Why High-Achieving Men Suffer in Silence
The cost of keeping it together is higher than most men realize.
Posted May 19, 2026 | Reviewed by Margaret Foley
A lot of American men seem to be doing pretty well these days — at least, on the outside. Despite a jumble of obligations at work and at home, they’re still meeting deadlines, maintaining their social lives, and showing up for their partners or families. They might struggle through a few sleepless nights here and there, or have to work all weekend every once in a while, or take the red-eye that gets in just before an important meeting — but that's normal, right? And having a couple of beers before you go to bed, or not being able to concentrate because a big problem is hanging over your head — that’s just a natural consequence of taking on so many responsibilities, you might say to yourself. But therein lies the problem: That same ability to take on so much, and the belief that you should be able to handle it, is also what makes it hard to see the distress you feel. So what does it actually cost to keep it together, and how long can you keep that up before something breaks?
This dynamic may be true for all American adults, but it's especially true for men these days because they aren’t seeking out the care they need. According to Eggenberger et al. (2021), while 52 percent of American women had received mental health care over the preceding year, only 40 percent of men had. A 2026 study by Kleidermacher et al. found consistently higher psychotherapy use among women than men — especially among adults between the ages of 18 and 25, where the gap is as high as 22 percentage points. One might also wonder if the type of career a man holds might make him more, or less, likely to enter therapy, and research from 2023 in the Journal of Primary Care and Community Health suggests that it does: Among the people surveyed, out of 11 emotionally distressed men with white-collar jobs, 10 hadn’t tried therapy for every one that had. The ratio was worse for men performing manual labor, where the study found 31 unhappy men outside of treatment for every one in it. (In this study, almost twice as many women at each occupational level had gone to therapy.) And the cost of this discrepancy isn't just psychological: According to the CDC, American men die by suicide at nearly four times the rate of American women, even though women are diagnosed with depression at higher rates (Streb et al., 2021).
These phenomena may be related to a harmful male-specific tendency toward emotional suppression (as most recently and explicitly identified in a 2023 study by Haver et al.). And a 2017 meta-analysis in the journal Emotion found that a greater reliance on suppression as a defense was associated with lower levels of social support, fewer connections to others, lower satisfaction with one's friendships, and lower-quality romantic relationships . Reducing emotional suppression is, in many cases, one of the goals of psychotherapy, where many people learn to openly articulate, cope with, and gain information from their feelings. Classic research by James Pennebaker supports this (Pennebaker & Beall, 1986), as do the hundreds of follow-up studies inspired by Pennebaker’s original work, which showed that expressive writing about a stressful experience could significantly improve many indicators of physical and psychological health. Suppressing your emotions means giving up the opportunity to moderate stress, curb anxiety , and relieve depression in this way.
Because they are seen as so competent — by others and by themselves — high-functioning men may be uniquely susceptible to this phenomenon. Ever since Herbert Freudenberger coined the term " burnout " in 1974, we've known that high-achieving people can lose their sense of purpose as they numbly work toward their daily goals and live up to the self-standards they have established. Even the World Health Organization acknowledges the syndrome of burnout, as of 2019, referring to it as a job-specific combination of exhaustion, pessimism , and a sense of constant, pointless effort. For men at higher levels of achievement or success, who are so much less likely to seek help or to vent their feelings, the warning signs of burnout or other mental health problems can be harder to recognize. And the longer these men go without treatment, the more entrenched and serious their symptoms can become — and the harder it gets to remember what feeling well actually felt like.
On the inside, just "keeping it together" doesn't feel great — but it may not feel like an emergency, either. There may be a persistent sense of uneasiness or discomfort, as though you’re “off your game” even though you get to work on time every day and can hold it together through all of your meetings. Things probably look fine to others, even if you're getting the sense that your usual ways of coping have started to become less and less effective. Maybe you're putting forth more effort and getting less relaxation or enjoyment out of it. Maybe your sleep isn't very restful; maybe regular exercise feels like a burden, rather than a chance to sweat it out and recharge. Or perhaps, most disorienting of all, you've accomplished exactly what you've been striving for, but are wondering why it hasn’t made you happy. You did what you set out to do, but where is the satisfaction? That specific experience — hitting the goal, but feeling nothing — is worth noticing. It often means that something needs attention , and it isn’t your next professional goal.
So, although you may never have tried to seek help before, or have any clear sense of why you would, perhaps now is a time to try something new. There are lots of reasons why this is a good idea, but consider this one first: If you've ever applied external standards to yourself or your performance, you know that an outside perspective — an objective advisor — can produce far better outcomes than going it alone. This is true in business, in sports, and in any domain where accomplishment matters. The best performers use every resource available. The same logic applies to therapy. In some ways, men need it even more than women do — paradoxically, because they're so much more likely to try to process things on their own. The men who benefit from treatment the most are those who recognize that and are ready to see their lives from a new point of view.
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Chervonsky, E., Hunt, C. (2017). Suppression and expression of emotion in social and interpersonal outcomes: A meta-analysis. Emotion, 17(4):669-683.
Eggenberger, L., Fordschmid, C., Ludwig, C., Weber, S., Grub, J., Komlenac, N., Walther, A. (2021). Men's psychotherapy use, male role norms, and male-typical depression symptoms: Examining 716 men and women experiencing psychological distress. Behavioral Sciences, 11(6):83.
Freudenberger, H.J. (1974). Staff burn-out. Journal of Social Issues, 30: 159-165.
Haver, A., Krampe, H., Danbolt, L.J., Stålsett, G., Schnell, T. (2023). Emotion regulation moderates the association between COVID-19 stress and mental distress: findings on buffering, exacerbation, and gender differences in a cross-sectional study from Norway. Frontiers in Psychology, 22;14.
Kleidermacher, L., Warner, M., & Olfson, M. (2026). Gender and Age Differences in Psychotherapy Use Among U.S. Adults With Depression and Anxiety. American Journal of Psychotherapy. Retrieved from https://psychiatryonline.org/doi/10.1176/appi.psychotherapy.20250050 .
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Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95(3), 274–281.
Streb, J., Ruppel, E., Möller-Leimkühler, A-M., Büsselmann, M., Franke, I. and Dudeck, M. (2021). Gender-specific differences in depressive behavior among forensic psychiatric Patients. Frontiers in Psychology, 12.
World Health Organization (2019, May 28). Burn-out an "occupational phenomenon": International Classification of Diseases. Retrieved from https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
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Loren Soeiro, Ph.D., ABPP , is a psychologist in private practice in New York City, specializing in helping people find success, fulfillment, and peace in their relationships and their work.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.