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.
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."
Lappen confessed his intent to kill himself to the counselor he was seeing, after which he admitted himself to a hospital.
"I had a realization that there was still a significant life force in me that did not want to cash out," Lappen said. "I thought I still had some talent and wanted to give myself a chance. But there are still times when I regret not following through."
While there are no studies to confirm whether the reported rates of depression in men are rising, clinicians say they have seen an increase, many of which are in the context of job losses.
"Losing a job is something anyone can understand, which makes it more acceptable to talk about it," Cook said. "It opens the door for people to learn about depression and to get help and that kind of direction can be a good thing."
Awareness and acceptance can go a long way to removing the stigma of male depression, but the illness is still viewed by many as a character flaw.
"How do you convert weakness to courage? You have to use the language of courage," Lappen said. "Asking for help means you are a social being and you're looking to fortify yourself. ... Convince [the depressed] person that asking for help is not weakness but is a sign of strength."
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