Men’s Mental Health Therapy in Pasadena, CA: A Complete Guide

The State of Men’s Mental Health

Men’s mental health is one of the most under discussed public health crises of our time. Millions of men across the United States are living with depression, anxiety, and other mental health conditions. Often without a diagnosis, without treatment, and without anyone in their lives knowing they are struggling.

According to the National Institute of Mental Health (NIMH), approximately six million American men suffer from depression every year. Yet men are far less likely than women to seek help for mental health problems including depression in particular.^[4]

The gap between how many men are suffering and how many men are receiving care is not due to lack of access. It is a gap shaped by culture, identity, and a set of deeply ingrained beliefs about what it means to be a man. Understanding that gap and closing it is one of the most important things we can do for men’s health.

At Sandoval Therapy in Pasadena, CA, Alejandro Sandoval and our team of therapists have spent over 12 years working with men navigating exactly these struggles. From men who knew something was wrong but didn’t know where to turn, to men who weren’t sure anything was wrong at all. What we know from our experience is that therapy work works, and men who take the step of reaching out almost always say they wish they had done it sooner.

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Common Mental Health Conditions in Men

Men and women can develop most of the same mental health conditions, but research shows that the way these conditions show up and how men experience them can differ significantly.

Depression

depression is the most common mental health condition in men, yet it is also among the most underdiagnosed. According to the American Psychological Association, researchers and clinicians are coming to recognize that the traditional signs of depression sadness, worthlessness, and excessive guilt may not represent many men’s experience of a depressive period.^[4] Research is starting to show that depression in men may be expressed through fatigue, irritability, anger, loss of interest in work or hobbies and sleep issues. It has been showed that men tend to use more substances to possibly self-medicate.

In Western countries, rates of formally diagnosed male depression are approximately half compared to females, yet male suicide rates are dramatically higher. Researchers point to men’s reluctance to express emotional distress and their resistance to seeking professional care as key reasons for this troubling discrepancy.^[2]

At Sandoval Therapy, our therapists have over 12 years of experience recognizing depression in men who would never describe themselves that way. We engage in a process that fits how our clients actually think and communicate, not how they are “supposed” to talk about their feelings.

Anxiety

Anxiety in men is frequently masked by outward expressions of irritability, anger, and control seeking behavior. Because these expressions do not fit the popular image of anxiety which often centers on visible worry or panic. Men may go undiagnosed and untreated for years, with their anxiety misread as a personality trait rather than a treatable condition.

Substance Use Disorders

Research has consistently shown that men are more likely than women to use drugs and alcohol as a way to cope with emotional pain. The APA notes that this self-medication approach can mask underlying mental health conditions, making depression significantly harder to detect and treat effectively.^[4] Substance use disorders and mental health conditions frequently co-occur in men, each worsening the other.

Post-Traumatic Stress Disorder (PTSD)

While PTSD is often discussed in the context of combat veterans, it affects men across all walks of life following a wide range of traumatic experiences including accidents, violence, childhood abuse, and workplace trauma. Men with PTSD often exhibit externalizing behaviors: aggression, emotional numbing and risk-taking rather than the hypervigilance and emotional reactivity more commonly associated with PTSD in clinical descriptions.

Borderline Personality Disorder (BPD)

BPD is frequently thought of as a condition that primarily affects women, but it is also diagnosed in men. In men, BPD often presents differently with anger, aggression, self-harm, and substance abuse as the more prominent features, rather than the emotional volatility typically described in clinical literature.^[5] This distinction matters because it means men with BPD are often misdiagnosed or missed entirely.

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Symptoms to Watch For in Men

Because men often experience and express mental health conditions differently, it is important to recognize that the symptoms to watch for are not always the ones we expect. According to both the NIMH and the APA, men experiencing depression or other mental health conditions may show some or all of the following:

It is worth noting that men who are depression may be far more likely to visit a doctor about physical symptoms chest tightness, headaches, chronic pain than to seek mental health support. The APA notes that this physical presentation of emotional distress is one reason depression in men is so frequently missed, particularly in older men who also have conditions like heart disease or cancer where depressive symptoms can be misattributed to the physical illness itself.^[4]

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Why Men Don’t Seek Help: The Barriers to Care

Understanding why men resist seeking mental health support is not a matter of casting blame it is a matter of understanding the powerful social and psychological forces that shape men’s relationship with vulnerability, help, and care.

