While most people associate the holidays with happiness, it can also be an especially challenging time for those suffering from depression. And an often-overlooked segment of society dealing with depression is middle-aged men.

Dr. Jesse Wright

The worst outcome for depression, of course, is suicide. In the U.S., white males commit suicide at a rate more than double that of any other group, and more men age 45-54 are victims than any other age ranges.

Dr. Jesse Wright, director of the University of Louisville Depression Center, said there are many reasons men don’t get the help they need.

“For some reason men seem to have a harder time talking about it, identifying that they have it and getting help,” Wright said. “We’ve seen right here in Louisville some terrible tragedies, even physicians that know about depression, know that help works, but for one reason or another didn’t get that help and ended up as a suicide.

“In men, depression is often a silent killer. If it doesn’t kill, it’s a silent damager, to their careers, to their relationships with their family, to their own personal health.”

Earlier this year, rock singer Chris Cornell took his own life at age 52, showing that fame and success don’t protect some men from depression.

Wright believes that men fear the stigma associated with having depression, and many attempt to hide their feelings. Meanwhile, where women tend to have a deeper and more connected network of friends, men often feel alone. The men Wright counsels and treats don’t always appear as deeply saddened, but their actions can reveal a hidden issue.

“There are a lot of guys who may have their only real friend is their wife or partner,” Wright said. “And if that’s troubled, then they don’t have anybody. They have people they work with, and people they know, but they aren’t close enough to really open up about their feelings and ask that person to help them. You see that with older guys. Older people, if they lose their spouse of many years, they’re sitting ducks.”

Family members can help the men in their lives – especially during the holidays – by looking for signs of trouble and reaching out.

“It can turn up in different kind of ways,” Wright said. “One of them is just a lot of irritability, lack of energy, not enjoying things like he used to. He used to go out and play tennis, or golf, or like to go to U of L basketball games with buddies. Maybe he played with a poker group. Then all of a sudden they’re not involved in that.”

Once a problem is identified, there are effective treatments, including counseling or even the use of anti-depressants. Wright said that prescription medications can have a mixed record — providing full remission for about 35 percent of patients, while 35 percent don’t benefit.

In addition, Wright advises modifications in diet and exercise for the men he works with.

While he said some men he sees are open with their feelings, on average they are less likely to talk about what’s going on inside their head.

“They tend to pull into themselves, isolate themselves, and it’s a private affair with their minds. Their minds are attacking their body. They’re riddled with negative thoughts, criticizing thoughts, thoughts that they’re not making it, thoughts that they’re a failure,” he said. “It’s a downward spiral moving deeper into the hole of depression. Then they get hopeless and ultimately suicidal. “

Wright believes that depression centers in the U.S. – including the U of L’s Depression Center, which specializes in treatment of depression and bipolar disorder – are following the lead of cancer centers, which were created to do research on the problem and also lesson the social stigma associated with it.