When Depression Doesn’t Look Like Sadness:

A Men’s Health Month Reality Check

By Dr. Chriss Mulumba, Board-Certified Psychiatrist 

STARS Integrative Care with TMS  ·  Suwanee, GA

 

Let me be direct: the picture most people carry of depression is wrong — and that wrong picture is costing men their health, their families, and sometimes their lives.

When we say “depression,” people imagine someone who is sad. Tearful. Slowed down. Staying in bed with the curtains drawn. For some people, that is exactly what it looks like. But in a lot of the men I treat here in Suwanee and Johns Creek, depression doesn’t look like sadness at all. It looks like anger.

It Looks Like the Guy Everyone Calls “Fine”

It looks like the father who’s suddenly snapping at his kids over nothing. The husband who’s checked out and short-tempered at home. The employee burying himself in 70-hour weeks because slowing down feels unbearable. The friend who’s drinking more, taking dumb risks, or who has just… gone quiet. A lot of the symptoms can also be seen in bipolar disorder, hence, the reason to see a psychiatrist.

These men don’t walk in and say, “I think I’m depressed.” They say, “I’m fine.” They say, “I’m just stressed.” They say, “I’m tired.” And because their symptoms don’t match the textbook image, the people around them — sometimes including their own doctor — miss it completely.

Here is what depression frequently looks like in men:

  • Irritability, a short fuse, or anger that feels out of proportion to what’s happening
  • Throwing yourself into work and refusing to stop
  • Drinking more, or leaning harder on other substances
  • Reckless behavior — with driving, spending, or risk-taking
  • Physical complaints with no clear cause: headaches, back pain, stomach trouble, and a bone-deep fatigue that sleep doesn’t fix
  • Pulling away from family, friends, and the things you used to enjoy
  • Trouble concentrating, remembering, or making simple decisions

Notice how few of those are “sadness.” That’s the whole point.

Why Men Get Missed

Part of this is biology, and part of it is how men are raised. From the time they’re boys, a lot of men are taught that emotions are weakness — that you handle it yourself, you don’t complain, you tough it out. So when something is wrong on the inside, it rarely comes out as “I need help.” It comes out sideways: as anger, as overwork, as another drink.

And the stakes are not small. Men die by suicide far more often than women, and they are far less likely to ever sit down with a provider and talk about their mental health. They white-knuckle it until they can’t.

I’m not telling you this to frighten you. I’m telling you because Men’s Health Month is exactly the right time to say the thing nobody says at the barbershop or on the job site: if you’ve felt off for weeks — angry, empty, exhausted, not yourself — that is not a character flaw. It is a medical condition, and it is one of the most treatable conditions in all of medicine.

If you are having thoughts of harming yourself or ending your life, please don’t wait for an appointment. Call or text 988, the Suicide and Crisis Lifeline, right now. It’s free, confidential, and available 24/7.

What Actually Helps

Now the part I most want you to hear: depression responds to treatment. The large majority of men who get the right care get better. Here is how we approach it at STARS.

It starts with a real evaluation — not a five-minute checklist, but an honest conversation about what’s actually going on in your life and your body. From there, treatment usually involves some combination of the following:

Medication management. The right medication, dosed correctly and properly monitored, can lift the fog for many men. These are not “happy pills,” and they are not necessarily forever.

Therapy. Talking with someone trained to help — and yes, men do this, and it works.

TMS therapy. This is for the men who’ve already tried medication — sometimes several — and still feel stuck. TMS is an FDA-cleared, drug-free, non-invasive treatment that uses gentle magnetic pulses to stimulate the parts of the brain involved in mood. You sit in a chair, awake the whole time, and walk out and go on with your day. No anesthesia, no downtime. For depression that hasn’t responded to medication, it can be a turning point.

Spravato® (esketamine). Another option for treatment-resistant depression, administered in our office under medical supervision.

The STARS Difference

Here’s what sets us apart. At STARS, your psychiatrist and your primary care physician are under one roof. That matters more than it sounds. So much of what drives mood is physical — thyroid problems, low testosterone, sleep apnea, vitamin deficiencies, chronic pain. When your mental health team and your medical team actually talk to each other, you stop falling through the cracks. We treat the whole man, not a slice of him.

We see patients ages 15 and up for behavioral health, and we accept most major insurance plans — Aetna, Blue Cross Blue Shield, Cigna, United Healthcare, and Humana — so cost doesn’t have to be the reason you keep waiting.

My Men’s Health Month Challenge to You

Stop calling it stress. Stop waiting for it to pass on its own. Stop white-knuckling it alone. Whether it’s you, or the man in your life you’ve been quietly worried about — make the call. One appointment. Let’s figure out what’s actually going on and what to do about it.

Call us at (470) 253-1350 or visit starsmedpsych.com to book. You can book an appointment in person or via telehealth in the privacy of your own home. We’re right here in Suwanee, serving Johns Creek, Duluth, Cumming, and the greater Gwinnett and Forsyth communities.

A safe place that harbors hope and healing — that’s not just a slogan. That’s the room I want you to walk into.

— Dr. Chriss Mulumba, Board-Certified Psychiatrist

 

A note on a sensitive topic: This article touches on depression and suicide risk. If you or someone you know is struggling, support is available — call or text 988 anytime, or reach STARS at (470) 253-1350 to schedule an evaluation.