would have tipped me closer to a sure thing that I’d get fired, made redundant, pushed out. They’d think I was weird, screwed up, which I was but I wasn’t presenting that way.

Stuart’s account highlights the deeply embedded, gendered stigmas within professional work cultures that equate mental illness with incapacity, difference, and irrationalities. These organisational norms not only shaped how mental illness was perceived in the workplace but also influenced how men evaluated themselves, reinforcing fears of appearing weak or incapable. In this environment, Stuart worked hard to conceal his mental illness and to pass as the antithesis for what he believed others associated with the limitations and deficits of a marginalised and depressed man. Stuart’s self-stigma was evident but overridden by his concealment efforts. For many participants, such faux-masculinities were considered essential to safeguarding their jobs and careers. Karl, 34, described the heavy toll of this additional work:

Professional life is a big problem when it comes to mental health. If one day you feel it would be best to stay home, or you experience hardship at work which affects your mental health, all of that is repressed. Anything that could be perceived as affecting your performance isn’t talked about and nothing encourages those conversations. I’m putting on a mask to go to work and pretending to be someone I’m not.

Karl’s experience underscored how gendered ideals enforce silence and emotional repression in men as the currency for belonging, at the expense of authenticity, genuine inclusion, and personal well-being. Operating outside these masculine ideals risks exclusion, which can have far-reaching negative effects across various masculine domains due to the loss of paid work – an identity closely tied to masculine ideals prizing the ability to provide. For most participants, there was a lot at stake, and concealment offered an avenue for feigning their embodiment of some critically important masculine ideals. In the anonymity of our interview, Karl criticised the prioritisation of performance over employee well-being, decrying the workplace’s lack of acceptance of mental illness. Though he argued that greater workplace support for male vulnerability and reasonable adjustments could have enhanced his performance and overall engagement at work, he remained publicly silent about these gender inequities, believing that protesting would be career-ending. Finally, Jamie, 32, felt stigmatised when he disclosed his depression during a team meeting:

I named it and got no response. I was in a meeting, and everyone was looking down, no-one responded or said, ‘what can we do?’. I felt so alienated. My need for care was far greater than what could possibly be provided at work.

Looking for some accommodations at a time of an impending mental illness crisis, Jamie’s disclosure was perhaps too confronting and beyond the capabilities of the group to whom he disclosed. Jamie’s experience illustrates how institutional expectations were enacted through everyday interpersonal interactions, where colleagues’ silence communicated the limits of acceptable masculine vulnerability. In what followed, Jamie’s manager suggested he be ‘performance managed’, a strategy Jamie interpreted as being summonsed to ‘toughen up and deal with it’. To cope and retain his job, Jamie reduced his hours amid quipping that had a colleague disclosed ‘some kind of physical illness’, the response would have been markedly different.

Across these men’s accounts, stigma was rarely experienced as overt exclusion but instead operated through organisational norms that aligned employability with masculine performance. Within this context, a persistent fear of discrimination rendered mental illness a potential disqualifying marker within key sites of masculine identity formation.

Suffering the Subtleties of Stigma

While encounters with stigma in everyday relationships were often subtle and difficult to pinpoint, particularly when embedded in routine social interactions, participants described the shaming effects of anticipating, as well as directly experiencing, negative judgements about their mental illness. Rather than being expressed through overt rejection, stigma more often emerged through subtle, gendered interactional cues that signalled when emotional disclosure violated masculine ideals of stoicism, self-control, and independence. Rather than repeat the concealment of their mental illness challenges as they had at work, some participants wanted to resist these ideals and disclose to family or friends in search of validation and support. However, such disclosures were understood as risky high-stakes decisions, typically long contemplated in carefully weighing the potential for support verses judgement, rejection, or both. Many men feared that their disclosures would alter how they were perceived by those closest to them. Anticipated judgement from others often became internalised, shaping men’s decisions about when and to whom disclosure felt safe and feeding uncertainty, as Rob, 48, explained:

You don’t quite know how someone’s going to react in terms of disclosing it, you don’t know what stories that are operating in there about what they make of it and how that will affect whatever the dynamic or situation is going forwards, so it’s always a risk.

Rob explained his apprehension and the potential for his disclosure to intensify the marginalisation he already experienced because of his depression and anxiety. Of particular concern was the possibility of invoking and inviting stigma from would-be confidants. Rob grappled with how to interpret their responses, or lack thereof, including silence. Masculine ideals for communication prioritise trust, dynamism, and directness, especially when sharing such ordinarily private mental illness matters, and Rob worried that gender stereotypes and stigmas might restrict what was said and how it was heard.

