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White working-class men living in rural areas are affected by increased rates of distress thought to lead to risk-taking behaviors. This study advances understanding of risk-taking-related distress by examining how men interpret their experiences and how these meaning-making processes connect to shifting social-structural conditions in rural working-class life. Drawing on 14 interviews with men affected by risk-taking-related distress, I find that men’s descriptions largely focus on interpersonal relationships and most often involve a woman who has treated them unfairly by leaving them. When respondents describe internal states, they describe feeling depressed and having nothing, and display feelings of resentment. Findings suggest that this group’s declining social position has led to a mismatch between expectations and resources necessary for achieving those expectations. A sense of failing to meet directives of their working-class masculine identities—especially maintaining control in romantic relationships—may lead men to manage distress by engaging in risk-taking behavior. Findings extend understanding of how macro-social conditions in areas with high rates of risk-taking-related mortality translate into distress through men’s cultural expectations and identity.