Depression Assessment: Men

Ask almost any mental health provider or researcher and they will tell you depression is more common in women than men. In fact, is has been a longstanding and well-accepted finding that depression is diagnosed 2-3 times more often in women. However, researchers have also suggested that this difference is due in part to differences in whether men seek treatment for depression as well as the types of depressive symptoms men report. Recent research supports this theory and suggests that compared to women, depression in men may more often include symptoms such as outbursts of anger, excessive risk-taking (e.g. driving recklessly) and substance abuse (Martin, Neighbors, & Griffith, 2013). In addition, suicide can be one of the more tragic outcomes on depression and men are much more likely than women to die by suicide.

Theories About The Causes of Gender Differences in Depression

There are several theories to explain why depression is diagnosed more commonly in women than in men (Addis, 2008). One idea is that depression exists as the same condition in men and women, but is characterized by different kinds of symptoms. Because of the symptoms that have thus far been used to classically define depression, women may be more likely to be identified. Research supports this theory, sometimes called the “Sex Differences” framework, by showing that men who are depressed more often report anger, risky behavior and substance abuse when compared to women.

Another possible explanation, the “Masked Depression” framework, suggests that cultural norms about typical male gender roles more often prevent men from telling someone directly when they are depressed and from seeking help for depression (i.e. “A real man can take care of himself”). Another possible explanation, the “Gendered Responding” framework, suggests that men may cope with life’s difficulties in a different way than women, which makes them less prone to depression. Research supports this theory by showing that women are more likely to engage in negative thoughts about the causes and consequences of negative experiences whereas men may be more likely to distract themselves from distress about such stressors, for example, by engaging in long work hours.  

Considerations for Treatment with Men

Following the general treatment guidelines for depression is always a good place to start for both men and women. However, if difficulties arise in encouraging a loved one to seek treatment and/or consider treatment options for depression, it may be helpful to convey that many people have difficulties with stress and depression from time to time and that getting treatment for depression is a logical response to those difficulties. For men with traditional ideas about what it means to be “manly”, it may be helpful to acknowledge that cultural norms sometimes make it more difficult for men to acknowledge distress and ask for help. Oftentimes, loved ones worry that asking about suicide may make a person more likely to have or act on suicidal thoughts. However, if there is concern that a man may be thinking about suicide, it can be helpful to ask him directly by saying something like “Have things been so bad that you’ve thought about hurting or killing yourself” or “Are you having suicidal thoughts.” If he answers yes to these questions or expresses suicidal thoughts, listening, providing support and helping to connect him to a medical or mental health professional are important steps to reduce the risk of dying by suicide.   

Addis, M. E. (2008). Gender and Depression in Men. Clinical Psychology Review, 15(3), 15.

Martin, L. A., Neighbors, H. W., & Griffith, D. M. (2013). The experience of symptoms of depression in men vs women: analysis of the National Comorbidity Survey Replication. JAMA Psychiatry, 70(10), 1100-1106. doi:10.1001/jamapsychiatry.2013.1985