Why Are The Signs Of Depression In Men Different?

Men and boys may face mental health stigmas that can cause accessing care to feel challenging or shameful. Depression is a common mental health condition that anyone of any gender can experience. Signs of depression, however, may vary between those of different genders. For example, men may be more likely to experience anger and aggression rather than sadness, and they may not realize that this can be a symptom of some types of depression, including major depressive disorder. 

There are five significant depression symptoms commonly experienced by men, including overindulging in escapism, medical symptoms, substance use disorder, irritability, and risky behaviors. Although anyone may experience these symptoms, they may be more common in men.

How Does Depression In Men Differ 

Even though the criterion in the Diagnostic and Statistical Manual of Mental Disorders does not distinguish men from women, men can experience different symptoms and signs of depression compared to women and other genders. These signs and symptoms often manifest alongside various coping mechanisms and depression-influenced behaviors. In some cases, depression in men may go undiagnosed because their untreated depression isn't recognized as depression. It's also possible that they will be reluctant to talk about symptoms, their symptoms will be downplayed, or they will resist reaching out for support. Depending on what symptoms a person is experiencing, it's also possible for depression to be misdiagnosed as a different mood disorder.

Men and boys might experience the following common depression symptoms:

Men also may have symptoms that might not be initially recognized as clinical depression by health care providers or others in their life, including: 

• Overindulging in escapism
• Medical issues
• Substance use disorder (sometimes incorrectly referred to as “drug abuse”)
• Irritability
• Risky behaviors

Depression might cause men to struggle without support due to stereotypes about what "masculinity" means for a man. These stereotypes might condition men to limit their expression of emotions linked to depression or refuse to seek emotional support in order to avoid being perceived as "sensitive."

Because men are less likely to reach out for support, they may be at a greater risk of their depression symptoms going undiagnosed or undertreated (according to the National Institute of Health). It's also possible that certain symptoms can be directly tied up with stereotypes of male masculinity, like those that affect sexual desire. More than half of people with untreated depression experience sexual problems, which may further contribute to the lack of motivation to seek support.

Unpacking Common Depression Symptoms In Men

There are many possible depression symptoms, some of which are found in all genders. However, the following symptoms are often reported by men diagnosed with the condition.

Escapism

Overindulging in escapist behaviors could signal a desire to escape from reality or the symptoms of depression. These behaviors might vary but could involve an unhealthy or unsustainable amount of time and money. Some escapist behaviors common among depressed men may include the following:

• Watching or paying for pornography
• Video games 
• Working out 
• Gambling and sports betting
• Watching sports 
• Binge-watching shows or films
• Using substances 
• Sex 

If you find yourself utilizing the above coping mechanisms or other distracting strategies to escape from any distressing symptoms or emotions, you might be experiencing escapism related to depression.

Medical Problems

Severe stress can indicate depression and might have an impact on physical health. Men struggling with stress and depression might experience headaches, gastrointestinal issues, and other ailments. Other physical manifestations of depression in men may include sudden or significant weight loss or gain, fatigue, and a racing heartbeat.

Substance Use Disorder

Men may turn to alcohol or substances to cope with their depressive symptoms. Although doctors may be less likely to view this as a sign of depression in men, it is commonly reported by men experiencing symptoms of the condition. Substance use disorder (sometimes incorrectly referred to as “substance abuse disorder”) may also trigger depression on its own. However, the conditions are often connected. Substance use can also be a method of escapism. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

Irritability

While men with severe depression may open up and discuss their depressive symptoms, they might be more likely to express these symptoms through anger or feelings of irritability. Testosterone occurs in higher levels in those assigned males at birth or those taking testosterone as hormone treatment. This hormone has been associated with higher rates of aggression, irritability, and hostility, which may cause irritability for cisgender men and trans-masculine individuals taking hormones. 

Medical professionals may not see irritability as a sign of depression in men as it may be linked to traditional "masculine" stereotypes. Men may be able to refute this by letting their medical provider know they're concerned about how they feel and would like to be evaluated for depression.

Risky Behaviors

Along with substance use disorder, men who are experiencing depression may be more likely to engage in risky behaviors, including dangerous driving, binge drinking, sex, and gambling, as well as other risky financial behaviors. People may use these behaviors as a shield to mask or distract from their depression. These symptoms might be mistaken for another condition, or a stereotype about how men should act.   

Reducing the "male experience" to risky behaviors may also feel invalidating for men. If doctors, friends, family, and others perpetuate the idea that men must partake in frequent sex, drink alcohol socially, or spend lots of money, men may grow up believing that these behaviors are normal and not part of an underlying concern. They might also sense that they are not being taken seriously if they try to reach out for support or talk to peers.

Combatting Depression

There are several ways to fight depression, including discussing your concerns with a professional, joining support groups, making changes to your lifestyle, and in some cases, treatment involving antidepressant medications. There are alternative options as well, including brain stimulation therapies. Certain therapies, like repetitive transcranial magnetic stimulation, have been shown to be effective in reducing depressive symptoms.

Brain stimulation therapies are usually reserved for treatment-resistant cases of depression, and it may be helpful to explore more conventional avenues of treatment first, like interpersonal therapy or counseling. It may also be important to stay in the right mindset. Thinking of depression as a condition you are experiencing instead of a “mental health problem” can help you stay positive as you consider seeking treatment. Although it can feel scary to consider professional treatment, meeting with a therapist or counselor can be a brave first step to finding support. 

Its also possible for a person to have thoughts of suicide while experiencing depression. Suicide prevention is of vital importance; if you or a loved one are experiencing suicidal thoughts, it is essential you reach out immediately. You can reach The Suicide and Crisis Lifeline (which is available 24/7) by dialing 988. 

Often, men discuss an urge to be strong or stoic for their partners, families, or friends and feel unable to voice their needs because doing so would take up space. This can be particularly true when they are experiencing a mental illness. Because families may share the same primary care provider, men may also feel uncomfortable discussing issues with their family doctor. Setting up a space just for yourself may allow you to focus more actively on others in your life. If you worry about visiting an in-person counselor, you can also try online therapy, which allows a more discreet treatment. You can choose between video, phone, or live chat sessions and can choose the name or nickname you use on the site. If you're uncomfortable spending much money on treatment, online therapy may be much more affordable than traditional counseling. Studies show that online therapy may be more effective for men than for other genders, as it often allows for the removal of gender-based stereotypes in treatment. 

If you're interested in talking to a professional online about treatment or depression risk factors for men, consider signing up for an online platform like BetterHelp, which offers a growing database of therapists. When you sign up, you can indicate if you feel most comfortable speaking to a male therapist.