The Mask of Anger in Elite Circles: Identifying and Managing Depression in Men of Prominence

High-profile leadership, trajectories of wealth, or upper socioeconomic status often presume resilience, composure, and unshakeable stamina.

Yet beneath the surface of outward authority, individuals in elite roles may carry a very different burden: unrecognised depressive distress masked by irritability, anger, withdrawal, or physical symptoms¹. In male demographics – where a prime contextual currency is often performance, visibility, and control – the clinical presentation can be further complicated, as what may be held as ‘the conventional image of depression’ (quiet sadness, tearfulness, retreat) may frequently be reversed or redirected^2-4.

For men operating in the upper echelons – whether in boardrooms, senior public office, global sport, or contexts of high wealth – the pressures are manifold: the weight of reputation, incessant connectivity, relentless expectation, and the imperative to present strength at all times⁵. These conditions can channel psychological suffering into forms that remain hidden or misinterpreted: bursts of anger perceived as temper intransigence; withdrawal seen as strategic focus; tension interpreted as drive rather than distress⁶.

This masked presentation may be compounded by a cultural matrix of masculinity – the expectation to “hold firm,” to remain unflappable, to prioritise duty over personal vulnerability². When men in prominent positions sense that emotional disclosure will be read as weakness – risking reputation, influence or standing – they may unconsciously suppress sadness, and instead experience rage, irritability or refined dysfunction⁷.

Yet these surface behaviours correlate with clinical evidence showing that men are more likely than women to die by suicide, less likely to seek help, and more likely to present with externalising symptoms when living with depression^8-10. Without recognising this grammar of masked distress, therefore, the cycle of underdiagnosis and untreated illness can only perpetuate.

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Real voices

A number of men in the public eye have dispensed the myth that success shields from psychological challenges¹¹. In doing so, they have helped show that depression in men can wear the mask of anger, irritability, or high-functioning withdrawal¹¹.

• Lewis Hamilton has spoken about dealing with “some really difficult phases” and depression “from a very early age […] I think it was the pressure of the racing and struggling at school. The bullying,” he said. “I had no one to talk to.¹²”
• Stephen Green (British musician and media personality better known as Professor Green has also said: ““I suffer with depression […] it’s pretty much been a constant for me, and it went undiagnosed for a long time […] it’s always been that if you’re down, you just kind of get on with it […] any kind of vulnerability or weakness is not seen as masculine, which I think is where men are probably just quite behind.⁷”
• The 28-medal winning Olympian and elite sportsperson Michael Phelps said his first “depression spell” happened in 2004, and again after the 2012 Games, where he sat in his bedroom for days “not wanting to be alive.” Having reached out for help, Phelps acknowledges his own struggles openly, saying “it’s OK to not be OK.¹³”
• Similarly, Dwayne ‘The Rock’ Johnson “found that with depression, one of the most important things you could realise is that you’re not alone. You’re not the first to go through it […] I wish I had someone at that time who could just pull me aside and say, ‘Hey, it’s going to be okay.¹⁴‘”
• During the 1990s, Brad Pitt struggled with depression, but gained a new perspective after witnessing poverty in Morocco: “I used to deal with depression, but I don’t now, not this decade – maybe last decade. But that’s also figuring out who you are. I see it as a great education, as one of the seasons or a semester – ‘This semester I was majoring in depression.¹⁵’”

In environments of high visibility and demand, the intersection of prominence, connectivity and the expectation of always-on performance can magnify the risk of masked depressive symptom-expression¹⁶.

Atypical presentations of depression in men of prominence

1. Anger, irritability, and externalising behaviours

Emerging evidence suggests that men often exhibit distinct affective profiles when experiencing depression¹⁷. In one clinical study of 217 patients diagnosed with major depression, men reported significantly higher rates of anger attacks – averaging more than four per month – compared with just over one per month in women¹⁷. Similarly, a regression analysis of nearly two thousand Japanese workers found that anger, both inwardly and outwardly expressed, accounted for a greater proportion of depressive symptom variance in men than in women¹⁸.

These externalising behaviours – irritability, agitation, anger outbursts, or increased risk-taking – are interpreted as indicators of mood disorder¹. More often, they are reframed as occupational stress, personality traits, or merely the natural consequences of working under pressure¹. Yet such readings can obscure the underlying pathology, allowing distress to become entrenched and, over time, to corrode both relational stability and physical health⁵.

