10 Signs of Depression in Men

Content warning: There are multiple mentions of suicide in this article.

Growing up, boys typically receive different societal messages than girls. These messages often communicate the need to suppress vulnerability and exhibit extreme self-reliance while also adopting a readiness to take risks. Later in life, this can translate into mental health conditions manifesting differently. For example, the signs of depression in men can look different than women. It’s essential  to recognize these gender differences because depression is associated with serious health consequences if unaddressed. Anyone who identifies as male is also less likely to report any signs of depression relative to anyone who identifies as female, and men are more likely to die by suicide, making education about men and depression even more critical.

What is depression?

Everyone feels down sometimes, but depression is more intense or long-lasting than the occasional blues. It’s a clinical condition that can affect how you think, feel, and act. Often, people experience changes in sleep, energy, concentration or appetite, and feelings of sadness or hopelessness. People with depression may find it tough to do their usual activities like getting up for work or participating in activities they usually enjoy.

Signs of depression in men

While some men experience these common symptoms, for many, male depression presents differently. Depression symptoms in men may include:

#1 Irritability

Irritability is one of the most noticeable signs of depression in men. While anger is a healthy emotion and there are positive ways to express it, irritability from depression can present as a constant, underlying bitterness. One reason this may happen is because men are socially sanctioned to express anger but not vulnerability. For example, while boys are often discouraged from crying, lashing out in anger may be condoned or even reinforced.

#2 Physical complaints

The mind and body are closely connected, which is why physical symptoms are common in depression. A depressed man may report vague somatic experiences like sleep changes, fatigue, exhaustion, aches and pains, and digestion issues—often unaware that these may stem from emotional distress.

#3 Isolating

Social isolation can raise the risk of depression in males or worsen already existing symptoms. Some men “turtle up” when distressed. They may avoid social interactions and only engage in surface-level conversations that feel safe.

#4 Substance use

There’s been a lot of research on the link between substance use and depression in men. Men and boys may use drugs and alcohol in an attempt to suppress painful feelings. The problem is that it’s a temporary solution to a long-term problem, and substance use can result in increased depression symptoms in men over time.

#5 Weight changes

Since depression is known to influence appetite and weight changes, weight loss or gain can be another sign of depression in men.

#6 Self-harm

Non-suicidal self-harm is sometimes a feature of depression in men. If someone engages in self-harm such as cutting or burning their skin, it’s a clear sign that they’re feeling a lot of emotional turmoil. However, when someone punches a hole in the wall or hits their head against something, it may look like anger, but it could actually be non-suicidal self-harm.

#7 Suicidality

Women with depression are more likely to experience suicidal thoughts, while men are more likely to go on to complete suicide. One study reviewed 4,000 self-harm hospitalizations and found men had higher suicidal intent, meaning they had a specific suicide plan and were more determined to make sure the outcome would be death. Other research shows that while there’s no difference in suicidal intent between men and women, men are more likely to attempt suicide by gun or hanging, which is more often fatal than using drugs or carbon monoxide poisoning.

#8 Difficulty focusing and enjoying activities

Men with depression may find it hard to work and take care of family and home responsibilities, which can fuel a sense of guilt. They may also stop participating in other activities they once enjoyed.

#9 Sexual issues

Depression in males can contribute to sexual problems like decreased libido and overall dissatisfaction with sex.

#10 Indecisiveness

Another sign of depression in men is indecisiveness. This could stem from fear of making a decision that could potentially worsen their distress.

Knowing the symptoms of depression in men can make it easier to proactively offer support. As a clinician, I often see male depression when it’s reached a crisis level—the person’s job is in danger, their marriage is on the rocks, or they’re having thoughts of suicide. It’s important to intervene as early as possible because it’s much easier to address symptoms before they reach the crisis level.

Causes of depression in men

The causes of depression in men and women are similar, but some situational factors such as mental health stigma and societal messages about “acceptable” emotions can affect men more than women.

Suppressed emotions

Whereas irritability, anger, and aggression are more socially acceptable emotions for men, expressing feelings of sadness and self-doubt may be more acceptable for women. When people feel pressured to suppress their feelings, it creates a vicious cycle that increases the likelihood of stress, depression, and anxiety. Stoicism may mask discomfort, but it takes a toll on well-being. When boys and men do express vulnerability, they may get neutral reactions at best, but negative social consequences and judgment may be more likely.

It’s important to note that restrictive male gender norms have been slowly changing since the birth of men’s psychology in the 1990s. As culture has shifted, men are parenting differently and demonstrating different emotional repertoires, especially among Millennials. Their openness to expressing emotions is very dramatic compared to, say, Gen-Xers.

Limited social support

A lack of community can contribute to male depression and social isolation. Men tend to have fewer social connections than women, and those friendships may be more transactional—they’re based on reciprocation, serve a clear purpose, and can easily end without distress.  Social support is an important protective factor against both depression and suicide.

Stigma

Many men don’t get help for depression due to the stigma around help-seeking. It’s universally observed and well-researched that in many cultures, at a very young age, boys are socialized to be less emotional and more physical and action-based than girls. Parent and adult interactions with boys tend to be less focused on identifying feelings or creating space to communicate those feelings.

