He isn’t crying, and he wouldn’t say he’s sad. He’s short with the kids over small things. He stays late at work, or disappears into the garage, or into his phone. He’s drinking a little more than he used to, sleeping worse, and when someone asks what’s wrong the honest answer is that he doesn’t know. If anyone has noticed that something is off, it’s more likely to be the people around him than the man himself.
November is the month a lot of men grow a moustache for men’s health, so it seems a good time to say something plainly: depression in men often doesn’t look the way people expect it to, and that is one reason it so often goes unnoticed, including by the man himself.
What the numbers say
In Canada, men make up about half the population but nearly three-quarters of deaths by suicide, and the highest rates are among men between 45 and 64. At the same time, men are much less likely to get help. In Statistics Canada’s most recent analysis, among people who met the criteria for a mood or anxiety problem, 42% of men had talked to a health professional about their mental health, compared with 56% of women. Among those who hadn’t received counselling, only about one man in five felt he needed it, and the most common reason men gave was a preference for managing on their own.
A national survey of 2,000 Canadian men by the Canadian Men’s Health Foundation this spring found much the same: two-thirds had never used a professional mental health service, while nearly a quarter were at risk of moderate to severe depression and half were at risk of social isolation. Put those together and you get a lot of men who are struggling, mostly alone, and who don’t see what they’re going through as something counselling is for.
Depression doesn’t always look like sadness
Part of the reason is that the standard picture of depression, low mood, tearfulness, loss of interest, was drawn largely from how it presents in women, who are diagnosed about twice as often. Many men do experience it that way. Many others experience something that looks different from the outside. In a large US study, researchers added symptoms such as anger attacks, irritability, substance use and risk-taking to the usual checklist. On the traditional symptoms alone, women were more often depressed. Once the broader list was included, men and women met the criteria at almost the same rate. The study used a single survey and the authors were careful about overstating it, but the pattern fits what many clinicians see.
In practice, that can mean a man who is irritable rather than tearful, who throws himself into work or exercise or projects, who gets more cynical and more withdrawn, whose drinking creeps up, or who starts taking risks he wouldn’t have taken a few years ago. It can also show up in the body first, as headaches, back pain, poor sleep or a stomach that’s always unsettled, which is often what finally gets him to a doctor. None of those things look like depression to the person living them. They feel like stress, or a rough patch, or just being a bit of a jerk lately.
Why asking for help is harder than it should be
Most men weren’t taught to notice their feelings, let alone talk about them, and many were taught the opposite: handle it, don’t make a fuss, don’t burden anyone. A systematic review of the research found that the more strongly a man holds to ideas like self-reliance and keeping emotions under control, the less likely he is to seek help for depression and the more negatively he tends to view the idea. That isn’t a character flaw. Those same qualities are what make a lot of men steady and dependable, and they serve them well most of the time. The trouble is that they don’t work on this, and the longer a man waits, the more convinced he becomes that nothing could.
There are practical reasons too. Men are more likely to say they’re too busy, and it’s hard to make time for something you aren’t sure will help. Plenty of men have also tried once, years ago, and found the experience vague or slow, which reinforces the view that counselling means sitting in a room talking about your childhood while the real problems wait outside.
What counselling can look like
That view is worth challenging, because the research on what men actually want from therapy is clear and reasonable. When researchers interviewed men who had been in treatment for depression, the ones who stayed wanted a clear explanation of how the work would go, a structure, specific skills they could use, and a sense of being in control of their own recovery. Those are reasonable expectations, the same ones most people bring to any professional they’re paying. The men who left treatment early often described sessions that felt unstructured and that didn’t seem to be going anywhere.
At Vista Counselling, the approach is both exploratory and practical. Sessions usually start with what’s happening in your life right now, and that becomes the way in to the patterns underneath. When something comes up, it gets worked with in the moment rather than only talked about. Depending on what you’re dealing with, that might draw on EMDR for experiences that haven’t settled, IFS for the parts of you that seem to pull in different directions, or AEDP for feelings that have been kept at arm’s length for a long time. Both of our counsellors, Dr. Kevin Klassen and Roshni Vedamanikam, work with men dealing with depression, anxiety and burnout, in person in Langley or online across BC. Kevin also works with first responders, who tend to arrive carrying years of calls rather than any single one, and who want a counsellor who understands the job and doesn’t flinch at the humour that goes with it.
You don’t need to know what’s wrong before you come. Most men don’t. Being able to say “I’m not myself and I don’t know why” is more than enough to start with, and a free 15-minute call is a low-stakes way to find out whether this feels like a fit before you commit to anything.
If you’re the one who noticed
Often it’s a partner, a friend or an adult child who sees it first. If that’s you, the most useful things tend to be specific and low-pressure. “You’ve seemed worn down for a while, and I’m worried about you” lands better than “we need to talk about your mental health.” Side-by-side conversations, on a drive or a walk, are often easier for men than face-to-face ones. And it helps to offer something concrete, like finding a counsellor’s number or booking the first call, rather than leaving the whole task to someone who is already running on empty.
If you’re worried that someone may be thinking about suicide, ask them directly. Asking doesn’t plant the idea, and it often comes as a relief. In a crisis, call or text 9-8-8 any time, or call 310-6789, BC’s mental health support line. In an emergency, call 911.
Vista Counselling provides individual counselling in person at our Langley, BC office and online across BC. If something in this post sounds familiar, contact us with your questions or book an appointment online. We respond within 1–2 business days.