The tensions between what people say and what they might truly think were also evident, leading Patrick, 45, and many men, to be especially selective in deciding who they could safely confide in:

With close family members it’s okay or [with] my partner. With friends, yes, but again it depends on what I’ve established with them as to what they’re willing to talk about and where they’re coming from. Some of my friends know and others don’t. There’s stigma tied up in that too, it’s a social thing. I won’t share that with others beyond a very prescribed range of familiarity.

For Patrick, disclosure involved carefully assessing each relationship, emphasising that he was selectively open and closed to ensure self-protections against social stigma and having his masculinity questioned. Sharing with close family or partners could provide tangible benefits in being authentically heard and held. Many men viewed the women in their lives – mothers, sisters, girlfriends, and partners – as empaths, skilled in such supportive roles and relations, and better equipped to discuss mental illness, as Callum, 29, described:

You learn to feel who’s going to be receptive and who isn’t. The more I think about it, generally it’s women that are more receptive. I think I’d tell the odd guy but it’s more accepted if you’re telling a woman and I wouldn’t tell you if you didn’t strike me as a person that was receptive to it, had some level of empathy for it.

Callum’s disclosures emerged as gendered and relational, reliant on calculating risk and emotional safety. The fragility and co-constructed nature of masculinity were evident, as Callum acknowledged the masculine deficits flowing from his anxiety and depression. Within this context, the subtle forms of shaming typically associated with failing to embody masculine ideals were accommodated by the presence of idealised feminine qualities of nurture and care, which provided a more accepting and supportive environment. Callum’s experience also reflected the competitiveness and hierarchical limits characterising many men’s same-sex friendships and social relations. These patterns highlight how masculine ideals shaped not only whether men disclosed but to whom, positioning women as safer emotional interlocutors while male peers remained sites of potential judgement and status loss. Also illustrated were the risks of social stigma as deeply embedded in the ways diverse gender relations co-construct emotions, affections, and expressions of strength. As such, social stigma could be used to simultaneously signal one’s own alignments to and other men’s deviations from masculine ideals valuing stoicism and self-reliance. Conversely, subtle forms of shaming could be avoided with authentic expression of care.

Social stigma could also be difficult to pinpoint and articulate, manifesting implicitly as a constant underlying presence in everyday interactions. Many participants felt social stigma as a pervasive undercurrent shaping how they were perceived and treated. Rob, introduced earlier, reflected on the difficulty of apprehending social stigma, emphasising the subtle, interactional ways in which stigma emerged in his everyday encounters:

It’s a bit of a tricky one to talk to because it’s kind of invisible, sort of like racism – you have these personal experiences of it, but you don’t say to your friends, ‘hey I had this experience. I haven’t been able to put my finger on it’. It’s not like an overt kind of thing; it’s more like a subtle judgement or just something in the way people start talking to you or backing out of a conversation after the disclosure of certain information.

Subtle expressions of stigma were deeply felt by Rob and many participants, embedded in shifting tones, body language, and social distancing. Such silences and conversational closures functioned as relational stigmas that subtly disciplined men back towards restrictive masculine ideals, marking the emotionality permissible in specific gender relations. Participants attributed these shutdowns to others’ uneasiness with mental illness and men’s disclosures as well as their lack of knowing how to fix what was shared. The awkwardness punctuating these relations was shared by Owen, 40:

They would sort of move on, I guess it is dismissive. They don’t get it and so just steer things elsewhere. I think a lot of it is also the way that it’s dismissed. If there’s real subtleties in the way that they move on or distance themselves from it that will hugely impact the way I come away from that. If there’s a kind of a scoffing sort of ‘Oh, you just need to …’ that’s got a real prejudice around that, not understanding it.

Owen contrasted the affirmation he felt when his disclosures were genuinely heard and understood, with the subtle dismissals – such as abrupt topic changes – conveying disinterest and judgement. Such reductive advice and scoffing responses were especially painful because participants clearly needed more understanding and support than they received. Joel, 29, described his deep hurt and disappointment at how his parents reacted to his depression:

My mother judged me more than any other person, whereas my father was more standoffish. My parents did know that I was getting help, but they never spoke to me about it, they never asked me questions about it or anything like that. Mum just said ‘oh, that’s nice dear’ and Dad said ‘oh, yeah good’ … it was sad.

Joel’s attempts to discuss his mental illness and experiences with professional help were met with dismissive, perfunctory responses and a lack of genuine engagement. These parental relationalities set a tone in which Joel needed, but did not receive, and ultimately came not to expect, emotional comfort. His father’s restraint and emotional distance tacitly affirmed masculine self-management and positioned distress as something to be managed privately. He experienced this disinterest and lack of empathy as intensifying his sense of being alone in his struggles. Similarly, Dean, 28, noticed shifts in his family dynamics after disclosing his depression:

I feel like it just put up a roadblock. It was almost like the elephant in the room where we just kept going around it and never addressed it. There was that light-footedness around me, usually Dad would be like ‘How are you performing at work?’ but you know, I don’t think he asked those sort of harder questions.

