Angry men may actually have undiagnosed depression, CDC-funded study found

• Formal screening tools for depression may not always work well for men, a forthcoming study suggests.
• Instead of saying they feel blue, low-energy, or hopeless, some men only report anger and irritability.
• "Men might be experiencing depression, which is often very linked to suicide risk, in different ways," a lead researcher said.

Sad, hopeless, fatigued, sluggish.

When experts screen for depression, these are red flags they look for using a set of standard questions.

Have you been feeling low energy? Hopeless? Or blue?

Maybe you're having difficulty concentrating, feeling worthless, not finding joy in things you used to do.

Rarely, if ever, do clinicians ask: "Are you angry?"

Some budding research suggests they should. Anger, researchers found, may be a central component of depression in working-age adult men, who have the highest suicide rate in the US.

"Our depression measures talk about being sad, and withdrawn, and lonely," Jodi Frey, who led the new multi-year study, said. "What if men are experiencing it as anger and irritability?"

Frey's study results, funded by the CDC, are slated to be published later this year.

The numbers suggest roughly 10-15% of men who may actually have depression won't meet the criteria using traditional survey measures.

'That angry coworker that no one wants to be around ... what if he's actually depressed?'

Frey, a social work professor at the University of Maryland and a leading expert on suicide prevention, told Insider: "We need to recognize that men might be experiencing depression, which is often very linked to suicide risk, in different ways than maybe we've been trained."

"That angry coworker that no one wants to be around, who is probably going to get in trouble and get fired, what if he's actually depressed?"

Frey's study, a five-year look at over 500 men in Michigan (aged 25 to 64), found many screened at risk for suicide - but they did not fit the "depression" profile. Instead, they screened at moderate or high risk for anger.

"I often think about the employee: a middle-aged man who is angry and just really pissed off at work about a million different things," Frey said. "No one wants to be around him. He's irritating. We don't feel sad for him. We don't feel empathy like we would, maybe, for a coworker who's depressed in a traditional sense."

Man Therapy speaks to men

Her study offered some study participants a tool to combat this: a website called Man Therapy, designed to tackle the stigma many men have around talking about their mental health.

The site pokes fun at the ways men may be trained not to talk about feelings, while also providing messages of hope and resilience from others who've been through tough times.

Joe Rosenberger, a Michigan man who discovered Man Therapy one night in 2014 when he wasn't sure how to go on, says one of the testimonials on the site "had a lot to do with saving my life."

"It was from just regular people," Rosenberger told Insider. "It wasn't a doctor telling me anything. It wasn't a drug company telling me something. It was another person who had walked the walk, telling me their story."

Eric Hipple, a former NFL quarterback for the Detroit Lions who's spoken openly about his struggles with suicidality, says the site addresses the "way men think."

"Men like to fix things, and what better way than to have the tools right there to pick from?" he said.

It is not meant to serve as a "replacement" for traditional care, Frey says. It encourages men to seek help from friends, family, co-workers, doctors, and themselves.

"Man Therapy tackles these ideas that are floating around society about what men should be and what they shouldn't be, and just uses humor to challenge it," she said. "We all know what happens when we can't express our feelings and our emotions. We get overwhelmed with anxiety, or with irritability, or with depression."