“The thing most likely to kill men between the ages of 16 to 49 is not terrorism, or heart attacks, or a car accident… it is themselves.”


First, allow me to tell you a true story, although for reasons that will become obvious as you read, I have changed all names and identifying information:

James was 18 years old, on a fine August morning, when he opened up his A-Level results.
                The immediate reaction and fist pump resulted in a family hug, out-bursting months of grinding hard work. James had done all the grafting, and like many bright-eyed teenagers, he was going to university!
                Except, this meant a lot more to James than the grades themselves could ever convey: He was going to follow in his father’s footsteps, along the treacherous road ahead, to one day become Dr James Killock. He was going to become the pinnacle of his family, a cornerstone of his community.

He sailed through medical school. Observing, learning, adapting and developing – and 6 years later his father wasn’t the only doctor of the family.
                He took up a post in Merseyside, undergoing his first two years post-graduation rotating between specialities. He took a liking to cardiology – who wouldn’t? The idea of life saving intervention on a daily basis and really, truly, improving the quality of life of the general public… James naturally applied for specialty training towards this field.

It was at the interview that he met Claire.
                They worked together at a large teaching hospital in Liverpool, spending every possible breathing minute together.

Two years on, James was a married man, and within two months of marriage was set to be a dad! James and Claire bought their first home together in leafy Cheshire and within four years, provided all things remained on track, James would be an interventional cardiologist – fulfilling every ounce of potential he promised since childhood.

James had everything:
                A beautiful wife, a house, a child, a successful job. Everything. Everyone would take one glance at James and say, ‘Yep. James has the definition of a perfect life.’

Everyone, that is, but James.

 A week before his 32nd birthday, James was found hanged in his garage.
                Swinging from a rope, he was found by his two-year old son, three hours later.


Mental health kills. Mental health destroys lives. Mental health takes away much more than the sanity of the individual who has to suffer it, affecting every single loved one as well.
                Like ‘James’, many people fail to tell anyone else what they’re going through.
                They fight their demons alone, trapped within their own minds.

In the mildest instances, you might find yourself increasingly tired, agitated and losing interest in your interests.
                You might not want to see your friends, or go to the gym, or do whatever you used to do that made you happy. You might find that your eating habits have changed, or that your sleep is a mess – either too much or too little.  There might even be thoughts of whether life is worth all the hassle, whether you’re worth it. This can include thoughts of suicide, whether a real consideration or not (such thoughts can be passive, appearing seemingly ‘out of the blue’ and imposing themselves onto you, unwelcomed).
                They can sometimes masquerade themselves, manifesting as questions or thoughts of worth: ‘What would happen to my family if I wasn’t here?’ or ‘Who would attend my funeral?’

The truth is, one in four people in the UK alone will suffer the devastating effects of a mental illness. You are not alone. One in four means it is more than likely that someone in your immediate family or friendship circle is going through hardship on a daily basis. Have a look around.

Even more so, mental health problems are the leading drivers of disability in 20- to 29-year-olds, with major depression being the second leading cause of disability world-wide.
                Most worryingly, of the 5’821 suicides reported to the UK Mental Health Foundation in 2017, 75% were males. Suicide is shockingly the largest cause of death in men under the age of 50.
                Think about that – the thing most likely to kill men between the ages of 16 to 49 is not terrorism, or heart attacks, or a car accident… it is themselves.

Largely speaking, societal expectations are such that men and women are supposed to play certain roles. You could easily imagine that the role for men includes the expectations of masculinity and to be ‘bread-winners’, traditionally perceiving strength, dominance and control as the way to enact their gender.
                But the research is clear: The men who have specific expectations of self-reliance and power have an increased prevalence for mental health issues – whether it’s anxiety, depression or otherwise, and as such are statistically more likely to suffer from addiction.
                There is further research supporting that men are often unable to speak about their emotions and that they are less likely to recognise symptoms within themselves, and therefore, for either reason, less likely to seek help…

