Are women more depressed than men? Research shows that women are more likely to experience what is known as "internalizing" kinds of symptoms such as depression and anxiety, conditions in which symptoms are thought to be turned against the self. The same line of research shows that men are more likely to experience "externalizing" kinds of symptoms (turned outward), which involves things like anger and aggression, and men are also more likely to abuse substances. By the numbers, this is true. Even though it is diagnosed less often in men, millions of them experience depressive symptoms each year. And men are often lost in the conversation.

What about the men who are depressed? Which men are at risk of depression and what predicts their symptoms? Knowing this would be a first step in thinking about the kinds of resources they might need. In our research, we examine what might predict depression (a classic internalizing symptom) and anger (a classic externalizing symptom) in men. Instead of comparing men to women, we consider what dynamics of masculinity and of being a man might explain why some men do indeed become depressed (and why they are angry).

We find that men who are more traditionally "masculine"—who endorse strict gendered norms discouraging emotional expression and encouraging independence and financial success—are at greater risk of both internalizing and externalizing mental health troubles.

We focus on older White men as a starting point for this investigation and examine which men among them have greater chances of experiencing depression and anger. This is a vital question since the extreme result of depression—suicide—is more common for older White men. In this population, it is clear that particular types of masculinity beliefs ("hegemonic" masculinity) predict much greater chances of experiencing anger, which is in line with expectations. Surprisingly, they are also more likely to experience depressive symptoms, prompting us to suggest that the sources of anger and depression may be similar. Hegemonic Masculinity is a rigid, traditional set of beliefs like men should be breadwinners and solve conflicts with their fists and it is especially predictive of sadness for older men in the face of difficult life circumstances like health or wealth decline.

When we look at two direct threats to masculinity beliefs—health decline and loss of wealth—we find that the original relationship between masculinity beliefs and negative mental health outcomes is even stronger among men who face these threats. In other words, men who feel as though they ought to be tough, independent, and able to handle things on their own are more likely to feel angry and suffer from depressive symptoms when they face a health challenge or when their financial security is challenged. Why is this the case? Declining health and wealth both threaten men's sense of independence and self-sufficiency, directly contradicting the tenets of hegemonic masculinity. Men whose masculinity beliefs are threatened may hide their emotions and avoid seeking help, which exacerbates their symptoms.

Our research suggests that it is important not only to compare men to women, but to think beyond the traditional notion that gender per se predicts who is more likely to experience which kind of mental health outcomes. Instead we look at what characteristics (or which men) are more likely to experience which kind of mental health outcomes. Again, why might some men and not others experience these kinds of problems?

It is critical to continue investigating how certain types of masculine ideals lead to symptoms of depression and anger (and potentially other outcomes) for older White men, and also to test whether this holds true across a range of men who vary in race, class, sexual orientation, and age. The answers to these questions would have broad implications for treatment and for how services should be aimed toward different subgroups of men.

For Further Reading

Smith, D. T., Mouzon, D. M., & Elliott, M. (2022). Hegemonic masculinity and mental health among older white men in the U.S.: The role of health and wealth decline. Sex Roles, 86, 605–619.

Smith, D. T., Mouzon, D. M., & Elliott, M. (2018). Reviewing the assumptions about men's mental health: An exploration of the gender binary. American Journal of Men's Health, 12(1), 78-89. doi:10.1177/1557988316630953

Powell, W. (Host) (2016, June). How masculinity can hurt mental health (No. 38). [Audio podcast episode]. In Speaking of psychology. American Psychological Association.

Pudrovska, T. (2010). Why is cancer more depressing for men than women among older White adults? Social Forces, 89(2), 535–558.

Dena T. Smith is Associate Professor of Sociology and director of The Graduate Program in Applied Sociology in the Department of Sociology, Anthropology, and Public Health at the University of Maryland, Baltimore County. She studies mental health professionals, specifically those who practice talk therapy, as well as gender and mental health.

Dawne M. Mouzon is Associate Professor of Sociology at Rutgers University. She studies Black families, Black aging, and the interplay between psychosocial stressors, coping, trauma, and resilience among Black American populations.

Marta Elliott is Professor and Chair of the Department of Sociology at the University of Nevada, Reno. She studies causal attributions of behavior consistent with psychiatric diagnoses and stigma, the curious and problematic overlap between diagnostic criteria for bipolar and borderline personality disorders, and the mental health impacts of the global pandemic.