Some men go to work every day and exceed their boss’s expectations. Others may coach their kids’ games with a smile and say they’re fine when anybody asks. From the outside, a guy may look like he’s got things all figured out and doesn’t need any help. However, he may be struggling in big or small ways that he doesn’t quite know how to describe.
Scott Mallon, LMFT explained that the trouble is that depression in men rarely looks the stereotypical way people have come to expect, and that mismatch can cost a man dearly before anyone realizes what’s really going on. In a candid conversation, Mallon covered the signs that don’t look like signs, why anger so often takes the place of sadness, and how to help a man who may not even realize he’s struggling.
About Our Expert: Scott Mallon is a licensed marriage and family therapist (LMFT) with extensive experience helping individuals, couples, and families navigate depression, anxiety, trauma, and major life transitions including divorce, grief, and career change.
Depression in men often doesn’t look like sadness at all
When most people envision what depression looks like, they may tell you about someone who can’t get out of bed or who is bursting into tears all the time. Mallon noted that this is one of the most stubborn myths out there. In his experience, men’s depression frequently looks like the opposite of falling apart.
He has supported men who never cried, never stayed in bed, and never once called themselves depressed. They held down demanding jobs and showed up for everyone around them, all while struggling underneath. As Mallon described it, depression in men can surface as “irritability, emotional distance, exhaustion, loss of motivation, feeling numb, and simply feeling disconnected from life.”
That picture lines up with the clinical research. The National Institute of Mental Health notes that depression can look different in men than in women, and that men may show symptoms other than sadness, instead seeming angry or irritable. The American Psychological Association has made the same point for years through its Real Men, Real Depression campaign, which observed that men may express depression through increased fatigue, irritability and anger, loss of interest in work or hobbies, and sleep disturbances rather than the textbook signs.
Mallon shared that most men don’t walk into his office announcing they’re depressed. Instead they tell him, “I don’t know what’s wrong with me, but I don’t feel like myself anymore.” He told me that sentence is usually where the real conversation begins.
The signs that get mistaken for stress, his personality, or a bad mood
Part of what makes male depression so easy to overlook is that it disguises itself as the very things society encourages, and sometimes seems to demand, in men. Mallon laid out how the same struggle gets quietly relabeled by everyone watching: “The man who works constantly gets praised for being dedicated. The man who keeps everything bottled up gets called strong. The man who’s increasingly irritable gets labeled as stressed. The man who isolates himself gets written off as private. The man who shares how he really feels is labelled as weak.”
What outsiders miss in those moments, he explained, is that they’re watching someone slowly lose connection with the people and activities that once gave life meaning. That’s why a particular phrase always makes him pay attention. When a spouse tells him, “He’s just not the same man he used to be,” Mallon said his ears perk up, because that observation can signal depression far more powerfully than someone who simply looks sad.
Why depression in men so often comes out as anger
For many men, anger and irritability become the visible edge of a much deeper struggle.
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Although sadness is the expected face of depression, anger is the one that tends to appear instead. Mallon explained that’s because “anger is often the only emotion many men have been given permission to express.”
He explained that many men aren’t encouraged to talk openly about loneliness, fear, grief, disappointment, or shame when they’re growing up. It’s often not welcomed in school or other places, either. Boys are often taught to bury and hide those feelings. However, burying an emotion doesn’t erase it. It simply reroutes it, and it often comes out in anger and irritability.
He recalled working with men whose families had written them off as angry. Over time, a different picture emerged. As Mallon put it, “They weren’t angry; they were exhausted, overwhelmed, grief ridden, or felt all alone.” What the world read as a temper was actually the visible edge of a much deeper inner struggle.
Research backs the link. A peer-reviewed article in Canadian Family Physician found that depression in men often manifests as irritability, anger, hostile or aggressive behavior, risk-taking, substance abuse, and escaping behaviors such as overinvolvement at work, signs that frequently don’t fit the textbook description at all.
How overwork and drinking quietly mask what’s underneath
Throwing himself into work can look like dedication while quietly serving as a way to avoid emotional pain.
