Avoiding help and being a man have become synonymous. From professional athletes to sitcom portrayals of dads, we are told that a man’s gotta do what a man’s gotta do and he often has to do it alone.   

A main reason why men avoid seeking help is due to gender role socialization, the beliefs and expectations that we have for how a man should think and behave. Men should value certain ideals, such as being in control, being financial providers, and restricting emotions. When men allow themselves to experience emotions, it should be only anger or rage. These emotions propel the man to action versus emotions like sadness, shame, or loneliness, which heighten vulnerability and undermine the power and control he has been taught to seek.

When men restrict emotions, they also restrict expressions of emotions, such as crying. Boys who are raised to believe that crying is weakness eventually grow up to be men who are skilled at hiding their true feelings.

This phenomenon becomes meaningful in the assessment and treatment of men with depression. Many therapists are trained to see emotions, such as sad mood, as the hallmark symptom of depression. But how do we accurately assess and treat depression if a man avoids emotions? Instead of the stereotypical sad mood, men may exhibit masculine-specific depressive symptoms such as anger, conflict with family or spouse, increased substance use, or workaholism.

At face value, these symptoms are not assumed to be related to depression. The image of an angry person and a depressed person are quite different. However, men may feel safety expressing anger more than sadness, or may use substances to blunt the impact of depression. I have seen many men in therapy who believed that their problem was mismanaged anger, drinking a little too much, or not knowing how to communicate with their spouse. When we examined these symptoms through the lens of depression, therapy became more meaningful. These men were able to acknowledge the long-lasting impact of depression and gained insight to change.

Many men do not realize that there is a hidden link between masculinity and depression. Men need to receive therapy that acknowledges gender influences and examines how they influence psychological wellness. My specialization in men’s issues led me to become a psychologist in the U.S. Navy and contributor to the academic journal, Psychology of Men & Masculinity. Learn more about my approach to therapy here or schedule an initial phone consultation here.

Contributions from Rabinowitz & Cochran (2008).