Why is it difficult for men to acknowledge depression?

It can be incredibly difficult for men to acknowledge they are depressed. In fact, many men with depression don’t even know it themselves.

Instead, they may find themselves addicted to their work, or to alcohol, drugs or sex. Or perhaps they find themselves flying off the handle at the smallest provocation. At the other extreme is the man who is anxious and lacking in confidence, almost afraid of life.

According to statistics, men don’t experience depression as much as women. In the UK one in four women have treatment for depression compared with only one in 10 men, according to the Mental Health Foundation.

But these figures probably hide a dramatic under-diagnosis of depression in men. This is because how depression appears is different with men than with women. In our culture, girls are encouraged from an early age to be in touch with their feelings, while boys are told to be ‘strong’ and not to cry.

This sets off a tendency in many men to play down the importance of their feelings and to actually lose touch with what they are feeling. It also means that men experiencing sadness, depression or other difficult feelings can feel somehow ashamed and not ‘manly’.

So, instead of seeking treatment, such as counselling, for depressed feelings many men channel their emotional pain into addiction, anger or passivity.

This is where we come across the man who works a draining and stressful 60-hour week, even though he doesn’t really need to. Or the man who seems continually angry or grumpy. Or the man whose life seems ruled by anxiety.

But to deal with these symptoms, in therapy, it is essential to explore the underlying depression. This will be difficult for the man because, while he may acknowledge he has a problem with addiction, anger or anxiety, he will usually be afraid of looking at the sadness, rage and grief that may underlie the depression.

It will usually take time for a man to begin to explore some of these difficult feelings in therapy, because he is afraid at some deep level of feeling shamed and ‘weak’. But if the therapist can build a trusting relationship with him then, over time, the deeper feelings will begin to emerge. 

The real work in therapy is dealing with these deeper feelings, making them more conscious and helping the client accept them. Paradoxically, it is only in acknowledging and accepting these difficult feelings that change can occur. Keeping them buried just means that they exert their power in a covert and unconscious way.