Many Men Like Me Keep a Dark Secret. Revealing It Saved My Life.

Medical Examiner Depression knows how to protect itself. I learned how to stop helping it. WMSTUDIO/Adobe Stock Sign up for the Slatest to get the most insightful analysis, criticism, and advice out there, delivered to your inbox daily. Rather than go to therapy, it’s said, men would sooner do … pretty much anything: start a war, read every book about ancient Rome, develop a Polymarket addiction, become a Marvel adult. A few points, in fairness to men: Ancient Rome is pretty fascinating!Good therapists can be awfully hard to find.A lot of non-men also have this problem. But the prevalence of this archetype almost elides the basic fact that spurning therapy is a symptom of a deeper avoidance: the denial of a need for treatment of any kind. Even in an age when some people do the whole mistaking-diagnosis-for-identity thing—trumpeting lines like “I’m proud of my personality disorder”—there’s a population that doesn’t crow or congratulate itself on mental illness. This population is big and, yes, often silent. As of 2025, an estimated 31 million U.S. adults experienced depressive symptoms on most days of the month. Roughly 10 million—about 1 in 3—have never discussed their mental health with a health professional. The latest survey from the Substance Abuse and Mental Health Services Administration sheds further light, estimating that among the 21.4 million U.S. adults who had a major depressive episode in 2024, 7.6 million—more than a third—received no mental-health treatment during that same year. A majority of that group didn’t perceive a need for mental-health treatment at all. In fact, among those who did perceive a need, a distressingly large majority said they felt they should’ve been able to cope on their own. And as much as one hates to grant seriousness to a meme, men are indeed less likely than women to seek treatment. I wasn’t part of those surveys, but the numbers confirm what I know from regrettable experience, as I describe in a new book. After years of debilitating depression, I found a way out—but the story would not have ended happily if I hadn’t frankly admitted my predicament. During childhood, I managed to be open with family and doctors about my depression. But then I returned to the depression closet, hiding it in high school and college and through too much of adult life. In fact, I became virtuosic at denial. As a performer of nondepression, I was a generational talent. The Shohei Ohtani of “Hey, you definitely don’t need to worry about me.” After a few colleagues read an early version of my new book, the one reaction they all shared was: How did we miss this? “You always had a joke,” one says. Or “You were always so kind with the assistants.” Indeed. A good thief projects honesty. And many people with major depressive disorder learn to project an artificial light. I’d been doing so, on and off, for years. The urge to project a placid, controlled demeanor to friends and lovers is often amplified by the desire to reassure employers of one’s emotional competence. (The American Psychological Association found in 2023 that 42 percent of employees worry that their careers will be threatened if their bosses know about their mental-health struggles; the National Alliance on Mental Illness 2025 Workplace Mental Health Poll arrived at a similar number, 43 percent.) In particular, many people across disrupted industries are terrified of being perceived as an unemployable liability. Small wonder that many continue to hide. For the above reasons and more, internal denial and a reluctance to seek help hold sway. Evidently, the cultural normalization of mental illness hasn’t eliminated the enormous gap between experiencing depression and recognizing it as a condition that warrants treatment. A massive, admirably raucous campaign to destigmatize has taken us only so far. Odds are, even in this semi-enlightened age, many of us will deny, deny, deny—in some cases until it’s too late. My own case of denial was mortifyingly textbook. The usual motives, pride and fear, encouraged me to downplay the depth of my depression. I even went to therapy—sometimes quite religiously! But therapists know only as much as you tell them. Too often, my attitude was something like I’m a sensitive guy given to episodes, but I don’t need or deserve serious help. And even when I met the rare psychiatrist who inspired trust, I tended to treat our sessions the way a rampant sinner treats weekly church: as a separate, palliative world where I admitted Hard Truths, took Communion (i.e., got a Zoloft prescription renewed), then went back to the real world pretending I’d been cleansed. When it came to friends and girlfriends, I didn’t want to distress anyone. And I definitely didn’t want to seem weak. It was predictable, then, that I saw two long-term relationships crumble because of the way I euphemized my problems. In 2015 a girlfriend and I spent a few months separated by an ocean, during a period when my depression was consuming me. As those months dragged on, I became two people: one who mustered the usual blithe charm on FaceTime, and another who spent nonwork and non-FaceTime hours hiding from the world