Why Are The Signs Of Depression In Men Different?

Men and boys may face particular mental health stigmas that can make seeking care for a mental illness feel especially challenging or even shameful. Depression is a common mental health condition that anyone of any gender can experience. Signs of depression, however, may vary between people of different genders due to how different genders are socialized. 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 seen in 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 criteria in the Diagnostic and Statistical Manual of Mental Disorders do not distinguish between depression in people of various genders, depression in men can manifest differently than it can in women and people of other genders. These signs and symptoms often appear alongside various coping mechanisms and depression-influenced behaviors. 

In some cases, depression in men may go undiagnosed because their symptoms aren’t recognized as depression. It's also possible for some men to be reluctant to talk about depression symptoms, to downplay them, or to resist reaching out for support. Depending on what signs and symptoms of major depressive disorder a person is experiencing, it's also possible for depression to be misdiagnosed as a different mood disorder.

Common symptoms of depression in general include the following:

Men with depression may also show symptoms that might not be initially recognized as clinical depression by healthcare providers or others in their life, including: 

• Overindulging in escapism

• Medical issues

• Substance misuse or substance use disorder (sometimes incorrectly referred to as “substance abuse”)

• Irritability

• Risky behaviors

It's also possible for a person to have thoughts of suicide while experiencing depression. Suicide prevention is of vital importance.

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

Men with depression and other health conditions might struggle without support due to stereotypes about what "masculinity" means to them. These stereotypes might condition men to limit their expression of emotions linked to depression or even refuse emotional support or health services in order to avoid being perceived as "sensitive."

Because men are less likely to reach out for support with various health topics, they may be at a greater risk of their depression symptoms going undiagnosed or untreated, according to the National Institute of Health. It's also possible that certain physical symptoms can be directly tied up in 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 symptoms of depression in men

People with depression might show many possible signs and symptoms, some of which are found in people of all genders. However, the following symptoms may be common in men diagnosed with depression.

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 spent on something. Some common escapist behaviors common among men with depression may include things like:

• Watching and/or paying for pornography

• Playing video games 

• Working out 

• Gambling and sports betting

• Watching sports 

• Binge-watching shows or films

• Using and/or misusing substances 

• Engaging in sexual activity

If you find yourself utilizing the above coping mechanisms or other distracting strategies to escape from difficult symptoms or emotions, you might be experiencing escapism related to depression, bipolar disorder, anxiety, or another mental health condition or challenge.

Medical problems

Severe stress can be related to depression and might have an impact on mental health and physical health as well. For example, people experiencing signs of high stress and depression might experience headaches, gastrointestinal issues, and other ailments. Other physical manifestations of male depression may include sudden or significant weight loss or gain, fatigue, and a racing heartbeat. Physical signs of depression may be more likely or more severe when related emotions are suppressed or ignored, which may be more common in those socialized as men.

Substance use disorder

Some people may turn to alcohol or substances to cope with their depressive symptoms. 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 used to cope with depression.

Irritability

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

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, unsafe sex, and excessive gambling or overspending. People may use these behaviors as a shield to mask or distract from their depression. These symptoms might be mistaken by the person or a friend or family member for another condition, such as bipolar disorder, or even 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 depression support or talk to peers.

Addressing depression in men

The first-line treatment for depression is usually talk therapy. In some cases, joining support groups, making changes to your lifestyle, and taking antidepressant medications may also be recommended. Be sure to consult with a doctor before starting, stopping, or changing any medication. There are alternative options for depression treatment as well, which may be used in cases of treatment-resistant depression, such as repetitive transcranial magnetic stimulation—which research suggests may be effective in reducing depressive symptoms.

Often, men feel the pressure to be strong or stoic for their partners, families, or friends and feel unable to voice their needs as a result. Although it can feel scary to consider seeking the support of a health professional for signs of clinical depression, meeting with a therapist or counselor can be a brave first step to finding support. Such professionals are also trained in creating a safe, nonjudgmental atmosphere in which you can be honest about your thoughts, feelings, and concerns so you can get support for depression or treatment-resistant depression.

Men and women and people of other genders who may be nervous about seeking in-person talk therapy for depression symptoms or other emotional challenges might consider online therapy instead. With a platform like BetterHelp, you can get matched with a licensed therapist and meet with them via phone, video call, and/or in-app messaging from anywhere you have an internet connection. 

This flexibility makes many individuals feel more comfortable seeking care. Plus, research suggests that online therapy may be especially effective for men, since this type of treatment often allows for reduced gender-based stereotypes and feelings of judgment.