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Men are four times more likely to die by suicide in the United States than women. However, men are diagnosed with depression at significantly lower rates. And while almost 10% of American men experience some form of depression, less than half seek treatment for it.

How could this be?

Societal expectations, social stigma, and different coping strategies can create vastly different landscapes for how men and women recognize, talk about, and seek help for their depression.

Understanding these differences can make it easier for men and their loved ones to notice depression symptoms and know how to find adequate help.

What Does Depression Look Like in Men?

Everyone experiences the ups and downs of life — it’s inevitable. Usually, the low feelings come and go without lasting too long. But some numb feelings or negative and ruminating thoughts can continue over time and turn into serious mood disorders, such as depression.

Depression can affect a person’s ability to think, feel, and handle daily tasks. For some, the pain is so great that it drives them to take their own lives.

What are common signs of depression in men?

Depression symptoms for both genders often include:

• A persistent sad or anxious mood.
• Difficulty sleeping.
• Fatigue.
• Guilt.
• Irritability.
• Loss of interest in daily life, including family, hobbies, and work.
• Trouble concentrating.

However, men with depression may present symptoms differently from women. Oftentimes, men may be more likely to express their depression through behaviors such as:

• Anger or aggression (versus sadness and worthlessness in women).
• Escapism, typically seen in overwork or sports obsessions.
• Physical symptoms, such as headaches, digestive problems, or cardiac issues.
• Risky behaviors, such as reckless driving.
• Sudden changes in energy level, mood, or appetite.
• Suicidal thoughts.
• Using substances (alcohol and drugs), which mask the signs of depression.

Men are also less likely to describe feelings of sadness or emotional pain.

If a man experiences these symptoms for more than two weeks, they may have major depressive disorder, also called clinical depression.

Even suicide statistics have a gendered slant. Women attempt suicide more often than men, but men are more likely to die from suicide because they tend to:

• Act more impulsively.
• Choose more lethal methods.
• Show fewer warning signs.

What causes depression in men?

Depression is caused by a variety of factors, including biology, environment, and physical and mental health. Most men’s depression is caused by a combination of factors, including:

• Environment — Life experiences such as divorce, death of a loved one, financial stress, work changes, or other stressful situations can cause depression.
• Genetics — Men are more likely to be diagnosed with depression if there is a family history of the disorder.
• Health — Certain health conditions, such as cancer, heart disease, diabetes, or other serious medical illnesses, can exacerbate depression. In addition, some medications taken for a health condition may cause or worsen depression symptoms as a side effect.

How Do Societal Expectations Play a Role in Depression in Men?

Modern American society encourages men to remain emotionally stoic and discourages them from sharing their feelings. This stigma can create a seemingly unsafe environment for men to openly discuss their mental health struggles with those around them. They may fear being judged, mocked, or not believed.

Because of these societal pressures, men are more likely to become avoidant and push their feelings deeper inside. Their depression may often surface as anger. This can make it more difficult for family members and friends to recognize it as a symptom of depression.

Men are less likely to admit to themselves that they have depression, let alone to seek help and guidance from a psychotherapist, psychiatrist, or even a trusted loved one. Women are more than twice as likely to take a medication for depression.

Men are also more likely to abuse alcohol and drugs when they are depressed. That can make the condition harder to detect and treat.

Research shows that the men who need depression-related services the most are the least likely to seek out help.

Untreated mental health disorders, including depression, can lead to dangerous consequences, such as:

• Abusing oneself and others.
• Addiction.
• Loss of job, home, and material possessions.
• Relationship issues.
• Suicide.

How does depression affect older men?

Depression in older men can be even harder to recognize. Symptoms may overlap with other health conditions common later in life, such as heart disease or cancer. Older men may be less likely to report changes in mood or emotional distress.

As a result, depression can go untreated in this group. This is especially concerning because older men have the highest rates of death by suicide, making early recognition and treatment critical.

How Can We Change the Stigma of Depression in Men?

Depression can feel like an unbearable weight that will never disappear. However, there are proven steps that you or a loved one can follow to help ease the burden of depression.

The most important step is to tell someone you trust that you are feeling this way and to reach out to a licensed professional. This could be:

• A counselor.
• A psychiatrist.
• A psychologist.
• A therapist.
• Your primary care provider (PCP).

You may also find great comfort in sharing your feelings with a trusted member of your community. This should be someone who you feel will not judge you.

Even if you are nervous or scared to share your raw emotions, it is more likely that a loved one will respond with support, encouragement, and empathy. You may even find your confidant has experienced their own depressive symptoms. You are not alone.

Research has shown that the quicker you receive treatment, the sooner symptoms resolve, and the less treatment is needed. But no matter where you are on your journey, reaching out for help is always the best option.  Your loved ones will want to help you.

How Can I Show Support for a Loved One with Depression Symptoms?

If you know of a loved one who may be suffering from depression, one way to provide support is by reminding them that you are here for them without judgment. Encouraging them to share their feelings, participate in physical or social activities, and reach out if they are feeling sad can make a big difference.

Remember that they may not recognize their symptoms and may decline your offers to talk or get help. Don’t take it personally, but continue supporting them in small ways. Be patient, steady, and ready to listen if they do reach out to talk.

Can Lifestyle Changes Help Manage Depression?

Yes. Here are some important reminders that can help with managing your depression:

• Avoid alcohol and drugs — It can be tempting to turn to substances as coping mechanisms. However, research shows this can easily lead to addiction, alcoholism, and other negative consequences for your life and relationships. When you are feeling especially vulnerable, look for healthy coping mechanisms or call up a trusted friend who won’t tempt you.
• Focus on your routines — Continuing your daily healthy habits can help keep depression away. This can include the times that you wake up and go to bed, what foods you eat, your daily routines of taking care of your pets or children, socializing, and participating in hobbies.
• Give medication time — If you are prescribed medication for your depression, be patient. You may notice some improvement after about two weeks, but it can take up to six weeks to feel the full effect. You may not feel like yourself for several days after beginning them. Talk with your care provider and stay hopeful. Remember that healing is a process that cannot be rushed.
• Move your body — Exercise releases endorphins that can help fight mild to moderate depression on a routine basis. Physical activity can also help those with severe depression. Your health care provider can help you create a workout plan that can provide a mental and physical release.
• Practice compassion for yourself — Dealing with depression is no small feat. It can take time to heal and feel like yourself again. If you’re feeling overwhelmed, break up your task list into manageable bites. Avoid making important decisions when you are feeling particularly low. Find love for yourself, even on the hard days. This too shall pass, and it’s OK to not feel OK.
• Socialize — Spending time with other people is an important human need. Our brains are wired to connect with others. Make sure you are creating time to communicate with others — whether that’s your family, friends, coworkers, neighbors, or online community. This can be through a face-to-face meetup, a phone call, or even a text to a friend to ask about their day. You don’t always have to be talking about your feelings, but the more you practice it, the more comfortable you’ll become at it.

Talking about your feelings, making lifestyle changes, and seeking help are ways we can break men’s mental health stigma. We have the power to change societal norms by talking about depression more openly and neutrally.

UPMC Western Behavioral Health provides support for your mental health and well-being. With nearly 60 locations, you can find resources you need close to home. For more on the services we provide, visit our website.