That's men for you: Padraig O'Morain'sguide to men's health.
Flying to Dublin on a very stormy Thursday recently, Barry McGale was convinced the plane was about to crash. As the plane tossed about in the storm, many of his fellow passengers also believed they were facing their last moments.
What sticks in his memory is noticing that the men on the plane, including himself, all put on a brave face while the women were screaming. But, "I was screaming inside" he told a recent public meeting on men's mental health, organised by Aware as part of its Depression Awareness week.
The brave faces told a lie. The men were afraid but they would not let it be seen. Fear is an unacceptable emotion: it must be covered up.
And it's not just about fear. Depression often goes undiagnosed in men. Even men who take their own lives may have covered up their depression from those who could have helped them, Dan Neville TD, president of the Irish Association of Suicidology, told the meeting.
As suicide-prevention officer with the Western Health and Social Services Board in Northern Ireland, Barry McGale is very familiar with men's tendency to cover up their feelings and the price that such cover-ups can exact on us.
He quoted Churchill to last week's meeting: "Too often the strong, silent man is silent only because he does not know what to say, and is reputed strong only because he has remained silent."
His own research bears this out. In an experiment, he asked men and women to look at photographs of faces and to name as many emotions as they could think of that might go with these faces. The women could name as many as 12 emotions with no bother - but the men "froze" after naming just a few.
It's a striking finding and one that suggests that men's silence about their feelings is accompanied by - perhaps partially caused by - a degree of emotional illiteracy.
Men, said McGale, develop a public/private split in expressing their feelings. "They only express their true feelings to the person they are closest to and in some cases that is themselves and not their partner."
A culture has developed in which it is okay for men to express anger but not okay for them to express sadness or pain. Women are frowned upon for expressing anger but it's okay for them to express sadness or pain.
When they go to the doctor, men are less likely than women to say they feel emotionally upset. Instead they will present with back pain, headaches or another physical ailment. In one recent study 91 per cent of men said they did not share their worries with their GP. McGale encourages GPs to ask male patients how things are with them in general even if they have come in complaining of a physical complaint.
Neville told the same meeting that many men - and not only men - "keep mental illness hidden within their hearts and within their families".
The result can be a deadly isolation.
This concealment, this almost automatic covering up of sadness and pain, takes its toll. In many hospitals, McGale said, self-harm is the second most common reason for the admission of men to medical wards. In some hospitals, self-harm accounts for as many as 50 per cent of admissions.
This concealment - the failure to seek help - may be behind some suicides. In the EU, he said, men are three times more likely than women to die by suicide. The ratio is even higher in some parts of Ireland. For instance, men in Co Donegal are seven times more likely than women to die by suicide.
Men are more likely than women to engage in risky behaviour such as excessive drinking, speeding and promiscuity. Yet we shy away from what we seem to see as the most risky behaviour of all - sharing our feelings with another human being.
Whether we can cease paying the price for our silence will depend to a large extent on our own willingness to break out of our self-imposed emotional prison.
pomorain@irish-times.ie
Padraig O'Morain's blog on men's issues, Just Like A Man, is at http://justlikeaman.blogspot.com/