The above might strike a chord with you. You may recognise these symptoms or behaviours within yourself – or perhaps you have recoiled, convinced more than ever that these absolutely do not apply to you, which in itself may be a defence mechanism.
                The good news is there are a number of amazing charities and organisations that provide help for those in need.
                Calm help provide support for those contemplating ending their lives, or in need in general mental health support.
                Samaritans provide someone to talk to, at any hour, whenever you need it. If your worried, stressed, thinking about suicide or whatever demons you’re fighting, Samaritans will always answer their phone.
                There are many more helplines and charities out there, their details available after a quick search online. It is highly recommended that you reach out to these services, as their expertise can help you to recognise and/or manage dark thoughts and the feelings of undue pressure that come with being a man, a human.

You can also speak to your GP about anything on your mind.
                They won’t judge, they won’t criticise you, and often they are there as a sounding board, listening and reflecting with you to understand the root of negative thoughts and mental health concerns – be they ‘biological’ or ‘circumstantial’.
                They can point you in directions of professional help, whether it’s counsellors, psychologists, or even crisis teams.

It might initially sound insignificant, but small, simple techniques such as being outside have shown to improve one’s wellbeing drastically. Exercise, early nights, social interaction and creativity all have purpose to raise one’s spirits.
                While an overdependence or overuse of technology can create and perpetuate negative thoughts, it can also be of use, if used responsibly; apps like ‘Calm’ and ‘Headspace’ offer easy-to-use meditation techniques, freely available on all smartphones.
                Admittedly, the ‘simple’ measures such as above might not work for everyone…
                If that is the case, if you are worried about someone, or worried about yourself, open up to someone you trust – a loved one or a close friend (those might even be the same person/people) – as this can help them know you need support and care. They will undoubtedly help you seek support elsewhere.
                Sometimes professional help is needed, whether that’s engagement with psychologists and clinicians, or medication, which is why – if you’re finding it difficult to manage your mental health through ‘simple’ means such as exercise, socialising or meditation – it’s recommended you go to your GP for a more comprehensive diagnosis.
                Speak to your GP – genuinely, being as candid as possible, as frightening as that may sound.
                There is nothing ‘masculine’ about staying silent, despite the romance of stoicism.
                Mental health struggles, you understand, is a silent killer, and a killer of the silent.

As mentioned at the start, although the names have been changed James’ story is unfortunately true. A ringing endorsement of the struggles and demons men face alone on a daily basis – because supposedly, a stiff upper lip is the description of being a man.
                It is not. You are not alone. Speak up and perhaps be surprised at how many others share your feelings and thoughts; how many there are that love and care for you, ready to lend their support.

To conclude, I will leave you with the following passage, written by Matt Haig in Reasons to Stay Alive:
                “…Depression is smaller than you. Always, it is smaller than you, even when it feels so vast. It operates within you. You do not operate within it.
                “It may be a dark cloud passing across the sky, but – if that is the metaphor, you are the sky.
                “You were there before it. The cloud can’t exist without the sky. But the sky can exist without the cloud….”


Dr Randeep S Sangha is currently a GP trainee and former Elderly Care registrar working in Hertfordshire and Northwest London.

If you were ever to meet him in person, a conversation about his dog would certainly arise. He is an unfortunate sufferer of Newcastle United Football Club and avid video gamer.

He’s also currently making a poor effort at powerlifting.


If you have been feeling low for a long time, or even consider that you might be depressed, it is strongly recommended you tell your Doctor at the earliest opportunity. Otherwise, there are several helplines that can also help:

US - Samaritans: http://www.samaritansusa.org/contact.php
UK - Samaritans: https://www.samaritans.org/how-we-can...
Canada - Crisis Services Canada: http://www.crisisservicescanada.ca Australia - Lifeline Australia: https://www.lifeline.org.au
France - Suicide Ecoute: https://suicideecoute.pads.fr/accueil
Germany - Telefonseelsorge: http://www.telefonseelsorge.de/ Netherlands - Stichting 113Online: https://www.113.nl/

If your country is not listed above, you can find your relevant helpline here: https://en.wikipedia.org/wiki/List_of_suicide_crisis_lines