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."..........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 inconveniences 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.