Hidden Sadness – Psychiatrist Says Men’s Depression Often Masks as Anger

When irritability replaces a man’s usual calm demeanour it may not simply be anger but hidden depression.

Dr Mark Rego, a psychiatrist and clinical assistant professor at Yale School of Medicine in New Haven, Connecticut in the United States, works with patients in community mental-health clinics and continues to teach at Yale New Haven Hospital.

According to Rego, men’s depression often hides behind behaviour that looks like frustration or aggression. “Depression in adult men is frequently quite different,” he explains. “A man who is usually calm and even tempered becomes irritable, prone to anger, criticism, disparaging remarks and cynicism.”

Rego says this shift is more than moodiness. It reflects a pattern of: “externalising emotions” where men direct blame outward rather than recognising the inner distress driving it. These reactions, he notes: “point outside the person for their causes and solutions.” As a result, families often see conflict and withdrawal where thereis really exhaustion and despair.

The problem is intensified by cultural pressure on men to appear strong. “Sadness in men is seen as weakness,” Rego warns. Many avoid therapy until anger strains relationships or jobs. Yet treatment can bring real relief. “Medication reduces the symptoms, and therapy helps in understanding what was happening and how it affected the life they are now rebuilding.”

For families, recognising that unusual irritability or harsh criticism may mask depression is vital. Instead of reacting to anger with anger, Rego suggests calm concern, asking whether the person feels overwhelmed or tired, and encouraging professional help early. Simple gestures such as checking in regularly, listening without judgement, and normalising therapy can help men move from defensiveness to openness.