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.”

For depressed male Hispanics, mental health treatment seems to work as well as it does for rest of the population

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.

Although the causes of depression are not completely understood, professionals agree that this is a “no-fault” illness that stems from the interplay of genetics and environment rather than from a character flaw. But despite new studies, many people still consider depression a weakness. “Sadly, the majority of Hispanic men with depression are never treated,” says Escobar, although treatment is becoming more acceptable with increased awareness among primary care doctors and new antidepressants.

With treatment, Trujillo has returned to all the things he once enjoyed

Escobar observes that when depressed Hispanic men do appear in clinics—often with the whole family—it’s because one of their children has recognized the symptoms.

In Trujillo’s case, however, his wife, Mary, 70, took action. “He didn’t have much of a say because he was so sick,” she says, recalling how he reached a point where he knew his name but little else. She would even have to comb his hair for him. Still, she says, “Depression was the last thing on my mind because he had been such an active person.”

For depressed male Hispanics, mental health treatment seems to work as well as it does for rest of the population, says Escobar. But he and Alva agree that more research is desperately needed.

“We are dealing with the fastest-growing minority group in the United States, yet most drug trials have been limited to Caucasian families,” Alva says.

With treatment, Trujillo has returned to all the things he once enjoyed: walking, playing golf, eating out, and spending time with his family. “I have to thank my wife and my children,” he says. “They and my belief in God helped turn things around.”

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