“How Are You?”
Three words. Most of us have said them hundreds of times. And most of the men in our lives have answered the same way: “I’m fine.” Or “good.” Or “not bad.” And then the conversation moves on.
Nobody is lying. It just never gets further than that. Not because men don’t have anything to say — but because for most of them, nothing else was ever an option. “I’m fine” is the answer they learned, and it is the answer that keeps the world moving without anyone having to stop and sit in something uncomfortable.
That three-word exchange is at the heart of why men’s mental health is a crisis that most people do not see coming until it is already serious.
Why Men Don’t Ask For Help
There is no single reason men avoid talking about what they are going through. But two patterns show up consistently — and they tend to feed each other.
The first is that many men genuinely do not have the language. This is not a figure of speech. From a very young age, most boys are taught that emotions are not useful. You manage them, suppress them, or wait them out. You do not talk about them. After enough years of that, the vocabulary fades. A man who has answered “how are you?” with “fine” for thirty years eventually stops knowing what a different answer would even sound like.
The second is that many men were taught that having those feelings in the first place was the problem. Not just that you should not talk about it — but that needing to talk about it meant something was wrong with you. That is a much heavier weight to carry.
These two things together — no language, and shame about needing it — explain a lot of what we see.
This is the premise of everything that follows.
It Starts Earlier Than We Think
This pattern does not begin in adulthood. It begins in childhood.
A boy who cries is told to toughen up. A teenager who talks about feeling anxious is told everyone feels that way. A young man who admits he is struggling gets quietly redirected to a safer topic. None of this is done with cruelty. Most of it comes from people who love him. But the message lands clearly: this is not what we talk about.
By the time that boy is a grown man, the pattern is deeply set. He has learned to convert what he feels into action — work harder, push through, keep going. The emotional vocabulary was never built because it was never allowed to be.
The Script That Follows Them
“Man up.”
Two words. Almost every man has had them directed at him at some point — by a coach, a peer, a parent, a teacher, a stranger on a team. Sometimes said with good intentions. Sometimes not. But the message is always the same: whatever you are feeling right now, push it down and keep moving.
That phrase — and the others like it: “boys don’t cry,” “stop being so sensitive,” “just deal with it” — is not a throwaway comment. Over years of repetition, it becomes a set of rules. Rules about what kind of man you are allowed to be. What you are allowed to feel. And what it says about you if you cannot handle things alone.
Researchers call this collection of unwritten rules “traditional masculinity ideology.” The American Psychological Association’s 2018 guidelines on working with men and boys documented its effects clearly: men who strongly internalize these norms show higher rates of depression, anxiety, and substance use — and are significantly less likely to seek help even when they know something is wrong.
A Canadian analysis published by CBC drew on research across nearly 20,000 participants from 78 studies. The finding was direct: men who conform most closely to these norms show consistently poorer mental health outcomes. The tighter a man holds to the script, the higher the risk.
The problem is not masculinity itself. Strength, resilience, showing up for the people you care about — these are genuinely good things. The problem is the version of masculinity that says emotions disqualify you from being strong. That needing help is weakness. That the only acceptable response to struggle is silence.
Most men did not choose this script. It was handed to them by men who had it handed to them first. The silence is generational. It does not move through families because anyone decided it should. It moves because nobody stopped it.
But it can stop. And that is exactly what this article is about.
The Numbers Are Hard to Ignore
In Canada, men account for approximately 75 percent of all suicide deaths. According to Statistics Canada, men die by suicide at roughly three times the rate of women.
These are not men who stopped caring about their lives. They are men who ran out of road, often without anyone around them knowing how far things had gone. Many of them had been saying they were fine right up until they were not.
The Movember Foundation, which has tracked men’s mental health and help-seeking behaviour for more than two decades, consistently finds that men are far less likely to seek support even when they know something is wrong. Roughly one in four men will ever speak to a professional about a mental health concern. The barrier is rarely access. It is the belief — deep and often unexamined — that asking for help is not what men do.
What Struggling Actually Looks Like in Men
Most people picture someone who is clearly falling apart. For men, struggling usually looks different from that.
It can look like anger that comes from nowhere. Irritability that everyone around him tiptoes around. It can look like disappearing into work so completely that there is nothing left for anyone else — pulling away from friends, drinking more, going quiet in conversations that used to come easily. Sometimes it looks like nothing at all. Just a man who seems a little far away.
