Around the world, women are typically diagnosed with depression twice as often as men. But a recent study published in JAMA Psychiatry looks at these disparities in a new way by considering alternative symptoms of depression typically attributed to men.

The researchers, led by Lisa A. Martin, Ph.D., analyzed data from a national mental health survey of 3,310 women and 2,382 men while also looking for alternative symptoms. They wanted to observe whether the sex differences in depression rates would disappear when these alternative symptoms were considered alongside more conventional ones.

Some of the alternative “male-type” symptoms included anger attacks, aggression, substance abuse and risk taking.

Results show that when both traditional and alternative symptoms are accounted for, men and women meet the criteria for depression in equal measures, with 30.6% of men and 33.3% of the women in the study classified as depressed.

The study authors note that most of the research exploring the sex differences in depression has focused on reasons for why women have a greater risk for developing it. But Lisa A. Martin says that “when men are depressed, they may experience symptoms that are different than what is included in current diagnostic criteria.”

Relying on men’s disclosure of traditional symptoms, note the researchers, could lead to men who are not properly diagnosed with depression. They say that medical professionals should contemplate other clues when diagnosing depression in men.