Society generally conditions men to be stoic and suppress their emotions, which can make it challenging for them to express themselves openly. As a result, men with depression may be more prone to masking their emotions, using defense mechanisms like humor, anger, or substance use to conceal or numb their inner struggles.

In The Things They Carried, Tim O’Brien gives this stunning confession of the emotional pain that men hide, when he remembers his fellow soldiers in Vietnam: “They carried their reputations. They carried the soldier’s greatest fear, which was the fear of blushing. Men killed, and died, because they were embarrassed not to. It was what brought them to the war in the first place, nothing positive, no dreams of glory or honor, just to avoid the blush of dishonor. They crawled into tunnels and walked point and advanced under fire. They were too frightened to be cowards.”

There is evidence to suggest that depression is under diagnosed in men compared to women. Several factors contribute to this under-diagnosis:

Stigma and Societal Expectations

Traditional masculine norms often discourage men from expressing vulnerability or seeking help for emotional problems. Men may feel pressured to appear strong and self-reliant, which can lead to underreporting or downplaying of depressive symptoms.

Symptom Presentation

Men may present depressive symptoms differently than the classic diagnostic criteria, which primarily focus on symptoms such as sadness and tearfulness. Instead, men may exhibit symptoms such as irritability, anger, aggression, and engagement in risky behaviors. These atypical symptoms may not be immediately recognized as signs of depression by healthcare professionals.

Masking or Misattributing Symptoms

Men may mask their depression by engaging in high-functioning behaviors or using coping mechanisms such as substance abuse, workaholism, or risk-taking activities. This can make it challenging to identify the underlying depressive symptoms and diagnose the condition accurately. Men generally have higher rates of substance use compared to women and start using substances at an earlier age.

Help-Seeking Behavior

Research indicates that men are less likely to seek help for mental health concerns, including depression, compared to women. They may be reluctant to disclose their emotions or may perceive seeking help as a sign of weakness. As a result, men may be less likely to consult healthcare professionals or receive a formal diagnosis.

Social Support

Women often have stronger social support networks and may be more inclined to seek support from friends and family. Men may have fewer social connections or may be less likely to disclose their emotional struggles, which can impact their experience of depression and the availability of support.

Anger

Here are a few ways in which anger can be a mask for other mental health issues:

Defense Mechanism: Anger can be a defense mechanism that protects individuals from acknowledging or experiencing painful emotions associated with depression. It may feel easier to express anger outwardly than to confront and express feelings of sadness, vulnerability, or despair.
Emotional Displacement: Sometimes, individuals with depression may unconsciously displace their emotional pain onto anger. They might redirect their inner turmoil and dissatisfaction outward, expressing it as anger towards others or specific situations, rather than acknowledging and addressing the underlying depressive feelings.
Masking Vulnerability: Anger can be seen as a more socially acceptable emotion than sadness or vulnerability. Some individuals with depression may use anger as a way to hide their true emotional state, fearing that expressing sadness or asking for help will make them appear weak or vulnerable.
Control and Empowerment: Anger can provide individuals with a sense of control and empowerment. In the face of depression’s overwhelming feelings of helplessness and lack of control, anger can create a temporary illusion of power and influence over their environment or relationships.
Externalizing Internal Pain: Depression often involves internalized pain and self-blame. By channeling their emotions into anger, individuals can externalize their pain, attributing it to external factors rather than recognizing their own internal struggles.

It’s important to note that these are general observations and not applicable to every individual. Further, societal expectations about masculinity are evolving, and the impact on the presentation of male depression may also change over time.

Seeking Help

Compassionate support from family and friends can play a crucial role in helping someone begin the journey of unmasking. A non-judgmental approach can encourage open and honest communication that leads a person to seek professional help. At the same time, it’s very important to take care of yourself, as masking behaviors often put safety at risk. While supporting your loved one, prioritize your own self-care, avoid participating in or covering up their destructive behaviors, set boundaries on what you are and are not willing to tolerate, and follow through on consequences if necessary. Boundaries can help create a healthier dynamic that encourages your loved one to seek help.

Supporting someone with a mental health condition can be a complex process. It’s important to be patient, compassionate, and understanding as much as possible. If you or someone you know is experiencing destructive behavior or other emotional challenges that may be related to depression, seek professional help from a mental health provider. Here at Atlanta Wellness Collective, we want to help. For support, contact us or request an appointment online.

Disclaimer: This blog is not intended to substitute professional therapeutic advice. Talk with your healthcare provider about your health concerns and before starting or stopping therapies. No content on this site, regardless of date, should ever be used as a substitute for direct professional advice from your doctor or other qualified clinician.

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