Understanding Depression in Men

Jane had been feeling sad and empty for a while. After talking it over with a friend, she made an appointment to see a mental health professional. She was diagnosed with depression and began a course of treatment that included counseling sessions and antidepressant medication. A few weeks later, Jane started feeling better.  

That’s not how it went for Joe. He felt tired and irritable for weeks at a time. He lost interest in his work and his activities outside of work. And despite feeling tired most of the time, Joe often had trouble sleeping. Sometimes he became angry and lashed out at people. After work, Joe tried to make himself feel better by self-medicating with alcohol. But he didn’t want to talk about what he was feeling, not even with his family or his closest friends.

Jane and Joe are fictional, but these different experiences with depression are characteristic of many women and men, says Robert McClure, MD, a psychiatrist at UNC Medical Center in Chapel Hill.

Men Are “Good at Hiding It”

Both men and women get clinically depressed. According to the National Institute of Mental Health (NIMH), women aged 18 years and older are much more likely to have depression.  About 8.5 percent of U.S. women had a major depressive episode in 2016, compared to 4.8 percent for men.

But men who are depressed often show it in less direct ways than women do. Many men do not recognize, acknowledge or seek help for their depression. This makes it much harder for family or friends to tell when a man may be depressed, Dr. McClure says.

“Men who are depressed can be quite good at hiding it,” he says.

Early Indicators of Depression in Men

Noticeable changes in a person’s behavior are often the first signs of depression. 

“Typically, the first thing that others see is a lot of social withdrawal, a man spending more time with himself, and less time with friends and family,” Dr. McClure says.

Other early indicators include:

  • Changes in sleep habits, such as: sleeping a lot more and spending more time in bed; sleeping less; difficulty falling asleep; waking up very early being unable to fall back asleep
  • Having less motivation and energy
  • Increased or decreased appetite
  • Acting out more, increased anger, irritability, lashing out at people

Modern Treatments Are More Efficient

One reason some men have for not seeking help is a concern that treatment will be open-ended, and expensive. But for most people who receive mental health treatment, that’s not the case, Dr. McClure says.

The most common course of treatment for depression is counseling sessions with a mental health professional, combined with medication. About 44 percent of people with depression follow this course. A smaller number receive counseling only (13 percent) or medication only (6 percent). Unfortunately, about 37 percent receive no treatment at all.

“Mental health care these days is a lot more problem-focused and symptom-focused, and treatments are a lot more efficient than they were 50 years ago,” Dr. McClure says. “In addition, most of the mental health care that people get now is time-limited.”

If you are unsure where to go for help for yourself or a loved one, Dr. McClure says, ask your family doctor. Or you can check with your insurance carrier to find a mental health professional who participates in your plan.

Help for Men in Crisis

Women with depression are more likely to attempt suicide, but men are more likely to die by suicide. Men often use more lethal methods in their attempts, such as firearms or hanging, while women are more likely to use less lethal methods such as poisoning (including self-induced drug overdoses).

If someone you know is in crisis and may be at risk for suicide, call 911 or take them to the nearest hospital emergency room, Dr. McClure says. If you are the person at risk, seek help immediately, either by calling the 988 Suicide & Crisis Lifeline or 911.

Depression can affect any man at any age. But with the right treatment, most men with depression can get better and gain back their interest in work, family and hobbies.

To make an appointment with UNC Medical Center’s Adult Psychiatry Outpatient Services, call 984-974-5217.