Depression in men: symptoms, treatment, and prevention

Living with depression can be exhausting, making even everyday activities a challenge. Both men and women can have depression, but symptoms of depression can be very different in men. 

In fact, sometimes men’s symptoms can be so different from those most people associate with depression that the condition often goes unrecognized and undiagnosed. Not only does this mean many men are suffering unnecessarily, but it also means many men may be in unrecognized danger. Women are twice as likely to be diagnosed with depression, but men with depression are four times as likely to die from suicide (Call, 2018).

All of this is to say: male depression is a condition that needs to be taken seriously. Keep reading to learn more. 

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Men and women with depression may have the same symptoms, such as feelings of worthlessness or lack of energy. But men may also have symptoms that are very different from those generally experienced by women, such as reckless or violent behavior.

It’s not clear why symptoms of depression in men can be so different from those in women. There may be biological reasons, and there may also be social causes. Unfortunately, many societies stigmatize the emotions and behaviors that can accompany depression, seeing these as signs of “weakness.” Some men may try to disguise their true feelings for this reason (Seidler, 2016).

In addition, as some healthcare practitioners and others have observed, men, in general, may be more reluctant to examine their emotions than women. Some men may also express their feelings differently. Bear in mind, though, that these are generalizations. Plenty of men are willing to look at their feelings, and any individual’s actual experience can be very different.

About one in nine men will be diagnosed with major depressive disorder (MDD) in their lifetime. (See this article for more on different types and symptoms of depression.) But this may not be an accurate measure of the number of men who actually have depression. Rates of undiagnosed depression are believed to be much higher in men. Men also seek mental healthcare less often than women. And healthcare provider bias may be involved as well: men are less likely to be diagnosed with MDD, even when they score the same on a standardized test for depression (Call, 2018).

Men who experience depression may have many of the same symptoms of depression as women do. The nine symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are used by healthcare providers to diagnose depression in both men and women. These are (Chand, 2021):

• Difficulty sleeping or sleeping too much

• Loss of interest in activities

• Guilt feelings or thoughts of worthlessness

• Changes in energy level

• Difficulties concentrating

• Changes in appetite or weight

• Changes in the way you move physically

• Suicidal thoughts

• Depressed mood (feeling “low,” sad, or hopeless)

But some men may have symptoms that aren’t listed in DSM-5 as symptoms of depression, including (Call, 2018):

• Aggression

• Irritability

• Violence

• Substance abuse

• Behaving recklessly

• Working too much

• Withdrawing from family and friends

• Sexual problems, like decreased libido or erectile dysfunction

• Physical problems, such as ongoing headaches, digestive problems, feelings of tightness in the chest, or racing heartbeat

Men with depression are more likely to report alcohol and drug abuse in particular (Cavanaugh, 2016).

Some men may feel that there is a stigma around male depression. They think they’ll be judged harshly for emotions or behavior that may seem “unmanly” or “weak.” They may also fear that admitting to having depression will affect their career or their status at their job. These individuals may be less willing to talk about their depression symptoms and may try to hide them.

If this is the case, depression may come out as one or more of the physical symptoms listed above, such as headaches or digestive problems. When depression is expressed as a physical symptom or symptoms, it makes it harder to diagnose depression because other causes of those physical symptoms are often evaluated first. Men, in general, are more likely than women to go to a primary care provider than a mental health practitioner for these types of symptoms. Both the individual and the primary care provider might not recognize the physical conditions as symptoms of depression (Scholz, 2017).

Loss of desire to have sex and erectile dysfunction are often symptoms of depression (Liu, 2018; Thakurdesai, 2018). Unfortunately, men, and even their healthcare providers, may be embarrassed to discuss these topics. If you’re having sexual problems, it’s important to bring them out into the open and discuss them with your healthcare provider so they can be treated and any underlying causes identified. Depression treatment can help to restore libido and cure erectile dysfunction. Certain medications for depression don’t have negative sexual side effects and may even enhance sex (although there aren’t many good studies on this).

For a formal diagnosis of depression, five of the nine items in the DSM-5 list must be present. One of them must be a depressed mood or loss of interest. Because men can have different depressive symptoms than women, if you suspect you may have depression, it may be a good idea to see a mental healthcare professional rather than a general practitioner. A mental healthcare professional may be more likely to be aware of the different ways that depression can show up in men (of course, depending on your insurance plan, you may be required to see a general practitioner first).

The first step in diagnosis is to rule out any other medical conditions or medications that could be causing the symptoms. This is done through an exam and lab tests. The healthcare professional will ask how long the symptoms have been present and about any drugs, alcohol, or other risky behaviors. If you’re being evaluated for depression, it’s essential to be completely honest about this. The healthcare professional will also ask about your family history to see if there’s any history of depression or any other conditions that could account for the symptoms.

Because some men may be reluctant to discuss their feelings or to consider that they might have depression, sometimes a loved one who sees signs of depression must urge them to see a medical professional for evaluation.

There are many different treatments available for depression. Usually, it’s treated with medications, psychotherapy (talk therapy), or a combination of both. Many different antidepressant medications can be used to treat depression. A type of antidepressant called SSRIs is often the first antidepressant medication to be tried out.

Cognitive behavioral therapy is a useful mental healthcare approach that helps break the chain of negative thoughts that can go along with depression. Physical exercise is an underused but often effective way to treat depression. Improved physical health can go a long way to improve mental health. And even eating certain foods may help fight depression.

If you’re living with depression, you can work together with a mental health professional to find healthy ways of coping with depression. These might include setting realistic goals for yourself, seeking out support from friends and family, learning ways to handle stress, doing things you enjoy (like sports or a hobby), developing a healthy lifestyle, and exercising.

Depression can have a “steamroller effect”—once it gets started, it can gain momentum. Some men have found that it’s possible to prevent depression by taking certain positive actions.

One study asked hundreds of men about the methods they used to prevent depression (Proudfoot, 2015). Here are some of the most regularly used prevention strategies by the study participants:

• Eating healthily

• Keeping busy

• Exercising

• Using humor to reframe thinking

• Helping another person

• Self-rewarding with something enjoyable

• Achieving something (big or small)

• Remembering that everyone messes up sometimes

• Helping another person

• Using distractions from negative thoughts or feelings

If you or someone close to you thinks you may have depression, see a healthcare provider. Remember that untreated depression affects not just you, but also your loved ones, friends, coworkers, and everyone around you. Reaching out takes courage—it’s a sign of strength, not weakness, and the reward can be a healthier, happier life.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

October 08, 2021

Written by

Alison Dalton

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.