I Don’t Want to Talk about It: Overcoming the Secret Legacy of Male Depression

Typically, upon hearing that someone is depressed, our immediate assumption is that the depressed person is female. That connection is not surprising, since, statistically, the rate of depression in women is considered to be two to four times the rate in men. Depression has for years been widely regarded as a women’s disease.

In his book “I Don’t Want to Talk about It: Overcoming the Secret Legacy of Male Depression,” Terrence Real, a psychotherapist who has treated men and their families for over twenty years, challenges that assumption. He contends that depression in men is extremely widespread, but mostly denied or overlooked and misdiagnosed.

“We tend not to recognize depression in men because the disorder itself is unmanly…

Men are not supposed to be vulnerable. Pain is something we are supposed to rise above. He who has been brought down by it will most likely see himself as shameful, and so, too may his family and friends, even the mental health profession. Yet I believe it is this secret pain that lies in the heart of many of the difficulties in men’s lives. Hidden depression drives many of the problems we think of as typically male: alcohol and drug abuse, domestic violence, failure in intimacy”.

Real describes two forms of depression, overt, in which the symptoms are obvious and the depression is acknowledged for what it is, and covert, where it is hidden, disguised by other behaviors and difficult to recognize. He discusses the cultural pressures on men to deny pain and hide vulnerable feelings, and describes how these destructive patterns begin in childhood when boys are discouraged from expressing vulnerable feelings. Further, he shows how this pressure to remain tough or “manly”, at all costs, drives men to escape those feelings through overwork, rejection of intimacy, even substance abuse and violence.

Citing research studies, case studies from his therapy practice and examples from literature and classical mythology, Real presents a compelling, really indisputable, case for his thesis as well offering important insights into men suffering from depression, and comfort and guidance to those close to them Real’s style, though not casual reading, is clear and thought provoking. His use of language is beautiful. He shares his own personal story and struggle with depression in a manner that is revealing without being self indulgent.

He writes with compassion for his father, for himself and for his patients whose stories he shares. We are invited into therapy sessions to trace the steps one goes through when choosing to confront one’s own pain and move beyond it to being all that one can be.

This is the central purpose of this book, to challenge old myths, and inspire a new direction for men, one that Real contends, will have wide ranging impact over generations “…the unresolved pain of previous generations operates in families like an emotional debt. We either face it or we leverage our children with it. When a man faces up to his depression … the struggle he wages has repercussions far beyond him. A man who transforms the internalized voice of contempt resists violence lying close to the heart of patriarchy itself … And his healing is a spiritual gift … He does more than relieve his own depression. He breaks the chain, interrupting the path of depressions transmission to the next generation.”