Far from being a “female” condition, depression is something that affects men as well—to the tune of about 6 million a year, according to the National Institutes of Mental Health. But men often experience depression very differently than women do.

Generally, the symptoms of depression are the same in both sexes. Persistent feelings of sadness, anxiety, hopelessness and guilt; loss of interest in previously enjoyed activities; sleep disturbances; and weight gain or loss are classic ones. But instead of talking about and expressing their negative emotions the way women do, men often focus on the physical manifestations of their condition, such as fatigue, inability to concentrate, headaches, or stomachaches. They may not even realize themselves that they’re depressed.

Why does the depression landscape look so different for men? Experts at the Cleveland Clinic say it’s because men in our culture are socialized to be strong, tough guys who are in control. Admitting to feelings of low self-esteem or loneliness would be seen as weak. Therefore, men who do feel depressed are more likely to act on their feelings in aggressive ways, such as drinking or abusing drugs. Some men become chronically angry, violent, abusive, reckless, or workaholics. Most tragically, some depressed men choose to end their own lives. Suicide is closely associated with depression, and it’s thought that the reason men are four times likelier than women to commit suicide is because they are unwilling or unable to get help.

Despite images from the media, young men are not the group with the highest suicide rate in this country. Older Caucasian men actually are at greatest risk. Why? Men past their prime of life may be feeling adrift after retiring from a profession that they felt defined who they were, they may have lost their partners or other loved ones, or they may be suffering from health problems.

The good news is that depression is treatable in most people. If you or someone you love is acting withdrawn or simply acting out, it’s crucial to get help. At the very least, therapy, antidepressants, or a combination of the two can provide relief and vastly improve the quality of life. And at the most, they can literally mean the difference between life and death.