Psychotherapist Terrence Real calls depression an overlooked epidemic among men.
While depression long has been considered a women's disease, Real contends in a new book that men actually suffer from depression at a much higher rate than ever realized. Men have long been considered to have anywhere from 25 to 50 percent of the rate of women, because depression has long been deemed "unmanly."
According to Real, who has spent two decades studying the problem, "Depression carries, to many, a double stain--the stigma of mental illness and also the stigma of 'feminine' emotionality." The result is that depression, which is usually spotted in women because it is overt and easily identifiable, in men becomes covert, in that it is disguised by other behaviors, including alcoholism, drug abuse, domestic violence, workaholism, and failure to achieve intimate relationships. These are all manifestations of depression, Real says.
In his book, I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression (Scribner, $24), the Massachusetts therapist says that there is "a terrible collusion in our society, a cultural cover-up about depression in men . . . One of the ironies about men's depression is that the very forces that help create it keep us from seeing it. Men are not supposed to be vulnerable. Pain is something we are to rise above. He who has been brought down by it will most likely see himself as shameful, and so, too, may his family and friends, even the mental health profession."
With an estimated eleven million people struggling with depression annually, the "combined effect of lost productivity and medical expense due to depression costs the United States over 47 billion dollars per year--a toll on a par with heart disease. And yet the condition goes mostly undiagnosed."
As a sufferer of manic depression since my teen years (I was graduated from high school in 1951), I know all about depression's pain and devastation. The cost to my family has been terrible. Although I recall incidents of depression dating back nearly a half century, I was not formally diagnosed until 1976. By that time I had flamed out at a number of jobs, experiencing a pattern that was to repeat itself often. First, I would commence a new position with enthusiasm, energy and skill, but eventually -- sometimes within a year, and always unpredictable -- I would become depressed, enter into a state of incapacity, and through physical and imagined illness eventually be fired from my post or leave when the signs were clear that dismissal was inevitable.
Treatment helped, although I'm a patient resistant to many medicines for depression and suffer debilitating side effects with those few that help. Today, I totter on a tightrope, usually neither manic nor depressed. However, I remain constantly vigilant for signs of "inappropriate" reactions to life, one of the early signs of an impending plunge into a new round of illness.
Therapist Real, a faculty member of the Family Institute of Cambridge, Mass., has produced a book filled with case studies and written in a down-to-earth style, free of jargon or puzzling medical terminology.
Depression is probably an inherited biological condition, according to most recent research. "Any boy or girl, given the right mix of chromosomes, will have a susceptibility to this disease. But in the majority of cases, biological vulnerability is not enough to bring about the disease. It is the collision of inherited vulnerability with psychological injury that produces depression."
My own life demonstrates the truth of Real's conclusion.
Real concludes that his work with depressed men and their partners "has convinced me that men's much-vaunted fear of women and of intimacy is really not a fear of either. What men fear is subjugation. . . Men's fear of entrapment, of female engulfment, is not really about women at all. It is a transposition of a male model of interaction to the living room and the bedroom. When men fear that their women will "engulf" them, they fear that their women will act like men."
What's needed, he says, are the rudimentary skills of communication, direct assertion, and accountability, which are "easily learned, taught by therapists all over the country." Improved relationships often help alleviate depression.
I Don't Want to Talk About It is a book you'll be talking about.
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