People teased 44-year-old Doug for his logical mind, but little did they know Doug’s outwardly calm interior was masking depression and deep anguish. Raised by indifferent, work-obsessed parents and an emotionally (and sometimes physically) abusive grandfather, he had learned always to be the perfect little adult, catching his mother’s attention only when he trotted out impressive facts.

As an adult, he married an affectionate, outgoing girl – and then spent the rest of their marriage criticizing her “over-emotional” behavior; mirroring – had he but realized it – his grandfather’s negative, critical behavior towards him during his childhood.

Doug was suffering from severe chronic depression, but he himself did not know it. He reported his life as always being “grey and pointless”, as far back as he could remember. He had developed a persona that acted as an effective mask for his symptoms. Doug could not even accept affection from his wife – though he dearly wanted and needed it.

When his wife finally persuaded him to accompany her to counseling, Doug spent the first three sessions talking about her “inappropriate” behavior. In Doug’s eyes, he himself was perfect, and his wife’s faults were the cause of all their problems. However, it didn’t take their counselor long to understand that the real problem was Doug’s childhood of abuse and emotional deprivation. The counselor understood both his severe depression and inability accept anything less than perfection from himself – or others.

At a private session which the counselor – with great difficulty – initiated, it all came pouring out. For the first time since early childhood, Doug cried, and confessed his deep unhappiness, as well as his anger and resentment towards his narcissistic, indifferent mother, the center of his childhood household. Frightened by and ashamed of this release of emotion, he abruptly stopped attending the counseling sessions.

How had Doug reached the age of 44 without anyone but his long-suffering wife cluing on to the fact that he had a deep problem?

Part of this may lie in the tendency of men to “mask” depression and hide it, whereas women are far more open to seeking support and expressing their feelings. This may seem like a sexist assumption, but according to Doug’s counselor, it’s a scenario that has been played out again and again.

Another reason everyone missed Doug’s despair: He had been able to function outwardly, attending his job like clockwork, proud of being utterly dependable. At home, however, his withdrawal was noticeable. He spent most of his time in the basement, obsessively playing computer games, angry at all attempts to get him to participate in any social occasions with his wife and children; or even just to “come upstairs and watch TV with us.”

Doug had no friends, didn’t attend church and his frustrated wife could barely get him to engage in conversation without his displaying irritation. “I feel like I’m always interrupting something important,” she confessed, during their first counseling session.

Another atypical depression symptom exhibited more by men than women: anger. Unlike his grandfather, however, Doug prided himself on keeping his emotions “under control”. He genuinely had no conception that his constant coldness and disapproval was having a damaging effect on his wife and children.

Doug’s real problem was typical of thousands of men and women – chronic depression, caused by early childhood abuse. However, he managed to mask it better than many.

Doug was resistant to taking anti-depressants and, after abandoning the counseling sessions, lapsed back into his old habits. He is now unemployed, crushed by the loss of his job and completely supported by his wife, who has “given up” trying to get him to help himself. She loves and accepts him as he is – but now she, too, is suffering from chronic depression, which most of the time she masks cheerfully. She has resumed her own sessions with their former counselor, who sees them as “co-dependent and dysfunctional.” Doug’s wife admits this, but still feels she has no choice but to stay in the relationship.

This is not a happy story of triumph over depression, but there is still hope for Doug – if he ever resumes treatment. Sometimes, events and patterns from our childhood have great power over us. These are the hardest dysfunctional habits to let go of, and we become unusually adept at masking them – or rationalizing why we cling to depression and harmful behaviors.

If you have seen yourself in this story, I urge you to be persistent. Take responsibility for your depression, and seek treatment. It will not feel comfortable and I’ll warn you right now, it will be the hardest challenge you’ll ever have to face… but if you are able to persevere through treatment, you will come out on the other side, and gain a joy you’ve never before experienced.