Let’s start with something simple, but often over-simplified: depression doesn’t always look like sadness. Especially not in men.
For many men, depression feels like a mask—one that looks like working overtime, losing patience over little things, retreating into silence, or numbing out with alcohol or distraction or a lack of interest in activities. And the problem is, most of the time, no one notices the often-subtle changes of what’s really going on. Not even the men themselves. We often just assume that working all the time and not having the energy to do anything is normal and what life is supposed to be. Although the occasional vacation is taken to breathe and regroup for the next months of hard labor. We think that a week or two off is enough to recharge from stress; however, we rarely actually take a vacation. Our phones and computers often keep us working and stressed even when we are off. That topic can be covered in a separate conversation.
We’ve made progress in how we talk about mental health. But when it comes to men, there’s still a long way to go.
We need to talk about what depression looks like in men, why so many men avoid getting help, and how we can begin to shift the culture—one conversation, one connection, one safe space at a time.
Men are diagnosed with depression far less often than women, yet they die by suicide at significantly higher rates (Rochlen et al., 2010). That gap speaks volumes—not just about what’s happening, but about what’s being missed. The suicide rates in developed countries are generally 3-4 times higher for men than women. This may be due to men often choosing more lethal methods than women. This is also an indication of the need to improve mental health services for men.
Men are often taught from an early age that vulnerability is dangerous. That means silence. That pain is something you work through, not talk through. These messages don’t just shape how men see themselves—they shape how they experience depression.
In fact, a study by Rochlen and colleagues found that many men described their depression in terms that don’t neatly align with the DSM: things like isolation, irritability, physical pain, or relentless overworking (Rochlen et al., 2010).
What Keeps Men From Seeking Therapy
There’s no single reason why men avoid therapy. But there are some very consistent themes, many of them rooted in masculine norms, internalized stigma, and systems that don’t feel welcoming.
The “Man Code” Gets in the Way
The unspoken rule: “Don’t show emotion. Don’t ask for help.” Over time, these beliefs become deeply ingrained. They don’t just discourage men from reaching out—they actually make them question if they should be feeling what they’re feeling at all. We have all heard the phrases such as “man up” “suck it up” “get tough” “boys don’t cry”, these messages are often heard starting at very early age and can have a big impact on how we perceive ourselves or environment and what we can do about it.
In a study by Staiger et al. (2020), men described how depression made them feel weak and disconnected from their identity as fathers, partners, and providers. But through therapy, they began to see that strength wasn’t about denying or hiding from feelings, it was about showing up, honestly, for themselves and their families.
Conformity to traditional masculine norms— emotional control, and self-reliance—has consistently been shown to delay or block help-seeking altogether (Seidler et al., 2016).
The Stigma is Real—and It’s Internalized
Even among men who want help, the fear of judgment is powerful. Some worry they’ll be seen as unstable or fragile. Others fear being misunderstood by their friends or family. Athletes, veterans, high-performing professionals—these are often the very men who carry the deepest pressure to appear “fine.”
In a study of varsity football players, participants said mental illness was seen as a liability—a weakness you don’t talk about. One even said, “You just suck it up and push through” (deLenardo & Terrion, 2014). But mental health isn’t something you push through. And silence doesn’t mean resilience.
This is supported by findings from Vogel et al. (2013), who showed that stigma—particularly around emotional vulnerability—can even stop men from encouraging other men to get help.
The System Isn’t Always Set Up to Help
Even when men overcome the internal hurdles, external ones remain. Limited appointment times, long waitlists, expensive out-of-pocket fees, and a lack of providers who understand male-specific concerns—all of it adds up. This creates additional frustration and possibly thoughts and feelings that they should just suck it up as no one cares.
In a province-wide survey, Quebec men said they’d be more likely to seek help if services were free, recommended by a doctor, or if they saw their mental health affecting their children (Montiel et al., 2022).
Despite all the barriers perceived, internal and external things can change.
The research is clear: when therapy feels accessible, culturally sensitive, and emotionally safe, men do engage—and they benefit deeply.
Make the First Step Feel Familiar
One approach that has shown promise is integrating therapy into everyday environments—primary care, gyms, workplaces, even sports programs. In Ireland, a combined program using mixed martial arts training and one-on-one counseling helped break through the stigma for young men. The participants cited that the structure of the martial arts was the initial attraction; however, having a place that felt supportive and open became equally attractive and a reason to continue. (Bird et al., 2019).
Creating ways to add education or support to everyday environments may help to reduce the intimidation factor and help men feel like they are not alone or broken for needing support.
