Depression is a mental health condition that can cause symptoms such as feelings of hopelessness and sadness, impaired daily functioning, and changes in sleep. Gender can play a role in how symptoms of depression are expressed, leading to potential differences in outcomes between men and women.
What are the symptoms of depression in men?
Depression can cause different symptoms from person to person, as well as differences between genders. As such, some symptoms of depression may be more likely in males than females, and there may be differences in the severity of specific symptoms [1].
Symptoms of depression that can occur in males include [1][2][3]:
- Loss of motivation and interest in hobbies
- Feelings of hopelessness, emptiness, and sadness
- Becoming angry, irritable, or violent
- Restlessness and hyperactivity
- Low self-esteem
- Poor concentration
- Physical pain, such as headaches or stomach issues
- Impaired social, professional, or personal functioning
- Increased or excessive focus on work
- Changes in sleep
- Changes in appetite
- Social withdrawal
- Drug and alcohol abuse
- Reckless behavior
- Impaired sexual function
- Suicidal ideation and attempts
Some of these symptoms are included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as criteria for major depressive disorder (MDD), also known as clinical depression [4]. However, some are not included and are commonly male-specific symptoms of depression [5].
Self-destructive, distracting, or masking symptoms are more common in males, including substance abuse, overinvolvement in work, and increased sexual activity [3][6].
What causes depression in men?
Generally, the causes of depression in men are the same as for women, including factors related to genetics and environment. In some cases, certain societal expectations of masculinity may act as triggers that increase the likelihood of depression among men, such as [1][6]:
- Unemployment
- Divorce
- Financial issues
- Physical illness
Due to societal norms and expectations regarding masculinity, men may view these circumstances as demonstrations of weakness, failure, or loss of power. As such, these situations can trigger depression in men [6].
Other risk factors for depression include [1][2]:
- Genetics: Depression is far more likely to occur in people who have a family history of depression or other mental illnesses.
- Environmental factors: Various life stressors and changes can increase the risk of depression, including issues with relationships, finances, and employment, the loss of a loved one, exposure to abuse and traumatic experiences, and loneliness.
- Illness: Some physical health conditions can cause symptoms that are similar to those of depression or can worsen pre-existing symptoms.
- Medications and substances: Various types of medications for physical and mental health conditions can cause or exacerbate symptoms of depression. Similarly, alcohol and illicit substances can also increase the risk or severity of depression.
Is depression more common in men or women?
Statistics suggest that depression is more common in females than males. Around 1 in 4 women are diagnosed with depression, compared to around 1 in 8 males [2][3].
However, these figures are likely to be a misrepresentation of the prevalence of depression. It has been observed that males tend to avoid seeking assistance for depression symptoms. Moreover, they often experience atypical symptoms and have a lower chance of receiving a diagnosis, irrespective of their symptoms. As such, the actual prevalence of male depression is not known [3][5][6].
This is further demonstrated by males being four times more likely to die from suicide than females. This statistic indicates that there are likely large numbers of males with undiagnosed or unreported mental health conditions [5][6].
Research shows that men are more likely to seek professional help for physical symptoms or impairments in functioning than for emotional distress [1][2].
Furthermore, males are more likely to present with escaping or masking behaviors, such as aggression and violence, an increased focus on work, sexual behaviors, gambling, or substance abuse. These symptoms can make it more difficult for depression to be recognized and diagnosed [3][6].
Additionally, symptoms that typically affect men are more likely to have an impact on others because they are externalized. For example, violence or substance abuse may affect partners, children, and friends [3][5].
Male depression diagnosis
Statistically, males are around half as likely as females to seek professional advice for mental health symptoms [5]. This is likely due to stigma and societal norms relating to masculinity. As such, it is often friends or family members who encourage males to seek professional help [1].
The stigma around societal norms and expectations of masculinity often begins at a young age, with teachers, parents, and peers encouraging stoicism in young boys. This causes young males to grow up believing that they should not cry or express their emotions as they would be perceived as weak [5][6].
Men often feel that they must demonstrate independence and control to be seen as masculine. This results in feelings of shame around admitting to emotional distress and vulnerability and fear of how they will be perceived.
In addition, this stigma can also result in men experiencing difficulties with recognizing and expressing their emotions. As such, even if they do seek professional help, symptoms of depression may go unnoticed or misinterpreted [3][7].
This is more likely to be the case in men who experience male-typical symptoms of depression, such as aggression, risky behaviors, and substance abuse. These symptoms are not listed in the DSM-5 as criteria for MDD [4], so a clinician may not recognize them as signs of depression and fail to make an appropriate diagnosis [5][7].
As such, mental health professionals must be adept at understanding body language, interpreting what is being vocalized, and recognizing male-specific symptoms. This may require the use of different questions and diagnostic tools when assessing men to accurately understand their symptoms [6][8].