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Two of the most common coping tools, Mallon observed, are also two of the most socially acceptable. “Work and alcohol are two of the most common ways men avoid emotional pain,” he said. Staying busy can feel productive, and a drink can dull the ache, so many men reach for one or both rather than sit with how they feel. “Some of the highest performers I’ve worked with were also the loneliest or abused alcohol.”
Clinicians see this pattern repeatedly. Mayo Clinic lists escapist behavior, such as spending a lot of time at work or on sports, along with problems with alcohol or drug use, among the behaviors in men that can be symptoms of depression. The NIMH adds that while increased substance use can signal depression in anyone, men are also more likely to turn to alcohol or drugs to cope with negative emotions.
When depression shows up in the body before anyone names it
Unexplained fatigue, sleep problems, and aches can be some of the first ways depression speaks through the body.
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Mallon said fatigue, aches, and sleep problems can arrive before anyone recognizes a mental health issue. He shared, “The body and the mind are deeply connected.”
In fact, he pointed out, “many men first show up in a doctor’s office, not a therapist’s office.” They report being exhausted, unable to sleep, unable to concentrate, and weighed down by unexplained aches and pains. Sometimes there’s an underlying medical cause, and sometimes, as Mallon described it, “When something is wrong emotionally, the body frequently carries part of that burden.”
The medical literature treats this as the rule, not the exception. A review in The Primary Care Companion to the Journal of Clinical Psychiatry cited a World Health Organization study in which, of patients across 14 countries who met the criteria for depression, 69% reported only physical symptoms as the reason for their visit. The same review explained that pain and mood share the neurotransmitters serotonin and norepinephrine, giving depression and physical pain a deeper biological connection than simple cause and effect. It’s a big reason depression can sit undiagnosed for so long.
Is it biology or how boys are raised?
So how much of this is wiring, and how much is conditioning? Mallon’s honest answer was that you probably can’t fully untangle the two. What he keeps coming back to is the message many men absorb before they’re old enough to question it: that their worth is measured by what they can “provide, protect, achieve, and endure.”
Those are meaningful qualities, he acknowledged, but they can harden into a crushing weight, especially when a man believes he has to shoulder it entirely on his own. The men who fare best, in his experience, aren’t the ones who never falter. As Mallon offered, “The healthiest men I know aren’t the ones who never struggle—they’re the ones who know when to stop carrying the weight by themselves.”
That stoic, self-reliant ideal has measurable consequences. A 2024 review in the Journal of Advanced Nursing found that traditional masculine norms such as stoicism and self-reliance can lessen the likelihood that men will seek support, partly because mental health struggles can feel at odds with cultural ideas of being strong and in control. A qualitative study in Frontiers in Psychiatry similarly reported that many men are more reluctant than women to seek help for mental health problems, with internalized masculine norms shaping that reluctance.
Why the signs get missed until something breaks
One of the hardest truths Mallon shared is about timing. Many of the men he works with don’t reach out while the depression is active. They come in after they’ve already lost something major: a marriage, a relationship with their kids, a job, or their connection to the life they built. By then, most of them assume the depression started with the loss.
The work, he explained, is often discovering that the order was reversed. “The depression didn’t necessarily follow the loss. In many cases, it came first.” The withdrawal, the irritability, the joylessness, and the sense of carrying everything alone had usually been present for months or years before the crisis hit.
So in therapy, he and his clients look backward together, connecting dots that weren’t obvious at the time. What a man had filed away as stress or a rough season was frequently depression reshaping his relationships, his work, and his sense of self. This is why Mallon urges men not to wait. By the time many finally ask for help, he cautioned, “They’re dealing with the consequences of years of untreated depression,” which is a far heavier load to carry than the depression alone.
How to bring it up without alienating him
Leading with concern instead of conclusions can open a door that a diagnosis would slam shut.
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If you suspect a man in your life is struggling, the way you open the conversation matters enormously. Mallon’s guiding principle is simple: “Lead with concern, not conclusions.”
