Celebrity chef Anthony Bourdain committed suicide at age 61. Photo / AP
As the world reels in the wake of Anthony Bourdain's suicide, experts warn he is just one of many men whose suicides and preceding struggles with mental illness often go overlooked.
Men in the US kill themselves at 3.5-times the rate that women do but may be less likely to seek medical help or community support. In comparison to New Zealand, for every woman that dies by suicide, three men do. In 2017, an alarming 606 people were reported to have killed themselves. That's one person dead every 15 hours.
Bourdain spoke openly and often about his own depression and fight to stay sober, but his fame and fortune may well have disguised even deeper troubles, reports Daily Mail.
The tragedy of his death ought to serve as a wake up call to men that their mental health is just as crucial to their survival as their physical health is, two doctors told Daily Mail Online.
Among the leading theories for why suicide is so much more prevalent among men than women is that men are more likely to abuse drugs and alcohol.
Dr Jonathan Gerkin, a University of North Carolina psychiatrist who says he takes a therapist's approach believes that our culture - particularly in the US, but worldwide - has not conditioned men to be reflective about, let alone accepting of their own emotions, and that can lead them to a profound sense of loneliness.
"Loneliness is such an attention-grabbing feeling, and if men can't reflect and respond to that, they can get caught up in trying to eliminate those feelings by minimizing, acting macho, or acting out in dangerous ways," including substance misuse, he says.
"Acting out can be outward, or it can be self-directed, like taking one's life," Dr Gerkin adds.
He says that this isolation happens to men who are not "lucky to encounter more acceptance, or be raised in a family that encourages it, or to be exposed to it in therapy."
But by adulthood, many of these opportunities have already passed men by, or they have already been taught to seek help is seen as not a masculine behaviour, leaving them unsure where to even begin when they are confronting mental health issues.
"That's the hard question," admits Dr Gerkin.
"On one hand, to seek it out, you have to have the motivation or level of insight that requires.
"But...say you have a male friend you think is struggling with something like this. You don't want to whack them over the head with 'something is wrong with you, you should get therapy,' because then they're more likely to feel invalidated and act out," says Dr Gerkin.
He suggests that we all take a more subtle approach to discussing mental health with the men in our lives.
"First, be present and, as much as you can, engage the person in whatever activities are healthy and they're interested in at the time," Dr Gerkin says.
"Through being engaged with them and sort of listening and asking permission to hear about their struggles, and just being with them might be an opportunity to share you you've dealt with things or suggest going to psychotherapy."
One group has found a simple metaphor for the body to help them discuss both physical and mental health with men in the US.
"For mental health, we use car as a kind of magnet to get guys to come see us," Dr Jamin Brahmbhatt says.
Dr Brahmbhatt is a urologist at the University of Florida, but each year he goes on the road with other doctors for Drive for Men's Health.
Without fail, mental health - including issues of body image - come up during their stops.
"We use the analogy of the car to talk about health. Just like a car get manuel tells you when to get things checked - not just physical but mental health - when those warning signals go off in your body, you go get that checked out."
In the case of men's mental health and suicide ideation, some of the warning signs include "feeling hopeless, trapped, burden to society, start withdrawing from people, having severe mood swings, drinking a lot more," Dr BrahmbHatt says.