Knowing how to recognise the signs of depression and potential suicide is the best gift you could ever give a friend. Here’s what to look out for.
There are some national days that you celebrate – like International Bacon Day – and then there are some that you don’t. Instead, they leave you feeling helpless, vulnerable and, well, depressed. World Suicide Prevention Day has admirable goals but the fact we need an international calendar day to remind us that suicide remains a very real issue, especially among young men, is both sobering and saddening.
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Depression in men remains a silent epidemic, and despite societal shifts in mental health awareness, many men still feel immense pressure to remain stoic, to “man up,” and to hide their emotions, with a survey finding that 40% of men have never spoken about their mental health, and one-third reporting that they’d had a diagnosable mental health condition at some point in their life.
“While dramatic shifts in awareness and communication about mental health issues have occurred in the last 10 years, rates of depression and suicide have remained stubbornly high, especially among men, and indeed have risen steeply, especially in Hong Kong, amongst young men under 30,” says Simon Westcott, a Hong Kong-based counsellor and therapist at Mapletress Counselling in Hong Kong.
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“Recognising the warning signs of depression and suicide among men in Hong Kong can be particularly challenging due to cultural and societal expectations,” says Hong Kong-based psychologist Kelvin Chung. “In Hong Kong, there is a strong emphasis on resilience, self-reliance, and maintaining a “tough” exterior. This often leads many men to suppress or hide their struggles, making it difficult for even close friends or family to notice when someone is dealing with depression or suicidal thoughts.”
“Moreover, the stigma surrounding mental health in Hong Kong can discourage men from seeking help or discussing their feelings openly. They might instead show signs that are less traditionally associated with mental health issues, such as working excessively, withdrawing socially, or displaying irritability and anger,” says Chung.
This is a problem echoed by Andrew Adler, a clinical psychologist practising in Hong Kong. “In both traditionally Eastern and Western cultures, we are raised to be ‘tough as nails’, that we should be unquestionably resilient and not acknowledge any experience that others would perceive as a weakness. This is especially true for psychological or psychiatric difficulties, with depression being the most common among the disorders.”
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He says that as children and teenagers, we are usually taught, in our families and schools, that thinking of ourselves as depressed, as well as acknowledging it, shows that our character is weak. “As a result, we may feel a sense of shame and humiliation if we even begin to feel depressed.”
This silence can be deadly. Globally, suicide remains one of the leading causes of death among men, with men being more likely to take their own lives than women (75-80% of suicides are men), and no city is immune – Hong Kong saw a decade-high number of suspected student suicides last year while 2023 saw Singapore suicide rates his a 22 year high. As World Suicide Prevention Day arrives for another year, it’s time to break the stigma and open up about the dangers of depression among men.
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Why Depression Among Men Goes Unnoticed
Depression can affect anyone, but it often manifests differently in men. Instead of displaying stereotypical sadness or withdrawal, men may react to depression with irritability, aggression, or substance abuse. Cultural expectations, which prize resilience and self-reliance, make it even harder for men to acknowledge emotional distress. Many feel that admitting to depression is a sign of weakness, leading them to suffer in silence rather than seeking help.
The consequences of this silent struggle are devastating. Men are more likely to act on suicidal thoughts because they’re less likely to ask for support when they need it most. Being aware of the warning signs in ourselves and others could be the difference between life and death.
“For men, loss of a job and/or financial difficulties are major risk factors for suicide,” says Adler. “I should point out that more women attempt suicide than do men, but men are more likely to die from a suicide attempt. Often, men feel like they have failed completely as a partner or father if they have job-related or financial difficulties. Given men’s frequent sense of failure in these situations, in addition to their high probability of dying from suicide attempts, it is extremely important to begin nonjudgmental conversations about these issues and provide ongoing emotional support.”
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Five Warning Signs Your Friend Is Suffering from Depression
“Men often ‘drown their sorrows’, and sometimes lose control of the things they use – or abuse – in the process, including alcohol, drugs, gaming, gambling, pornography,” says Westcott. “Even those who maintain a broader social network, or who remain more or less functional at work, struggle to admit to or talk through their struggles with others, which is why it’s often so hard to spot the signs of depression and potential self-harm.”
He says low-grade suicidal ideation – fleeting thoughts about ending things – is also more common than people think (up 1 in 6 of some populations, according to recent studies), although reported more prevalently among women, who have lower overall rates of actual suicide. “Men say less, and act (out) more,” says Westcott.
Irritability and Anger
Depression in men often shows up as irritability or unexplained anger. If your friend is suddenly quick to anger, argumentative, or seems constantly frustrated over small things, this could be a sign. To help, approach them with empathy, not judgment. Let them know that you’re there to listen and that it’s okay to feel angry, but that you’re worried about the cause of these feelings.
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Withdrawal from Social Activities
If your mate is consistently avoiding social events, cancelling plans, or becoming distant, they may be struggling with depression. This withdrawal can be gradual, making it easy to miss, but if someone who was once social becomes isolated, it’s a red flag. To combat this trend, try to engage them in low-pressure activities, even if it’s just going for a walk. Sometimes, just showing up can remind them that they don’t have to face things alone.