It is not uncommon for public figures or executives who later speak openly about their experiences to describe a period of escalating irritability or volatile temperament long before the word “depression” was used^11-15. This pattern illustrates how depressive expression – when filtered through masculine norms of control and dominance – often becomes behavioural rather than verbal; visible, but misread^19-20.

2. Withdrawal, somatic symptoms, and functional masking

Whereas some men externalise distress, others present forms of physical or functional withdrawal²¹. Somatic symptoms (persistent headaches, gastrointestinal upset, sleep disruption) are frequent features of male depression²¹. Yet these tend to elicit medical rather than psychological inquiry, particularly when the individual in question appears to maintain outward productivity²¹.

In elite circles, this “quiet withdrawal” can take on a deceptively adaptive form: overworking, perfectionism, or hyper-functioning. Rather than collapsing under the weight of their symptoms, men in positions of influence often respond by doubling down – working longer hours, micromanaging details, or exercising rigid control²². This behavioural compensation sustains the façade of composure, but amplifies physiological strain³. Within such contexts, breakdown rarely presents as acute crisis; instead, it unfolds as a slow, hidden erosion⁴.

3. Diagnostic blind spots and help-seeking reluctance

Masculine ideals of self-reliance and emotional composure discourage disclosure, while fear of reputational damage can add an additional layer of inhibition for men of prominence^19-20. Aviva’s 2024 report found that fewer than one in ten men would tell their employer about mental health challenges, and broader workplace surveys indicate that only around half of men experiencing psychological distress seek professional help at all^23-24.

When a public image of competence must be sustained, vulnerability can feel both professionally and personally dangerous²². As a result, the presentation of depression is frequently disguised, not through deliberate deception, but through the deeply conditioned reflex to contain and control emotion³. 

In these circumstances, trusted advisors such as family physicians, personal assistants, wealth managers, or family-office staff may be the first to notice subtle behavioural changes. Their capacity to recognise such cues and facilitate discreet assessment can act as the hinge between prolonged suffering and early intervention.

Performance culture: visibility and expected resilience

Within high-visibility environments – boardrooms, media, elite sports, life in the public eye – performance and composure are currency²⁵. The unspoken rule is that resilience must be perpetual. Public failure, or even the perception of diminished control, carries reputational costs that most prominent men have been conditioned to avoid²⁶. Consequently, distress is contained rather than expressed, leading to masking behaviours: the active projection of success and stability while privately struggling with exhaustion, irritability, or despair^3-4.

The psychological toll of such duality is significant⁴. Maintaining the mask requires continuous self-monitoring and suppression of affect, which, over time, compounds the internal strain³. The more flawlessly a man appears to function, the less visible his distress becomes, until only those in his innermost circle detect the dissonance²⁷.

Masculine ideals in cultural context

The conventional masculine archetype – self-reliant, stoic, in control – remains deeply embedded in many professional and cultural systems^19-20. When depression conflicts with this identity, it is frequently rechannelled into expressions more congruent with social expectations: anger, risk-taking, or compulsive work³. More traditional symptoms (such as sadness or tearfulness) are often regarded as antithetical to masculine strength, leading men to conceal or reinterpret their experiences rather than seek help⁴.

• Similar norms persist in Chinese contexts: emotional suppression is often valorised, and admitting distress may conflict with the image of strength and control. Official and cultural discourse around masculinity emphasises fortitude, achievement, and emotional moderation²⁸. A recent analysis notes that when masculinity is perceived to be under threat, men may overcompensate through aggressive behaviours or relentless pursuit of status, which may mask or exacerbate psychological distress²⁸.
• In the Arab cultural context, concepts of masculinity are closely tied to reputation, authority, resilience, and provider‑status²⁹. A thematic study of first‑generation Arab‑Australian men revealed that masculinity and mental health attitudes were deeply entwined: men described being “stuck between two worlds”, struggling to reconcile cultural expectations with help‑seeking behaviour³⁰.

Among many societies, emotional expression for men remains stigmatised, vulnerability is equated with weakness, and the suppression of symptoms or reliance on informal coping or self‑management is common³¹. Therefore, constructing a therapeutic alliance within these cultural paradigms means acknowledging the masculine commitment to duty and performance, reframing emotional expression as strategic resilience, and offering discreet, culturally‑anchored pathways to evaluation and care.

Reflections on the landscape of male depression

Contemporary evidence underscores that depressive distress in men of prominence often manifests atypically – through irritability, anger, withdrawal, or functional hyper‑engagement – rather than through the classical presentation of sadness or tearfulness³². Understanding these patterns requires clinicians, advisors, and organisations to appreciate the interplay between individual psychology, sociocultural norms, and the relentless pressures of elite environments^5-6.

