When you think of depression, you probably think of a person unable to move from their bed and plagued by thoughts of despair and misery.
But some experts say the mental health condition, which affects 21 million US adults, can cause a much wider variety of symptoms than most people know of.
Surprisingly, some of this is determined by your gender.
Olesya Luraschi, a Harvard-educated psychologist and leadership coach, says the traditional signs of depression that most people recognize are mainly seen in women.
Male depression usually ‘looks completely different’ from female depression, she said in a TikTok with over 5million views.
Because men are raised to be tough, instead of expressing sadness when they’re depressed, they’re more likely to withdraw from their social network and hobbies, pour themselves into work and have outbursts of anger.
By contrast, women are more likely to have difficulty concentrating, sleep problems and sadness.
In men, Ms Luraschi said, ‘there’s typically a denial of pain so in male depression males will not be talking about sadness, they will not be talking about their pain.’
Other experts agree.
‘We’ve taught boys that they don’t cry; so instead of crying, they get angry and threatening’ Dr Andrew Angelino, the Chair of Psychiatry at Howard County General Hospital said.
Robin Williams dealt with depression his whole life, his wife, Susan Schneider Williams, shared in a 2016 article in the journal Neurology
Though women are almost twice as likely to be diagnosed with depression than men, many experts say that cases in men often go unnoticed as they are more likely to avoid seeking help.
Men are four times more likely to die by suicide, according to Johns Hopkins. They also account for eight out of 10 suicides in America.
One high profile man to have struggled with the mental illness is the beloved actor Robin Williams, according to his wife, Susan Schneider Williams.
After being diagnosed with an aggressive form of dementia, called lewy-body disease, Mr Williams took his own life.
The differences in depression between the sexes can be explained by societal differences and some biological differences.
Because women deal with hormonal fluctuations surrounding their monthly cycle, pregnancy and menopause, they are more likely to have interrupted sleep, mood fluctuations and low self-esteem than men, according to Mayo Clinic Staff.
This could make women with depression more likely to express sadness, have problems with energy and difficulty concentrating.
Men have less estrogen in their system, and tend to be more affected by hormones they produce in higher proportions, like testosterone, which can drive aggression, impulsivity and feelings of anger.
One of the most common ways that men display depression has to do with slowly changing their routine, and isolating themselves, Ms Luraschi said. She added that once they feel isolated, men may begin to lash out in outbursts of anger because that’s easier for them to express than sadness.
‘Anger is one of the only socially acceptable negative emotions that men are typically conditioned that they’re able to feel,’ she said.
For example, a depressed man might begin spending more and more time at work, withdrawing from friends and family.
‘This is extremely common so if you see this in yourself or you see this in others, know that you’re not alone,’ Ms Luraschi said. ‘It’s good to be aware that male depression looks nothing like female depression.’