死亡率是女性的3倍：男性抑郁患者困在隐蔽的痛苦中 The mortality rate is three times higher for men: male depression patients trapped in hidden suffering
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*本文为「三联生活周刊」原创内容 This article is original content by "Sanlian Life Weekly"
2019年，我国首次全国成人精神障碍流行病学调查结果显示，各类抑郁障碍中，女性患病率均高于男性，其中抑郁症男性患者约为 35%，女性患者约占 65%。而另一方面，中国疾控中心今年10月发布的一项研究表示，在抑郁症状严重的患者中，男性的死亡率是女性的3倍。社会通常认为，女性更善于感受和表达，从生理上来说，受激素影响，女性在孕产期、更年期也更容易情绪波动。那么男性呢？
In 2019, the results of the first national epidemiological survey of adult mental disorders in China showed that the prevalence of various depressive disorders was higher in women than in men, with male patients accounting for about 35% and female patients about 65%. On the other hand, a study released by the Chinese Center for Disease Control and Prevention in October this year indicated that among patients with severe depressive symptoms, the mortality rate for men is three times that of women. Society usually believes that women are better at feeling and expressing emotions, and physiologically, due to hormonal influences, women are more prone to mood swings during pregnancy and menopause. But what about men?
在本文采访的几位男性抑郁症患者中，他们几乎都伴随着“少说话多做事”、“男儿有泪不轻弹”的教导长大。面对汹涌的情绪时，他们的痛苦和求助都以更为隐蔽的方式存在。
Among the male depression patients interviewed in this article, almost all grew up with the teachings of "speak less, do more" and "men don't easily shed tears." When faced with overwhelming emotions, their pain and pleas for help exist in more concealed ways.
记者｜彭丽编辑｜徐菁菁 Reporter | Peng Li Editor | Xu Jingjing
压抑后的崩溃 Collapse after repression
45岁那年，韩风经历了人生重大的变故：父亲因病住院，家人为了不耽误他的工作一直没有告诉他，等韩风赶到医院时，没能见到最后一面。
At the age of 45, Han Feng experienced a major upheaval in his life: his father was hospitalized due to illness, and his family, not wanting to disrupt his work, didn't inform him. By the time Han Feng arrived at the hospital, he was unable to see his father for the last time.
韩风对父亲的感情很复杂。他的母亲是医生，父亲从体制内辞职去做生意。初中二年级以前，父亲慈爱，陪他一起做作业，从不打骂他。作为家中最小的儿子，韩风拥有受宠且安稳的生活。直到韩风初二，父亲为信任的朋友作担保，朋友消失后，债务落到了韩风一家头上。
Han Feng had complex feelings towards his father. His mother was a doctor, and his father had resigned from a government job to start a business. Before the second year of middle school, his father was loving, helped him with homework, and never scolded him. As the youngest son in the family, Han Feng enjoyed a pampered and stable life. Until the second year of middle school, when his father vouched for a trusted friend, who disappeared, leaving the debt to fall on Han Feng's family.
稳定的生活就此被打断，每天都有人上门讨债，父亲为了躲债常常不在家里。“经常见不到爸爸，所以放学也无趣，只能在家做作业，但又要面对讨债者，家属院里的邻居也会有异样的眼神”。韩风回忆起过往，觉得自己“那时太孤独了”。
The stable life was thus disrupted, with debt collectors visiting daily, and his father often absent to avoid them. "I often couldn't see my dad, so after school was boring, I could only do homework at home, but then I had to face the debt collectors, and the neighbors in the family compound would give strange looks." Recalling the past, Han Feng felt he was "too lonely at that time."
与父亲的关系也逐渐生出嫌隙，“我明明内心深处很爱自己的爸爸，但是我总觉得他给家庭带来了祸端，我知道他委屈，但我也委屈”。这些情绪都被韩风压在心里，父母忙于生计，他选择排解的方式是更努力地学习、离开家。
The relationship with his father gradually developed rifts, "Deep down, I really loved my dad, but I always felt he brought disaster to the family. I knew he was aggrieved, but I was aggrieved too." All these emotions were suppressed by Han Feng, as his parents were busy making a living, and he chose to cope by studying harder and leaving home.
后来韩风如期考上大学，在外打拼，很少回家。他隔段时间给家里打个电话，“和爸爸说上两句话，就找我妈，一直没有和爸爸认真聊过天”。直到这次父亲突然去世。悲痛之余，韩风内心深处有驱之不去的愧疚，他总是忍不住想，自己本应对父亲更好。
Later, Han Feng was admitted to university as expected and worked hard outside, rarely returning home. He would call home from time to time, "say a few words to his father, then look for his mother, and never had a serious conversation with his father." Until this time, his father suddenly passed away. In addition to his grief, Han Feng felt an unshakable guilt deep inside, always thinking that he should have treated his father better.
