6 Reasons Men Keep Their Depression a Secret
By Kenneth England, MFT, Primary Therapist, Promises Malibu
My son was 2 years old when he started preschool. I was astounded when I discovered they were teaching kids that young how to say, “I don’t like that.” Both boys and girls were encouraged to speak up for themselves. My son was shown how to express emotions without having to act them out, which was a big change from my childhood. When I was a kid, boys were taught to get aggressive with someone or yell rather than say, “Hey, I don’t like that.” And we were taught to hide other emotions, like sadness, at all costs.
Happily, my son, now 14, is part of a younger generation that is more oriented around feelings. But this is not the case with all guys, and certainly not the generations before him.
Men, in our culture and around the world, are taught to hide real feelings and suppress emotions deep down inside, which is one of the major reasons depression in men is underdiagnosed and undertreated. Research shows men are less likely than women to ask for help when it comes to depression. Many don’t even realize there’s a problem. Studies show there is a discrepancy between a man’s perception that he may need help and actually seeking it.
One of my main jobs as a therapist, especially with men, is to introduce them to the idea that they need a more emotional life. As they develop more emotional familiarity, they can learn to experience feelings, address them and cope more effectively.
Why Men Don’t Seek Help
Gender stereotyping plays an insidious part in how men learn to deal with their emotions. There are many influences at work. The first is family and immediate caregivers who teach males how men should conduct themselves in family life. Then there are societal pressures around how men are supposed to show up in the world. And then there is the media, which is filled with commercials, movies, TV shows and representations of men who are tough, have things under control and respond with aggression, never with vulnerability. There is the implication that men should not be affected by emotional things. It all adds up to make men feel badly about themselves when they don’t match those expectations and creates a barrier to asking for help.
As with everything, awareness is the first step toward healing and it can help men and their partners have a better understanding of depression. Here are a few of the main reasons men don’t ask for help:
- They don’t know how to ask. Statistically women tend to suffer from depression in larger numbers but they also are more likely to identify symptoms and seek professional and medical help. Diagnosing depression is a process of narrowing things down and eliminating other conditions. A therapist will ask a man how often he’s depressed, to what degree, does he feel sad or hopeless, and for how long. Men may not always have the emotional language to explain what they’re experiencing. Or they may be embarrassed or think it’s unnecessary to report
- Sadness is taboo. One of the main criteria for diagnosing depression is sadness. Men are not as likely to talk about “sadness” unless there’s been a death, which then makes it acceptable. It’s not something that men typically feel comfortable with. It often boils down to gender stereotyping, in that men are more often raised with family and social messages of what is appropriate for boys versus girls.
- Crying is forbidden. Tears are a common expression of the internal pain of depression but a man who cries may be called a wuss or worse. They learn from an early age that shedding tears is unmanly. The United States is not the only place where being an alpha male is celebrated. Many cultures believe males should be tougher than females and this can create many levels of emotional constriction. Showing emotions through tears is often considered unacceptable to men, and to the people around them, so sharing their pain is risky.
- Emotions are not the common vernacular. I notice that men tend to say archaic things about feelings, such as, “You shouldn’t be feeling this, this is not OK.” Or they say nothing at all. Not only are they uncomfortable talking about their feelings, they lack familiarity with the uncharted area of emotions. As a therapist, my number one source of information is my clients. If they are locked into beliefs based on stereotyping, it can be difficult to get them talking. They lack the skillset. They have to develop those skills and practice them.
- They tell themselves to just get over it. Men often make excuses about reaching out for help because they truly believe their emotions should not be an issue. As one client said, “I’m 45 years old. I don’t know why this stuff is bothering me. I should be done with this.” Men often feel stupid about having emotional pain. It takes work to help them realize sadness could be a response to an old trauma that’s been triggered, and that it’s wired in their system through their experiences from the past.
- It gets masked by addiction. Using alcohol or other drugs or turning to sex or other activities can make people feel good in the moment and take the pain away. Many of the clients I see have co-occurring disorders such as anxiety and depression. We do an exercise that explores the positives of drinking and drugs, as well as the plusses and minuses of being in recovery. Invariably, clients will come to the conclusion that the “benefits” of drinking and drugs is emotional-coping. It’s a powerful moment when they realize they’ve used drugs and alcohol to self-soothe. It’s the first step toward developing healthier coping skills. Part of the new skill is to learn to express sadness rather than covering it up.
Men don’t typically choose to put themselves in a place of vulnerability. They’re more comfortable with acting out and expressing angry types of emotions. In my work as a therapist, I aim to teach men that there is power in vulnerability and there is certainly no shame in it.