Men's Mental Health Panel: What 5 Therapists Are Seeing Right Now
Men account for nearly 80% of suicide deaths in the United States. One in five men will experience anxiety or depression in their lifetime, but less than half will ever get professional help. Four out of ten men say they avoid talking about their mental health altogether.
Those numbers opened a recent roundtable episode of Therapeutically Aligned, where I sat down with my Co-Host Marc Azoulay, LPC, for the episode, and three male therapists who specialize in working with men; Ryan Landau, LMHC, Drew Klobuchar, LCSW, and Justin Carotti, LCSW. What followed was an honest conversation about what's actually happening in their therapy rooms.
The "Man Box" Still Shapes How Men Show Up
Every panelist described some version of the same early lesson: emotion, outside of anger, confidence, or aggression, wasn't welcome. Sadness, fear, and vulnerability got redirected into slammed doors, stonewalling, or silence. That framework doesn't disappear when men grow up; it shows up again in therapy as guardedness, difficulty naming needs, and discomfort with face-to-face emotional conversation.
It's Not Anger and Substance Use Anymore, It's Helplessness
The panel agreed that the clinical literature on men's mental health hasn't caught up to what they're actually seeing. Instead of straightforward anger or substance use, they described a deeper theme: helplessness. In younger men, it shows up as either relentless self-optimization such as supplements, workouts, "become the alpha", or as a giving-up cynicism about dating, education, and the future before they've even started. In midlife men, it shows up as burnout, gambling, and what one panelist called "white-knuckling" or gripping so hard for so long that there's nothing left to give.
Financial Pressure and a Shrinking American Dream
One of the more sobering threads was economic. The panel cited research showing millennial men are on track to be the first generation to earn less than their fathers and that this shift is hitting identity, not just finances. For men raised to believe a stable career and a family were the "starting point," realizing that outcome now takes far more effort or may not be available at all is, in one panelist's words, identity-shattering.
What Healthy Masculinity Looks Like Going Forward
The conversation ended on a hopeful note. The panel pointed to more men opening up, more fathers prioritizing presence over provision, and a slow cultural shift from outcome-based masculinity ("what did you achieve") toward character-based masculinity ("how do you treat people"). As one panelist put it: if you want to be a healthier version of a man, go help someone.
Where to go next: If any part of this conversation resonated, each panelist has also done a full individual episode on Therapeutically Aligned. And if you're a man who's been putting off reaching out, consider this your sign.
Watch full episode on YouTube.
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