Men & Depression: Facing Darkness
http://www.msnbc.msn.com/id/17190411/site/newsweek/
By Julie Scelfo
Newsweek
Feb. 26, 2007 issue - For nearly a decade, while serving as an elected official and working as an attorney, Massachusetts state Sen. Bob Antonioni struggled with depression, although he didn't know it. Most days, he attended Senate meetings and appeared on behalf of clients at the courthouse. But privately, he was irritable and short-tempered, ruminating endlessly over his cases and becoming easily frustrated by small things, like deciding which TV show to watch with his girlfriend. After a morning at the state house, he'd be so exhausted by noon that he'd drive home and collapse on the couch, unable to move for the rest of the day.
When his younger brother, who was similarly moody, killed himself in 1999, Antonioni, then 40, decided to seek help. For three years, he clandestinely saw a therapist, paying in cash so there would be no record. He took antidepressants, but had his prescriptions filled at a pharmacy 20 miles away. His depression was his burden, and his secret. He couldn't bear for his image to be any less than what he thought it should be. "I didn't want to sound like I couldn't take care of myself, that I wasn't a man," says Antonioni.

Then, in 2002, his chief of staff discovered him on the floor of his state-house office, unable to stop crying. Antonioni, now 48, decided he had to open up to his friends and family. A few months later, invited to speak at a mental-health vigil, he found the courage to talk publicly about his problem. Soon after, a local reporter wrote about Antonioni's ongoing struggle with the disease. Instead of being greeted with jeers, he was hailed as a hero, and inundated with cards and letters from his constituents. "The response was universally positive. I was astounded."
Six million American men will be diagnosed with depression this year. But millions more suffer silently, unaware that their problem has a name or unwilling to seek treatment. In a confessional culture in which Americans are increasingly obsessed with their health, it may seem clichéd—men are from Mars, women from Venus, and all that—to say that men tend not to take care of themselves and are reluctant to own up to mental illness. But the facts suggest that, well, men tend not to take care of themselves and are reluctant to own up to mental illness. Although depression is emotionally crippling and has numerous medical implications—some of them deadly—many men fail to recognize the symptoms. Instead of talking about their feelings, men may mask them with alcohol, drug abuse, gambling, anger or by becoming workaholics. And even when they do realize they have a problem, men often view asking for help as an admission of weakness, a betrayal of their male identities.

The result is a hidden epidemic of despair that is destroying marriages, disrupting careers, filling jail cells, clogging emergency rooms and costing society billions of dollars in lost productivity and medical bills. It is also creating a cohort of children who carry the burden of their fathers' pain for the rest of their lives. The Gary Cooper model of manhood—what Tony Soprano called "the strong, silent type" to his psychiatrist, Dr. Melfi—is so deeply embedded in our social psyche that some men would rather kill themselves than confront the fact that they feel despondent, inadequate or helpless. "Our definition of a successful man in this culture does not include being depressed, down or sad," says Michael Addis, chair of psychology at Clark University in Massachusetts. "In many ways it's the exact opposite. A successful man is always up, positive, in charge and in control of his emotions."
As awareness of the problem grows—among the public and medical professionals alike—the stigma surrounding male depression is beginning to lift. New tools for diagnosing the disease—which ranges from the chronic inability to feel good, to major depression, to bipolar disorder—and new approaches to treating it, offer hope for millions. And as scientists gain insight into how depression occurs in the brain, their findings are spurring research into an array of new treatments including faster-acting, more-effective drugs that could benefit those who struggle with what Winston Churchill called his "black dog."

For decades, psychologists believed that men experienced depression at only a fraction of the rate of women. But this overly rosy view, doctors now recognize, was due to the fact that men were better at hiding their feelings. Depressed women often weep and talk about feeling bad; depressed men are more likely to get into bar fights, scream at their wives, have affairs or become enraged by small inconven-iences like lousy service at a restaurant. "Men's irritability is usually seen as a character flaw," says Harvard Medical School's William Pollack, "not as a sign of depression." In many cases, however, that's exactly what it is: depression.

Social attitudes toward depression are changing, thanks in part to men themselves. John Aberle is a sales and marketing consultant, retired Air Force security specialist, part-time radio talk-show host, devoted husband, active father and a 6-foot-4, 250-pound body-builder who twice faced a depression so deep, he cried on his knees. He readily tells other men it's their duty to get better. "There's no crime in having a disorder, whatever it is," says Aberle, 38. "The crime is not dealing with it. It's your responsibility to be at the top of your game." Taking care of yourself physically, mentally and emotionally—maybe that's the real definition of what it means to be a man.
With Karen Springen in Chicago and Mary Carmichael in Boston