What depression looks like in a man, when he keeps going to work.

Ravi’s wife booked the consultation. He joined the call from his car in a supermarket car park and told me he was not depressed, he was tired. Tired of his job, tired of the noise at home, tired of weekends. He had stopped playing football eight months earlier and had no idea why. By the end of twenty minutes he said: “I don’t feel anything about anything any more.”

01The male mask

Men tend to describe depression through the body and through action. Sleep goes wrong. Libido drops. Headaches and back pain appear. Joy leaves quietly, through the hobbies first.

02High-functioning depression

Plenty of depressed men hold down senior jobs. They hit targets, pay the mortgage, coach the under-tens. Inside, they run on effort alone. Doctors sometimes call long-lasting low mood persistent depressive disorder. The men I see call it “how I’ve always been”.

High-functioning does not mean mild. It means hidden. When the crash comes, it surprises everyone except him.

He did not stop feeling sad. He stopped feeling.

Kita Tabachka, relational therapist

03Why men miss it

Most men learned depression looks like a woman crying in bed. When it looks like a man shouting at a printer, nobody joins the dots, including him.

Men are also slower to see a GP, and quicker to self-medicate with alcohol, work or the gym. In the UK, around three in four suicides are men.

04What helps

If you are reading because you are worried about your partner, see supporting your husband with depression, including looking after your own needs.

Start with the body. Book a GP appointment and say the plain words: “I think I might be depressed.” Your GP checks for physical causes, such as thyroid problems or low testosterone, and talks through options including talking therapy and medication.

Then talk. Therapy for men works best when it starts with what is happening this month, not your childhood. We look at the flatness, the anger, the drinking, and what each of them protects you from feeling.

Ravi’s first goal was football. He went back in week six and told me he did not enjoy it. In week nine, he did. If anger is the loudest symptom in your house, how to control anger in a relationship is a useful next read.

More from the journal

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Written by

Kita Tabachka

I am a BACP-registered relational therapist. I work with individuals and couples, many of them living far from where they began, on relationship anxiety, attachment, intimacy and the strange business of building a self in a new country. The stories here are composites. The patterns are real. My writing is a door into the work, never a substitute for it.

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