Rather than announcing “I think you’re depressed,” he suggested something gentler and far less likely to trigger a wall: “I’ve noticed you don’t seem like yourself lately.” That small shift, he explained, changes the temperature of the whole exchange and feels safer to the person on the receiving end. Crucially, the aim isn’t to slap on a label. As Mallon emphasized, “Your goal is not to diagnose someone, it’s to create a safe space for them to be heard and understood.”
What not to say to a man who’s struggling
Some of the most discouraging responses, Mallon noted, come from people with the kindest intentions. Phrases like “you’ll be fine” or “keep pushing forward” can land badly, because many men have already spent years pretending to be fine and pushing forward. “What they really need is permission and space to say when they aren’t,” he said.
Even gratitude can backfire. Telling a struggling man “you have it all” or “you’ve got so much to be grateful for” can be heard as “what do you have to be depressed about?” Mallon suggested flipping the script with openers that invite rather than dismiss, such as “I can see you’re carrying a lot on your shoulders right now.”
When worry should turn into encouraging professional help
There’s no precise moment a switch flips, Mallon acknowledged, but there are concrete signals worth watching for. He pointed to a handful of red flags that suggest it’s time to gently encourage someone toward professional support: relationships beginning to suffer, work performance slipping, withdrawal from family and friends, drinking or substance use starting or increasing, daily exhaustion, and a sense of being paralyzed and unable to move forward.
The broader principle he kept returning to is that no one should have to reach a breaking point to deserve help. Too often, he stressed, men wait until a marriage is hanging by a thread or their health is failing before they reach out. Mental health experts echo the urgency: the Anxiety and Depression Association of America reports that nearly 1 in 10 men experience depression or anxiety, yet fewer than half receive treatment, and men are four times more likely to die by suicide than women. That four-to-one gap holds up in federal data, too. According to SAVE (Suicide Awareness Voices of Education), drawing on CDC figures, the suicide rate among males is roughly four times higher than among females, and men account for about 80% of all suicide deaths in the United States.
What every man who sees himself in this should know
For the man reading this who might be experiencing some of these struggles, Mallon had a direct and tender message. “Struggling doesn’t mean you’ve failed. It just means you’re human like everyone else,” he said. Whether he’s a father straining to provide, a veteran carrying experiences few people understand, a husband trying to hold it all together, or a professional buried under responsibility, the same thing holds true: “you don’t have to earn the right to ask for help.”
And the thing he most wishes everyone understood? That outward strength can be a mask for private agony. “The men who appear strongest on the outside are often fighting the hardest battles on the inside,” Mallon reflected. Reaching out, far from being a failure of manhood, is the opposite. He put it plainly, “Asking for help is not a weakness. It’s one of the bravest things a person can do.”
More about our expert:
Scott Mallon, LMFT, a licensed marriage and family therapist.
(Courtesy of Scott Mallon, LMFT)
Scott Mallon, LMFT, is a licensed marriage and family therapist who works with individuals, couples, and families facing anxiety, depression, trauma, relationship difficulties, and major life changes such as divorce, grief, career transitions, and family conflict. At Breathable Mental Health, he helps clients strengthen relationships, improve communication, and build resilience during times of stress and uncertainty. With advanced training in Emotionally Focused Therapy (EFT) from the San Diego Center for EFT and the New York Center for EFT, he helps couples reconnect, navigate the demands of parenthood and partnership, and build healthier relationships, and he has extensive experience supporting trauma survivors, adolescents, and families managing behavioral and developmental challenges. Known for a compassionate, down-to-earth style shaped by his blue-collar upbringing, Scott is recognized for creating a safe, nonjudgmental space where clients feel heard, understood, and empowered to make lasting change. He is verified by Psychology Today.
Please note: This article is intended for general informational and educational purposes only, and it’s meant to be a friendly starting point rather than a substitute for professional care. It isn’t medical advice, a diagnosis, or a treatment plan, and reading it doesn’t create a therapist-client relationship. If you or someone you love is struggling with depression or any mental health concern, please reach out to a licensed professional who can offer personalized guidance. If you’re in the U.S. and in crisis or thinking about self-harm, you can call or text 988 to reach the Suicide and Crisis Lifeline, available 24/7. You deserve support, and help is always within reach.
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