Is He Depressed or Just Crabby?

Sadness that won’t go away. Episodes of crying. Dwelling on bad feelings. All of those familiar mood-disorder symptoms are common in women with depression — but not so much in men.

“When men are depressed, they may be less likely to express sadness and more likely to express anger, irritability and aggression,” says clinical psychologist Adam Borland, PsyD.

Other signs of depression in men can include:

• Impulsivity.
• Apathy.
• Low self-esteem.
• Blaming others. (Depressed women more often blame themselves.)
• Isolation from others.
• Increased focus on work.
• Needing to feel in control.
• Substance abuse.
• Gambling.
• Risky sexual behavior.

All of these signs can be cover-ups for sadness.

“Men and women also may share some basic depressive symptoms, like low energy, poor concentration and lost interest in activities they used to enjoy,” says Dr. Borland.

Not all drops in mood are depression, he says. Common sadness or irritability is usually temporary and triggered by something specific. Depression may have no clear trigger. And symptoms seem to take over your life (emotionally and physically), for two weeks or longer.

The effect on a man’s body

The thing about a mood disorder is that it’s not just an emotional problem. It can have physical effects too.

In women, depression can present as panic attacks or eating problems. Men, however, are more likely to complain of headaches, digestive problems or other physical aches and pains, says Dr. Borland. They may have trouble sleeping or eating — or sleep or eat too much.

They also may have decreased sex drive and trouble performing in the bedroom.

“It’s often easier for men to see a doctor for their physical issues than emotional ones,” says Dr. Borland. “They may be less willing than women to talk about emotional issues or less likely to realize their physical symptoms are depression.”

How to treat male depression

Men who may be depressed should start by seeing their primary care provider, who can rule out other health conditions and discuss ways to treat depression. Usually depression is treated with psychotherapy, medication or both.

“Psychotherapy, also called ‘talk therapy,’ can be just as helpful as medication,” says Dr. Borland. “Clinical psychologists and psychiatrists help patients uncover and change unhealthy thoughts and behaviors that could be contributing to depression. Sometimes it includes finding new ways of dealing with interpersonal conflict or other problems.”

Medications, called antidepressants, often are prescribed by a primary care physician or psychiatrist. They treat depression well, but can take several weeks to work fully. Symptoms may lift slowly and gradually.

There are dozens of safe and effective antidepressants available, but they don’t work the same in everyone. It may take more than one try for you and your doctor to find the right antidepressant for you.

What to do if your man is depressed

Many men won’t seek medical care for depression on their own. They may need encouragement from family or friends who’ve noticed a change in their ability to work, interact with others or function in everyday life.

If you think the man in your life may be depressed, here’s how you can help:

• Acknowledge his depression. “Tell him you’ve noticed a change,” says Dr. Borland. “Sometimes it’s best not to use the word ‘depressed.’”
• Offer your support. Remind him it’s ok to ask for help. Be patient and encouraging. Be a good listener when he wants to talk.
• Promote healthy living and self-care. Regular exercise and healthy eating are part of treating depression. Encourage social activity, but monitor use of alcohol, drugs, nicotine and caffeine. Discourage their use by not having them readily available.
• Focus on smaller, achievable daily goals. Completing them can be a boost, and staying engaged is good for mental health.
• Involve a doctor or mental health professional. Offer to help schedule an appointment and go with him. He may be more open to seeing his regular doctor about fatigue, loss of appetite or other physical signs of depression.
• Report warning signs of suicide. Men with depression are more likely than women to die by suicide (although women are more likely to attempt it). If he talks often about death or wanting to die, contact his doctor or therapist or call, text or chat with a counselor using the 988 Suicide & Crisis Lifeline.

Depression will go away

Overall, remember that healing from depression takes time — sometimes longer than you expect. With the right treatment, most men with depression will feel better eventually and regain their ability to work, sleep, eat and live normally.