Cultural expectations of masculinity shape both the expression of distress and pathways to help‑seeking³³. In many contexts, stoicism, self-reliance, and the imperative to maintain reputation act as potent modifiers of symptom visibility^19-20. The internalisation of these ideals can convert emotional suffering into behaviours more congruent with perceived strength: bursts of anger, relentless work, or somatic preoccupations⁶. Recognising these culturally inflected presentations is essential for accurate assessment and timely intervention^28-31.

Looking forward, the challenge is twofold: to create systems and cultures that enable men to disclose and manage depressive distress without fear of reputational loss, and to develop clinician and advisor competencies in detecting masked presentations³⁴. For men of prominence, recognition – coupled with culturally and contextually sensitive clinical frameworks – offers the promise of resilience that is both psychologically sustainable and operationally effective.

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Further reading:

• Neurodiversity and Mental Health in High Performers
• Paul Flynn on burnout and misalignment
• Holding Trauma in the Public Eye
• How Should We Be Rethinking Men’s Mental Health?

References:

1. https://elitebusinessmagazine.co.uk/analysis/item/beyond-the-bottom-line-chronic-stress-and-mental-health-as-a-business-owner
2. https://pubadmin.institute/gender-sensitization/exploring-social-constructs-of-masculinity
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC6142169/
4. https://www.mensmindsmatter.org/masculinity-and-masculine-norms/
5. https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/men-and-mental-health
6. https://www.independent.co.uk/voices/commentators/joan-smith/joan-smith-depression-is-more-deadly-in-the-male-1820856.html
7. https://archive.thetab.com/uk/2016/11/02/men-just-dont-talk-professor-green-male-mental-health-crisis-24489 
8. https://www.bbc.co.uk/future/article/20190313-why-more-men-kill-themselves-than-women
9. https://pmc.ncbi.nlm.nih.gov/articles/PMC7444121/
10. https://psychiatryonline.org/doi/10.1176/appi.pn.2013.10a24
11. https://www.webmd.com/depression/ss/slideshow-depression-celebs
12. https://people.com/lewis-hamilton-says-he-struggled-with-depression-from-very-early-8720324
13. https://www.cnn.com/2018/01/19/health/michael-phelps-depression
14. https://www.latimes.com/entertainment-arts/movies/story/2023-05-15/dwayne-johnson-depression-mental-health
15. https://www.telegraph.co.uk/news/celebritynews/9042512/Brad-Pitt-I-suffered-depression.html
16. https://medium.com/@equacoaching/37-famous-men-on-dealing-with-anxiety-depression-and-mental-health-issues-580ad2d4f19b
17. https://pubmed.ncbi.nlm.nih.gov/16088268/
18. https://www.researchgate.net/publication/359376832_Gender_Differences_in_the_Contribution_of_Anger_Components_to_Depressive_Symptomatology
19. https://pmc.ncbi.nlm.nih.gov/articles/PMC7036518/
20. https://www.sciencedirect.com/science/article/pii/S2666560323000907 
21. https://www.hopkinsmedicine.org/health/conditions-and-diseases/depression-his-versus-hers
22. https://www.psychologytoday.com/gb/blog/pieces-of-mind/202209/emotional-well-being-and-the-high-achiever
23. https://www.aviva.com/newsroom/news-releases/2024/06/fewer-than-one-in-ten-men-would-tell-their-employer-about-mental-health-struggles/
24. https://www.healthline.com/health/mental-health/signs-of-mental-illness-in-men 
25. https://www.mckinsey.com/capabilities/people-and-organizational-performance/our-insights/the-organization-blog/establish-a-performance-culture-as-your-secret-sauce
26. https://www.researchgate.net/publication/334813415_After_the_Fall_How_Perceived_Self-Control_Protects_the_Legitimacy_of_Higher-Ranking_Employees_After_Status_Loss 
27. https://summer.harvard.edu/blog/perfectionism-might-be-hurting-you-heres-how-to-change-your-relationship-to-achievement/ 
28. https://www.ewadirect.com/proceedings/chr/article/view/11670
29. https://www.jstor.org/stable/j.ctv21zp26x
30. https://psycnet.apa.org/record/2025-93709-001
31. https://pmc.ncbi.nlm.nih.gov/articles/PMC12117241/
32. https://www.jstor.org/stable/48511205
33. https://pmc.ncbi.nlm.nih.gov/articles/PMC8661038/
34. https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1146078/full