In all cases, doctors will likely ask about the individual’s history of physical and mental health conditions and whether there is a family history of mental illness. They will also ask about any current diagnoses or medications that could cause symptoms, and if the individual uses drugs or alcohol.
The clinician will gather information about the presenting symptoms. This will include when they started, how they have changed or worsened, and how they are impacting the individual’s life [1].
Complications of male depression
Because men are less likely to seek help for depression, receive a diagnosis, or express emotional distress, many men live with unrecognized depression for several years [6]. Some of these men experience a severe worsening in their symptoms, particularly if they are socially isolated with no support system. This can lead to severe consequences, such as [1][5][6]:
- Substance and alcohol use disorders
- Increase in functional impairments
- Professional, financial, and housing issues
- Significantly reduced quality of life
- Increase in suicide risk
Statistics show that men are four times more likely to die by suicide than women. Suicide attempts may be of equal prevalence or slightly higher in women, but men have a much higher death rate. Furthermore, men are less likely to show signs of suicidal ideation or prior attempts, contributing to difficulties in recognizing suicide risk [1][5][6].
This highlights the importance of seeking professional help for symptoms of depression. Similarly, it indicates that there is a need for increased understanding among clinicians of male-typical symptoms of depression to enable accurate diagnosis.
Treatment for depression in men
Typically, men will be provided the same treatment for depression as women, which often involves the use of therapy and medication. However, some treatments may be tailored to suit individual needs, which can differ between males and females [6][8].
Therapy
Therapy can provide an opportunity for males to learn how to better recognize and express their emotional distress. This can help to reduce emotional symptoms and develop positive coping strategies to prevent externalized symptoms [1].
Men might find it useful to attend an all-male group therapy, as this can help to reduce feelings of shame and stigma around mental health, provide a support system, and create a better understanding of male depression [6].
Medication
Antidepressant medication might be prescribed to help reduce symptoms, although this can cause side effects. It is important to discuss any side effects with your doctor, who can monitor any physical and mental health changes, making alterations to your dosage or medication if necessary [1][6].
Self-care
It is possible to reduce or manage symptoms of depression by utilizing certain self-care strategies, such as [1][2]:
- Eating a healthy diet and drinking plenty of water
- Engaging in regular exercise
- Getting enough sleep
- Engaging in hobbies and social activities
- Using relaxation and breathing exercises
- Yoga and meditation
- Talking to others
- National Institute of Mental Health. (Revised 2017). Men and Depression. NIMH. Retrieved from https://www.nimh.nih.gov/health/publications/men-and-depression
- Health Direct. (Reviewed 2021). Depression in Men.Health Direct. Retrieved from https://www.healthdirect.gov.au/depression-in-men
- Martin, L.A., Neighbors, H.W., Griffith, D.M. (2013). The Experience of Symptoms of Depression in Men vs Women: Analysis of the National Comorbidity Survey Replication. JAMA Psychiatry, 70(10), 1100–1106. Retrieved from https://doi.org/10.1001/jamapsychiatry.2013.1985
- American Psychiatric Association. (2013, text revision 2022). Depressive Disorders. In The Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).APA. Retrieved from https://doi.org/10.1176/appi.books.9780890425787.x04_Depressive_Disorders
- Call, J.B., & Shafer, K. (2018). Gendered Manifestations of Depression and Help Seeking Among Men. American Journal of Men’s Health, 12(1), 41–51. Retrieved from https://doi.org/10.1177/1557988315623993
- Ogrodniczuk, J.S., & Oliffe, J.L. (2011). Men and Depression. Canadian Family Physician Medecin de Famille Canadien, 57(2), 153–155. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038800/
- Addis, M.E., & Hoffman, E. (2017). Men’s Depression and Help-Seeking Through the Lenses of Gender. In R.F. Levant & Y.J. Wong (Eds.), The Psychology of Men and Masculinities(pp. 171–196). American Psychological Association. Retrieved from https://doi.org/10.1037/0000023-007
- Stiawa, M., Müller-Stierlin, A., Staiger, T., Kilian, R., Becker, T., Gündel, H., Beschoner, P., Grinschgl, A., Frasch, K., Schmauß, M., Panzirsch, M., Mayer, L., Sittenberger, E., & Krumm, S. (2020). Mental Health Professionals View About the Impact of Male Gender for the Treatment of Men with Depression – A Qualitative Study. BMC Psychiatry 20,276. Retrieved from https://doi.org/10.1186/s12888-020-02686-x
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Naomi Carr is a writer with a background in English Literature from Oxford Brookes University.
Dr. Jenni Jacobsen, PhD is a medical reviewer, licensed social worker, and behavioral health consultant, holding a PhD in clinical psychology.
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