One of the reasons I became a therapist  is my interest in helping people suffering from anxiety, social awkwardness, bipolar disorder, and depression. Over the years I’ve  observed that many men with depression have trouble admitting they are depressed. They often can’t even verbalize the words, “I am depressed.” According to Mental Health America, six million men suffer from depression. Research conducted by US  Department of Health and Human Services shows that depressive symptoms in boys have increased from 4.3 to 5.7% nationwide. Grim numbers for certain but the most worrisome aspect of all is the fact that  untreated depression can lead to anti-social behavior and suicide.

Does depression in men really differ from depression in women? Yes, men seem to experience and cope with depression in different ways than women but it’s important to consider the impact of societal ideals of masculinity on the differences.1. There’s a simplistic view that may be partially rooted in truth: women get sad, men get mad. Other male symptoms  include: fatigue, body pain, severe sleep disturbances, and erectile dysfunction. 

How Toxic Masculinity Hurts Men

In the American culture, and others, many men have difficulty expressing emotion due to toxic masculinity. Toxic masculinity refers to actions that discourage displays of emotion—other than anger—in men while also encouraging behavior that will deem the male “dominant” in a given situation. Even as children, young boys who express feelings are compared to girls in a negative context. Common responses to young males who become emotional include:

  • Boys don’t cry!
  • Man up!
  • Don’t be such a baby!
  • Don’t cry like a girl!
  • Be a man—get over it!
  • You throw like a girl!

You’ve likely heard these phrases directed at you or someone around you. You have probably noticed them in dialogue or in storylines on television shows and movies. And, you may even be guilty of uttering them yourself.

Imagine being a young boy, crying over a painful injury or an emotional heartbreak that feels like the end of the world, and then being told to “man up,” instead of being gently asked what’s making you cry, how you feel about it, and what you think you can do about it.

When feelings are dismissed and gender-defining thinking is heard repeatedly, a young person learns to avoid expressing their real feelings and begins to bottle up sadness. Over time, such behavior can lead to a dysfunctional emotional expression and ultimately, depression. 

A Cycle of Depression in Men: Recognizing the Symptoms

When a young boy grows up after absorbing the negativity portrayed by others, they often raise their own children—especially boys— the same way. Society dictates that boys be raised to believe that confidence, strength, success, and composure are the core elements of being a man, and anything “emotional” is girly or womanly, and should therefore be stifled and ignored. For this reason, symptoms of depression in men often manifest differently then they do in women.

Signs and symptoms of depression in men include:

  • Eating disorders
  • Erectile dysfunction
  • Fatigue
  • Feeling sad or angry inside but showing rage and anger to appear masculine
  • Unable to perform daily chores
  • Increased irritability
  • Lack of concentration
  • Lack of interest at work and in family
  • Lack of sleep
  • Self-medication with street drugs
  • Suicidal thoughts 

Men, Masculinity, and External Coping

Men raised in a system that promotes traditional masculinity have complicated feelings towards their own emotions. Often, they attempt to shut them off or avoid them completely. I believe that this is the reason why men are more likely to use external methods to cope with the inward turmoil and pain caused by depression. Men often deal with depression by over-working. They also self-medicate by turning to substances such as drugs and alcohol as a way to avoid dealing with depression and anxiety.  Physiologist and medical doctor Sigmund Freud, who is widely regarded as the father of psychoanalysis, famously said people repress from their conscious mind what they believe are shameful thoughts. In other words, people bury what they are ashamed of.  In 2003, the work of Harvard Professor of Psychiatry, EJ Khantzian, MD2 linked repression of emotion to self-medication as way of achieving emotional and psychological stability.

Lastly, many men express their internal conflicts by directing anger at those around them, like their partners or children. What do all of these external “coping” methods have in common? None of them actually help men cope with, or even face, what they are actually struggling with. 

Changing Our View of Men and Depression

Unfortunately, I’ve had several male clients relay painful stories about the insensitive responses they received when they confided in a loved one about their struggles with depression. Sadly, they weren’t met with sympathy or encouragement. Instead, remarks along the lines of,  “Why are you depressed about, are you on your period?” are fairly typical.

Yes, the friend was joking and likely trying to make my client feel better, but of course had the opposite effect. It’s easy to understand why men often prefer to keep depression to themselves—hidden from their friends and family members.

We need to change how we see depression in men; depression is not related to gender. No man or woman chooses to live with depression. Traumatic events lead to depression, and we need to accept this fact instead of dispiriting the problem and the sufferer. 

What You Can Do

Here are some tips you that can help you build trust and encourage the men you love to be more comfortable sharing their emotions:

Avoid trivializing depression in men. Instead of saying, “Are you insane?” or “Why are you acting like an emotionally-challenged person?” use empathy and provide support to your male friends and family members who are depressed. Finding the right words can be difficult and saying them can feel awkward  but being willing to listen, without judgment, is often the best thing you can do for someone who is depressed. Motivate them to share their feelings and emotions with you, and when they do, provide the moral support that they need instead of belittling them.

Change your expectations and reactions. As a therapist, I have witnessed that men suffering from depression never share their feelings because they would be mocked. The fact is that when someone is suffering from depression, sharing their feelings and emotions is necessary to help them cope with the problem. We need to be better friends, better partners and be the support that men need.

Be part of the solution by sincerely encouraging men to help them express emotions better. To help men you have to help them get rid of their hesitation in sharing their emotions. We must accept the fact that expressing emotion and crying are normal tendencies for all people, regardless of gender. Crying must not be associated with gender roles. Addressing and processing emotions is what makes us human, and crying is a fundamental emotion.

Each person is born with unique assets and challenges that affect how they grow and develop biologically, psychologically, and socially. Adult family members as well as adults in  neighborhoods, schools and the broader community, can facilitate that person moving toward growth and development. Help them face risks and challenges by helping them achieve a positive outcome. We often refer to overcoming adversity as promoting resilience.

We can change the model of masculinity by telling children that it’s fine for boys to express and show emotion. Male role models can practice what they preach by expressing affection and emotion: telling their children they love them; being comfortable hugging them; showing that it’s okay to cry at weddings, funerals, when they are injured, etc. and discussing everyday emotions such as, “my day at work was overwhelming and I struggled with some low points.” Teaching boys how to express their emotions adequately is the key to helping them become emotionally expressive. These lessons will have a positive effect on their life in the future.

It has been too long, that we have lived with the traditional model of masculinity and if you ask me, NOW is a great time to change how the society perceives emotional responses in men.

Depression is often a life-long illness. In most cases, long-term help may be needed to stay well, which includes sticking with treatment and developing and facilitating a plan for when symptoms return. Setbacks can happen to anyone even if you’ve been feeling well for a long time. Many men and women who live with depression learn to cope and are able to live fulfilling lives. Take it one step at a time, one day at a time. Your family, friends, and treatment team are resources.

If you are in crisis, you are not alone. Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, seven days a week. The service is open to anyone. All calls are confidential.

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Last Updated: Dec 5, 2018