Peak Pursuit: From Silence To Strength in Facing Male Depression
Juanmonino
“We all go thru the sludge … and depression never discriminates. Took me a long time to realize it but the key is to not be afraid to open up. Especially us dudes have a tendency to keep it in. You’re not alone.”
—Dwayne Johnson (also known as The Rock), actor and professional wrestler, shares this wisdom from his own experience with depression.
Men are not alone—more than 300 million people are living with depression, the leading cause of ill health and disability worldwide. Depression is a mood disorder that is characterized by a persistent feeling of sadness and loss of interest in activities that were previously enjoyable. Lack of support for people with mental health conditions and a fear of stigma prevent many people from seeking treatment. Depression is also accompanied by social withdrawal and feelings of isolation, which can make it even harder for people to seek support.
Alongside depression, many men also grapple with masculine ideals that discourage emotional awareness, expression, and vulnerability. Emotional stoicism, self-control, independence, and competitiveness are often expected of men. These expectations can lead men to be unaware that they are experiencing depression. Those who are aware of their depression may avoid seeking treatment due to the overwhelming shame of not living up to societal ideals of masculinity. This shame intensifies the depression and feelings of isolation and helplessness. The Man Box study found that most men feel pressured to live in the “Man Box”—“a rigid construct of cultural ideas about male identity”—and that doing so has harmful effects. “The majority of men who adhere to the rules of the Man Box are more likely to put their health and well-being at risk, to cut themselves off from intimate friendships, to resist seeking help when they need it, to experience depression and to think frequently about ending their own lives.”
There is also a lack of awareness and recognition of depression in men among their friends, family, and healthcare providers. Studies suggest that doctors miss diagnosing depression in men 70% of the time. Men are diagnosed with depression at half the rate of women, yet their suicide rate is four times higher, accounting for 80% of suicides in the U.S. Depression is the most common condition associated with suicide. Men are less likely to show warning signs or discuss thoughts of suicide and tend to use more lethal means. Rising at an alarming rate, male suicide has been classified as a silent epidemic. Suffering in silence is costing men their lives.
Depression is associated with genetic, biochemical, and environmental factors, as well as physical and mental health conditions, including substance use disorders. Trauma and major life changes such as health and career issues, financial difficulties, divorce, and death of a loved one can lead to depression. Male depression is often described as covert depression, because the signs are less obvious than the more recognizable ones like persistent sadness seen in overt depression. Depression can also present differently in men than it does in women. However, the commonly used diagnostic criteria for depression are primarily based on how the condition presents in women, as they constitute the majority of those seeking treatment. Here are some of the common signs and symptoms for male depression:
1. A need for alcohol or drugs
2. High-risk activities, such as reckless driving, dangerous sports, and unsafe sex
3. Anger, irritability, or aggressiveness (for no apparent reason)
4. Escapist behavior, such as workaholism, having affairs, gambling, and playing sports or video games
5. Trouble sleeping (more common in men than women)
6. Feeling anxious
7. Loss of interest in activities that were previously enjoyable (including sex)
8. Feeling sad, lonely, or worthless
9. Suicidal thoughts or attempts
10. Physical ailments, such as random pains, headaches, backaches, digestive issues, and sexual dysfunction
11. Zoning out and being unable to keep up with responsibilities
12. Isolation
13. Mood swings
14. Controlling, violent, or abusive behavior
The three most commonly overlooked signs of depression in men are anger, risky or escapist behavior, and physical ailments. Anger, irritability, or argumentativeness towards the people that men are close to is often the first sign of depression that is observed, as anger is considered a socially acceptable outlet for men. Having a tendency to act out their stress rather than talk about it, men are more likely to use unhealthy coping mechanisms such as working or drinking too much. When men do seek treatment for depression, they are more likely to see a doctor for the physical symptoms of the condition. A referral from a doctor they trust is often what leads men to receiving mental health care. Men typically don’t disclose having any emotional problems to their doctors, and the problems they do disclose tend to be work-related. If they do disclose emotional problems, they tend to talk about them in terms of stress rather than sadness.
Marriage and family counselor Dr. Michael Gurian says, “For many males, increased anger and/or withdrawal are clear signals of sadness, hurt, and potential depression.” He adds that instead of expecting men to tell us that they are sad or hurt, we need to accept that the anger or withdrawal is already the expression of sadness, hurt, and potential depression. The inability to feel or describe emotion that accompanies covert depression is considered normative among men. It is called normative male alexithymia and is defined by the American Psychological Association as “a subclinical form of alexithymia found in boys and men reared to conform to traditional masculine norms that emphasize toughness, teamwork, stoicism, and competition and that discourage the expression of vulnerable emotions.” Therapist Dr. Assael Romanelli explains, “In fact, boys are born just as sensitive as girls. But through the socialization process, boys lose permission to feel and become disconnected from their core.”
As men become disconnected from their needs and other people, the key to healing lies in feeling their own emotions and connection. We can support them by gently bringing their attention to the changes we are noticing and encouraging them to seek professional help if needed. When interacting with them, it’s important to listen without judging, avoid minimizing their feelings, and respond with understanding and compassion. In addition to therapy, social support can also come from attending support groups, participating in social activities, volunteering, or caring for a pet. Men can also support their health by getting 7–9 hours of sleep per night, managing stress, practicing relaxation techniques such as meditation, getting adequate sunlight, exercising for 30 minutes per day, and having a healthy diet that avoids alcohol, caffeine, sugar, refined carbs, and trans fats.
"If you're going through your own version of mental wellness turning into mental hell-ness, the most important thing you can do is talk to somebody.” "It can't be fixed if you keep that pain inside. Having the courage to talk to someone is your superpower,” The Rock reminds us.
Facing depression takes courage, vulnerability, and support. Choosing this path opens the door to healing, growth, and resilience—and that is a powerful sign of strength.