Men are commonly known for keeping their emotional struggles inside, especially those that show any signs of perceived weakness. That doesn’t mean that those feelings aren’t there, but rather that they aren’t choosing to share their inner battles, even with close family and friends. While most men may not be comfortable with discussing their emotions, we’re hoping to shine some light in the dark places.

The National Institute of Mental Health (NIMH) notes that because men may respond to depression differently than women, their family, friends and even physicians may not pinpoint the problem. Instead of feeling sad, a man battling depression may come across as angry or aggressive, which can delay a proper diagnosis and treatment.

Depression can show up at any point in a man’s life and is attributed to genetic factors, environmental stress and/or illness. It is more likely to occur if a man has a family history of depression or experiences a major life shift such as relationship changes (break-ups, divorce, etc.), the death of a loved one, financial difficulties or career problems such as a lost job or demotion.

Additionally, depression often goes hand in hand with other disease diagnoses, including diabetes, cancer, heart disease or Parkinson’s disease, and can complicate these health problems. Medications for these diseases may also worsen or activate depression.

Ken Jones, a psychologist and director of behavioral health at Texas Health Arlington Memorial Hospital, says men are often afraid to open up about depression due to societal norms and expectations.

“Although our culture is becoming less rigid with regard to gender roles, we still ingrain messages into our boys and young men that to cry or express emotion is a sign of weakness,” he explains. “Men grow up comparing themselves to a ‘gold standard’ which prizes power, invincibility and control as key traits of manliness. We must continue to redefine what it means to be a healthy male, to include the importance of emotional expression.”

Although depression can affect anyone — despite gender, income level, culture or level of education — Jones says men are less likely to receive the care they need for depression due to their hesitancy to admit that they may need help.

“Men need to understand that depression is not their fault; it is really the ‘common cold’ of the brain,” Jones explains. “It’s also important for men to know that they aren’t alone, that their depression is treatable and that it doesn’t indicate weakness. Being willing to reach out and accept help is actually a sign of strength.”

Depression may affect men and women differently, but it’s also important to note that symptoms will differ from person to person as well. The NIMH provides the following potential symptoms:

• Feelings of anger, irritability or aggressiveness
• Sadness and/or hopelessness
• Anxiety, restlessness or edginess
• Loss of interest in things that previously brought fulfillment, such as family, work and/or hobbies
• An inability to concentrate, recall details or handle normal, daily responsibilities
• Social isolation
• Lethargy
• Sleep issues, including insomnia or sleeping too much
• Sexual problems, including difficulty with desire and/or performance
• Eating too much or too little
• Physical problems, including pain, headaches, cramps and/or digestive issues.
• Engaging in high-risk activities, including overuse of alcohol or drugs
• Thoughts of suicide

Jones explains that it’s important to watch for the signs of depression in men, especially those that may seem unusual from their regular behavior patterns.

“It is important to understand that men often express depression in atypical ways, such as reckless behavior, social withdrawal, substance abuse, outbursts of anger or unexplained irritability,” he says.

If you notice a change in behavior in a man in your life, rather than giving him space to ‘work it out,’ Jones says to engage with him by pointing out the changes you are seeing. Doing so often shows support by acknowledging the non-verbal communication you are witnessing, and if you suspect depression, by encouraging them to seek professional help.

“Some men may initially be more willing to talk to their primary care physician rather than a mental health professional and that’s okay,” Jones adds. “A referral from a doctor they trust is frequently the bridge that connects them to a mental health specialist and the treatment they are needing.”

If you think you are experiencing depression, make an appointment to see your primary care physician to discuss your symptoms. He or she may prescribe an anti-depressant and/or send you to a specialist for therapy. Remember, depression is a real medical issue and should be treated as such, not viewed as weakness.

In addition to seeing your doctor, the NIMH suggests the following tips for self-care:

• Avoid isolation by spending time with family and friends, and talk about your feelings with those you feel comfortable with.
• Seek ways to find enjoyment in things you appreciated before your depression.
• Increase physical activity, as exercise can alleviate symptoms of depression.
• Set small goals to accomplish tasks that seem overwhelming.
• Maintain a daily routine by waking, eating meals and going to bed at the same time.
• Avoid alcohol and drugs.
• Don’t make any significant life changes or decisions until your depression lifts.

It may take several weeks for any medication to start helping your depression, so stick with it until it does. If you experience any troubling side-effects, or you feel like it’s not helping or making things worse, let your doctor know.

While living with depression is difficult, it’s perhaps just as painful to watch a spouse, family member or friend go through it. You may feel helpless, but be his advocate by doing the following:

• Be supportive by being patient, understanding and encouraging.
• Let him know you are a safe place where he can talk openly without fearing judgment.
• Help him by encouraging social and physical activity. Don’t push too hard if he says no, but keep trying.
• Remind him to take his medication, report any ongoing concerns and keep his doctor’s appointments.
• Never ignore comments about self-harm or suicide; but alert his physician.
• Be positive and remind him that with time and treatment, his depression will improve.

Jones says that while depression is treatable, it shouldn’t be taken lightly.

“There are very real consequences to untreated depression, especially in men,” he says. “While women more often report experiencing suicidal thoughts, men are 3.5 times more likely to die by suicide. If someone you know is experiencing depression or you have reason to believe they may be at risk for suicide, stay with them, call 911 or get them to the nearest emergency room for an assessment.”

If you or someone you know is struggling with depression or other mental health issues, call the helpline at 682-236-6023, which is available 24/7.