Validate
Men aren’t afraid of hard work or doing hard things. They’ve carried burdens for years. What they’re afraid of is being misunderstood or dismissed. Listening, not labeling, can be crucial to allowing men to seek help.
Many men benefit from therapy that’s strengths-based, action-oriented, and focused on real-life outcomes. That might look like developing better communication in relationships, learning how to manage stress without shutting down, or reconnecting with their sense of purpose (Stiawa et al., 2020).
Depression in men isn’t rare—it’s just rarely named. And healing doesn’t start with fixing. It starts with seeing.
When we make space for men to be honest—when we honor their struggle without judgment—we create the conditions for real, sustainable change. Men don’t need to be told to “man up.” They need to be reminded that they’re human—and that help is not just available, it’s deserved. It’s not about sugarcoating. It’s about honoring the ways men have survived—and offering new tools for how they can start to thrive.
- Notice the behavior behind the behavior. Irritability, overworking, and withdrawing, these might be signs of distress, not disinterest.
- Open the door without pushing. “I’ve noticed you’ve seemed off lately. I’m here if you want to talk.” Simple, but powerful.
- Normalize therapy. Share your own experiences or recommend providers who have experience working with men.
- Be patient. Change takes time. And sometimes, the first “yes” comes after a hundred internal nos.
And if you’re reading this and wondering if what you’re feeling might be depression? You don’t have to have all the words. You just need to take the next small step. That alone is an act of courage.
Start Working With A Therapist for Men in Powhatan, VA
If you’re feeling overwhelmed, disconnected, or just not like yourself, you’re not alone. A therapist for men in Powhatan, VA, can help you navigate life’s challenges with strength and support. You can take the first step toward healing with Gray Horse Counseling by following these simple steps:
- Contact me to schedule your free consultation
- Read my FAQs and learn more about me
- Start reconnecting with yourself and overcoming the stigma of depression!
Other Services Offered with Gray Horse Counseling
Depression treatment is one of the many services offered by Gray Horse Counseling. I’m happy to offer both in-person and online support across Powhatan, Richmond, New Kent, and across the state. Other services offered include equine-assisted therapy, individual therapy, life transitions therapy, group therapy, EMDR therapy, clinical supervision, equine therapy, and anxiety therapy. Check out my FAQs, read about me, and contact me today to get the help you deserve!
References
Bird, N., McCarthy, G., & O’Sullivan, K. (2019). Exploring the effectiveness of an integrated mixed martial arts and psychotherapy intervention for young men’s mental health. American Journal of Men’s Health, 13(1), 1–11.
deLenardo, S., & Terrion, J. L. (2014). Suck it up: Opinions and attitudes about mental illness stigma and help-seeking behavior of male varsity football players. Canadian Journal of Community Mental Health, 33(3), 43–56.
Montiel, C., Duhoux, A., Tremblay, G., Villeneuve, R., Roy, J., Lavoie, B., & Houle, J. (2022). Psychological distress and help-seeking facilitators in Quebec men: Findings from a province-wide survey. International Journal of Men’s Community and Social Health, 5(1), 1–26.
Rochlen, A. B., Paterniti, D. A., Epstein, R. M., Duberstein, P., Willeford, L., & Kravitz, R. L. (2010). Barriers in diagnosing and treating men with depression: A focus group report. American Journal of Men’s Health, 4(2), 167–175.
Seidler, Z. E., Dawes, A. J., Rice, S., Oliffe, J. L., & Dhillon, H. M. (2016). The role of masculinity in men’s help-seeking depression: A systematic review. Clinical Psychology Review, 49, 106–118.
Staiger, T., Stiawa, M., Mueller-Stierlin, A. S., Kilian, R., Beschoner, P., Gündel, H., Becker, T., Frasch, K., Panzirsch, M., Schmauß, M., & Krumm, S. (2020). Masculinity and help-seeking among men with depression: A qualitative study. Frontiers in Psychiatry, 11, 599039.
Stiawa, M., Müller-Stierlin, A., Staiger, T., Kilian, R., Becker, T., Gündel, H., Grinschgl, A., Frasch, K., Schmauß, M., Panzirsch, M., Mayer, L., Sittenberger, E., & Krumm, S. (2020). Mental health professionals’ view about the impact of male gender for the treatment of men with depression: A qualitative study. BMC Psychiatry, 20, 276.
Vogel, D. L., Wester, S. R., Hammer, J. H., & Downing-Matibag, T. M. (2013). Referring men to seek help: The influence of gender role conflict and stigma. Psychology of Men & Masculinity, 14(2), 213–223.