Dean craved direct and deeper conversations about his mental illness, but instead he felt misunderstood and somewhat unseen. Like others, Dean’s disclosure did not elicit the empathy he had hoped for; instead, it was met with cautions that conveyed shame. Well-intentioned remarks such as ‘just go for a walk’ or ‘everyone feels that way’ invalidated men’s experiences, reinforcing stigma by minimising their distress and implying a lack of resilience. Many participants described how not being met in moments of openness led them to withdraw further. Jamie, 32, shared how this lack of recognition affected him:

In terms of specific actions that could be seen as stigma, they would be few but significant, I would say feeling like no-one understands my experience or can relate to what I’m going through or understands what I need causes me to really withdraw inside and not share my experience. Put up a facade basically. So, in terms of stigma, I interpret it as not being understood or not being seen for me in my experience.

For Jamie, the lack of understanding and validation from others was a subtle but powerful form of stigma. Rather than a single moment or event, stigma was experienced as omnipresent and cumulative, an ongoing sense that mental illness was best self-managed rather than seen and heard by others. Paradoxically, the freeing potential of being heard and understood was often muted by subtle shaming cues that reframed men’s struggles as personal shortcomings and failing to demonstrate gender correctly. These subtle cues pushed participants towards stoic and self-reliant masculine ideals, positioning the problem, and its solution, as residing in the participants, rather than reflecting their mental illness. Over time, these subtle interpersonal responses did more than regulate disclosure; they also shaped how men came to understand themselves and their mental illness.

Carrying an Invisible Burden

For many participants, stigma was most powerfully experienced as self-stigma, as men evaluated themselves against hegemonic masculine ideals and came to interpret mental illness as evidence of personal failure, weakness, or inadequacy to be a man. The extent to which participants had internalised negative portrayals of mental illness was evident in the way that they described themselves using derogatory terms such as ‘wimp’, ‘coward’, ‘slacker’, ‘lazy’, ‘not normal’, and ‘dysfunctional’. Echoing broader structural and social stigmas, men’s self-stigma manifested as carrying an invisible burden. Living with depression or bipolar or anxiety disorders deeply affected their self-evaluation, making them feel ‘flawed’, ‘less-than’, or ‘different’. For many, mental illness inexplicably reshaped their masculine identity. Rob, 48, reflected on his low self-esteem and deepened sense of disconnection:

I think it [mental illness] distorts how I see myself. I get feedback from other people including my partner that I’m seeing something that’s not really there, or it’s there but only because I’ve made it be there and they don’t see it. It puts you at odds with society, you’re sort of outside the main narratives, you’re in this place that’s like in the cracks or the basement. It’s an othering and it does something in terms of your consciousness or self-awareness.

Rob struggled with feeling fundamentally different from those around him, ultimately attributing the challenges of his altered state to himself. This sense of otherness deepened over time. Rob’s reflections illustrate how broader societal expectations around work, success, and masculinity were internalised as personal shame. While he did not contest his partner’s corrective feedback, it underscored his diminished sense of agency and his increasing tendency to concede that he had misinterpreted events and circumstances. In terms of gender relations, there was an openness with his partner, but also heightened alienation as Rob increasingly ruminated about his dependency and lack of self-reliance and rationality. For many participants, social stigma fed self-stigma. Jamie, 32, described how he came to adopt the same harsh views about himself that he once held towards others with mental illness:

There’s lots of negative stereotypes, freak or broken, there’s something wrong with you, not good enough, inadequate. One of the challenging things is I hold these too, so then I judge myself with them. Just a real sense of something deeply wrong with me and I can’t get away from that perception, like it’s fundamentally caught in there, it’s become part of my identity.

For Jamie, the insights he had into his mental illness, as well as his own world views, manifested as unrelenting self-stigma. Driven by internalised feelings of inadequacy, low self-worth, and a belief that his masculine identity was irreversibly tainted by depression, Jamie clearly operated within subordinate and marginalised masculine states. Many participants described a similar sense of irrevocable deficits, where mental illness reshaped how they saw themselves. Patrick, 45, reflected on how living with bipolar disorder had transformed his life:

I don’t think I’m a normal person because I try and shake off my mood and I can’t, even with medication. I’m sure other people can live by themselves and find it easy, but I struggle. It’s [bipolar] changed my lifestyle, totally. I used to be a bright, bubbly person. I used to be happy go lucky, I used to be able to get out and about. I don’t do that now; my outlook of life has changed.

