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Depression is an illness many of us must come to grips with in midlife. Depression can come as the product of genetic or emotional precipitating factors in our lives, perhaps expedited by one or more external events, but ending up with the potential to ruin jobs, families, and lives. In some cases, depression may actually have started earlier in our lives, masquerading through high school, college, and beyond as an inability to produce in school or at work or to perform successfully in one or another of life's relationships.

Depression is not a character weakness. It is a correctable, sometimes crippling condition that is probably inherited and certainly biochemically induced. It comes and goes elusively and, if uncontrolled, can kill. Medications such as older tricyclic antidepressants; newer, "cleaner" serotonin reuptake inhibitors such as Prozac, Paxil, and Zoloft; and lithium can restore energy levels and stabilize nasty mood swings. They are the keys that might break the cycle, the downward spiral of depression, and launch you back on the road to feeling good. It's more likely that such medications in conjunction with some sort of cognitive therapy will be necessary to bring you around to at least a level playing field from which to get better.

Recognizing and accepting depression as a bona fide disease is critical. Depression may not be a macho affliction, but without recognition and acceptance, either you'll never seek the help you need or you'll quit therapy or medication too early, risking your return to the abyss. So either be honest with yourself or find an impartial therapist who will act as your guide on your journey.

Some psychologists argue that healthy, positive memories of the past help to eliminate depression. One technique is to keep a journal. Libraries are filled with works by people who have chosen to publish and share their own life reviews. Another method is to join a men's group. Tell the group. Tell your wife or your lover what you have found out. Tell your bartender (that's a bartender's job, after all); tell your children; tell your best friend. They may squirm; they may fall asleep or try to leave the room. But if you're lucky, this process will be very familiar to all of them because as we slip and slide through one or another of life's rites of passage, almost everyone spends some time sharing his or her own brand of mortality, immortality, struggle, angst, or depression.

Sharing will ensure that you do not have to be alone. Those who share your honesty could help you appreciate how significant your struggle has been. Sure, there is a greater chance of exposing your own vulnerability. That's why you have to choose your sounding boards wisely. Remember that everyone has suffered in one way or another. Those closest to you can help you appreciate your own uniqueness and the value of your own life.

In return, you may have to listen to someone else's dirty laundry. There is no better way to ensure confidentiality than having shared someone else's innermost struggles. You often have to give to get, and it's worth it.


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