Seeing Dwayne “The Rock” Johnson hit the big screens in blockbuster action-comedies like Jumanji and Tooth Fairy, you’d never guess that the wrestler-turned-actor was struggling with his mental health behind closed doors. But in a recent episode of The Pivot podcast, Johnson, 51, opened up to the retired NFL star hosts about his three bouts of depression and how he was able to recover.
“I’ve worked hard over the years to gain the emotional tools to work through any mental pain that may come to test me,” Johnson wrote in an Instagram post about his appearance on The Pivot. “But years ago I didn’t know what mental health struggle was. As men, we didn’t talk about it.”
“Men are less likely to recognize they have depression because they tend to stigmatize depression more than women,” says Gail Saltz, M.D., Clinical Associate Professor of Psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine and host of the How Can I Help? Podcast.
Those who do recognize the problem don’t necessarily take action. American men are 160 percent less likely to receive any form of mental health treatment, according to a 2019 review (1).
The lack of support and treatment can have devastating consequences. Male suicide rates show that 27.3 per 100,000 middle aged men ages 45 to 65 committed suicide in 2020— that’s nearly four times as high as women, according to CDC data.
Does Depression Affect Men Differently?
One reason that depression goes unrecognized is that symptoms of depression often look different in men than in women.
“Men, more so than women, can feel and appear angry, highly irritable, and may not appear as sad as women when they are experiencing depression,” says Saltz. “[Because of this], others around them are less likely to recognize they have depression, and men will likely push others away.”
Saltz says that men are also more likely to turn to self-destructive behaviors like binge drinking and substance abuse to alleviate their depression
Men are also more likely to complete a suicidal attempt, because they frequently use lethal methods like guns, according to CDC data. 85 percent of suicide attempts with a gun result in death, according to Harvard University.
Reasons for Depression in Middle-Aged Men
When early-career football injuries squashed The Rock’s big league aspirations, he says that he fell into his first bout of depression—he just didn’t know it at the time. “The interesting thing at that time is I just didn’t know what it was. I didn’t know what mental health was. I didn’t know what depression was,” Johnson told The Pivot.
Saltz says that environmental stressors—like the pressure to succeed in work, money, and family or feeling that certain doors have closed—commonly spark midlife depression in men.
Indeed, men may be up to 50 percent more likely to develop depression after a stressful event, according to a study by the University of Michigan School of Public Health that followed men 25 years after the stressor occurred (2).
When Johnson recognized that he was starting to experience depression for a second time, he reached out to friends.
“I knew what it was at that time and luckily I had some friends that I could lean on and say, ‘Hey I’m feeling a little wobbly now. I got a little struggle happening,’” Johnson said.
That step, which may have saved his life, isn’t one many men make. “We know men are less likely to lean on others for emotional support or go to therapy,” Saltz says.
The tendency to bottle up mental health concerns could also pose major health risks and exacerbate depression. Long-term loneliness may even be as bad for you as smoking 15 cigarettes a day, according to the National Institute on Aging.
And male loneliness is on the rise. Fifteen percent of male respondents in a 2021 survey by the American Perspectives Survey reported that they had no close friends (3). This is a sharp jump from 1990 figures in the same survey in which only three percent of men said they had no close friends.
“If you’re going through your own version of mental wellness turning into mental hell-ness, the most important thing you can do is talk to somebody. It can’t be fixed if you keep that pain inside,” Johnson says. “Having the courage to talk to someone is your superpower.”
While Johnson didn’t say that his hormones played a role in his depression, they can be a factor for many middle aged men. Testosterone levels begin to drop around the age of 35 for most men. That normal decline can result in feelings of depression and anxiety, says Saltz. It could even trigger “a second or third round of depression which started earlier in life.”
Men may be particularly prone to hormone-related depression. Older men with major depressive disorder (MDD) were found to have lower free and total T levels than their mentally healthy counterparts in a 2017 study (4). In the same study, there was no link found between hormone levels and MDD in women participants.
If you find yourself lashing out at loved ones, feeling irritable, or leaning on drugs or alcohol to cope—all symptoms of depression in men—it’s critical to reach out to a friend, family member, or healthcare professional. Recovery is possible with the proper treatment. Most people see a therapist or take medication to treat their depression, but research actually suggests that a combination of both is the best route for many men.
If you or someone you know needs help, visit 988lifeline.org or call or text the Suicide and Crisis Lifeline at 988.
Sagar-Ouriaghli, at al (2019). Improving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-Seeking.
Assari, et al (2016). Stressful Life Events and Risk of Depression 25 Years Later: Race and Gender Differences.
Survey Center on American Life (2021). Men’s Social Circles are Shrinking.
Giltay, et al (2017). Plasma Testosterone and the Course of Major Depressive Disorder in Older Men and Women.