Recognizing Depression in Men

June is Men’s Mental Health Month. While both women and men experience depression, men tend to suffer in silence or don’t seek help due to a variety of reasons, including a reluctance to talk about their feelings and the stigma of mental illness.

In honor of Men’s Mental Health Month, we are spotlighting the prevalence of depression in men and encourage all men to get the treatment they need. We are also digging into some of the major reasons that prevent men from seeking help and tips for getting care. Whether you or someone you love is experiencing depression, take action by looking out for those you love, checking in on them, and making sure they get the support they need.

Men and depression: The statistics

Six million men experience depression each year, and it often goes undiagnosed. Men with mental illnesses are also less likely to have received mental health treatment than women in the past year. This statistic is especially true for Black, Latino, and Asian men, who have much lower utilization rates than white men.¹

According to the Centers for Disease Control and Prevention, men are more than four times as likely to die by suicide than women.^2,3 When providers evaluate men, they are less likely than women to be diagnosed with a mood disorder, even when reporting the same symptoms. Men may also be more likely to underreport symptoms and struggle with disclosure.⁴

It is clear that men struggling with depression are not getting the help they need. Understanding depression in men and what actions to take is the first step to tackling this issue.

Understanding the symptoms of depression in men

Men and women can develop most of the same mental disorders and conditions but may experience different symptoms. Some of these symptoms include:

Typical symptoms of depression in both men & women:^{5, 6}

• Feeling down, depressed, or hopeless
• Less interest in or pleasure from daily activities
• Significant weight loss or gain or appetite changes
• Insomnia or excessive sleepiness
• Physical agitation or lethargy
• Fatigue and lack of energy
• Feeling worthless or excessively guilty
• Inability to think or concentrate
• Recurring thoughts of death or suicide
• Problems with sexual desire and performance

Symptoms of depression that men are more likely to experience than women:^{5, 6}

• Anger, irritability, or aggressiveness
• Loss of interest in work or hobbies
• Feeling very tired, not being able to sleep, or sleeping too much
• Physical aches or pains, headaches, cramps, or digestive problems
• Engaging in high-risk activities
• Alcohol or substance abuse to self-medicate
• Withdrawing from family and friends or becoming isolated

Not every man who is depressed experiences every symptom. Some men experience only a few symptoms, while others may experience many.

Reasons why men might not get the help they need

From feeling reluctant to open up about their feelings due to the stigma associated with depression and mental illness, here are some common reasons men might not get the help they need.

Toxic masculinity & reluctance to talk about feelings

Some men may feel apprehensive about sharing their feelings with family or friends, let alone with a doctor or mental health professional. Due to the social stigma that it’s not “manly” to express feelings and emotions associated with depression, many men attempt to keep them bottled up inside.

Toxic masculinity prevents some men from getting help. According to a study, men with typically “masculine” traits, such as dominance, independence, and stoicism, are more likely to suffer from poor mental health and less likely to reach out for help. Additionally, men who valued traits such as self-reliance were more prone to suffer from negative mental health outcomes, likely because they have difficulty utilizing social support and reaching out for help.⁷ Men with these characteristics are more likely to cope with their depression symptoms by depleting their internal resources, and only seeking help only when symptoms have worsened. They may also resort to negative coping styles such as substance use, high-risk behaviors, violence, or avoidance through over-committing to work or other activities.^{4, 7}

They are downplaying symptoms

Some men may not recognize how much their symptoms affect them. Additionally, some men may not want to admit to themselves or anyone else that they’re depressed. However, ignoring, suppressing, or masking depression with unhealthy behavior will only worsen the negative feelings and emotions.

Failure to recognize & diagnose depression

Men may think that feeling sad or emotional is always the main symptom of depression. For many men, however, feeling sad isn’t always the primary symptom. For example, headaches, digestive problems, tiredness, irritability, anger, and aggression can sometimes indicate depression.⁶ Because men may experience male-typical symptoms, their friends, families, and even medical providers may not always recognize depression in men.

In a study of about 2,000 men published in the American Journal of Men’s Health, those who scored higher on traditional symptoms of depression were more likely to seek help.⁴ Traditional symptoms included depressed mood, loss of interest, change in appetite, sleep dysregulation, loss of energy, feelings of worthlessness, and inability to concentrate. Those who scored higher on male-typical symptoms of depression were less likely to seek help. Male-typical symptoms included stress, irritability, aggression, risky behaviors, hyperactivity, and substance use. Experiencing symptoms of both types of depression made individuals more likely to initially seek help from a medical provider. However, those with male-typical symptoms were less likely to seek help for their depression and more likely to visit a medical professional rather than a mental health specialist. Since male-typical symptoms can look different in the medical setting, depressive symptoms may go undiagnosed or there may not be sufficient resources to provide adequate follow-up care.^4,8

The stigma associated with mental illness

Even if some men suspect they have depression, they may avoid diagnosis or refuse treatment. Sadly, the stigma surrounding mental illness may prevent men from getting the help they need. They may worry that it could damage their careers or cause family and friends to lose respect.