You’ll see this not only with parents, but also teachers and caregivers. The underlying message is that men are to be strong and unemotional, and if there’s a problem, you keep it to yourself. This isn’t done with malicious intent—it’s an ingrained, subconscious societal thread that limits opportunities for males to self-identify their emotions or observe healthy modeling on how to communicate their feelings.

Genetics

There’s also a hereditary component of depression in males and females. Studies show that you’re two or three times more likely to have depression if you have a parent or sibling with depression. If you’re predisposed to depression in this way, environmental factors can more easily bring depression to the forefront.

Situational factors

Stressful life events can trigger symptoms of depression in men, too. These may include situations like involuntary job loss, grief and bereavement, trauma from childhood neglect and abuse, military combat, dysfunctional attachments styles, or assault.

Illness

Medical conditions like heart disease, Parkinson’s disease, cancer, and chronic pain can all lead to depression symptoms in men or exacerbate already existing depression.

Misconceptions about depression in men

Given the different ways men and women are socialized, there are a lot of misconceptions about depression in men. For example:

Depression is a “women’s issue.”

Research shows that 10.5 percent of females in the United States are diagnosed with at least one major depressive episode each year compared to 6.2 percent of males. Some people look at prevalence rates of depression in men and think, “Well, depression is just more common in women than men,” and that it’s just biological. However, those prevalence rates have a lot to do with reporting. Men are less likely to report feeling depressed, but if you look at depression indicators such as suicide, substance use, anger, and overactivity like workaholism, male depression statistics don’t tell the whole story.

Some of these reporting discrepancies could be attributed to simply lacking the words to express their emotions. Alexithymia is a term referring to the difficulties of being aware of, identifying, and describing emotional states. Instead of reporting feelings of depression, men may use descriptors like stressed, tired, or run-down. Psychologist and former American Psychological Association president Dr. Ronald F. Levant argued that many men are consistently emotionally shut off—at least to some degree—and coined the term normative male alexithymia to describe this gendered difference in emotional literacy. This lack of vocabulary to express yourself can ultimately affect the quality of your life and the people around you.

Whatever the presentation of male distress, as a clinician, I proceed with this idea that there are feelings of helplessness, low self-esteem, and shame around the symptoms of depression in men. What you see on the outside doesn’t always reflect what’s happening on the inside.

Depression is a weakness.

Men are typically conditioned from a young age to never show vulnerability. In fact, research shows that men are more likely to agree with statements like, “Depression is a sign of personal weakness in men,” and that men who die by suicide are “irresponsible” or “pathetic.” Furthermore, men who have experienced depression or suicidal ideation report more embarrasment and self-stigma about getting help. In reality, getting help for depression is courageous. Each man who steps forward to seek help for depression becomes an example for other men. It is not an exaggeration to say that men who engage in therapy may help save another man’s life.

Depression makes you a burden on others.

Allowing others to help them or even see their sadness can feel very difficult for some men. Societal messages, like that men should be strong, self-reliant, and the “breadwinner” can make you feel like you’re letting others down if you don’t keep up with responsibilities or take time to do the things that can help you feel better. However, if you’re depressed, you can’t be there for yourself or your loved ones in the way you’d like to be.

Depression isn’t a real problem.

Men may think depression isn’t a real medical condition. They may believe they should be able to just snap out of it or that it will pass on its own. The truth: Depression is a medical condition that can significantly affect your thoughts, behaviors, and health. It should be given the same attention as any other medical concern like a physical illness or injury.

Effective approaches for depression in males

For both men and women, support for depression typically includes counseling and/or medication. Finding a mental health care provider with a culturally responsive perspective can help you stay engaged. For example, instead of looking at ways to “explore your inner thoughts or feelings,” you may feel more comfortable problem-solving and finding ways to “tackle, confront, or outthink” depression.

Behavioral activation is a key component of cognitive behavioral therapy (CBT) and, as a stand alone approach, is aligned with a lot of traditional male values. This technique focuses on changing what day-to-day life looks like rather than “digging down into your feelings.” With behavioral activation, you identify what you care about, what you’re doing (or not doing) that represents those values, and how you can take action to enact those values in your daily life.

By anchoring on things like values and goals, you can prioritize what matters most to you as you orient to change. Once you identify your values, such as being a good employee, father, or member of your community, you can explore behaviors that align with and represent these important aspects of a desired quality of life. For example, you may still feel depressed sometimes, but you can also take your kids to the swimming pool and activate your value of being a good dad.

How to help a man with depression

If you’re trying to support a depressed man, you might broach the subject with thoughtfulness around gender-sensitive language. If you say something like, “You seem sad,” or, “you look stressed,” some men may be likely to put it back on you: “That’s because I am stressed.” Try language like, “You seem kind of checked out,” or “I’m worried you’re not feeling your best.”

Normalize depression with analogies and frame seeking help in terms of strength. For example, maybe you point out that if you’ve injured yourself, the next step is physical therapy. Psychology is kind of like that. If your central nervous system is overstressed, you need to get to the cause of it just like an athlete would an injury: “Let’s address the pain and get you back out there.”

Depression is treatable

Getting help for depression is a sign of strength. With the right support, you can reclaim enjoyment and satisfaction in life and move forward.