You’ve thought about therapy. Maybe your partner has suggested it, occasionally during an argument, which probably didn’t make you more enthusiastic. Maybe you’ve looked up a few therapists, read their websites, and closed the tabs.

You’re not necessarily against it. You just haven’t made the appointment.

There may be good reasons. Finding someone takes time. Therapy costs money. And talking to a stranger about things you don’t entirely understand yourself isn’t everybody’s idea of a productive afternoon.

But sometimes the hesitation is harder to explain. You know something isn’t working. You’re tired of having the same argument, being irritated by everyone, or getting through the day only to spend the evening wanting to be left alone. You’d like things to change. You’re less sure what talking would accomplish.

If you’re reading this because you’re worried about a man you love, some of this may help explain his reluctance. Being able to see that someone needs help doesn’t necessarily mean he can see it himself—or that he knows how to begin.

Whatever brought you to this page, here’s a look at why men don’t go to therapy, and why those reasons may not hold up as well as they seem.

“It’s not bad enough”

You’re working. The bills are paid. You take care of your responsibilities. Whatever else is going on, you’re handling it.

Even though you’re on top of things, handling them takes more out of you than it used to.

Maybe you have less patience with your kids, or you’re staying up later than you should because it’s the only time nobody wants anything from you. You still see friends, but you’d often rather cancel. Your partner asks what’s wrong, and you say “Nothing,” partly because you don’t have a better answer.

None of this feels like a crisis. Each thing has an explanation: work, getting older, a difficult stretch in your marriage. You keep adjusting to it until feeling this way seems normal.

How your life looks from the outside doesn’t tell the whole story. You can be successful, responsible, and there for everyone else, and still be getting very little out of it yourself. That’s worth paying attention to before it becomes a crisis, not after.

“I should be able to figure this out myself”

You may have good reason to trust your ability to solve problems. It’s gotten you through a lot.

Perhaps it was also expected of you. You learned early to keep moving, avoid complaining, and sort things out yourself. Asking for help can feel uncomfortable even when you’d have no trouble encouraging someone else to do it.

The difficulty is that your usual approach may be contributing to the problem. You withdraw to avoid saying something you’ll regret. Your partner feels shut out and pushes harder. You feel criticized and withdraw further. By the end, you’re both convinced the other person started it.

You can spend a long time trying to win that argument without understanding why you keep having it.

Part of therapy is looking closely at what you do when you’re hurt, worried, disappointed, or overwhelmed. Usually there’s a reason you learned to respond that way. Understanding the reason gives you more say in whether you keep doing it.

“I wouldn’t know what to talk about”

This comes up often when I talk with men about therapy. There’s a concern that you’re supposed to arrive knowing what’s wrong and be ready to explain it to someone you’ve just met.

You aren’t.

“I’ve been snapping at everyone” is enough to start. So is “Nothing’s really wrong, but I don’t seem to enjoy much.” You can even say, “My wife wanted me to come, and I’m not convinced this will help.”

That gives us something to talk about.

You also don’t have to tell me everything in the first hour. Trust takes time. I’ll ask questions, help you make sense of what you’re describing, and talk with you about where we might go from there. You’re allowed to be uncertain, skeptical, or uncomfortable.

“I’m not depressed. I’m just fed up.”

This is one of the most common reasons men put off therapy.

If you picture depression as crying, staying in bed, or feeling obviously sad, you may not recognize yourself in it. You’re getting up and going to work. You may be working more than ever. What you do notice is that everyone is getting on your nerves.

One large national study found that when depression screenings included symptoms like anger, irritability, and heavier drinking, men reported depression at about the same rate as women.

Some possible signs of depression in men are easier to explain away:

Irritability. Ordinary questions feel like demands. Small frustrations get a bigger reaction than you intended.

Anger. You feel justified in the moment, then find yourself dealing with the damage afterward.

Numbness or loss of interest. You’re doing what you need to do, but there isn’t much pleasure in it.

Poor sleep. You’re exhausted during the day and wide awake when you finally have a chance to rest.

These experiences don’t automatically mean you’re depressed. They can have several causes. But if they persist, or they’re affecting your relationships and daily life, they’re worth understanding.

You may be calling it stress. Your partner may be calling it distance. What gets missed is how you’re actually feeling underneath it.

I’ve written more about irritability, anger, feeling numb, and trouble sleeping. If one of those sounds more familiar than “depression,” start there.

What happens in the first session?

Mostly, we talk.

I’ll want to know what brought you in, how long it’s been going on, and what you’ve tried. I’ll ask about the parts of your life that seem relevant. You can ask how I work and tell me what you’re hoping to get out of this—or what you’re worried it will be like.

My approach is practical and collaborative. If you describe an argument, we might slow it down: What happened? What did you think your partner meant? What did you want to say? What came out instead?

Those details often tell us more than a general conversation about “communication problems” would.

The first session also gives you a chance to see how it feels to talk with me. Can you be candid? Do my questions make sense? Do you feel understood, including when I challenge something? Those are useful things to pay attention to.

What changes when you keep coming?

That depends on what brings you in. We should have some agreement about what you want to be different, so you can tell whether the work is helping.

You might begin to notice that you’re hurt before you become angry. You might tell your partner what’s bothering you while you can still have a conversation about it. You might understand why being asked a perfectly reasonable question sometimes feels like being told you’ve failed.

Some of that can be uncomfortable. You may discover that a complaint you’ve had about someone else also involves something you do. We need to be able to talk about that directly.

Over time, the aim is to give you more choices in moments when you’ve tended to react automatically. You can still get angry, disagree, or need time alone. But you may get better at saying what you mean, understanding what you need, and doing something useful about it.

Therapy for men in Bethesda

You don’t have to be certain therapy will help before you make an appointment. It’s reasonable to want a conversation before deciding whether to continue.

When you’ve been putting it off, that first step can start to feel bigger than it is. You’re arranging a time to talk about something that’s been bothering you. We can begin there.

You can read more about my approach on the Therapy for Men service page, or contact me for a free 20-minute consultation.