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Why Depression in Men May Be Underdiagnosed

Your Health / Conditions / Mental Health / Why Depression in Men May Be Underdiagnosed

Published on Nov 22, 2017​​​​​​​​​​​​​​​​​​​​​​​​​​​​
​​​​​​​Authored by Pfizer Medical Team


Over 700,000 Australian and around 200,00 New Zealand men suffer from depression each year, yet the condition tends to be underdiagnosed in men. There are a number of reasons for this, but it may be because men can experience a different set of depression signs and symptoms than women.

Currently, women are diagnosed with depression twice as often as men, and most research on the topic focuses on why women are at greater risk for developing the disorder. The problem may be compounded by the notion that men are said to be reluctant to talk about how they are feeling, and so they may not recognise, acknowledge, or seek help for depression.

Different Symptoms in Men

Men seem to be less likely to show “typical” signs of depression, though this observation is not yet well understood. Typical depression signs are crying, sadness, loss of interest in previously enjoyable activities, and verbally expressing thoughts of suicide. However, men have higher rates of anger attacks/aggression, substance abuse and risk-taking compared with women.

Depressed men are more likely to experience the following symptoms as well:

  • Exhaustion
  • Sleeplessness
  • Irritability
  • Physical pain
  • Loss of interest in work

Because men may feel shame or try to “tough it out” on their own, they may also self-medicate with drugs or alcohol. Unfortunately, healthcare professionals may miss the opportunity to diagnose depression accurately in men. For some men, by the time clinical depression is diagnosed, the condition has gone undiagnosed for years and can be severe.

Causes and Treatment of Depression

Regardless of gender, depression may be caused by a combination of three factors:

  • ​​​​​​​Genes—A family history of depression increases a person’s likelihood of being diagnosed with depression
  • ​​​​​​​Hormones—Brain chemistry can be affected by hormones that control mood and emotions  
  • ​​​​​​​Stress—External factors (e.g., finances, relationships, losing a loved one) can affect mood and lead to depression

Up to 90% of people diagnosed with major depression can be treated effectively with antidepressants and psychotherapy. Additionally, peer support and attention to lifestyle, including diet, exercise, and smoking cessation, have been shown to result in better physical and mental health. In some non-responsive or other cases, electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) may be used.

Seeking Help

If you think you may have atypical signs or symptoms of depression, speak with a doctor or a licensed mental health professional. If you know someone who may be depressed, be supportive, listen carefully, and encourage treatment. Never ignore thoughts or mentions of suicide. In such a case, the Suicide Prevention Lifeline is an important resource to turn to for help: 13 11 14 (Australia)  0508 TAUTOKO [0508 82 88 65] (New Zealand)

Reviewed by Daniel Karlin, MD,MA, Director in the Neuroscience Research Unit at Pfizer.



  1. Mindframe National Media Initiative. Accessed 10/2/2017.
  2. Wells EJ et al. Te Rau Hinengaro: New Zealand Mental Health Survey. Aus & NZ J Psych 2006; 40:845–854. Accessed 10/2/2017.
  3. Khalid Saad Al-Harbi. Treatment-resistant depression: therapeutic trends, challenges, and future directions. PMC 2012; 6:369–388. doi: 10.2147/PPA.S29716. Accessed 10/2/2017.

Last reviewed: 8/10/2019​​​​​​​


External Resources

-Suicide Prevention Australia
-Lifeline Aotearoa

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