White, older man staring off into distance

Coming Out of the Dark: Men and Depression

When a boy or young man gets hurt physically or emotionally, more often than not he’s told to be tough and keep his feelings hidden. The phrase “Boys don’t cry” has a solid place in our national lexicon as American males are expected to suppress emotions that are commonly viewed as weak.

According to a 2014 report by the Substance Abuse and Mental Health Services Administration, more than 18 percent of American adults, or 43.6 million people, experienced mental illness in the previous year. This includes 6.6 percent who had a major depressive episode (MDE), which is categorized as depressed mood, loss of interest or pleasure in activities, significant weight loss or gain, insomnia or hypersomnia, restlessness, lethargy, feelings of worthlessness or excessive guilt, distractibility, and recurrent thoughts of death or suicide.

While women are statistically more likely to have a serious mental illness (5 percent) than men (3.1 percent), the percentage of men (3.6 percent) with a co-occurring mental illness and substance abuse disorder was higher than that of females (3 percent).

These statistics raise the following question: If millions of American men are suffering from mental illness but don’t feel comfortable expressing their emotions, what happens when their state of mind takes a turn into dark places?

Ross Teemant, senior director of Behavioral Health Outpatient Services for Texas Health Resources, said it’s difficult to know whether men “feel” depression differently than women, but their reactions will often differ based on conventional expectations.

“We all experience feelings in different ways, but I think there are traditional and societal differences that affect how men interact or communicate about depression,” he said. “The age-old rules requiring males to be tough and strong and not cry sometimes make it difficult for men to talk about feelings and express the symptoms they are experiencing. This is especially true if the symptoms challenge their personal rules about being a man.”

As many as 10 million Americans experience a serious mental illness every year. While more women than men are diagnosed, males (63.6 percent) receive treatment at a lower rate than females (71.6 percent).

Teemant explained that there are often clear disparities in the way men and women handle or experience depressive symptoms.

“Men seek treatment at a lower rate than women and I believe that is partly due to the drive to not be seen as weak,” he said. “Research shows that men tend to use distractions to deal with feelings and women tend to ruminate when feeling depressed.”

When males deal with untreated depression, their coping mechanisms can be extremely harmful, especially in younger men. Young Americans struggling with mental illness report much higher rates of untreated mental illness, contemplated suicide and alcohol dependence or abuse, with males ages 18-25 reporting almost double the rate of alcohol abuse — 8.7 percent for males versus 4.6 percent for females.

“Men are more likely to have co-occurring substance use which may be an attempt to self-medicate depression or could also lead to symptoms of depression,” Teemant suggested. “They have a tendency to express their depression through anger or external outlets such as physical activity, reckless driving and gambling. Additionally, men are more likely to use lethal means in suicide attempts and also have a tendency to be more impulsive.”

There is hope for men struggling with mental illness and depression, as multiple treatment options are available.

“There is some research that discusses differences in the way men and women metabolize medications, which may prove helpful in treatment protocols if future research supports early conclusions,” Teemant explained. “For now, treatment recommendations are very similar to research showing that a combination of pharmacology and psychotherapy is most effective.”

If you or someone you know is struggling with depression or other mental health issues, visit Texas Health Behavioral Health or call the help line at 682-236-6023, which is available 24/7.

Think menopause only affects women? Think again. Take our “Separating Fact From Fiction” quiz to learn more about how aging can affect male hormones. 


  • Charles James says:

    I am a male who suffered from depression for many years before seeking help. I found out it did not make one weak to take medications for depression. Men ARE told to bottle up your emotions. I found it to be too damaging to my heart to keep doing this. Guys, it is okay if we get depressed. It is okay if we cry at times. It is okay to get depression treated. Guys must be tough is a harmful phrase. Yes, guys can even be sensitive. From my studies, more men than women commit suicide or do something harmful to themselves. Sad but guys remember this: It is okay.

  • David Bratcher says:

    As I get older, my current age is 74, I am more emotional. I hate this but don’t know how to stop. I hide my true feelings as much as I can. Is this normal for older men?

  • John Fee says:

    Good article on who is affected by depression. However I would also expected some simple but effective easy treatment for this disease, such as exercise, diet, vitamins, etc.

  • Brent Dixon says:

    I suffered with depression for about 37″yrs of my life and then realized that it was a MIND over matter & if you don’t mind It don’t matter it’s the only thing I have found that change my life I am human and NO one is perfect the future is brighter buy the minute

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