What are the signs of depression in men?

Men, women and people of all gender identities can experience depression at some point in their lives. Symptoms range from mild to severe and may include feelings of hopelessness and exhaustion, withdrawing socially, low self-esteem, and problems with sleep.

However, the symptoms of depression can be affected by a combination of social and biological factors that make it challenging to detect and diagnose in men. For example, they may feel pressured to hide their emotions to fit with masculine gender norms.

"While discussions around mental health seem to be expanding in reach and compassion, there's still some cultural and social stigma around depression, particularly among men," says Alison Sampson, a clinical psychologist at Priory Wellbeing Centre Southampton. "Generally, men are socialised by society to hold in their emotions, though we know doing so isn't healthy."

Although more women are diagnosed with depression², men are more likely to die by suicide³. This may be because women are more likely to seek support for a mental health problem and therefore access treatment.

What are the signs of depression in men?

Persistent low mood and suicidal thoughts

Although the signs of depression can present uniquely in each individual, there are some symptoms that present more commonly in men compared to women. "These include persistent low mood which can escalate to suicidal thoughts and feelings," Sampson explains.

"Other symptoms include agitated mood, irritability, feelings of anger and frustration, appetite changes - either eating significantly more or less - and difficulty sleeping."

Alcohol and drug use

Research has indicated that symptoms of depression in men is more likely to be expressed in ways that differ from the core symptoms of sadness and hopelessness. Appearing 'emotional' is often stigmatised, so depression can lead to unhealthy behaviours such as substance misuse⁴

"Men who experience consistent low mood may turn to drinking alcohol or taking recreational substances as a means of coping with their emotional discomfort," says Dr Natasha Bijlani, consultant psychiatrist at Priory Hospital Roehampton London.

However, research has shown there is a cyclical relationship between unhealthy alcohol consumption and depression⁴. Often, alcohol is used to make someone feel better, but drinking alcohol in excess can trigger or make mental health problems worse as it is a depressant. Drinking heavily can also increase the likelihood of risky behaviours, such as drink-driving.

These symptoms can be harder to recognise than the more typical signs of depression, such as persistent sadness. They may be seen as separate problems - rather than as a sign of a deeper mental health issue.

Anger

Some men who become depressed may hide their emotions of sadness and low mood and may present instead with anger, irritability or aggression.

"The symptoms of low mood are often suppressed by men and ultimately expressed by frustration," says Sampson. "Women, on the other hand, may be inclined to express their low mood in tears and words. Men have often been socialised to stand alone and limit their emotional expressiveness.

"For some men, seeking help is a sign of weakness and they do not feel they require support," she adds. "Depression in men is more likely to go unrecognised by other people and can be seen as external life problems, rather than an internal reaction to stress."

Why do symptoms of depression differ?

Often, how depression manifests can depend on the individual and the cause(s). Gender stereotypes and social conditioning are known to play key roles, but it can be linked to trauma, stressful events, bereavement, and other experiences too. Loneliness, birth and family history are risk factors too.

In recent years, researchers have begun to explore potential biological and genetic factors when it comes to differences in symptoms among genders. In 2018, a study⁵ proposed that there are molecular differences in the brains of cisgender men and women with depression. However, they concluded that more research was needed to understand the implications of the findings.

What to do if you are struggling with your mental health

Speak to your doctor

If you are struggling with your mental health or mood, it is important to speak to your doctor or a mental health professional. From counselling and therapy to medication, there are many different ways to manage and treat depression and other mental health problems. You can also self-refer for therapy on the NHS.

Speak to trusted friends and family

It's important to talk to trusted friends and family members about how you feel. It's not easy, but remember that depression is a common problem and isn't a sign of weakness.

Seek support for alcohol or drug problems

If you're worried about your alcohol intake or any substance abuse, speak to your doctor. They will be able to provide non-judgemental advice on support services in your local area. Try to be honest about how much you drink and any problems it may be causing you. The charities Drinkaware and Alcohol Change also provide advice and support.

Get help in a crisis

If you're experiencing a mental health crisis, get help straightaway. You can ring Samaritans UK on 116 123. You can also text "SHOUT" for free to 85258 from all major UK mobile networks. The NHS has local mental health helplines - search online to find one near you.

Further reading

1. Priory Group: 40% of men won't talk about their mental health.

2. Albert: Why is depression more prevalent in women?

3. Freeman et al: A cross-national study on gender differences in suicide intent.

4. Johannessen et al: Anxiety and depression symptoms and alcohol use among adolescents - a cross sectional study of Norwegian secondary school students.

5. Seney et al: Opposite molecular signatures of depression in men and women.