12 Signs of Depression in Men

People who are depressed undergo a series of physical and emotional changes. They can experience fatigue, as well as psychomotor retardation, or a slowing down of physical movements, speech, and thought processes.

According to Josh Klapow, PhD, a clinical psychologist with the University of Alabama at Birmingham's School of Public Health, men are more likely than women to report fatigue and other physical symptoms of depression as their chief complaints.

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Health problems such as constipation or diarrhea, as well as headaches and back pain, are common in people who are depressed.

But men often don't realize that chronic pain and digestive disorders go hand in hand with depression, according to focus groups conducted by the National Institute of Mental Health. Norman Sussman, MD, a professor of psychiatry at the NYU Langone Medical Center, says people who are depressed do genuinely feel bad physically.

"It is a medical disorder," says Dr. Sussman.

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Instead of seeming down, men who are depressed often show signs of irritability. "If they talk about an emotional component, it could be sadness with irritability," says Dr. Cook.

In addition, says Klapow, negative thoughts are a common aspect of depression. "Men will report feeling irritable because they are having negative thoughts constantly," he says.

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Psychomotor retardation can slow down a man's ability to process information, thereby impairing concentration on work or other tasks.

"Depression fills one with negative thoughts, almost like an intrusion," Klapow says. "You're slowed down and constantly thinking about negative things in your world. As a result it makes it very difficult to focus on anything."

"I describe depression as a form of reversible brain failure, Dr. Sussman says. "When you're depressed, it's like your CPU [central processing unit] isn't working properly."

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Some men manifest depression by being hostile, angry, or aggressive, says. Dr. Sussman. "A man who realizes something is wrong may need to compensate by demonstrating that he is still strong or capable," he says.

Anger and hostility are different than irritability. "Anger tends to be a stronger emotion," Klapow says. "Irritability is a crankiness."

Dr. Sussman says he's also seen men become hostile when they have withdrawn as a result of their depression and feel under pressure by friends or family to rejoin society.

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"Men might be more likely to report symptoms of depression as stress. It's not that they have more stress; it's that it's more socially acceptable to report it," Klapow says.

According to Dr. Cook, stress and depression can also travel a two-way street. "It's accurate to say that feeling stressed can be an indicator of having clinical depression but also be part of the cause," he says.

Research has shown that prolonged exposure to stress can lead to changes both in the body and brain, which can in turn lead to depression.

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Research has shown a strong link between anxiety disorders and depression.

Men may be no more likely than women to experience anxiety—in fact, anxiety disorders are about twice as prevalent in women—but it's often easier for men to talk about feeling anxious rather than sad, Dr. Cook says.

Men may discuss concerns about work and whether the loss of a job will impede their ability to provide for themselves and their family. "It may be easier to put words to worries and fears," Dr. Cook says.

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Depression is a common reason for loss of desire and erectile dysfunction (ED), and it's one symptom that men are inclined not to report. "Performance problems can come from depression and make depression worse," Dr. Cook says.

However, ED can be the result of other medical conditions or medications (including antidepressants), and ED by itself does not signal depression.

"My strong recommendation...is that you can't go after one symptom; it's a group of symptoms," Klapow says.

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"I can't count the number of people who have said, 'I had money in the bank but the phone got shut off because I couldn't bring myself to [pay the bill] or decide what to do and when.' It gets overwhelming," Dr. Cook says.

Some people naturally have a hard time making decisions, so an inability to make choices is usually worrisome only if it's a new behavior.

"It's an information-processing issue," and depression slows down your ability to decide, Klapow says.

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Women are more likely to attempt suicide, but men are more than four times as likely to die if they do attempt suicide. One reason is that men tend to choose more lethal methods. "They more often use firearms and kill themselves the first time they try," Dr. Cook says.

Older men are at highest risk for suicide, and doctors may miss depression symptoms in this group. In fact, more than 70% of older suicide victims saw their primary care physician within the month of their death.

Depression is not a normal part of aging in men or women.

If you or someone you know is considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), text “help” to the Crisis Text Line at 741-741 or go to suicidepreventionlifeline.org.

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