Masculine Norms and the “Man Up” Culture

A 2025 peer-reviewed systematic review published in the American Journal of Men’s Health, drawing on 47 studies conducted between 2000 and 2024, found that traditional masculinity norms significantly deter men from seeking mental health support and this pattern holds across cultures and income levels worldwide.^[1]

The research identifies conventional masculine norms being strong, successful, independent, in charge, and emotionally unavailable as key contributors to men’s resistance to seeking help with depression. Depression, in particular, is often characterized as being fundamentally “incompatible” with traditional masculinity because it is associated with helplessness and loss of control, leaving men feeling weak and vulnerable in ways that violate their internalized sense of identity.^[1]

“Society mistakenly views signs of distress as signs of weakness; because of this, our male population typically avoids the mental health support systems in place, and views them as unnecessary or perhaps inadequate in addressing their demographic’s issues.” — NAMI, Addressing Male Suicide^[5]

The Social Conditioning of Boys

The barriers to help-seeking do not begin in adulthood. Research shows that boys who learn early on that others will not react favorably to expressions of emotional distress are significantly less likely to display mental health symptoms to others later in life. This social conditioning creates a pattern that, once set, is extremely difficult to interrupt.^[1]

Normative Male Alexithymia

APA President Ronald Levant, EdD, coined the term “normative male alexithymia” to describe a pattern found in many men: a learned difficulty identifying and expressing emotions. This is not a permanent personality trait but a socially conditioned one and it represents both a contributor to depression and a major barrier to treatment, because men who struggle to name what they are feeling find it even harder to seek help for it.^[4]

Research led by psychologist Aaron Rochlen, PhD, at the University of Texas found that the men who are most in need of mental health services are the least interested in getting them and that this is directly linked to how the traditional male role restricts emotional expression and instead encourages a preoccupation with success, power, and competition.^[4]

Self-Stigma: The Barrier Within

A 2016 peer-reviewed study published in the Community Mental Health Journal, based on a national survey of 901 Canadian adults, found that more than a third of respondents without personal experience of depression endorsed the view that men with depression are unpredictable and that men themselves held more stigmatizing views about male depression than women did.^[2]

More striking still: men with direct personal experience of depression were more likely to report feeling embarrassed about seeking help. This is the devastating reality of self-stigma. Even men who know they are suffering internalize shame about their own condition, becoming their own greatest barrier to care.^[2]

The Lifespan Effect

A population study of 14,516 Australian men published in BMC Psychology in 2021 found that while conformity to masculine norms decreased with age, higher conformity was consistently associated with increased risk of depressive symptoms and this effect was actually strongest in older men. This underscores the importance of mental health campaigns that address the complexity of gendered help-seeking behavior across the entire male lifespan, not just for young men.^[3]

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Breaking the Stigma — Why It Saves Lives

The stigma around men’s mental health is a public health emergency. When men cannot or will not seek help, untreated depression escalates, self-medication increases, relationships break down, and in the most tragic cases, men take their own lives.

Reducing stigma means actively changing the message men receive about what it means to struggle and to seek support. As NAMI puts it, if we can reframe asking for help as a courageous and “manly” action rather than a sign of weakness, we give men a path forward that does not require them to abandon their identity to walk through a therapist’s door.^[5]

Research on male suicide prevention strategies has found that men respond positively to receiving support from a trusted individual, forming connections with others who have had similar experiences, and having help-seeking reframed as a form of strength rather than a failure.^[5]

“Traditional masculinity norms significantly deter men from seeking mental health support, highlighting the need for culturally sensitive interventions that address these barriers.” — Mokhwelepa & Sumbane, American Journal of Men’s Health, 2025^[1]

Changing the culture around men’s mental health also means changing how therapy and treatment are positioned. Some clinicians have found success by reframing therapeutic conversations around goals, strategies, and problem-solving language that resonates more naturally with many men and by making space for shared activities and indirect communication rather than demanding immediate emotional disclosure.^[4]

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Men and Suicide: The Statistics Behind the Silence

Nowhere is the cost of men’s untreated mental health more visible — and more devastating — than in suicide statistics. The numbers are stark, consistent, and demand urgent attention.

