Maybe you’re wondering why the nice guy in your life has been acting different lately—like a jerk. Maybe he seems irritated and crabby, or he’s having some uncharacteristic outbursts of anger, or he’s drinking way more than usual.
But maybe he’s not being a jerk at all. Maybe he’s depressed.
Turns out, men often express their depression differently than women do. Instead of crying, seeming sad, or talking about it, he might be going out of his way to avoid his feelings, even lashing out at friends and family in unexpected ways.
Depression, after all, is not an equal opportunity problem. Men are less likely than women to reach out for treatment of depression, or even realize that they may have it. Research shows that men experience it a lot less often than women do. Scientists haven’t figured out exactly why that is, but worldwide, more than twice as many women as men suffer from depression.
“There are classic symptoms that everybody experiences,” says Kerrie Smedley, Ph.D., a licensed clinical psychologist in Annville, Pennsylvania, “like loss of enjoyment, feelings of hopelessness and guilt, withdrawal, and focusing on flaws. But there are very real differences in the ways those symptoms are expressed. Men are much more likely to say they’ve got an anger problem. When I hear that, the first thing on my radar is depression.”
Nobody’s exactly sure why depression is much less common in men—but there are lots of theories. Some researchers think it could be genetic: A recent study found that some of the genes that regulate mood are expressed differently in men than in women.
Or we could blame it on hormones. “It’s possible that the higher levels of male reproductive hormones in men may have a protective effect against depression,” says Pavel Blagov, Ph.D., Associate Professor of Psychology at Whitman College in Walla Walla, Washington. However, he cautions that the jury is still out on this and the research isn’t conclusive.
It is also possible that depression is cultural. Women are often socialized to express their feelings and share them with others.
“Decades of research show that women are more likely to ruminate,” explains Smedley. “They tend to replay problems in their heads and talk about their emotions with friends, thinking they can solve their problems that way. But you can’t think your way out of problems—overthinking just tends to amplify our emotions. Men, on the other hand, are more likely to distract themselves from negative emotions by doing something else—and that can help them avoid depression.”
But even though men experience fewer episodes of depression than women do, they’re far more likely to commit suicide. The suicide rate is four times higher for men. Though women are more likely to attempt suicide, men are more likely to succeed.
“Depressed men are more likely to experience a sense of shame and humiliation,” says Smedley, “and that may lead them to suicide. For them, it’s not a cry for help or a way to communicate. It’s a decisive act that stems from their intolerance of those emotions.”
That makes it especially important to be on the lookout for signs of depression in guys.
“There are very well documented differences,” says Smedley, “in how men and women cope with distress.” So if you’re worried about that guy—your spouse, your friend, your brother—here’s how you can help.
Pay attention. “Be on the lookout for sudden, distinct changes,” advises Smedley. If you notice that a guy is acting differently than usual—like drinking a lot more, turning into a workaholic, having angry outbursts, or immersing himself more than usual in video games or sports—those changes may be warning signs of depression.
Start a conversation. Bring up your concerns, but be sure to talk about them gently. “Speak in a way that’s empathic and validating,” advises Smedley. “Things will go better if you say, ‘I’m really worried about you—I can tell you’re having a hard time.’ That’s way more helpful than telling the person he needs to see a therapist—which, in turn, makes therapy a weapon to show someone how bad they are. It makes it much less likely that they’ll seek help.”
Explore solutions. Though depression may look a little different in men, the treatments are pretty much the same—and equally effective.
“I don’t vary treatment by gender,” explains Smedley. Cognitive behavioral therapy (CBT) and other evidence-based treatments are super helpful, she points out, and for moderate to severe depression, physicians can prescribe antidepressant medication.
Help your friend seek out a therapist, or encourage him to visit his family doctor. Remind him to ask the doctor about the Genomind Professional PGx ExpressTM genetic test, which can assist your physician in making treatment decisions.