The reason men’s struggles so often go unnoticed is that they learned to translate emotional pain into something that looked more acceptable. Anger is more socially comfortable for many men than sadness. Overworking reads as dedication. Withdrawal gets written off as stress. These are not masks being consciously worn. They are the only vocabulary that was ever made available.
When There Really Are No Words
Researchers have a term for this: normative male alexithymia. It sounds clinical, but the idea is straightforward.
Alexithymia comes from the Greek — it means, literally, “no words for feelings.” The normative male version describes something specific: a learned pattern in men who grew up in environments where emotional expression was consistently discouraged. It is not a diagnosis or a disorder. It is the documented outcome of a boyhood where talking about feelings was off the table.
Here is what it looks like in practice. A man can tell you in precise detail what went wrong at work last Tuesday — the timeline, who said what, exactly how it played out. But ask him how he feels about it, and he says “I don’t know” — and he genuinely means it. He is not hiding anything. He cannot locate the feeling, because the internal connection between what he experiences and the words for it was never developed.
Research published in Frontiers in Psychiatry found that men who grew up under strong cultural pressure to suppress emotions are significantly more likely to lose access to their own emotional experience — and that sustained suppression, over time, shapes how the brain processes and accesses feelings. It is not just a habit. It becomes structural.
The important thing is that this is learned. Which means it can be unlearned. Building the vocabulary — becoming able to name what you are actually feeling — is something therapy is specifically designed to help with.
Healthy masculinity isn’t the absence of emotion; it’s the ability to understand and steward it well. Many men were raised to endure silently, but when they develop the language to name grief, fear, or shame, they often discover that real strength is the courage to face those emotions rather than bury them.
– Yousif Farag, Cornerstore Therapist
A Problem That Crosses Every Community
The belief that men should not show vulnerability is not unique to any single culture or background.
Whether a man grew up in a Coptic Egyptian household, a South Asian family, an African-Canadian home, or a White Canadian suburb, the messages he likely received from the men around him were often the same. Hold it together. Don’t be a burden. Figure it out. Be strong.
The language was different. The traditions were different. The specific pressures varied. But the result was often the same: a man without words for what he is carrying, and no clear sense that there is anywhere safe to take it.
The fathers, coaches, uncles, and older men who passed this on were not trying to cause harm. They were doing what they were taught — by men who had been taught the same thing before them. The silence is generational. It moves through families without anyone choosing it.
But it does not have to keep moving. The fact that more men are beginning to seek support — and that the people who love them are learning how to ask better questions — is not a small shift. It is where real change starts. One conversation at a time.
What Therapy Looks Like For Men
The most common thing men say when they first come in is some version of: “I didn’t actually want to be here.”
Some were encouraged by a partner. Some reached a point where saying “I’m fine” felt dishonest even to themselves. Some just ran out of other options. However they got there, what most of them say afterward is: “It wasn’t what I expected.”
Many men come in expecting to be analyzed, told what is wrong with them, or to cry in front of a stranger and feel worse for it. That is not what happens.
A man came in not long ago — mid-forties, said almost nothing for the first ten minutes. Then: “I don’t know what’s wrong with me. I just can’t stop being angry at everyone I love.” That sentence had probably been sitting in him for years. What followed wasn’t analysis. It was relief. Naming the thing he had never named was the start of understanding it. (Details changed to protect privacy.)
Session one is usually a conversation, not an assessment. A therapist will ask what brought you in, what has been going on, and what you are hoping to get out of the process. You do not need to have the answers. You do not need to arrive with anything figured out. Showing up is the whole job for that first hour.
After that, you decide whether to continue. If you do, the work becomes more specific — and more useful.
What Is Involved in Therapy at Cornerstone?
Therapy is not one thing. We use several approaches, and a good therapist will use what fits the person in front of them. Here is what some of the most common ones look like in plain language.
Cognitive Behavioural Therapy, or CBT, focuses on patterns — specifically, the connection between how you think, how you feel, and what you do. If you tend to assume the worst, interpret setbacks as personal failures, or talk to yourself in ways you would never talk to anyone else, CBT helps you notice those patterns and interrupt them. It is practical and structured. Most men find it straightforward to engage with.