According to a CDC National Center for Health Statistics Data Brief analyzing mortality data from 1999 through 2017, the age-adjusted suicide rate for males increased 26% over that period from 17.8 to 22.4 per 100,000. Middle-aged men saw some of the steepest increases, with men aged 45–64 rising from 20.8 to 30.1 per 100,000. Men aged 75 and older had the highest overall rate of any group in both years.^[6]

Suicide has ranked as the 10th leading cause of death for all ages in the United States since 2008. By 2016, it had become the second leading cause of death for people aged 10–34 and the fourth for those aged 35–54.^[6]

Geography compounds the crisis. Rural men face significantly greater risk the suicide rate in the most rural counties in 2017 was 1.8 times higher than in the most urban counties, a disparity that has widened over time. This reflects the compounding effect of geographic isolation, reduced access to mental health services, and cultural norms in rural communities that may place even greater emphasis on stoicism and self-reliance.^[6]

According to NAMI, Dr. Jeffrey C. Sung, M.D., a psychiatrist at the University of Washington, links the elevated suicide risk among middle-aged men specifically to a lack of mental health messaging designed for that demographic combined with the persistent grip of cultural norms around masculinity.^[5]

The research from 13,884 Australian men cited in the 2025 systematic review is particularly illuminating: men’s risk of attempting suicide increased dramatically when they adhered to masculine standards of emotional suppression and stoicism. In other words, the very norms men use to appear strong are the ones putting their lives at risk.^[1]

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Treatment Works — And It Works Well

Perhaps the most important fact in this entire article is one of the most underreported: eight out of 10 cases of depression respond to treatment.^[4]

Depression is not a permanent state. Anxiety is not a character flaw to endure. PTSD does not have to define the rest of a man’s life. These are medical conditions with well-established, evidence-based treatments and the vast majority of men who engage with treatment experience meaningful, lasting improvement.

Treatment options include individual psychotherapy (including Cognitive Behavioral Therapy and other modalities), medication, or a combination of both. Research shows that older men, a group at particularly high risk, respond well to treatment through both medication and psychotherapy.^[4]

Clinicians working with men have also found that adapting the therapeutic environment and language to better match how men communicate can significantly improve engagement. Framing sessions as goal-oriented consultations, incorporating problem-solving language, and allowing for indirect conversation rather than demanding direct emotional disclosure have all shown promise in reducing barriers for men who might otherwise never walk through a therapist’s door.^[4]

This is the approach the team at Sandoval Therapy in Pasadena, CA has taken for over a decade. Alejandro Sandoval and our therapists are trained in evidence-based modalities and understand how to create a space where men feel settled enough to do the work on their own terms and at their own pace.

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How to Get Help

You do not have to have a crisis to deserve support. You do not have to have hit rock bottom to benefit from therapy. Asking for help is not a last resort it is a proactive decision to invest in your wellbeing, your relationships, and your future.

What to Expect During a Therapy Appointment

The first session or two will often involve the therapist getting to know you better. This is also a time for you to learn more about their approach and ask any questions that will make it easier for you to understand what future sessions might be like.

You should work with someone you feel comfortable with. If you are not clicking within a few sessions, it is completely normal to consider other options many men work with more than one therapist before finding the right fit. The quality of that relationship is one of the strongest predictors of a good outcome, so finding the right match is worth the time it takes.

After the first one or two sessions, you and your therapist can begin to dig into what brought you in, and they can offer insight and strategies for getting to a better place. Your goals and the nature of what you are dealing with will shape how long you work together — and that looks different for every person. Therapists are trained in a range of evidence-based techniques to help you work through mental health challenges, make changes in your life, and resolve personal issues.

