The Hollow Men: Covert Depression and Addictions

terrencereal“That is not to say that covertly depressed men are not fully responsible for their offending behaviors. But it is clear that the stable ratio of women in therapy and men in prison has something to teach us about the ways in which each sex is taught by our culture to handle pain. Men make up close to 93 percent of the prison population, leading one “Men’s Movement” leader to quip that the largest men’s gathering in the United States is San Quentin.


It is time to conceptualize depression in men as a wide-ranging spectrum, with many variations and differences. Overtly depressed men […] occupy one place along that spectrum. Covertly depressed men […] occupy another. The common denominator linking them all is violence. All of these men are violent toward themselves […] or violent toward others […]. And the origins of so much violence can be traced back to the ordinary, everyday violence our boys are immersed in as a central part of their socialization. To understand depression in men, we must come to terms with the conditions that create it, the ways in which, in the name of masculinity and often with the best of intentions, we betray and deform our sons.”

Pp. 83-85 in Real, Terrence. 1997. I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression. New York: Scribner. [See here. From chapter three, “The Hollow Men: Covert Depression and Addictions,” pp. 59-85. The graph above is from p. 84. Real is arguing that while depression in women is largely seen in affective disorders and anxiety disorders, depression in men is largely seen through substance abuse disorders (note the gendered disparities in the table above).]

2 thoughts on “The Hollow Men: Covert Depression and Addictions

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    1. Sure! Real cites Kessler, R. C., et al. 1994. “Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States. Results from the National Comorbidity Survey.” Archives of General Psychiatry, 51(1):8. Here’s a link to a .pdf (the table is on page 9 of 12):

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