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A Culture of Silence

Hispanic men tend to be more reluctant to seek depression treatment.

En español | “It happened all of a sudden,” says Alberto Trujillo, a 75-year-old retired mechanic from Clint, Texas. “I couldn’t do anything. I couldn’t think, write, or drive. I didn’t go out of the house. I stayed away from church.” His wife, Mary, had him hospitalized.

See also: The face of addiction.

For Rodolfo Palma-Lulión, 28, of Saline, Michigan, “it happened over several years. I just wasn’t functioning,” he says. “My mind wasn’t working. I was in college at the time, but I couldn’t make it to class.” Although Palma-Lulión didn’t realize what was wrong, his girlfriend demanded he seek help.

Despite the men’s disparate backgrounds, they share a bond: both have suffered from depression. Trujillo, born in the United States, is Mexican American and has seven children. Palma-Lulión, a native of Chile who came to this country at age six, is married, has one child and is expecting a second in February, and works with a community service program at the University of Michigan

Although nearly twice as many women suffer from depression, the disease strikes 7 percent of men—some 6 million—each year, according to the National Institute of Mental Health. This medical condition affects a person’s body, mood, and thoughts. Left untreated, it strips the joy out of life. It can even turn fatal: about 7 percent of depressed men commit suicide.

“Unfortunately, Hispanic men are less likely to be accurately diagnosed or to receive appropriate care,” says Javier Escobar, chair of the psychiatry department at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. In addition, says the Colombian-born doctor, “Latino males tend to present with physical symptoms rather than mental ones.”

Trujillo says he had trouble sleeping and sometimes didn’t feel like eating. Palma-Lulión experienced similar problems.

Says Escobar, “Particularly those men from Puerto Rico and South American countries complain of multiple pains, aches, migraine headaches, joint pain, weakness, and fatigue.” Laboratory tests reveal no cause for these complaints. When the men share their stories, however, they often point to their heart to explain their symptoms, avoiding mention of sadness or nervousness.

Men in different cultures often handle depression differently, says Escobar, and members of the Hispanic population are diverse. Mexican men, for example, are hesitant to talk to a psychiatrist, while Puerto Ricans are more likely to use mental health services.

“Hispanic men are more likely to seek out the clergy or a spiritual healer, a curandero,” says Gustavo Alva, an associate professor at the University of California-Irvine Department of Psychiatry and Human Behavior. “There is a whole slew of barriers [to treatment].” Alva lists unfamiliarity with the languages and economic difficulties among the top obstacles. And in what researchers call the “Latino paradox,” mental disorders appear less often among Hispanics born outside the United States.

“Medicine and God got me out,” says Trujillo, but it took four and a half years after his hospitalization for his doctors to come up with the right drug combination.

The difficulty of finding medication that works is exacerbated by another problem. "Overall, these men are much less likely to participate in psychotherapy or to take antidepressants when they are prescribed,” says Escobar. One common side effect of the medications, sexual dysfunction, is particularly difficult for Latin males.

Next: Depression as a cultural taboo.>>

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