Treatment for depression

While some symptoms may differ, depression treatment options for both men and women are the same.

Therapy

Therapy can be an effective treatment option for men suffering from depression. However, nine different qualitative studies indicated that men tend to prefer solution-focused, action-oriented treatment to other forms of talk therapy. Those that do seek treatment for their mental health condition, regardless of how strongly they identify with masculine ideals, have more positive connotations with providers than those who don’t.⁴

Medication

Medication is an effective form of depression treatment for many people. Because there are many forms of depression, and each individual is unique, getting the best result requires matching each individual to the right medication. Then, once a treatment plan has been established, your doctor can fine-tune further treatment based on your response to the medication.

Medications commonly prescribed as the first line of treatment for depression include selective serotonin reuptake inhibitors (SSRIs) and norepinephrine-dopamine reuptake inhibitors (NDRIs). Common examples include Sertraline (Zoloft), Escitalopram (Lexapro) and Bupropion (Wellbutrin). There are other categories of medications that are used as well. Have a conversation with your doctor to figure out if medication is the right treatment option for you.

Self-care

Many treatment plans for depression involve aspects of self-care. Getting regular exercise and good quality sleep can have a significant effect on managing your depression and anxiety. Practicing mindfulness, keeping a healthy and balanced diet, and connecting with loved ones or a support group are also highly impactful ways to aid in treating depression.

Getting the help you need

Many men have trouble communicating what they’re feeling and figuring out how to talk about it. It’s important to know that if you are suffering from depression, you shouldn’t feel shame or embarrassment. These conditions are illnesses––not weaknesses.

Here are some essential first steps in getting the help you need:

• Seek professional help. Your mental health care provider is trained on how to deal with these issues. He or she can help you get the treatment you need.
• Find healthy ways to cope with your feelings. For many men, yelling, acting out, or turning to drugs and alcohol are the only ways they are able to cope with their symptoms of depression. If you found yourself nodding along, try to find some healthier coping mechanisms, such as breathing exercises. Breathe in deeply through your nose while counting to ten, and then slowly breathe out through your mouth. Meditation and gentle stretching may also help you relax and cope with your emotions in a healthy way.
• Manage your stress at work and at home. While very different, both work stress and home stress can worsen the symptoms of your depression. Don’t feel guilty about carving out time for yourself to do things you enjoy.
• Prioritize your physical health. Get plenty of good quality sleep, maintain a healthy and balanced diet with lots of fruits and vegetables, and abstain from using drugs and alcohol. Daily exercise can also help relieve the symptoms of depression. Overall, taking care of yourself can put you in a better mindset to deal with the symptoms of your depression.
• Tell someone immediately if you have thoughts of harming yourself. Call 911 or go to a hospital emergency room. Ask a friend or family member to stay with you. Don’t be alone. You can also call the toll-free 24-hour hotline of the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255); TTY: 800-799-4TTY (4889) and talk to a trained counselor.

Supporting a loved one with depression

It’s likely that someone you know is experiencing feelings of depression, and starting a conversation with them about their mental health is not always easy. Remember that even though it may be difficult, showing your support can make a difference in their lives.

Here are some ways to support a male loved one with depression:

• Listen carefully and patiently while you talk with him. When he opens up to you, offer him support, understanding, and encouragement.
• There are no “casual” comments about suicide. Never ignore comments about suicide or suicidal thoughts, and be sure to alert his medical provider.
• Invite him on a walk or a hike to help him increase his physical and social activity. If he declines, keep trying, but don’t force him to take on more than he is comfortable with.
• If he has concerns about medications, encourage him to have a conversation with his health care provider.

Remember that with time and treatment, the depression will lift. Click here to connect with one of our providers today, and get back to feeling like yourself again.

Sources

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3928067/
2. https://www.cdc.gov/nchs/products/databriefs/db330.htm
3. https://afsp.org/suicide-statistics/
4. https://www.sciencedirect.com/science/article/abs/pii/S0272735816300046
5. https://pubmed.ncbi.nlm.nih.gov/18575787/
6. https://pubmed.ncbi.nlm.nih.gov/15982748/
7. https://www.apa.org/pubs/journals/releases/cou-cou0000176.pdf
8. https://journals.sagepub.com/doi/pdf/10.1177/1557988315623993