During an episode of the hit NBC drama, “This is Us,” two brothers-in-law shared their mental health struggles:

“I can’t picture you with anxiety,” Toby tells Randall. “You know, the way you present.”

“That’s what we do, right?” Randall says, placing his fist on his chest. “Men.”

Toby hesitates, then shares that he takes antidepressants. “Without it, life gets pretty scary.”

“Never would have known,” Randall says, shaking his head.

“Yeah, well…,” Toby replies, tapping his fist against his head. “Man.”

This rare exchange on a popular primetime television show underscores that men are often reluctant to share their mental health struggles, including depression.

“Fighting depression is difficult. Not only do you have to fight the illness, but you also fight the stigma attached to it. For men, the fear of looking weak or unmanly adds to this strain. Anger, shame and other defenses can kick in as a means of self-protection but may ultimately prevent men from seeking treatment,” wrote Joshua R. Beharry in a blog post for NAMI. Mr. Beharry is a project coordinator for HeadsUpGuys, a resource for men in pursuit of better mental health.

It’s important for men to share and treat their mental health challenges. Mental health is a vital part of overall health.

Men & Hidden Depression

 If you are a man who has experienced depression, you aren’t alone. The Centers for Disease Control and Prevention report that “nearly 1 in 10 men say they feel some depression or anxiety every day, and almost 1 in 3 have gone through a period of major depression at some point in their lives.”

Finding help for depression is crucial, as depression is one of the leading causes of suicide.  According to the American Foundation for Suicide Prevention, “in 2017, men died by suicide 3.54x more often than women, and the rate of suicide is highest in middle-aged white men in particular”.

HeadsUpGuys suggests there are several “misconceptions about depression that make it difficult for men to talk to others and take charge of their health” including:

• “Depression is a sign of personal weakness” – This is a myth. According to the American Psychiatric Association (APA), depression is an illness and is not the same as being sad. Depression lasts longer than two weeks and is often accompanied by other symptoms like feelings of worthlessness and self-loathing.
• Another myth that’s dangerously wrong is that men should somehow be able to “snap out of it.” Depression treatment requires tools to fight the illness – just like other physical medical conditions and illnesses.
• Thinking that asking for help makes you “unmanly” is another error. True strength comes in knowing you are struggling and getting the help you need.

Understanding Signs of Hidden Depression

Many people recognize the signs of depression – sadness, hopelessness, lack of appetite, sleep trouble, etc. – in both men and women.

However, while some depression symptoms are common for both men and women, the Mayo Clinic suggests that some behaviors men exhibit may point to signs of hidden depression, including:

• Escapist behavior, such as spending a lot of time at work or on sports
• Alcohol or drug abuse
• Controlling, violent or abusive behavior
• Irritability or inappropriate anger
• Risky behavior, such as reckless driving

Some of these symptoms and behaviors may overlap with other medical conditions. Accordingly, the Mayo Clinic suggests that men need to see mental health professionals to ensure accurate diagnosis and appropriate treatment.

Fighting the Stigma of Mental Illness

Just like Randall and Toby, the first step to fighting the stigma of mental illness is talking about it.

Since depression affects an estimated one in 15 adults (6.7%) in any given year, according to the APA, your friend or family member may be suffering. However, you might not know it and they might not know if they can talk about it with you. Sharing your own experience may make someone feel comfortable enough to share their own.

As a society, progress has been made in reducing the stigma of depression. It’s no longer “taboo” to talk about it in television shows, movies or music. However, a lot of work still needs to be done. There are many organizations working to reduce the stigma associated with mental illness. Some examples include:

• NAMI (https://www.nami.org/stigma) – the National Alliance on Mental Illness has a website dedicated to the issue
• Make It OK (https://makeitok.org/)–offers tips about how to start the conversation, recognizing stigma, and other suggestions
• Mental Health America (https://www.mentalhealthamerica.net/feelslike) – encourages people to share their struggles using the hashtag #mentalillnessfeelslike –
• Depression and Bipolar Support Alliance (https://www.dbsalliance.org/get-involved/) – created the Well Beyond blue initiative to accelerate innovation in treatment and care across the entire health system. They also offer peer support groups across the nation and online.

Together, we can help men (and women) feel comfortable getting treatment for their depression.

For more information about depression and stigma, please visit our blog post: “Why are so few people getting treatment for depression?”