“When women are depressed, they either eat or go shopping. Men invade another country.

~ Elayne Boosler, comedian

Men and women are different. Therefore, when a man comes to therapy, he often requires a different approach. Here are some ideas about how men and women differ, in general and on average, in their experience of depression. It is important to understand the unique needs of men when it comes to helping them heal.

Different Causes

In general, women tend to become depressed when they feel unloved, unappreciated, or unwanted. A woman’s depression is usually feeling-oriented, resulting from negative feelings about self or others. Feminine depression tends to occur in the context of interpersonal relationships and emotional experiences. In fact, one of the most common causes of depression in women is relationship or family problems. One of the most common fears among women is the fear of being unlovable or alone.

Men on average tend to become depressed when they feel unproductive, disrespected, incompetent, or powerless. A man’s depression is usually behavior-oriented, resulting from a perceived inability to control circumstances, succeed, or “do” things well. Depression can result when a man feels chronically disrespected by his romantic partner, coworkers, or peers. Masculine depression tends to occur in the context of actions and personal striving. One common cause of depression in men is job loss or job stress. One of the most common fears among men, not surprisingly, is failure.

Different Symptoms

A depressed woman will usually complain most about feeling sad or withdrawn, whereas a depressed man’s chief complaint will often be anger issues. Chronic anger in men is very often a sign of depression. Intolerant irritability is a signal that he is emotionally out of balance and may be struggling with depression, powerlessness, or some type of hurt.

Depressed men may: be irritable, blame others, feel suspicious or guarded, create conflict, seek to be in control all the time, or use alcohol, drugs, TV, sports, sex, or other activities to self-medicate. This is why substance abuse or addiction of any kind is a red flag that a man may be depressed. Another interesting potential signal of male depression is an inflated ego or haughty arrogance. The more a man has to “posture” or display macho bravado, the more insecure, out of control, and potentially depressed, he is likely to be.

 What Helps?

Clinical experience has taught me that most men struggling with depression frequently need help to do the following:

Become more assertive. Most men eventually discover a connection between feeling disrespected and feeling angry/depressed. Some men, ironically even those struggling with anger issues, need to learn to become increasingly interpersonally assertive (not aggressive) to get their needs met appropriately or to stop people in their lives from hurting their feelings, violating their boundaries or treating them poorly.

Increase emotional intelligence. This involves learning to identify their core emotions, what causes them, and appropriate, effective ways to handle them.

Deal with trauma and loss. Many men have survived traumatic experiences or profound loss, whether in childhood or adulthood, but it is far less socially acceptable for a man to openly discuss his pain. Some men need the space and safety to both disclose their traumatic pain and loss and work through the shame it has caused them.

Understand anger. Men can learn to recognize their anger as a signal that something in their life is out of balance and channel angry energy more adaptively.

Foster Spirituality. Men are capable of intense, meaningful spirituality and accessing a man’s reserves of faith and surrender is often a large part of his ultimate healing.

Take responsibility. To grow and heal, it is important for men to stop blaming others for their pain or struggles and to take responsibility for their own emotions, behavior, and decisions (this is important for women, too, by the way).

Deal with father issues. Many men need to forgive their father either for what their dad did or failed to do. If possible, creating a better relationship with him now can sometimes be helpful.

Increase connections. Most men need to feel connected with other men in relationships characterized by mutuality, openness, accountability, honesty, respect, and support. Yes, such relationships are most productive when men share their emotions and struggles with each other, though this looks very different than it does in female relationships.

Traditional talk therapy is often distasteful to men experiencing depressed. Some men will either avoid therapy altogether or not return after the first visit because therapy requires they do the very things men find most challenging: asking for help, being vulnerable, talking about emotions. The good news is that therapy can be quite helpful for a man if he is motivated and works with a mental health professional sensitive his unique needs.

For further reading on this topic, check out the following books: “Hold on to your N.U.T.s (Nonnegatiable, Unalterable Truths)” by Wayne Levine; “No More Mr. Nice Guy” by Robert Glover;“Wild at Heart” by John Eldredge.