in a dark room watching bad TV. (Some depressives will feel unworthy of good TV.) By the time we came back together, the poor girlfriend was understandably shaken to discover, in person, the reality I’d been hiding behind a screen. My lies felt somehow worse than if I’d cheated. We broke up three weeks later. But in the shell game of Hide the Depression, you’re always your own biggest mark, and my lies began with the ones I told myself. For one thing, I liked to imagine that because I’d experienced and survived acute depression in the past, I must’ve become more resilient—strong in the broken places, to quote one guy, a manly writer who (to be glib) would rather run with the bulls than go to therapy. But, of course, a person isn’t always strong in the broken places. If you’ll permit a shift in metaphor: Wood singed once makes for better kindling. In 2020–21, the flames took me as never before. But this time I did something different. I told my friends. All of them. I even told my bosses, saying, essentially: Hey, I’ve been getting outpatient ketamine treatments for weeks, to no avail, and now I’m going to try a touch of electroconvulsive therapy. In part, I felt free to do so because it struck me that any worries about what the bosses might think were nothing compared to the risks now posed by the disease. More important, by the time things reached that awful stage, one of the few shreds of clarity I clung to was the knowledge that my friends and girlfriend could handle the truth (a much-belated insight from all those years of half-wasted therapy). However ugly or unlovable my admissions might make me—and however much they might sadden my circle—I knew that if I didn’t disclose to those who cared for me, if I didn’t accept their help, I’d likely end up hurting them a lot more. (Statistically, people who experience severe depression and keep their struggles secret face greater suicide risk, most notably when their silence prevents others from recognizing that they need help.) By this time, I’d developed what psychiatrists diplomatically call a passive death wish. I needed a dramatic intervention, and I had the good sense to seek one. Eventually, it was through ECT that I found a measure of salvation. (Lots of people imagine the treatment as a horror show, but I was surprised at how comparatively gentle it was. And the nurses always had a joke at the ready.) Really, though, no breakthrough or remission would’ve been possible if I hadn’t been honest with others about how far I’d plunged emotionally and psychologically. My friends created a text chain to chronicle all developments, no matter how grim or how small. They coordinated who would drive me to each appointment, shared tips on how to keep me fed, shared their private fury when a given doctor seemed inattentive, or their horrible disappointment when, after two steps forward, I inevitably took another one back. Through it all, they buoyed each other’s spirits. (Caring for a friend in the myopic depths of major depression is one of the most thankless jobs yet devised.) Two years after I recovered, I started to report a book about the whole mess, and my friends shared their texts and emails. I printed them out. Laid before me was a mosaic of worry, anger, confusion, and deep love. Taken together, these photos and emojis and sentence fragments represented a schematic for the machine that had kept me alive. These days I’m quite well. Since my remission, I’ve returned to my day job in journalism, written a book, gotten married, and attained various other conventional markers of well-being. I also write and talk about mental health, and I’ve helped coach a number of people—friends of friends, mothers of friends, even near-strangers—through their own ECT journeys. Reviewing my text exchanges with these people while researching my book, I notice a pattern: I keep gently encouraging each to be open with their families about the pain, even about fleeting thoughts of suicide. It’s some of the simplest and best advice I’ve given. If you delay disclosure until too late, you might simply not feel capable of seeking help, and that’s when you risk wounding many more people than just yourself. I sometimes still get funny looks from friends if my expression goes vacant for a moment, or if I seem distracted or frowny. I can’t blame them for being skeptical when I reassure them that, actually, things are going pretty great these days! It’s not their fault. If you’ve ever hidden how sick you are, then remission can turn you into the boy who didn’t cry wolf. “I know what I said last time,” you tell your worried pals. “But this time, I swear, there’s really no wolf there.” Ultimately, the best way to keep the wolves at bay is to know that your friends and colleagues are strong enough to hear the truth, and to be painfully honest when you feel the darkness closing in. Though ECT is far less scary than it might sound, most of us probably don’t need to get electrocuted. As for the Roman Empire, read as much about it as you like. But also: Be real with yourself and the ones who love you. There’s too much at stake. It’s OK to start slow. Rome, after all, took a while to build. Or so I keep reading. Mental Health Research Men