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Depression Can Look Different in Men

If you’re concerned about a man in your life who seems depressed, let him know you care and encourage him to seek help, says Michael Levy, MD, Senior Attending Physician in the Department of Psychiatry at Montefiore Nyack Hospital. “Men are much less likely than women to ask for help when they feel depressed,” he says. “They’re more likely to fall off the radar when they’re struggling.

Fortunately, most men with depression who seek treatment can get better and regain their zest for life, says Dr. Levy.

Who’s at Greatest Risk?
There are different forms of depression. Some people have one or several episodes of major depression, which interfere with their ability to work, sleep, eat, study and enjoy life. Others have persistent depressive disorder, which lasts for at least two years.

Depression seems to be more common in the elderly, says Dr. Levy. “It is often related to loss—as you get older you can lose loved ones, struggle with finances and declining health.” Men who are single, widowed or divorced are at higher risk of depression, as well as those with alcohol use disorder, financial problems, unemployment or a family history of depression.

Detecting Depression
Men who are depressed may have well-known signs, such as feeling sad, “empty,” flat, or hopeless. They may feel tired, not be able to concentrate or sleep, or they may sleep too much. They can withdraw from friends and family or become isolated. These signs are also common in women with depression. But depressed men are more likely than women to show anger, irritability, or aggressiveness.

Men struggling with depression also may have physical symptoms, such as a racing heart, tightening chest, ongoing headaches, or digestive issues.

The doctor will perform an exam and possibly lab tests to rule out other medical conditions that may have symptoms similar to depression. He or she also will ask about symptoms, including when they started, how severe they are, whether they have occurred before, and whether there is a family history of depression or other mental health disorders.

A Combination of Treatments
Treatment often includes a combination of antidepressant medication and/or psychotherapy. “A combination of both approaches is especially effective,” says Dr. Levy.

Antidepressants (if helpful) generally are taken for at least six months before the doctor determines whether the person should try to start tapering off the medication. “People with more than one episode of depression often stay on the medication indefinitely,” he says.

Talk-based therapy can help men learn new ways of thinking and behaving and help them change habits that can contribute to depression.

How Can I Help?
If you think someone is depressed, offer to help him find a doctor and make an appointment. If he doesn’t want to see a mental health professional, suggest he see his primary care doctor for physical symptoms such as feeling tired or trouble concentrating. Offer to bring him to doctor’s appointments and try to find activities that will keep him active and engaged. Offer encouragement rather than advice. Often, the best support you can give is simply to be present, be patient, and listen.

Don’t Ignore Signs of Depression
Anyone experiencing five or more of these symptoms for two weeks or longer should see their doctor or a mental health professional:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

(Source: National Institute of Mental Health)

Suicide Alert
Never ignore comments about suicide. If a person makes comments about suicide, alert his family, doctor, or therapist. “More than half of people who ultimately commit suicide have talked about suicide or made a previous attempt in the prior six months,” says Michael Levy, MD, Senior Attending Physician in the Department of Psychiatry at Montefiore Nyack Hospital. For immediate help, call the 24-hour, toll-free confidential National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or go to