The South African Government has identified July as Mental Illness Awareness Month. Although there are a variety of mental illnesses, there is one which can easily be ignored, namely male depression.

In most cultures, men are brought up with the belief that they have to be strong and in control of their emotions at all times. Therefore, when they feel hopeless or overwhelmed by despair, they tend to deny it or cover it up by drinking too much, behaving recklessly or exploding with anger. But depression in men is a common condition.

Reasons men with depression are not easily diagnosed

  • Failure to recognise depression. Feeling sad or emotional is a well-known symptom of depression. However, for many men that is not the primary depression symptom. Headaches, digestive problems, fatigue, irritability or chronic pain can sometimes indicate depression. So can feeling isolated and seeking distraction to avoid dealing with feelings or relationships.
  • Downplaying signs and symptoms. Many men may not recognise how much their symptoms affect them or they may not want to admit to themselves or to anyone else that they are depressed. But ignoring, suppressing or masking depression with unhealthy behaviour will not make it go away.
  • Reluctance to discuss depression symptoms. Many men are not open to talk about their feelings with family or friends, let alone with a health care professional.
  • Resisting mental health treatment. Some men may suspect they have depression, but they avoid diagnosis or refuse treatment. They may avoid getting help because they are worried that the stigma of depression could damage their career or cause family and friends to lose respect for them.

Causes of depression in men

There is no single cause of depression in men. Biological, psychological and social factors all play a part, as do lifestyle choices, relationships and coping skills. Stressful life events or anything that makes him feel useless, helpless, alone, profoundly sad or overwhelmed by stress can also trigger depression in men. These could include:

  • Overwhelming stress at work or home
  • Marital or relationship problems
  • Not reaching important goals
  • Losing or changing jobs
  • Constant money problems
  • Health problems such as chronic illness, injury and disability
  • Recently quitting smoking
  • Death of a loved one
  • Family responsibilities such as caring for children, a spouse or aging parents
  • Retirement; loss of independence.

Warning signs

A man may be depressed if he has felt sad and miserable most of the time or lost interest and pleasure in his usual activities for more than two weeks.

While different people have different combinations of other symptoms of depression, the following are common symptoms that help in recognising depression in men.

  • Withdrawing from family, friends and activities
  • Becoming restless, unmotivated or generally slowing down
  • Inability to find pleasure in activities that are usually enjoyed
  • Moodiness or irritability – which can sometimes come across as aggression
  • Feelings of sadness, hopelessness or emptiness
  • Losing self-confidence, feeling like a failure
  • Suicidal thoughts
  • Sleeping more or less than usual
  • Feeling tired all the time
  • Unexplained headaches, backaches or other physical pain
  • Digestive upsets, nausea, changes in bowel habits
  • Significant changes in appetite, and/or weight loss or gain.

Difference between men and women

The following table is adapted from Male Menopause by Jed Diamond.

Women tend to: Men tend to:
Blame themselves Blame others
Feel sad, apathetic and worthless Feel angry, irritable and ego inflated
Feel anxious and scared Feel suspicious and guarded
Avoid conflicts at all costs Create conflicts
Feel slowed down and nervous Feel restless and agitated
Have trouble setting boundaries Need to feel in control at all costs
Find it easy to talk about self-doubt and despair Find it “weak” to admit self-doubt or despair
Use food, friends and “love” to self-medicate Use alcohol, TV, sports and sex to self-medicate

It is important for any man to seek help with depression before feelings of despair become feelings of suicide. You need to talk honestly with a friend, loved one or doctor about what is going on in your mind as well as your body. Once correctly diagnosed, there is plenty you can do to successfully treat and manage depression.


Author: Dr Colin Burns, retired medical practitioner and wellness coach