Does Depression Show up Differently in Men?
Many men displaying anger or engaging in escapist or risky behaviors might be unaware that these behaviors are actually symptoms of underlying depression.
3 min read
Imagine a depressed person. What do you imagine? What is their energy level like, their temperament? What sort of comments do they make, how responsive or expressive are they? Now imagine that this depressed person is a man. Are you imagining the same symptoms?
Embedded in many descriptions of clinical depression is the symptom most commonly associated with depression, experiencing a “persistent feeling of sadness”. To openly display sadness, or even to experience it internally, requires a certain degree of vulnerability.
As many men who live and work in NYC understand, it can seem ill-advised to dwell on feelings of sadness or despondency in such a competitive & fast-paced city . Men have often learned, via socialization, to emphasize self-control at all times, a tendency which can cause them to deny their sadness. This denial can result in their depression manifesting outwardly in ways that might not initially be understood to be symptoms of depression.
So how does depression show up in men?
Stefan Allen-Hickey, a therapist at Downtown Somatic Therapy in Lower Manhattan who works primarily with men, notes that a salient symptom of depression in men is “irritability and/or impulsive aggressiveness”. Stefan says that “for many men anger appears to be a more comfortable emotion to feel than sadness. A lot of guys enter therapy to work on ‘anger issues’ only for therapy to reveal that they are deeply dissatisfied with various facets of their lives, or are contending with unprocessed grief or trauma”.
“For many men anger appears to be a more comfortable emotion to feel than sadness.”
Stefan suggests that somatic (body-focused) therapy can allow men to “slow down into an understanding of the sadness, hurt or dissatisfaction that their anger might be serving to cover up”. Stefan warns of a potential danger: “if depression masquerading as anger goes unchecked it can metastasize into controlling, violent or abusive behavior. Some men lash out at loved ones, co-workers, friends or even strangers if they feel they are losing control or influence in their lives.”
“A lot of guys enter therapy to work on ‘anger issues’ only for therapy to reveal that they are deeply dissatisfied with various facets of their lives, or are contending with unprocessed grief or trauma.”
In addition to anger, some men contending with depression might engage in escapist or avoidant behavior, either spending a lot of time at work or working out obsessively. As the end result of these endeavors could be more money or improved physical fitness, it can be hard to detect that the driver for this behavior is to avoid dealing with deep unhappiness. Men might also lean into alcohol or drug use, or engage in risky behaviors like driving recklessly or partaking in unsafe sex. Chronic despair might also appear in the form of a loss of drive, or an utter lack of interest, even in things that used to bring joy.
Stefan also reports that some men experience a “deep feeling of emptiness, a hole inside that they have no idea the cause of, nor how to fix or fill”. Stefan connects this depression symptom to the “existential theme of meaning/purpose.”
Stefan stresses the importance of men receiving effective therapeutic treatment for these various external expressions of depression: “without proper diagnosis it is unlikely that men will receive the care that they need, the sort of personalized attention that gets to the heart of what is really troubling them. To solely treat anger instead of the depression undergirding it, for example, merely equips a man with healthier ways to cope with a life that is making him unhappy. Getting at the underlying depression, however, can allow him to contend with the aspects of his life that are causing him to feel dissatisfied.”
If you or a man you care about is exhibiting increased irritability, escapist or avoidant tendencies, risky behaviors, sustained or increasing substance use, displaying a loss of drive, lack of interest, pessimistic worldview and/or difficulty discerning the purpose of their life, please don’t hesitate to reach out to Stefan or one of our other talented therapists at Downtown Somatic Therapy for a free consultation.