Depression comes with despair, withdrawal, hopelessness, guilt. It can hit you out of nowhere or loom overhead before it strikes aggressively. It can hang around for a few weeks, months, years, or an entire lifetime. In few words, it is a difficult illness to deal with and manage—but it’s also treatable.

That’s depression in a nutshell. But did you know that depression can present itself differently in men and women? Both sexes can experience the symptoms listed above, but there are a few symptoms that are more common in men.

Withdrawal, agitation, and repression 

Men often distance themselves from loved ones, are easily agitated, and repress their emotions as well as hide them from their loved ones. Courtney Glashow, Licensed Clinical Social Worker and Founder of Anchor Therapy, LLC, helps to explain these depression symptoms in men:

1. Withdrawal: First, men tend to distance themselves from their loved ones when they feel depressed. “When men are feeling depressed, it often looks like that are disinterested and distance themselves. They will avoid people they are closest with and they will stop engaging in activities that they usually enjoy doing. If a man usually spends his free time socializing on the weekends while playing golf, then you will not see him on the green when he is feeling down,” Glashow explains.

2. Agitation: It is also common for men to act agitated or angry when they feel depressed, as opposed to sad or upset. “When men are depressed, it can come off as agitation or anger. A man may be aware that he is feeling down, but has a hard time accepting that. Mental health issues are stigmatized in which men are seen as weak if they succumb to sad feelings. While we know the opposite is true and the man is just feeling sad. It may not have a cause or reason. Sometimes our brain creates sad thoughts and feelings within us. This is a time a man will become frustrated that he cannot find the reason and cannot make sense of it all,” says Glashow. “The man may find relief from arguing with others or letting out their anger through exercise if they feel this building within them.”

3. Repression: Finally, men are also more likely to experience, hide, and act on suicidal thoughts. “Adult men are the most prevalent to actually kill themselves due to depression. It is more common that a man will feel depressed, experience suicidal thoughts, create a plan to hurt themselves, and execute the plan without telling anyone anything,” says Glashow. “A woman is more inclined to feel these same things and go through these same steps, but that they usually feel comfortable confiding in someone. Men usually use more lethal means to kill themselves as well as women are shown to harm themselves in ways that are not as lethal.” 

What’s the best form of treatment for men with depression?

While one might expect there to be treatment designed specifically for men with depression, considering there are often specific differences in presentation, that is not the case—at least not yet. Instead, there are a few treatment methods that prove effective for both sexes. 

Catherine Burnette, an assistant professor in the School of Social Work at Tulane University, explains: “Generally, the treatments for depression have not been developed with sex in mind; they include counseling, medication, and lifestyle changes.” Counseling—cognitive behavioral therapy (CBT) in specific—can help individuals better understand the connections between their thoughts, feelings, and behaviors, of which can contribute to depression. Depression counselors help their clients to get to the root of the problem and better manage symptoms. Medication, such as antidepressants, and lifestyle changes, like prioritizing self-care, can also help both men and women with depression. That said, it’s possible that future treatments will be designed with one’s sex in mind. “Much more can be learned about how men and women may be more and less responsive to different types of treatment,” says Burnette.