Editor’s note: This is part of a series of articles focused on health issues men need to talk about with their primary care providers.

For many men, the thought they have depression seems absurd.

It may sound stereotypical, but many men consider themselves the protectors and providers of their family. They’re the strong, stable supporters who can’t possibly have mental health issues.

“As the historic ‘providers,’ men have a perception they have to keep emotions to themselves and be ‘strong’,” said Dr. Patricia Ellis, a Marshfield Clinic psychologist. “However, when they feel it’s wrong or inappropriate to share emotions, they can actually feed their depression.”

The rate of depression in men is nearly identical to women. The stark reality is more women may attempt suicide, but more men likely are to die by suicide, according to the National Institute of Mental Health (NIMH).

Symptoms different for men

Men and women are different in many ways, and depression is no different. Men often show different signs and symptoms. Whereas a woman may be more likely to openly express her sadness, men often reflect these symptoms internally.

According to the NIMH, depressed men often:

• Feel tired and irritable.
• Lose interest in work, family and hobbies.
• Are more likely than women to have trouble sleeping.

We find that men who are depressed commonly isolate themselves and stop doing the things they enjoy. Their signs and symptoms of depression might show up in stress reaction or headaches,” Ellis said.

Quitting hobbies they enjoy and separating themselves from people they love can worsen depression.

“Support systems are so important. If you’ve lost contact with people, reengage,” Ellis said.

Be the man, face depression

Ideally, a man would tell his primary care provider if he’s depressed. That’s rarely the case.

Ellis often asks questions about how her male patients are sleeping, eating and if they’re having any relationship problems to gain insight. These questions offer clues into if a man is depressed or dealing with other mental health issues.

“We’ve made strides to fight mental health stigmas, but male insecurities about being perceived as weak still exist,” Ellis said. “I’m optimistic more men will address their depression head on, rather than letting it go untreated until it reaches a boiling point.”

Thinking and feeling are different

“An often-missed message is that it’s okay to find a balance between thinking and feeling,” Ellis said. “If you ask a man how something makes him feel, he’s more likely than a woman to start by responding with, ‘I think…’.  It’s helpful to address depression by learning the difference between ‘I think’ and ‘I feel,’ and that both are present with each other.”

A male can practice expressing his feelings. Understand that this does not mean he has to be dramatic or that he has to cry to express them.

“These perceptions about men not showing emotion are based on historical stereotypes. Though these are changing over time, they still exist,” she said.

Completing these thoughts can help a man learn to express feelings:

• This is what I think.
• This is how it makes me feel.
• This is what I can do about it.

Depression: As treatable as broken bones

The most common causes of depression in men are rooted in genes, brain chemistry, hormones and stress, Ellis said. But guess what? It’s very treatable.

Ellis and other providers at Marshfield Clinic use a standard test to screen men for depression. Once men realize (and admit) a real problem exists, they’re usually open to treatment, which may include medication and/or therapy.

“Men are usually pretty honest once they begin to talk about depression. Then providers and others can talk about how depression is a medical problem, demystify it and how it has a medical solution,” Ellis said. “It’s very rare we have a man who refuses treatment once we identify depression.”

Remember, if you’re depressed, seek help immediately. Denying or ignoring depression puts your health at risk, Ellis said, and it doesn’t always just ‘go away,’ without treatment.

Talk to your provider, because it’s manly to get help.