This is a reprint of an article by Donna Koehn "Depression A Dark Secret of Men" in the 6/20/08 TAMPA TRIBUNE
"He might be found curled up in bed as the clock ticks into Saturday afternoon. Maybe he's the guy grinning through gritted teeth as he pushes his next customer into a used car, still going after a 12- or 14-hour day. He might be behind the wheel, screaming at that damned woman who pauses too long at the four-way stop. Where he likely won't be found is a therapist's office.
Depression can sit differently on men.They can be irritable, angry, withdrawn or uncommunicative. They don't have the problem - it's their wives, their bosses, that bad driver in their way. Some turn to drink or drugs to self-medicate. Heart attacks claim others.
Hispanic men, in particular, seem to deny what they consider a weakness, experts say. Angel Dedios' life seemed as frantic as the pace of the 24-hour burger place he managed. Even his sleep was fitful and tormented, haunted by long-dead relatives and the stress he tried to ignore by day.
"My wife asked about counseling, but I said we were two adults who should be able to fix our problems," the Tampa man says. "Then we separated. I didn't believe in depression. I just thought I was sad. Men are supposed to remain strong."
For Javier, a Tampa maintenance worker, depression meant lying in bed, feeling unable to move, plagued by headaches and irritability. "It's a very strange feeling - you don't want to talk to nobody," says Javier, who asked that his last name not be used. "People think you are irresponsible, or have a lazy attitude."
Rafael Fuentes, a Tampa mental health counselor, says many men know something is wrong but would never think depression. "Culturally speaking, it is a problem for Hispanic men especially, because we have to be the provider, we have to be macho." Some of his clients become workaholics.
"They are more comfortable staying at work than going home and facing their problems," Fuentes says. "I especially see that in men who sell cars or own their own businesses. Sometimes they start to slip at work and don't understand why."
An estimated 6 million to 7 million men in the United States are depressed, but most of them don't seek treatment. Hispanic men are further hindered by a lack of therapists who speak Spanish; describing feelings is difficult enough without trying to do so in a second language, they say.
According to "Men Get Depression," a documentary airing this month on PBS, men don't realize the effect their misery has on others. Family members blame themselves, or don't know how to broach the topic without fear of an angry response. The disease affects men of all backgrounds.
'Clobbered By The Disease' Tom Johnson, former publisher of the Los Angeles Times and former chief executive officer of CNN, describes in the documentary how he hid his mental state from colleagues. "Depression clobbered me," he says. "I found it very difficult to get out of bed in the morning. I was so down, but I kept it secret. I put up that front, but beneath it all I was in great agony."
Antidepressant medication helped Johnson and Javier, who was misdiagnosed with schizophrenia as a young adult on vacation in Puerto Rico. "I came to this country in 1991 to go to chef school," he says. "I finished high school at Gaither, then enrolled in culinary arts school. I didn't finish because I had a breakdown." The medication for schizophrenia turned him into "a zombie," he says.
'Serious But Treatable'
Javier's mother recognized his symptoms as depression because she and several family members also have the illness. Depression tends to run in families. She found help for him with Francisco Fernandez, a University of South Florida professor and chairman of the department of psychiatry. Fernandez and Javier appear together in the PBS documentary in a segment about Hispanic men.
"Depression is serious but treatable," Fernandez says. "Men feel helpless, hopeless and hapless - as if they've run out of luck. They may have no energy and either lose interest or can't get the same degree of enjoyment out of things. The symptoms themselves can cause a man to resist treatment. "In no other disease is your instinct for survival extinct," he says. "Cancer need not rob you of your spirit. Depression will rob you of it."
Estimates are that more than 80 percent of suicides arise from depression, and men of all ages kill themselves at rates that outpace women 4-to-1. Suicide is the second leading cause of death among college-age men. Men age 70 and older, especially those who are widowed or unmarried, also are at special risk.
Javier says he would have died if not for his psychiatrist. "Dr. Fernandez saved my life," says Javier, who now takes classes in hopes of becoming a home inspector. Dedios continues to work his shifts at Burger King, but remains upbeat with help from sessions with Fuentes. Hypnosis encourages deep relaxation, a tonic for stress. Art therapy helps him articulate his feelings. He is back with his family and hopes for a career as a graphic designer. "My wife and I have learned how to sit down and talk in the moment," Dedios says. "I love her so much, and I've learned it's OK to cry and to tell her that."
