Eleonora Maria Vladimiro, Well.cy
When we hear the word “depression,” we usually think of someone who feels sad, withdraws from others or loses interest in things they once enjoyed. But what happens when depression does not show up as sadness or tears, but instead manifests as anger, irritability and aggression?
In men, depression can look very different from what many people expect. This is one reason some men fail to recognize the signs and get the help they need.
When emotional struggles hide behind an image of strength
Society has long associated masculinity with strength, self-control and the ability to handle any challenge. These expectations can lead some men to hide their emotions, sometimes even from themselves.
Eating disorders in men are one example. Actor Sylvester Stallone's personal account has drawn attention to how an unhealthy relationship with body image and food can exist behind an outwardly healthy appearance.
A man who spends excessive amounts of time at the gym, constantly striving to build more muscle, may be struggling with his body image without even realizing it. This does not mean that a strong commitment to fitness is itself a disorder. However, when it is accompanied by obsessive thoughts, anxiety or significant disruption to everyday life, it deserves attention.
The same can happen with depression.
In the United States, figures on men's mental health suggest that approximately one in 10 men experiences depression or anxiety, while only about half seek treatment. Rates vary depending on the study, population and measurement methods, but they point to an important problem: many men remain reluctant to seek mental health support.
Psychiatrist Dan Iosifescu has pointed out that many men grow up believing they must always be strong and that depression is something that should never happen to them. As a result, they may mistakenly view emotional struggles as a sign of weakness.
The reality is very different. Depression can affect anyone, regardless of gender, personality, professional success or physical strength.
The symptom that often goes unnoticed: Anger and irritability
The main symptoms of depression are similar in men and women. They can include persistent sadness, extreme fatigue, difficulty concentrating, sleep problems and a loss of interest or pleasure in activities that once brought joy.
However, some men express their emotional struggles differently.
Rather than appearing sad, they may seem constantly irritated, impatient or angry. Minor everyday situations can trigger disproportionate reactions, while arguments with family members, partners or colleagues may become increasingly frequent.
Anger can be an outward expression of emotional distress that a person struggles to recognize or put into words.
It is important to understand that irritability, angry outbursts and, in some cases, aggressive behavior can be associated with depression.
However, these are not exclusive or definitive signs of the condition, and they do not affect every man. Nor does every man who gets angry necessarily have depression.
Alcohol, adrenaline and staying constantly busy: Other hidden signs
Beyond anger, certain behaviors can become ways of temporarily escaping difficult emotions.
Some men may start drinking more alcohol, constantly seek out high-adrenaline activities or take greater risks than they normally would.
Others turn to seemingly harmless habits, such as spending hours watching sports or playing video games.
Clinical social worker Whitney Willborn explains that these activities can stop being simple sources of enjoyment and become ways of avoiding emotional pain.
The problem, then, is not the hobby itself, but how it is used. When an activity becomes excessive, affects relationships, sleep or daily responsibilities, and is regularly used to avoid confronting emotions, it may be a sign that something is wrong.
Why do so many men hide how they feel?
According to psychotherapist Matthew Strobel, the stigma surrounding sadness and emotional expression can lead many men to hide their mental health struggles.
Instead of talking about their disappointment, fear or loneliness, they choose to keep themselves constantly busy.
Workaholism, for example, can sometimes become a way of avoiding difficult emotions. A man may fill his schedule with professional commitments, leaving himself no time to confront the thoughts and feelings that are troubling him.
Although this approach may provide temporary relief, it does not address the underlying cause of his emotional distress.
Reluctance to seek help can also delay the recognition and treatment of depression. Women are diagnosed with depression more frequently, but that does not mean men are immune to serious mental health problems.
The traditional image of depression, usually associated with sadness, crying and anhedonia, or the inability to experience pleasure, does not always reflect the different ways the condition can manifest itself.
‘I have no patience’, ‘I'm exhausted’: What may be hiding behind these phrases
Experts have observed that many men decide to visit a psychotherapist only after someone close to them encourages them to seek help.
Even then, they may not describe their situation by saying that they feel sad.
Instead, they may use expressions such as:
- “I'm tired all the time.”
- “I have absolutely no patience.”
- “Everything gets on my nerves.”
- “Nothing makes me happy anymore.”
- “I don't feel like doing anything.”
Some men expect to feel better almost immediately. However, psychotherapy takes time and requires trust, patience and a gradual understanding of one's emotions.
For many, one of the most important steps is realizing that they do not always need to have all the answers. Sometimes, what they need most is someone who will listen without judging them.
How can you help a man who may be experiencing depression?
If you notice that a man in your life has changed his behavior, is withdrawing from others, becoming irritated more frequently or losing interest in things he once loved, the first step is to reach out.
You do not need to diagnose him or pressure him into admitting that he may be experiencing depression.
Instead, experts recommend taking a calm and supportive approach, without criticism or judgment.
For example, you could say:
- “I've noticed you haven't quite been yourself lately. Would you like to talk?”
- “I've noticed you've been withdrawing and haven't been sleeping well. Is something bothering you?”
- “You seem more preoccupied lately. Are you okay?”
- “I've noticed you no longer do the things you used to enjoy. Would you like to tell me what's going on?”
The most important thing is to create a safe environment where the other person feels comfortable opening up without worrying about being judged.
Encouraging them to speak with a psychologist, psychiatrist or another qualified healthcare professional can also make a significant difference.
When should someone seek professional help?
When a loss of interest, low mood or other symptoms persist for two weeks or longer and begin interfering with everyday life, it is important to seek an assessment from a mental health professional.
Depression can also involve changes in appetite or weight, sleep problems, difficulty concentrating, feelings of guilt or worthlessness and, in more serious cases, thoughts of death or suicide.
However, no one needs to wait two weeks before seeking help, particularly when symptoms are severe. Anyone experiencing suicidal thoughts or facing immediate danger needs urgent support.
Depression is treatable. Depending on the individual's needs, treatment may involve psychotherapy, medication or a combination of both.
Real strength means knowing when to ask for help
For a man who has always seen himself as the family's protector, the person everyone relies on and the one who finds solutions to every problem, admitting that he is struggling emotionally can be particularly difficult.
But mental health deserves just as much attention as physical health.
Depression is neither a personal failure nor a sign of a weak character. It is a genuine health condition that deserves recognition, care and, when necessary, treatment.
Ultimately, strength is not about always hiding how you feel. It is about recognizing when you need help and allowing yourself to accept it.
Sources
- Mayo Clinic: Male depression: Understanding the issues
- National Institute of Mental Health (NIMH): Men and Mental Health
- NIMH: Depression
- CDC: Mental Health Treatment Among Adults: United States, 2024
- National Library of Medicine / PubMed Central: Men and depression
