The mass of men, Henry David Thoreau once said, live lives of quiet desperation.

For the millions of men with clinical depression, that is certainly true - with many brought up not to complain about pain or show "weakness." In fact, the number of men with depression is rising, but it's largely because men are becoming less afraid to admit they need help, according to experts like Dr. Richard Winer, a Roswell, Ga., psychiatrist.In 1970, three times as many women than men were treated for depression. That ratio has narrowed to 1.7-to-1, according to University of Michigan researchers.

As new research keeps indicating depression has biological roots, more men are coming forward, Winer says. Just recently, researchers reported in the journal Nature that they had found that the brain's prefrontal cortex, the seat of moods and emotions, was "exceptionally inactive" in depressed people.

Winer says many more men are coming to see him for depression than just a few years ago. Many have heard of new drugs that work in 80 percent to 90 percent of cases. Medications are especially effective if taken along with doses of psychotherapy, Winer says.

Depression is a crushing mental disorder affecting an estimated 1 in 10 Americans and is characterized by irritability, chronic unhappiness, insomnia, eating problems, loss of libido, guilt, poor concentration and severe lethargy.

Nobody knows for certain what causes it. Episodes of depression can be triggered by unpleasant events. But there's also a strong genetic component involving a brain chemical called serotonin.

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While the genetic component is significant, Winer says it doesn't predestine anyone to depression.

For depression many doctors prescribe selective serotonin reuptake inhibitors, which block serotonin reabsorption into the brain's neurons. The result is an increased amount of serotonin in nerve synapses, which alleviates symptoms of depression.

Winer feels certain that men are reporting depression in greater numbers because they're more willing to seek help than their fathers were - and perhaps because of downsizings, layoffs, corporate mergers, divorce and confusion in an increasingly complex world.

That's also the view of Dr. Terrence Real, a Cambridge, Mass., psychotherapist who just published a book about depression in men, "I Don't Want To Talk About It" (Scribner, 324 pages, $22). He argues that unrecognized depression is rampant among men, that men and women succumb to depression at the same rate and always have, and that boys have long been socialized to hold in their feelings, while girls have been encouraged to show theirs.

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