Risky or Reckless Behaviour
Depression in men is often linked to risky or reckless behaviour, such as excessive drinking, substance abuse, or dangerous activities. This is sometimes a way of coping or numbing emotional pain. It’s important that you don’t ignore or enable this troubling behaviour. Instead, have a candid conversation, expressing your concern about the change in their actions and offering to help them seek professional support.
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“Although both men and women usually feel sad and down when depressed, men also tend to become more aggressive, often verbally and sometimes, physically,” says Adler. “Also, men are more likely to use alcohol to self-medicate their negative feelings. Partners, family members and friends should pay attention to signs of increased aggressive behaviour and alcohol consumption as possible signs of depression along with the more well-known symptoms such as sadness, decreased motivation and changes in sleep and eating patterns.”
Talking About Feeling Trapped or Hopeless
When men are struggling with depression, they may express feelings of being trapped, hopeless, or a burden to others. They may say things like, “What’s the point?” or “Everyone would be better off without me.” Take these comments seriously. Let them know that they are not alone and that their feelings matter. Encourage them to speak with a therapist or counsellor, and if the situation is urgent, seek professional help immediately.
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Changes in Sleep and Appetite
A common sign of depression is a sudden change in sleep patterns (sleeping too much or too little) or a drastic shift in eating habits (eating excessively or losing appetite entirely). These physical symptoms can be an outward sign of an inner struggle. A good mate would gently ask if they’ve noticed these changes in themselves and offer to help them explore solutions, whether it’s trying a healthier routine or seeking medical advice. Offer to hit the gym together, have a cheat day meal, and bring the lads together for some healthier activities.
How You Can Help a Friend Suffering from Depression
If you do suspect that there’s a deeper problem afoot, recognising the signs is only the first step. Taking action and offering support in the right way can make a world of difference.
“To better support friends who might be struggling, it’s important to create a safe space where open conversations about mental health are normalised,” says Chung. “Sometimes, just letting someone know that you’re there to listen without trying to “fix” things can provide the reassurance they need to seek help. In Hong Kong’s fast-paced environment, showing genuine concern and letting someone know they are not alone can make a significant difference.”
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Here’s how you can help:
Start the Conversation
Approach the topic sensitively but directly, and expect a little (or a lot) of pushback. Let your friend know you’ve noticed some changes and that you’re concerned. Offer a non-judgmental space for them to talk about what they’re going through. Sometimes, just knowing someone cares can be a lifeline.
Be There, But Don’t Push
You don’t need to fix their problems or have all the answers. Simply being present and letting them know you’re there is often enough to convey the message that it’s not all on their shoulders. Avoid pushing them to “cheer up” or “snap out of it”—depression simply doesn’t work that way.
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“Openly recognising and acknowledging signs of depression as soon as possible is always important but especially for men as they are much less likely to recognise and talk about their own feelings,” says Adler. “Because many men continue to believe that talking about depression is not okay, it is very important to approach them with care and understanding. One strategy that often works is to demonstrate empathy, acknowledging how challenging it can be for men to talk about negative feelings.”
Encourage Professional Help
If your friend is hesitant to seek help, remind them that seeing a therapist or counsellor isn’t a sign of weakness but instead is a proactive step toward feeling better. Offer to help them find a professional or even go with them to an appointment if they feel anxious about it.
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Check In Regularly
Depression can be a long and isolating journey. Even after an initial conversation, continue to check in with your friend. Whether it’s a text, a call, or meeting up, regular contact shows that you care and can make a big difference in their recovery.
“Just check in, and don’t be afraid to ask the same question a few times,” says Westcott, suggesting that friends look for subtle shifts in the person’s sense of their position in relation to others, either friends, colleagues or even strangers, including paranoia, a sense of persecution, or attributing exaggerated or unprovable motives or actions to the wider social group. “This may take the form of victimhood, but it may also manifest in increased aggression towards others, intended or actual, a harm which can also be turned on the self.”
Know When to Seek Emergency Help
If your friend talks about self-harm or suicide, take it seriously. Don’t leave them alone. Encourage them to reach out to a professional immediately or contact a crisis line. In urgent cases, don’t hesitate to seek emergency services.
“By keeping close to our friends, and following the weft and weave of their life, we can understand the very real and painful pressure points that make people contemplate the previously unthinkable: financial stress, relationship break-up, the impact of addiction, or the triggering of historic or childhood trauma,” suggests Westcott.
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Breaking the Silence Around Men’s Mental Health
Men’s mental health deserves to be talked about, not in hushed tones or behind closed doors, but openly and compassionately. Depression is not a sign of weakness, and asking for help is one of the bravest things a man can do. By recognising the warning signs in ourselves and others, and by fostering a culture of support and understanding, we can save lives.
“Partners, friends and family members can be highly supportive when a man struggles with a mental health problem,” says Adler. “Just listening and empathising, showing that you care, often go a long way to helping him know that he is not struggling alone. If he continues to experience this problem, don’t be afraid to recommend that he see a therapist or counsellor. You can explain that seeing a therapist is not a sign of weakness but rather one of courage.”
This World Suicide Prevention Day, let’s commit to breaking the stigma around men’s mental health and depression. If you or someone you know is struggling, reach out. Help is available, and it’s never too late to start the conversation.
If you or someone you know is experiencing suicidal thoughts, contact a local crisis hotline or seek professional help immediately. You are not alone.
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