Identifying depression in men can be challenging for mental health care providers, however it can be even more difficult for the average man to know he has it. He may notice changes in his behavior, and know that he doesn’t feel like himself, but he may not link these symptoms
with depression because they are not the typical symptoms he sees on the antidepressant commercials. The truth is that male depression can be different than female depression, it can feel different and look different. It is easier to confuse male depression with stress, anger, irritability, etc… This may explain why male depression is under diagnosed and men continue to suffer in silence. Times have evolved and men are no longer expected to ‘tough it out’ when they feel depressed just like they wouldn’t be expected to deal with a broken arm without seeking professional help. Depression is not a sign of weakness, but a biological imbalance of neurotransmitters which can be successfully treated.
When compared to women, men are more likely to manifest their psychological symptoms of depression as physical ailments which are considered more socially acceptable. They may report feeling fatigued throughout the day, problems with excessive sleep or insomnia, high levels of stress, stomach aches or back/shoulder pains, problems concentrating and indecision. They may abuse alcohol or other substances as a way to escape their emotions; men will often be more irritable, angry and hostile towards those around them. Depression can also lead to complaints about anxiety, or an increase of reckless behavior. All of these symptoms are commonly found among men with depression, and are often the first signs to a professional that there may be something wrong.
As noted above, men and women present symptoms of depression differently. Women are likely to show more emotional disregulation (i.e., crying, sadness) while men are more likely to show more physical ailments. Below is a side by side comparison of depression among women and men, showing how the same disorder can present very differently among genders.
Women vs. Men1
Blame themselves vs. blame others
Feel sad, apathetic and worthless vs. feel angry, irritable and ego inflated
Feel anxious and scared vs. feel suspicious and guarded
Avoid conflicts vs. create conflicts
Feel slowed down and nervous vs. feel restless and agitated
Have trouble setting boundaries vs. feel the need to remain in control
Find it easy to talk about self-doubt vs. admitting self-doubt equates with being weak
Use food, friends, and love to self medicate vs. uses alcohol, TV, sports, and sex to self–medicate
Seeing the contrasting symptoms presented this way allows for a clearer understanding of how depression differs between men and women. Additionally, men also have some of the more common symptoms such as a persistent sad or empty mood, feelings of hopelessness, feelings of guilt, loss of interest or pleasure in hobbies, decreased energy, difficulty concentrating, difficulty remembering, difficulty making decisions, appetite or weight changes, restlessness, irritability or persistent physical symptoms2. These physical symptoms are often chronic headaches, digestive problems, fatigue, or chronic pain3. Since men display more physical symptoms of depression, they are likely to report these to their medical doctor not understanding that the root cause is psychological. The doctor may run some tests and announce the patient is fine, not understanding that their patient’s complaints are the result of an emotional illness.
Although there are multiple reasons why depression can develop, men are more likely to report triggers which exacerbate their symptoms. Some of these triggers are overwhelming stress at work, home or school, relationship problems, not reaching important goals, losing a job, constant money problems, chronic health problems, quitting smoking, death of a loved one, family responsibilities that are overwhelming (i.e., caring for an aging parent), or retirement4. When women experience these stressors, they may react with feelings of anxiety and being overwhelmed, however, the same situation creates feelings of inadequacy, hopelessness, and depression in men. Men often present as functionally depressed, meaning they are clinically depressed and suffer from symptoms of depression but continue to function at the minimum level throughout the day. They carry on with their routines, completing what is expected of them, but finding little to no enjoyment in what they are doing. It has become more about the routine and functionality of the tasks and less about the personal pleasure or enjoyment one normally finds in the daily tasks of life.
The presentation of depression varies depending on gender. Being aware of the different symptoms can help men find a clear diagnosis and present them with effective treatment options. A variety of empirically supported treatments are available for depression including medications, therapy, and behavioral changes which can be used in conjunction to produce a very effective treatment approach. If you or someone you know is suffering from depression, seek medical or psychological assistance immediately.
1 Diamond, J. (1998). Male Menopause. Chicago: Sourcebooks.
4 Lawrence, R., & Segal, J. (2013). Depression in Men. Retrieved from: http://www.helpguide.org/mental/depression_men_male.htm
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Last reviewed: 25 Aug 2014