The Intersection of Toxic Masculinity and Mental Illness

Author: Zachary Burton

The California hills were quickly turning to gold. Our weekends were filled with barbecues, swimming, and late nights around our fire pit. Life couldn’t be better.

I certainly thought so, as I hurtled toward my PhD qualifying exams in the late spring of 2017. I was on top of the world. I was a soon-to-be-doctor at Stanford University, where each day I was thrilled to bury myself in innovative research alongside renowned professors and brilliant peers. I was doing all the things that school, the TV, and the grown-ups told little-boy-Zack were the keys to leading a “successful” life. I was working extremely hard, I was supporting myself financially and emotionally, and I was fiercely independent. I definitely didn’t need anyone else’s help.

And then, my world imploded. While everyone else slept, I climbed the concrete stairs to the top of a five-story campus parking garage. At 3:30 a.m. on May 8th, I was overwhelmed with the urgent desire to end my life.

Miraculously, I dialed my mom first. Somehow, in a moment of hyperacute clarity, I remembered her saying to me (over ten years earlier) to tell her if I ever felt like hurting myself. She picked up the phone, and my mom saved my life.

I was hospitalized, and 2017 quickly became the most chaotic year of my life. In a matter of days—in a matter of hours, really—I went from utterly invincible to paralyzingly insecure.

But, gradually, something amazing happened: I realized I needed everyone’s help. My family, my partner, my roommates and close friends, my professors and mentors… after they saved my life, they also helped me get my life back. And—despite the psychotic breaks, prolonged all-day therapy, Bipolar I diagnosis, and many months of crippling fear and a complete loss of confidence in myself—it has been a vastly better life.

As I learned to lean on others, I also learned to speak. I was freed from a cage I didn’t realize I was in—I was no longer the young man who forcibly bottled up his emotions. I felt so privileged to be wholly accepted by my loved ones and colleagues despite what I had thought would be seen as my deep flaw, my weakness, my mark of shame. And so, I decided to add my own voice to those of the mental health advocates I read about in the news. My partner and I founded a play that showcases diverse true stories of mental illness to break the silence—to disrupt stigma. Alongside dozens of brave storytellers, I shared my own story of mental illness.


Being vulnerable—opening up about our emotions and feelings, let alone opening up about our mental illness—is terrifying, especially when all our lives we’re told “boys don’t cry,” when all our lives we’re told to “man up.” But little boys who are taught to “take it like a man” grow into men who fail to seek mental health treatment1.

Asking for help and being vulnerable seems impossible or wrong, when throughout their lives boys and men are told to be strong—are told that it is their duty to be the self-reliant protector and provider of the house, are told to be the tough, fearless, courageous leader of their business or their community.

Patriarchal society propagates strongly stigmatizing rhetoric that bashes “sensitive” men, or those who would open up about their emotions (including mental health struggles). The reinforcement of traditional masculine norms is harmful not only because of the attendant sexism and unequal treatment of women and non-binary individuals, but also because of the harmful—and, oftentimes fatal—effects on men themselves.

Across the world, men are more likely to die by suicide2. In the United States, men are 3.6 times more likely to die by suicide than women—for example, in 2018 nearly 70% of suicide deaths were those of white males3. Various factors may influence heightened rates of male suicide4, and most of these factors seem intimately linked to society’s traditional notions of masculinity. For example: men seek mental health help less often5; men are more likely to abuse alcohol6; men (and especially Veterans7) use more lethal means when attempting suicide—most gun owners are men, more men keep a loaded gun easily accessible8, and most suicides are by firearm9; men may feel disproportionate pressure to succeed professionally—thus, their mental health suffers, especially during economic downturns10; men adhering to masculine norms have lower health literacy11; norms encouraging men to be self-reliant—to not share their emotions—may cut men off from critical social support networks12.

Toxic effects of masculine norms also disproportionately affect men in certain marginalized demographics. Black men living below the poverty line are significantly more likely to report psychological distress than those over the poverty line13. Access exacerbates this problem—impoverished communities face a relative dearth of mental health services14. Furthermore, Black men—who are nearly twice as likely to be diagnosed with schizophrenia as non-Hispanic whites, and who are at significant risk for PTSD if exposed to childhood violence15—are subjected to significant stigma surrounding mental illness, and may be less likely to seek help even when it is available16.

Masculine norms hurt mental health. We as a society must break down both the stigma of straying from masculine norms and the stigma of mental illness. Mental illness does not make you weak—mental illness does not make you less “manly.” On the contrary, seeking help makes you proactive and solution-oriented—you’re taking initiative towards self-improvement. Opening up to a loved one, to your boss, to a peer during a group therapy session makes you courageous and brave—sharing about my mental health has been more difficult and even more rewarding than finishing up a PhD at Stanford University.

Mental illness does not make us weak—if anything, it makes us stronger.


Author’s note: I’d like to thank Dana Murguia (my mom—and Senior Program Manager of Public Health for Humboldt County, including suicide prevention and mental health programs) and Dr. Jasmine Dobbs-Marsh (Clinical Psychology Postdoctoral Fellow at Stanford School of Medicine) for their input.


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Zachary Burton

Zack was two years into his PhD in geology at Stanford University when he had his first psychotic break and was subsequently diagnosed with Bipolar I Disorder. Feeling immensely grateful for the loved ones who saved his life, but also saddened and infuriated by the stigma that his own family members and friends with mental illness faced, Zack founded The Manic Monologues with Elisa Hofmeister to disrupt the stigma surrounding mental health disorders. The Manic Monologues is a play that features diverse, true stories of mental illness. It has been performed at Stanford, at UCLA, and in Des Moines, Iowa, and has been featured by The Washington Post, NPR, Broadway World, NAMI, Psychology Today, iHeart Radio, and others. Zack and Elisa continue to work with communities across the country to spread the conversation. They both serve on the Advisory Council of actress Glenn Close’s mental health nonprofit Bring Change to Mind.

Zack is now in the final year of his PhD, and is a researcher for the U.S. Department of Energy and NASA. He has published in numerous scientific journals and has spoken for TEDx, Project Happiness, Stanford School of Medicine, the U.S. Department of State, and others. He dabbles in writing silly science poetry, which was featured in The Wall Street Journal.

All of these “accomplishments” have happened—and more importantly, some of the most meaningful relationships in his life have most flourished—after his hospitalization and diagnosis.

Please never hesitate to reach out:

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