Acceptance and Commitment Therapy, or ACT, focuses on what you can and cannot control — and on building a clearer sense of what actually matters to you. For men who are used to pushing through, ACT offers something concrete: not how to feel better necessarily, but how to move forward even when you do not.
Attachment-based therapy looks at how you learned to connect — or not connect — with the people around you. Many men who struggle with intimacy, conflict, or emotional withdrawal were not born that way. They learned it. This approach helps you understand those patterns and, if you want to, shift them.
Solution-focused therapy spends less time on what went wrong and more time on what has worked before and what the next step forward looks like. For men who find open-ended exploration uncomfortable, this approach tends to feel more manageable.
At Cornerstone, we also offer faith-integrated therapy for those who want their spiritual beliefs to be part of the process. This is always optional. You choose.
What you walk out with — across all of these — is a better understanding of what is driving the patterns in your life, and more practical options for what to do about them.
All Cornerstone therapists are registered with the College of Registered Psychotherapists of Ontario (CRPO) and hold master’s degrees. Our Clinical Director holds a PhD and a Doctorate in Counselling and Psychotherapy.
We have been serving men and families in Mississauga and Peel Region for fifteen years, in English, French, and Arabic. For those who need it, we offer sliding scale fees and free sessions for eligible Peel Region residents through the CARE grant program.
How Do You Know If It’s Working?
This is one of the most common questions men ask, and it is a fair one.
Progress in therapy does not always feel linear. Some sessions are harder than others. Early on, naming things you have never named can feel worse before it feels better. That is normal and worth knowing in advance.
What tends to shift, over time, is smaller than people expect. You notice the anger coming before it lands on someone. You catch yourself in a thought pattern that used to run unchecked. You have a conversation with your partner or your son that would have ended badly six months ago, and it does not. You sleep a little better. You stop dreading Sunday nights.
The changes are usually incremental. But they are real. And most men, when they look back, can point to a specific moment — sometimes just a single session — where something shifted.
If You Love Someone Who Won’t Ask For Help
For the partners, parents, and friends reading this: you are usually the first to notice. You see the shift before he does.
The most useful thing you can do is ask — not as a confrontation, not out of frustration, but with genuine curiosity. “You seem a bit tired lately. How are you actually doing?” And then wait. Let the “fine” sit there for a moment. Often what comes after the silence is closer to the truth.
Do not wait for a crisis.
Many men arrive at therapy at their lowest point — job lost, relationship broken, health already suffering. They waited until there was no other option. A difficult conversation when someone is still functioning is hard. The same conversation when someone is in crisis is much harder — and much less likely to land. Earlier is almost always better, for everyone.
You do not need the perfect words. You do not need to have any answers at all. You just need to ask an honest question and be genuinely willing to hear what comes back.
The Language Is Learnable
Here is the thing this whole article has been building toward.
Men are not avoiding support because they do not care about their lives. They are avoiding it because they were taught — early, consistently, and by people who meant well — that needing support meant something was wrong with them. That the feelings themselves were the problem. That the answer to every hard thing was to man up and keep moving.
That belief is not true. And it can be changed.
The language that was never taught can be learned. The silence that was passed down does not have to keep moving. And it usually starts with something very small — an honest answer to a question that has been answered with “fine” for far too long.
If you are not sure you are ready to call anyone yet, HeadsUpGuys is a free Canadian resource from the University of British Columbia with plain-language articles, a depression self-check, and over 100 recovery stories from real men. It is a good place to start anonymously, at your own pace. You can test our self evaluation tools or checkout the videos we have curated from trusted sources.
When you are ready to talk to someone, we are here.
Book the first session and bring us whatever you’re carrying — even if you don’t have the words for it yet.
[email protected] | 905.214.7363
References
- Statistics Canada — Suicide and Suicide Rate, by Sex: www150.statcan.gc.ca
- Movember Foundation — Men’s Health Publications and Reports: us.movember.com/about/publications
- American Psychological Association — Guidelines for Psychological Practice with Boys and Men (2018): apa.org/guidelines
- Frontiers in Psychiatry — Normative Male Alexithymia and Emotional Suppression (2020): frontiersin.org
- CBC — Research on Manning Up Culture and Men’s Mental Health in Canada: cbc.ca
