Mental Health

Across Scotland, gay, bisexual and all men who have sex with men are more likely to experience mental health problems compared to the general population. 

Before going any further, it is important to emphasise that, despite the disproportionate impact, not all GBMSM will experience mental health problems.  

Understanding why more men experience poor mental health is a complex issue, but it is closely tied to broader health and social inequalities experienced by our communities. 

Specific factors that can impact on GBMSM experiences of mental health can include: 

• Quality of sex education – things are improving, but many men’s experiences of school education underplayed or ignored LGBTQ+ identities. People do not always have the opportunity to learn what it means to be LGBTQ+ and what healthy relationships look like. 
• Experience of discrimination – despite significant progress, many LGBTQ+ people continue to experience discrimination based on their sexuality.  
• Cultural factors – our culture broadly reflects a majority heterosexual society, with LGBTQ+ identities and lives less visible. As a result LGBTQ+ identities and relationships can falsely come to be viewed as less valid.  
• Lack of community spaces – LGBTQ+ community groups play a vital role in providing spaces where people can meet and share experiences in a safe environment. This provides a space to develop a greater sense of who we are. Unfortunately the availability of groups is limited, especially outside of major cities.

The cumulative effect of these influences is that many LGBTQ+ people struggle with their identity and find it difficult to find answers. They can learn to internalise much of what they see around them, leading to a sense of shame about their identity. This can impact their mental health, and leave them with a sense of isolation from the community around them. 

Most of us feel down at some points in our lives. Usually, these feelings don’t stop you from living your life, but they can leave you feeling sad or unhappy. 

However, when these feelings start impacting your life and your health, it may be something more than feeling down. 

People who experience depression often have intense feelings and emotions over periods of weeks, months or even years.  You might experience some or all of them:  

• Feeling down, upset or sad 
• Losing your appetite 
• Having difficulty sleeping or wanting to sleep all the time 
• Using more alcohol or drugs than you normally would 
• Retreating into yourself – becoming less likely to go out and be social 
• Feeling less interested in things you used to enjoy 
• Losing interest in sex 
• Having aches and pains in your muscles and joints 
• Feeling like, or thinking about ending your life

If you’re feeling like depression is affecting your health and wellbeing, support is available.   

In the first instance, you can try talking to a friend or partner, but if that doesn’t help, it’s important to seek support whether it’s from your GP, talking therapies or community groups. 

In daily life, most of us will find ourselves in situations that cause anxiety. 

Being anxious – that feeling of being unsettled, uneasy or scared – is a natural human response to stress and is designed to protect us from a perceived danger. This is often known as the fight, flight or freeze response. 

Usually, we can manage these feelings and they pass over time, but sometimes they can become overwhelming, affecting our ability to get on with our lives. 

People who are experiencing anxiety will often experience symptoms that affect them emotionally and physically, including:. 

• you worry all the time, sometimes with no reason, or out of proportion 
• you notice physical symptoms like feeling sick, losing your appetite, struggling to sleep (or oversleeping), losing interest in sex, feeling your heart racing in your chest, changing toilet habits, pins and needles 
• you may feel your mind is racing with many thoughts – some of which may be unpleasant 
• you have panic attacks – intense and sudden feelings of fear or discomfort, often accompanied with shortness of breath, nausea and a feeling of ‘losing control’ 
• you have a tendency to always see the negative things in any situation 
• you avoid everyday situations that you may find difficult 

If you’re feeling like anxiety is affecting your health and wellbeing, support is available.  

In the first instance, you can try talking to a friend or partner, but if that doesn’t help, it’s important to seek support whether it’s from your GP, talking therapies or community groups. 

Self-harm is when someone intentionally damages or injures their body, often at times when feelings of distress and anxiety become very intense. 

Self-harm is something that is often misunderstood. It is usually associated with cutting, but the reality is more complicated. 

It is important to know that self-harm is not ‘attention seeking’ and that addressing it requires professional help. You should feel confident in accessing that, just like you would for any other health condition that affects your life. 

If you are thinking of harming yourself or have thoughts about suicide, you should seek professional help immediately. 

• You can call 999, or contact Breathing Space or the Samaritans. 

Eating disorders refer to a number of conditions characterised by eating patterns that affect a person’s health and wellbeing. 

Such eating patterns can include things like restricting food intake, purging after eating or binge eating.  

There can be numerous causes of eating disorders, but some signs to look out for could include: 

• Reducing food intake (e.g. smaller portion sizes) 
• Skipping meals 
• Rarely eating food around other people, or being secretive about food 
• An obsession with weight 
• Going to the bathroom often after eating 
• Cutting food into small pieces and eating very slowly 
• Eating a lot of food very fast 
• Excessive exercise 
• Wearing loose or baggy clothes to hide weight loss or gain 
• Having strict habits or routines around food 
• Being distressed or anxious around food 

Living with an eating disorder is a complex mental health condition which can lead to serious health complications, so it’s important to get help and advice if you’re worried about it. 

You can find out more about eating disorders by visiting www.beateatingdisorders.org.uk 

Thinking about suicide is more common than people think. It is not necessarily about wanting to die – it can be about not wanting to live because you feel overwhelmed or can’t see a way through a situation. 

Support is always available. 

If you are really distressed and think you might be at risk of harm (or you have done something that has caused you harm), you should access help immediately. You can do this by: 

• call 999 and ask for an ambulance 
• go to your nearest hospital emergency department  

Support is also available from the following helplines: 

• Samaritans – Call 116 123 – lines are open 24/7 
• NHS 24 – Call 111 and select the mental health option when prompted
• Breathing Space – Call 0800 838587 (Mon-Thurs 6pm-2am and from Friday 6pm–Monday 6am 

If you are worried that someone you care about is thinking about suicide, then one of the most important things you can do is being there for them to talk to.  Often speaking to a close friend or family can help someone to share how they feel, and by talking to someone it can often make things feel just a little less difficult or painful.   

The charity SAMH has produced a guide about how to support someone. Remember to look after yourself as well, and no matter what happens showing you care will always be helpful to the person concerned.   

Today in Scotland, you can live long and well with HIV. HIV can however still impact your mental health.  

The treatments that are now available in Scotland allow a person living with HIV to live a long healthy life and, thanks to U=U, we know that treatment can even help to prevent the spread of the condition. 

Despite improved treatment however, HIV continues to carry a lot of stigma. One of the most damaging consequences of this stigma is the impact that it has on the mental health of people living with HIV.  

Coming to terms with a diagnosis, and the decision of whether to tell other people can cause significant stress and anxiety, particularly if you are newly diagnosed. At the same time, HIV stigma continues to be a factor in the anxiety around the sex that we have.  

If you are living with HIV, there are lots of support options available to help you through these issues. 

At Waverley Care, we can provide one-to-one support to help you overcome the challenges you are facing and provide information and advice about how you can enjoy good physical, emotional and sexual health. We can also link you up with peer supporters – volunteers who are living with HIV and can help you to answer any questions you have. 

Your specialist HIV doctors and nurses are also well equipped when it comes to supporting with the mental health of their patients and you can talk to them about your concerns. 

• Samaritans – 24/7 listening and emotional support service. You can call free on 116123 
• Breathing Space – a free, confidential service for people living in Scotland who are experiencing low mood, depression or anxiety. You can call free on 0800 838587 (Mon-Thurs 6pm-2am and from Friday 6pm – Monday 6am 
• Scottish Association for Mental Health – Scotland’s leading mental health charity. There is lots of information and support available through their website.