Therapy for Men in Pasadena, CA

At Sandoval Therapy, Alejandro Sandoval brings over 12 years of practice in men’s mental health issues. He and our team focus specifically on working with men especially those navigating emotional intimacy, relationship, and connection. We also specialize in racial identity, trauma, stress, depression, anxiety, and more.

If you are ready to take the first step, contact us today. Our therapists will answer your questions, walk you through what to expect, and set up a session that works for you. You do not need to have everything figured out before you reach out.

Men’s Support Group in Pasadena, CA

Sandoval Therapy also offers Men in Intimacy, an in-person processing group for men working through barriers to connection and intimate relationships. It’s a confidential, collaborative space to share experiences, build communication skills, and develop healthier patterns of connection alongside other men.

Resources available to you now:

• Talk to your primary care doctor about what you have been experiencing — physical symptoms included
• Call or text 988 (Suicide & Crisis Lifeline) if you are in immediate distress — available 24/7, free and confidential
• Call the NAMI HelpLine at 1-800-950-6264 (Monday–Friday, 10am–10pm ET) for support, guidance, and referrals
• Visit NIMH’s Men and Mental Health page for further information and resources
• Contact Sandoval Therapy our therapists can answer your questions and help set up an initial session at your pace

Frequently Asked Questions About Men’s Mental Health

Answers to the questions men — and the people who care about them — most commonly ask.

How is depression different in men compared to women?

While depression is the same medical condition regardless of gender, the way it tends to show up in men often looks different. Where women more commonly report sadness, worthlessness, and excessive guilt, men are more likely to experience depression through irritability, anger, fatigue, loss of interest in hobbies, sleep disruption, and increased substance use. Because these presentations don’t match the popular image of depression, they frequently go unrecognized — both by the men experiencing them and by the clinicians who treat them.

Why are men so reluctant to seek help for mental health problems?

Research consistently points to traditional masculinity norms as the primary barrier. Men are socially conditioned from childhood to equate strength with emotional self-sufficiency, and to view needing help as a sign of weakness or failure. This creates a phenomenon known as “normative male alexithymia” — a learned difficulty identifying and expressing emotions — that makes it harder for men to even recognize when they need support, let alone ask for it. Self-stigma compounds the problem: studies show that men who have personally experienced depression are more likely to feel embarrassed about seeking care, not less.

What should I do if I think a man I love is struggling with his mental health?

The most effective first step is to create a low-pressure opening — not a confrontation. Research shows that men respond most positively to receiving support from a trusted person rather than being told what to do. Try talking side by side (during a walk or a drive) rather than face to face, which can feel less threatening. Be direct but non-judgmental: “I’ve noticed you seem more stressed lately — I’m here if you ever want to talk.” If there is any concern about immediate safety, don’t hesitate to contact the 988 Suicide & Crisis Lifeline by calling or texting 988.

Can men fully recover from depression and anxiety?

Yes. According to the National Institute of Mental Health, eight out of ten cases of depression respond to treatment. Depression is not a permanent state, anxiety is not a character flaw to endure, and PTSD does not have to define the rest of a man’s life. These are medical conditions with well-established, evidence-based treatments — including individual psychotherapy, medication, and combinations of both — and the vast majority of men who engage with treatment experience meaningful, lasting improvement. Older men, a group at particularly elevated risk, have been shown to respond well to both medication and psychotherapy.

How do I find a therapist who has experience working with men?

Look for a licensed mental health professional: an LCSW, LMFT, PhD, or PsyD who explicitly mentions men’s mental health, masculinity, or trauma-informed care in their profile. When you contact a potential therapist, ask directly how they approach working with men and whether they have experience with the specific issues you are dealing with. A good fit matters the therapeutic relationship is one of the strongest predictors of successful outcomes. If you are in the Pasadena area, Sandoval Therapy specializes in men’s mental health and our therapists have worked with men on depression, anxiety, trauma, relationship issues, and more for over 12 years. You can reach us directly to ask questions and set up an initial session.