Darkness Visible: Men and Depression

By: R. Jack Crain - Guest columnist

For the thing which

I greatly feared is come upon


and that which I was afraid of

is come unto me.

I was not in safety, neither

had I rest, neither was I quiet;

yet trouble came.

– Job

William Styron, noted author and recipient of the Pulitzer Prize for “The Confessions of Nat Turner,” poignantly describes his bout with severe depression in his illuminating book, “Darkness Visible”: “To most of those who have experienced it, the horror of depression is so overwhelming as to be quite beyond expression.”

Depression (not the “occasional blues”) is the No. 1 mental health problem in the world. An estimated 17.5 million Americans — one in 10 adults — suffer from depression. Of that number, nearly 10 million have major or clinical depression. It is generally accepted that women experience depression at roughly twice the rate of men. But do they?

While 80 percent to 90 percent of depressed patients who seek help get relief through earlier and better detection and by using a combination of psychotherapy and new psychiatric drugs, it is estimated that nearly two-thirds do not get the help they need because their depression goes unrecognized and/or unreported. This may be especially true of men.

Terrence Real, author of the book, “I Don’t Want To Talk About It,” writes about the impact of his father’s violent outbursts and beatings on his early life and vividly describes his discovery of the “dark, jagged emptiness” that has plagued men for generations. “This is one of the most prevalent disorders in modern American society and yet it is almost completely ignored,” Real says. “There is nothing less than a cultural cover-up about depression and men.”

Real and others, notably “Iron John: A Book About Men” author Robert Bly, have sparked a growing interest in talking about men and depression. According to Real, the patterns, cruelty, contagion, and numbing desperation of depression drive many men into traumatic “midlife crises,” which he describes as covert depression.

Real says, “Because of what our culture continues to do to little girls and little boys, men and women handle their feelings very differently. Everything men do and feel gets filtered through performance — their achievements. Women’s self-esteem tends to be more relationship oriented.” Bly has long supported the theory that men “inherit depression” from their fathers and believes the rising increase of domestic violence may be related to similar increase in undiagnosed depression among men.

Styron writes, “Depression is a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self — to the mediating intellect — as to verge close to being beyond description.”

Because sadness may not always be the dominant feeling of a depressed person, depression often goes undetected. There are many possible symptoms associated with the illness: eating and/or sleeping imbalance, chronic fatigue, a sense of worthlessness, persistent sadness, anxious or empty mood, recurring thoughts of death and a lack of interest in activities once enjoyed.

“Incomplete mourning” — being unable to complete the grieving process in the death of a parent or significant other during childhood — can result in later years in an unbearable sense of rage and guilt that may become the potential seeds of severe depression and self-destruction, particularly in men. Abraham Lincoln, “in his youth was often in a suicidal turmoil and came close more than once to making an attempt on his own life. The behavior seems directly linked to the death of Lincoln’s mother, Nancy Hanks, when he was 9, and to unexpressed grief exacerbated by his sister’s death 10 years later,” according to Styron.

The fear of seeking counseling and being labeled “crazy,” the erroneous belief that depression in men is unmanly and shameful, and the difficulty men experience in expressing their true feelings result in too many men living their lives in quiet desperation. And the longer they live with desperation (depression), the more they may mask their sadness and pain by striking out at their wives/lovers, children and co-workers, and/or self-medicating with destructive behaviors: addictive gambling, abusing alcohol and other drugs, high-risk sexual activity, and violence.

Without proper diagnosis and treatment, depression can be deadly. The vicious nature of the illness slowly leads to hopelessness and saps one’s energy and motivation to seek help. Statistics indicate that men kill themselves at least four times more often than women do.

Don’t delay! Seek assistance today in making the darkness visible.

And so we came forth, and once again beheld the stars.

– Dante


R. Jack Crain

Guest columnist

R. Jack Crain is a Licensed Employee Assistance professional with Southeastern Health’s Employee Assistance Program. August is National Depression Awareness Month.

R. Jack Crain is a Licensed Employee Assistance professional with Southeastern Health’s Employee Assistance Program. August is National Depression Awareness Month.