Performance awareness is a good thing. It drives us and gives us a sense of satisfaction once we have achieved a goal or accomplished something. However, when performance awareness turns into constant performance pressure, it can lead to depression and burnout. Particularly success-oriented men tend to “self-medicate” in this situation—with alcohol, medication, and drugs.

 

Performance as Part of Male Identity

 

For many men, the necessity of maintaining unwavering performance readiness well into old age is part of their male identity. This often affects all areas of life: it starts in the most private sphere, such as sex, and extends to the professional and public domains. The performance mindset and constant competition are dominant and appear to be without alternatives.

 

This personal feeling of “having to perform” is often demanded from the outside, by society. Successfully existing in a performance-oriented society means having to withstand constant pressure. The expectation to perform and to perform more is thus also socially constructed. We have internalized this “must-perform” mentality to such an extent that we practically sanction ourselves in case of failure. Not meeting an expected level of performance leads to negative emotions and causes men to question themselves. While in Asian societies, “not performing” often triggers feelings of shame, in Western societies, it tends to lead to feelings of guilt. One’s own performance becomes a source of insecurity, perceived as insufficient or worthless. At the same time, external validation becomes increasingly important. This vicious cycle ultimately leads to burnout and depression.

 

Self-Therapy with Alcohol & Drugs

 

Male depression is accompanied by a decline in performance: mental, emotional, and physical capabilities decrease, while stress and anxiety increase. Since this is often a gradual process, many affected individuals do not even notice their behavioral changes. Irritability is frequently externalized. Particularly performance-conscious men tend to compensate for their loss of energy on their own, without seeking external help.

 

On the one hand, so-called overcompensatory activities (spending even more time at work, increasing sports activities, etc.) are often undertaken. On the other hand, various substances are frequently used, including alcohol, nicotine, caffeine-containing products such as energy drinks, stimulants, and various illegal substances intended to enhance performance. Even Viagra falls into this category.

 

Performance-oriented young men often gain experience with amphetamines and Ritalin during their studies. Modafinil has also experienced significant hype. These substances promote wakefulness, activity, performance, and concentration. What was initially used as a short-term aid for exam performance during university may later become a tool for handling professional pressure.

 

To “wind down” in the evening, people often turn to a strong drink or a bottle of wine. Beyond the misuse of legal substances and prescription medications, some affected individuals also attempt to escape their perceived performance slump with hard drugs such as cocaine or crystal meth. However, these users do not fit the typical “junkie” stereotype; rather, they are often highly successful individuals in leadership positions. These substances trigger an extreme release of dopamine, serotonin, and norepinephrine, creating a temporary high. They appear to fulfill the promise of increased performance, boosting productivity and enabling individuals to work for days with intense focus, seemingly supplying boundless energy.

 

Mental Health: Being Aware of One’s Performance

 

It is not advisable to ignore a significant decline in performance, nor to treat it with performance-enhancing substances. Instead, a thorough medical assessment should always take priority to determine the underlying cause of this unfamiliar condition. In many cases, depression is the root issue.