Grace Under Pressure: Changing What Male Depression Means

For many men it takes a lot more than feeling down to recognize that they are depressed and get help. Depression experts and patients say seeking treatment for depression must be recast as a strength, not a weakness.

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Having Depression Does Not Indicate Failure

Rather than admit to what they see as a failure to cope with life, men are more likely to abuse drugs and alcohol, isolate themselves, often by working more, and engaging in risky behavior such as gambling or having multiple sexual partners as a way to avoid confronting their illness, depression experts say.

"For the moment, it allows them to feel better and escape from the pain rather than entering the full impact of the depression," said Dr. Jonathan Alpert, psychiatrist and associate director of the Depression Clinical and Research Program at Massachusetts General Hospital. "Men are less likely to talk about lower self esteem or feeling bad about themselves. ... A man's attention is more likely to be gotten by a physical symptom than an emotional one."

The symptoms of depression most commonly seen in men may include loss of sleep or appetite, gaining or losing a significant amount of weight, headaches, irritability and a lack of concentration.

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But, if no one recognizes that such symptoms mask an underlying depressed condition, the depression can go untreated for years. And, for men, depression can be lethal. While women attempt suicide more often than men, the rate of completed suicide is four times higher in men, Alpert said.

Depression Increases the Risk of Suicide

Lappen's first breakdown occurred during his first semester at college in 1969, when he became so depressed he could not get out of bed to go to class. He admitted himself to a hospital when he was faced with the choice to drop out of college or to fail all his classes. Even so, Lappen refused to take medications while in the hospital and after he was released four months later.

"I didn't want my temple contaminated by these medications," Lappen said. "All I was doing was denying the diagnosis. The pills were a reminder that something was broken in me that I couldn't fix."

Lappen's depression persisted, although he was able to complete college, and became severe again during his first semester of doctoral studies.

"I'd gotten a glass cutter, gotten a hose and found a remote site where no one would find me," Lappen said. "I felt my life as a creative individual was over and I would just die, at my own hands."