Joan Smith: Depression is more deadly in the male

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In 2003, the German goalkeeper Robert Enke played a single match for the Turkish football club Fenerbahce. Enke was on loan from Barcelona for the opening match of the season, a home game against Istanbulspor. Fenerbahce lost 3-0 and furious fans rounded on the goalkeeper, hurling abuse, bottles and mobile phones. Clearly shocked, Enke left the club after only 13 days, protesting that he "had not deserved the hate they showed me". Despite this setback, Enke's star soon began to rise: he signed for Hanover and played for the German national team, raising expectations that he would represent his country at the world cup in South Africa next year. All that came to an end last week when he committed suicide by stepping in front of a train.

It was a violent and shocking death, and also carefully planned. Enke's team-mates did not know he suffered from severe depression, and he concealed his intentions from the small number of people who were aware of it. His wife said he was afraid that their adopted daughter, Leila, would be taken away if his illness became more widely known, fearing her loss all the more because their biological daughter, Lara, died of a heart defect three years ago. But she also said his illness predated the child's death, and his suicide highlights the dark side of a game which offers huge material rewards but very little in the way of emotional support.

Professional footballers are highly competitive, driven by a longing for adulation and a need to win. It isn't an environment in which it's easy to admit to anxiety and self-doubt, and clubs are more interested in results than mental health. Indeed it's obvious that the skills needed on the pitch – lightning responses, tribal loyalty, aggression – have disastrous consequences in the outside world: hence the parade of highly-paid footballers accused of speeding in expensive cars, brawling in nightclubs, and even rape. The protracted self-destruction of George Best, who went from being the golden boy of football to a frail alcoholic, demonstrates the absence of mentoring for young men who suddenly have the world at their feet.

Robert Enke chose such a dreadful way of dealing with his depression that his poor wife had to be sedated after identifying his body. When he walked on to the railway line, he punished himself, his family and his colleagues, some of whom broke down in public last week. Men often choose violent methods of suicide and they're much more likely to succeed than women; according to the Royal College of Psychiatrists, men are around three times more likely to kill themselves and they're also more likely to use drugs and alcohol than seek professional help for depression. In the UK, suicide rates have been falling but the rate for men in 2007 was 16.8 per 100,000 of population, whereas for women it was only five per 100,000.

The public image of depression may have something to do with this. It's often seen as a female malady, suffered mainly by middle-aged women, and the idea that its symptoms include anger and irritability as well as self-hatred isn't sufficiently understood. The rewards of professional football are ludicrously high but fans are brutally intolerant of mistakes, as Enke discovered during his two weeks in Turkey. He may have feared failing again, especially after he was capped for the national team, and he clearly lived in terror of not being a good enough father.

When sport, business and the media idolise alpha males, we shouldn't be surprised if a handful of individuals would rather die than admit to being vulnerable men.

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