Depression can happen to anyone, but it might not look the same from person to person.

When our head fills with negative thoughts and feelings of hopelessness, it can make us feel deeply alone. Feeling like no one understands us can cause us to self-isolate, worsening our chances of getting better.

Women are more likely to try confiding in a friend or loved one. They’re also more likely to seek out a therapist. It’s socially accepted that they can articulate their feelings.

Men, however, are less likely to accept, discuss, and seek treatment for depression, despite the large number of men it affects every year. If you’re a man, or are concerned that one of your male loved ones is depressed, the first step is acknowledging it.

Here are four different ways depression presents in men.

Risky and Aggressive Behavior

Men with depressions may be easily angered, irritable, or aggressive. Women are more likely to appear sad. Depression comes with low self-esteem, and one way men typically deal with this is through dramatic displays of masculinity. (Think punching walls, raising their voice over minor frustrations, or starting fights.)

Men’s comfortability with aggression, in general, puts them the most at the risk of suicide. While women are more likely to try non-violent means of taking their own life, men follow through more often because they use violent, quick means.

Suicide can also be accidental when men engage in risky behaviors. Frantic driving, for example, can make a man feel more in charge of his vehicle, until one wrong move spins him off the road.

Filling life with stints of risky excitement is not how to conquer depression. Showing yourself love, care, and well-intentioned maintenance is.

Escapist Mentality

Men are more likely to numb their feelings by abusing drugs and alcohol than women. They may wake up and immediately feel a deep need to drink or smoke to avoid reality. Social time with friends may never be sober, and they may substitute meals for a quick hit.

Depression can affect your appetite by suppressing it or boosting it. Turning to comfort foods to cope and mentally escape can lead to unwanted health problems down the road, especially if binge drinking or smoking is a part of an already unhealthy diet.

Escapism can sometimes be hard to catch. Men may devote an unreasonable amount of time to work, exercising, or getting lost in video games, all to avoid their current reality. While things like exercising and playing sports are great for our health, revolving our lives around them can lead to burnout and stronger, unchecked depressive symptoms.

Avoidant Conversations

Men may avoid talking about their feelings out of fear of being perceived as weak or immature, two traditionally masculine points of view on mental health. The narrative is shifting today, but a person’s ingrained socialization can still be hard to overcome.

While “sadness” is everyone’s first thought of depression, the primary symptoms in men are actually a little different. Headaches, stomach problems, excessive fatigue, and a short temper can all be signs of underlying depression.

Constantly changing the subject or actively seeking distraction can also be indicators. Men are more likely to downplay their symptoms or convince their loved ones that they have it handled.

Resisting Treatment

Asking a man to open up about his depression can be a heavy ask. However, opening up to a professional about depression is different because it’s private. Here, he may be more willing to share.

However, men typically worry that being seen as “depressed” will threaten their career or the respect they have from friends and family. The question is, what’s more respectable? A man who centers his life around his health and well-being, or a man who lets it suffer and bleed over into his relationships?

The choice is yours. Everyone is welcome at my practice. I’m not in the business of making people feel weaker; I’m here to help them find strength.