The Hidden Epidemic: Male Depression in the Shadows

Hello and welcome! Whether you’re new here or have been following along for a while, I’m thrilled to have you. You might notice that things look a little different—let me explain.

I’m currently in the process of writing a book about suicide, grief, and men’s mental health. Writing a book requires a lot of focus and words, so I thought: why not share the journey with you, live, each week? That’s exactly what this newsletter is going to be—an open window into my writing process, right in your inbox.

Each week, I’ll dive into a topic, share the books and research that inspired me, and offer my reflections. Last week, we explored the introduction to men’s mental health, discussing societal expectations and masculinity’s impact, drawing inspiration from The Mask of Masculinity by Lewis Howes (Introduction and Chapters 1-3).

This week, I’ve been reading I Don’t Want to Talk About It by Terrence Real (Chapters 1-4), and I’ll be exploring the hidden epidemic of male depression, its symptoms, and how society reacts to men’s mental health struggles.

I encourage you to respond with your thoughts, concerns, critiques, or compliments. Your feedback will help shape this book and make the conversation about men’s mental health even richer. I’m excited to hear what you think!

The Hidden Epidemic: Male Depression in the Shadows

In the early chapters of I Don’t Want to Talk About It, Terrence Real brings to light a pervasive yet often unacknowledged phenomenon: the hidden epidemic of male depression. This form of depression, unlike its more visible counterpart often experienced by women, thrives in the darkness of societal expectations and emotional suppression. It’s not that men don’t experience depression—they do and in staggering numbers—but the way it manifests often escapes traditional detection.

Male depression operates under the radar, camouflaged by cultural norms that discourage men from exhibiting vulnerability. From a young age, men are conditioned to present themselves as emotionally resilient, stoic, and impervious to pain. More on that can be found here. As a result, they internalize their struggles, turning inward with their suffering, and locking it away where even those closest to them might not perceive it. This invisibility creates what Real calls a "hidden epidemic," which has serious ramifications for the individuals affected and society at large. The consequences ripple through families, communities, and generations.

Pain Unspoken: Internal vs External Expression

While the pain of male depression may be internal, its effects often spill outward in unexpected and misunderstood ways. Real eloquently describes the divergence between internal and external expressions of pain. Men, socialized to suppress emotional displays, frequently translate their inner turmoil into external behaviors, often destructive.

The internal experience of pain manifests as feelings of inadequacy, self-loathing, and a deep-seated sense of unworthiness. Yet, rather than vocalizing these internal battles, men tend to mask them through behaviors like aggression, substance abuse, or withdrawal. This externalization does not reflect a lack of suffering, but rather a different language in which suffering is communicated. Anger, recklessness, and even detachment become the outward-facing signs of a much deeper emotional wound. These expressions are often misunderstood, misdiagnosed, or ignored, further alienating men from the help they desperately need.

Overt vs Covert Depression: The Quiet Suffering of Men

Real’s distinction between overt and covert depression is key to understanding why male depression is so often overlooked. Overt depression is the more recognizable form, marked by visible signs of sadness, withdrawal, and emotional incapacity. This is the depression that society is familiar with, the one for which people seek help. However, this is not the depression most men experience.

Instead, male depression often presents covertly, hidden beneath layers of behaviors that, on the surface, might seem normal or even productive. Men may channel their depression into compulsive work habits, excessive fitness routines, or detachment from relationships. They may become irritable or domineering, traits that are not traditionally associated with depression. These covert symptoms allow depression to thrive unnoticed, leading men to continue suffering in silence, while their external behaviors are rationalized or accepted as part of masculine identity. This covert depression is insidious because it denies men the ability to recognize their own need for help, as their behaviors are so deeply ingrained in societal notions of masculinity.

Trauma’s Two Faces: Type One vs Type Two

Understanding trauma is essential to understanding male depression. Real introduces two categories of trauma that shape men’s emotional experiences: Type One and Type Two. Type One trauma is easily recognizable—it results from acute, identifiable incidents such as abuse, violence, or major life events. These are the traumas that leave visible scars.

However, Type Two trauma, which is chronic and accumulative, often leaves scars of a different nature—scars that are hidden and easily dismissed. This form of trauma results from prolonged emotional neglect, unspoken shame, or sustained exposure to environments that stifle emotional expression. For many men, Type Two trauma is deeply rooted in their formative experiences, where societal expectations and unhealthy familial dynamics force them to suppress their emotional selves. Over time, these unaddressed wounds fester, manifesting as depression, anxiety, or compulsive behaviors that mask deeper unresolved pain.

Type Two trauma is particularly damaging because it is less visible, more difficult to identify, and often dismissed as part of the natural male experience. It accumulates over years of unexpressed grief and unprocessed emotions, leading to profound long-term psychological impacts.

Society’s Silent Gaze: Reactions to Male Depression

At the core of the male depression epidemic is the role society plays in perpetuating it. Real argues that societal reactions to male depression are often dismissive, or worse, contemptuous. The cultural script for men has long been one of emotional restraint, stoicism, and an almost pathological independence. Again, more on this here. To deviate from this script—to express sadness, vulnerability, or despair—is to risk being perceived as weak or unmanly.

The result is a society that discourages men from seeking help, forcing them to navigate their emotional landscapes in isolation. The societal ideal of the “strong, silent” man leaves little room for emotional complexity, let alone open dialogue about mental health. Depression in men is thus relegated to the shadows, unspoken and untreated, as society turns its gaze elsewhere.

What Real calls for—and what is urgently needed—is a cultural reevaluation of how we understand and react to male depression. The long-standing dichotomy between masculinity and emotional vulnerability must be dismantled to make space for men to not only feel but to seek help without fear of judgment or alienation.

If you’ve made it this far, thank you. Please don’t forget to share your thoughts. Your feedback means everything to me, and it’s a key part of shaping this book.

As always, I see you.

Warm regards,
Ethan