Why depression in men is so hard to diagnose

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According to the World Health Organisation, depression, which currently affects over 120 million people worldwide, will be one of the biggest contributors of global disease, second only to heart disease, by the year 2020. 

Depression is a mood disorder, typically characterised by feelings of intense sadness, a lack of motivation, apathy, a lack of joy and feeling empty on the inside. It has various types and often needs treatment using both psychotherapy and medication. In its mildest form it can have a negative impact on your daily life. At the severe end of the spectrum, it can be totally disabling.

Although genetics can play a role, as can having a family history of it, depression is typically triggered by stress. We all have a fuse box in our heads, one that regulates our reactions to the stresses and strains of everyday life but when a major stressful event occurs or lots of stressful events happen at the same time, the fuses can blow and you can go into a depressed state.

Depression is concerned with loss and failure. Stressful events can include the loss of income, or of a loved one, the breakup of a relationship and so on.

On top of that, a media-driven ideal of the perfect physique means that men are as concerned about body image as women.

However, it seems that psychological problems in men are hard for us to spot and recent research suggests that men are twice as likely to have conditions such as depression written off as nothing more than a low mood. One study showed that, due in part to the assumption that men are ‘tough,’ both sexes are less likely to spot the telltale signs of depression.

One doctor involved in the study, said, “In our society men are led to believe they don’t suffer from depression. Dominant views of masculinity stress toughness and strength.” But, based on figures from the National Office of Statistics, while it’s women that are more likely to suffer from depression than men, it’s men that account for 75 per cent of all UK suicides.

The problem isn’t just stress, loss or the media however, but men themselves.

Just as women are twice as likely to visit the doctor, so too are they more likely to seek out the services of a therapist. Typically, men tend to deny having depression (or any other emotional problems) in the first place. Depression is seen as a sign of weakness.

In fact, in another study, more than one in three young men said they would rather smash something up than talk about their feelings. Depression isn’t a sign that you’re weak though. In his book Depressive Illness: The Curse of the Strong Dr Tim Cantopher says it typically affects those who try to ‘tough it out’ no matter what.

Think of it as an illness (as common as the cold, as calamitous as cancer) that can affect anyone.

Seeking help isn’t a sign of weakness either. It takes strength to admit you’re in trouble. Another problem with diagnosing depression in men is that they tend to display it a little differently to women, typically masking it with anger and hostility. Which places us firmly back in ‘smash things up’ territory. It can also have a very negative effect on your libido.

So, if you’re stressed, irritable and have lost your sex drive, you might want to consider the D word.

If you think you have it, don’t hide it away like a guilty secret, do something about it. On a very practical front, the first step to solving a problem is recognising there is one in the first place.

And while there are various therapies out there, cognitive behaviour therapy is one of the more hands-on and practical of approaches. It’s very much concerned with looking at where you are, where you want to be, and giving you the tools to help you get there.

You may wish to consider any or all of the following, which have all been shown to help:


Antidepressants typically scare people away, but they shouldn’t. Yes, they are a mood-altering substance, but so are alcohol, cigarettes and, even, coffee. Side effects are minimal and you don’t have to stay on them forever. Think of them as a sticking plaster as you heal underneath.


All forms of meditation are excellent, but  mindfulness meditation, especially, is proving itself effective. Meditation boosts the production of happy hormones such as serotonin and dopamine.


Study after study has shown that exercise also boosts the production of serotonin and dopamine, thereby lifting your mood. Regular exercise can even be as effective as antidepressants.


A healthy diet can work wonders. So, ditch the junk food and go for foods rich in nutrients and high in anti-oxidants. Think ‘Mediterranean diet’ and you’ll have it covered.

As with most things in life, early detection is important. The earlier depression is diagnosed, the earlier you can start working on it, and the quicker you can get back on track.

For advice and information on depression contact Mind.

Daniel Fryer is a freelance journalist and psychotherapist.

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