Patrick grieved his former self, amid being increasingly isolated and struggling with his life and mental illness. The loss of his former identity, coupled with the ongoing struggle to manage his limitations, left Patrick internalising and lamenting his defective identity. Over time, this fragmented sense of self fuelled a cycle of perceived failure, deepening his crippling sense of shame and self-blame for all that had happened and continued to happen to him. These self-stigmas were an inescapable constant, though many men tried to put it out of sight. As Owen put it, ‘I think so many of us carry shame quietly and hide it’.

For others, self-stigma provided a focus that was more accessible than structural and social stigmas, as Trevor, 50, described: ‘There is a definite sense that the shame should be centred on myself because if I really wanted to, I could control these things’. Assigning the persistence of his depression and anxiety, as a consequence of ‘not doing enough’ to recover, Trevor’s self-stigma extended beyond his mental illness to encase his lack of control as the core issue. This sense of personal fault created a cycle of shame, self-criticism, and diminished self-worth. Others expressed a similar sense of shame tied to reduced functioning as a man and unmet life expectations. Stigma shaped men’s self-perception through painful comparisons with others seen as ‘normal’ or meeting societal standards and masculine markers of career, relationships, and financial success. Andrew, 58, who had been out of work for a decade due to bipolar disorder, described this internal narrative:

I think I’ve wasted a life basically through having this illness, it’s gone. I wasted my life because I haven’t been strong enough or too self-conscious, too worried about what other people are doing instead of working on myself, putting people on pedestals who are professional people who have got a good outlook on life. So yeah, this comparing happens all the time.

Andrew’s comparisons to others he perceived as embodying societal ideals underscored his shortfalls, and while his mental illness was explanatory, it was not excusatory. Instead, his self-stigma extended to suggest he’d unwisely focussed on external factors rather than his own self-help. A failed masculinity coupled with a resigned acceptance of his subordinated status rendered Andrew’s struggles as personal failures. Many participants described similar feelings, interpreting the impact of mental illness as evidence of failure to be man and lost potential, which intensified with ruminating thoughts.

For men who were unemployed or underemployed due to enduring mental illness, social stigmas equating joblessness and benefit receipt with societal burdensomeness became deeply internalised. Rob, introduced earlier, elaborated:

I felt shame, period. Shame about the mental illness, shame of what my life is. It seems slightly different but it’s the same thing. It’s tied into a narrative I tell myself of where I am socially, financially or career wise and how I feel and think about myself in terms of self-esteem and value. I’m almost 50, I have no assets, no house, work part-time, still depend on the state funded income to exist. All of that is really shameful and painful to live with.

Rob’s reliance on welfare, coupled with his inability to achieve masculine milestones and material markers of success, underscored his profound loss of masculine capital. His stigma-induced shame extended far beyond his mental illness, encompassing every social milestone where he felt he had come up short. Such harsh self-appraisals also rendered social connections risky, and many men withdrew to protect themselves, seeing and situating themselves as unworthy. This withdrawal reflected how deeply self-stigma and feelings of shame and worthlessness had been internalised. Withdrawal functioned as both a consequence of self-stigma and a gendered coping strategy, allowing men to manage the risk of public emotional exposure while reinforcing ideals of masculine self-containment. Gary, 48, described retreating from social networks as both a symptom of his mental health struggles and a manifestation of self-stigma:

I think it [stigma] also gets internalised, where we stigmatise ourselves. We don’t go out and get drunk in a bar [with others], we go and get drunk alone, by ourselves. The isolation factor is also a self-stigmatising thing, where it’s like I can't trust myself. What if I’m out there and I have a panic attack? Or I break down and start crying? What are people going to think?

By avoiding social spaces and hiding emotional displays, Gary shielded but also fed his shame. In Gary’s case, risk taking and risk management co-occurred through solitary self-medicating practices. Using substances alone is often accepted, even idealised as a masculine practice, with the deliberate choice to be alone reducing the risk of being perceived as mentally ill. Men’s withdrawal and concern for burdening others by expressing negative emotions also bought into masculine ideals for men privately dealing with their self-stigmas. Jack, 25, explained how severe self-stigma sabotaged and severed his social connections, leaving him isolated in and by his mental illness, saying, ‘Everything that I felt was driven by me and unhelpful thinking styles. I wrecked friendships, I ended up just isolating myself, crossing the road to avoid friendships, always feeling that I was the awkward one in this situation’. His discomfort reflected an internal conflict that ultimately kept his mental illness battle private. This tension was not just about navigating social situations; it stemmed from deeply held beliefs about having a mental illness, which rendered him a flawed man, unworthy of human connection and help. While withdrawing helped men avoid the discomfort of public vulnerabilities, over time it became isolating, cutting them off from relationships and supports amid feeding unrelenting self-stigma for all that was felt, lost, and grieved. In this way, self-stigma did not merely reflect internal distress but actively reproduced marginalised masculinities, as men came to see themselves as burdensome, deficient, or undeserving of care.