I work with a lot of teenagers with suicidal ideation, so I was shocked when I learned that, according to the latest CDC report, the suicide rate in the United States is actually highest amongst middle-aged white males, who accounted for 69.68% of suicide deaths in 2020. Male suicide rates are 3.88 times higher than female suicide rates. And yet when most people think of depression, they think of the stereotyped image on the anti-depressant commercials- the dejected-looking woman sitting on the sofa with a cat in her lap, staring blankly out the window. By the end of the commercial, she has taken the magic pill and is now smiling while painting or taking a walk in the sunshine. We don’t likely picture a husband who is a workaholic or who yells at his kids as someone whose problem is depression.
Though depression is a wide and deep topic- there are different kinds of depression and the severity and effects can greatly vary- it is still typically considered a woman’s disease, even though it’s just as common in men. What are some reasons for the misconceptions?
1. Admission of depression is shameful for a man.
While women tend to be in tune with their emotions and express them fairly easily, men often struggle to articulate and share emotions. Men are likely to fear being thought of as weak or incompetent if they share feelings, especially those like sadness, fear, or anxiety, which are thought of as more vulnerable. Anger or jealousy may seem more “macho” and “appropriate” for a man to feel. If a man feels overwhelming sadness, he may feel ashamed and embarrassed to talk to anyone about it- especially other men, and even his wife. Though his wife may be a person he is more easily able to be vulnerable with, he still doesn’t want her to think of him as “less of a man,” and admission of depression may equate to that.
2. Big boys don’t cry.
Just like women may be more easily able to identify their emotions, and benefit from talking through them with someone, they also cry more easily, which can help them feel that they are releasing the negative emotions more effectively, purging themselves of them. I’m sure you’ve even heard women say they “needed a good cry,” because they realize how therapeutic that release can be. Men, however, have usually been conditioned from childhood to believe that crying isn’t as acceptable for them. Again, it’s perceived as a sign of weakness. Another depression stereotype is that people who struggle with it are always crying, so if a man senses he may be depressed, his first instinct is usually to shove that idea and its accompanying emotions way down deep, so that he WON’T find himself crying. The problem is that just because we ignore emotions or push them down doesn’t mean they will go away.
3. Emotions unexpressed become expressed as anger.
This statement isn’t a 100% of the time fact, but generally, anger is a secondary emotion. We feel fearful of losing something we have, so we get angry at whatever seems to threaten our security. We feel insecure about our ability to perform a task, so we lash out at the person who seems to question our competence.
Often women wonder why their husbands may get angry when they cry instead of giving the tender and empathetic response they desire, but if your tears are over something he feels he hasn’t done right, he isn’t angry at you, he’s angry at himself. Because of this, you won’t generally see a depressed man actually appear sad- you’ll see him be hostile and angry. In his book, “Unmasking Male Depression,” Archibald Hart asserts that while women may blame themselves for their depression, men may blame others for their depression, so that simmering anger may even have a target.
Conversely, male depression may also be expressed in passivity- not fulfilling his typical roles and responsibilities, or no longer caring in the way he once may have. Men are pros at stonewalling, as mentioned above, and that can apply not only to shutdown of emotional expression but shut down period.
4. Men have different coping mechanisms.
While a woman may turn to friends to help meet her emotional needs or use food as a coping mechanism- either not eating or overindulging- men tend to turn to different avenues of escape. Yes, men are quite likely to have a change in eating patterns when depressed, but more common escapes for men are tv, online and/or video games, pornography, sports or other beloved hobbies, drugs or alcohol, or even workaholism. Some depressed men actually throw themselves further into volunteer work or church ministry as a way to not only escape their feelings of sadness but also as a way to hide- who could suspect anything was wrong with a man who loves to serve? Yet it can be a warning sign if he does so at the expense of his family or other responsibilities- to an unhealthy extreme- and if accompanied by other signs of depression.
5. Causes of male depression can be different.
Certainly, there are those who seem to be deficient in “feel good” chemicals such as serotonin of both genders. There are also those of both genders who experience depression because of unresolved wounds of their pasts, shame over actions such as marital unfaithfulness, or circumstantial depression due to life situations (death of a loved one, loss of a job, etc.). Men do tend to have lengthier circumstantial depressions because of greater difficulty with going through a healthy process of grieving. Hart addresses testosterone-linked depression in men, as well as sexual implications for men of other types of depression.
He also asserts that men are more likely to be candidates for post-adrenaline depression. You know how when you push through a tough week at work or a project, or even after a vacation, you experience a “crash,” sometimes feeling completely drained, down emotionally, or even get sick? That is a normal process of your body trying to recover from using adrenaline, which was intended to be our body’s “fight or flight” mechanism, but in our culture is used for day-to-day activities. We can fail to slow down, pushing ourselves to succeed, even enjoying the adrenaline “high” we feel from an exciting event or project. Long-term use of adrenaline- type "A" personalities are most at risk- can lead to a total burnout, frequently accompanied by depression.
What now?
If you are a man who believes you may be depressed, I highly recommend you check out Dr. Hart’s book- it is informative but easy to read, and includes a valuable chapter for wives on healthy coping and responses, and even how to deal with a season of role reversal if your husband is unable to care for you or your children as he needs to because of his temporary inability to properly care for himself.
I know counseling can be hard for men, but if you’re willing to submit to that process, it can be helpful in
figuring out the contributing factors to your depression and to healing from it. Try to find a Godly man to talk to who can encourage you, such as a mentor or accountability partner. Being in community is
incredibly helpful, so finding a men’s small group, basketball league, or anything that gets you connected to others can help you feel better. It doesn’t have to be a place you talk about depression- it can be a safe space to be the version of yourself that you desire to be. If you already have an inner circle of buddies, don’t be tempted to withdraw from them during this time. Engage with them. If you’re married, talk to your wife. If you are depressed, it’s having an impact on her- it will make it so much easier for both of you if you let her in.
If you sense a man or teen boy in your life may be depressed, consider starting up a conversation about what you’re seeing. Affirm that you care. Show him that you respect him- don’t demean or patronize- but also show him that you are a safe place to be vulnerable with what he feels. No judging, no telling him how you think he should fix it- that’s what the professionals are for. Just listen. Be prepared that if he really is depressed, he will probably be really defensive at first. Remember that depression in men often manifests in anger- like a wounded animal, he may just be lashing out to protect himself. So just keep showing up. Just be there.