然而，和初二的自己一样，他把愧疚和悲痛压了下来，用工作来麻痹自我。韩风在一家媒体当记者，人到中年，他想要再往上冲一冲。此外，他也想证明给父亲看。“我和爸爸直接的交流不多，但我知道他会偷偷和熟人说我很孝顺，也在外做成了很多事”，韩风觉得，如果自己做得更好，就能告慰父亲的在天之灵。接下来的几年里，他主动申请加班、出差，经常通宵写稿。
However, just like when he was in the second year of middle school, he suppressed his guilt and grief, using work to numb himself. Han Feng worked as a journalist for a media company. In middle age, he wanted to push himself further. Additionally, he wanted to prove himself to his father. "I didn't communicate much directly with my father, but I knew he would secretly tell acquaintances that I was very filial and had achieved a lot outside," Han Feng thought that if he did better, he could comfort his father's spirit in heaven. In the following years, he actively applied for overtime and business trips, often staying up all night writing articles.
但内心深处，不对劲的感觉始终存在。慢慢地，对于父亲的愧疚总会不经意地侵袭脑海，“以前出去出差会很开心，享受自己的工作，但后来就变得很低落，对什么都提不起兴趣”。失眠也变得越来越严重，不借助安眠药很难睡着。
But deep inside, the feeling of unease always persisted. Gradually, the guilt towards his father would inadvertently invade his mind, "I used to be very happy when going on business trips, enjoying my work, but later I became very depressed and lost interest in everything." Insomnia also became increasingly severe, and it was difficult to sleep without the aid of sleeping pills.
在父亲去世的第三年，2018年秋天，韩风已经无法出门，没有食欲。最严重的时候，他躺在床上一动不动，连拿水杯的力气也没有，轻生的念头反复闪现。虽然韩风此前对抑郁症已经有过了解，但此时，他什么都不想做。最后，是家人看出他的异样，坚持把他带去北京安定医院就医。经过一系列诊断，韩风此时已经是重度抑郁，需要住院。
In the third year after his father's death, in the autumn of 2018, Han Feng was unable to leave the house and had no appetite. At its worst, he lay motionless in bed, without even the strength to hold a cup of water, and thoughts of ending his life repeatedly flashed through his mind. Although Han Feng had previously understood depression, at this point, he didn't want to do anything. In the end, it was his family who noticed his abnormality and insisted on taking him to Beijing Anding Hospital for treatment. After a series of diagnoses, Han Feng was already suffering from severe depression and needed hospitalization.
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The \"2022 National Depression Blue Book\" shows that the lifetime prevalence of depressive disorders among adults in China is 6.8%, with depression accounting for 3.4%, affecting 95 million people. According to the first national epidemiological survey of adult mental disorders in 2019, the prevalence of various depressive disorders is higher in women than in men, with male depression patients accounting for about 35% and female patients about 65%. However, in October 2024, the latest research by the Chinese Center for Disease Control and Prevention indicated that among patients with severe depressive symptoms, the mortality rate for men is three times that of women.
不易被诊断的男性抑郁 Depression in men is not easily diagnosed
上海交通大学医学院附属仁济医院心理医学科医生吴志国曾在2014年8月参与过《中国抑郁障碍症状学调查》。吴志国告诉本刊，与女性抑郁不同，男性抑郁的症状主要表现为容易发脾气、焦躁不安，绝望感和挫败感会更多，非典型症状更多，比如吃得多、睡得多。但男
Wu Zhiguo, a doctor in the Department of Psychological Medicine at Renji Hospital affiliated with Shanghai Jiao Tong University School of Medicine, participated in the \"China Depression Disorder Symptomatology Survey\" in August 2014. Wu Zhiguo told this publication that, unlike female depression, the symptoms of male depression mainly manifest as irritability, restlessness, and a greater sense of hopelessness and frustration, with more atypical symptoms such as overeating and oversleeping. However, the proportion of men showing core symptoms of depression is lower than that of women, such as low mood, lack of pleasure, and reduced interest and motivation. This suggests that male depression may be relatively difficult to identify.
吴志国曾遇到一位来自湖南农村的男性患者，50岁出头，靠在城里打工把一双儿女送上大学。这位患者有段时间产生了一个妄想症状：自己的妻子在外面遭人迫害（实际上并无此事），但他自己说是“忍耐下来算了”。最初，患者自己并不认为自己有抑郁情绪（比如情绪低落、缺乏愉快感），“你问他有没有因为这件事（老婆遭人“迫害”）不开心，他总是‘嗐’一声说算了，我们农村人又能怎么办，让你觉得他可能有些淡漠的表现，而淡漠是精神分裂症的核心症状表现。”吴志国解释，情
Wu Zhiguo once encountered a male patient from a rural area in Hunan, just over 50 years old, who worked in the city to send his two children to college. For a period, this patient developed a delusional symptom: that his wife was being persecuted by others (which was not true), but he himself said he would \"endure it.\" Initially, the patient did not consider himself to have depressive emotions (such as low mood or lack of pleasure). \"When you ask him if he was unhappy about this matter (his wife being 'persecuted'), he would always dismiss it with a 'sigh' and say, 'What can we rural people do?' making you feel he might be showing some indifference, which is a core symptom of schizophrenia,\" Wu Zhiguo explained. To be diagnosed with depression, at least one of the two core symptoms—low mood and lack of pleasure and interest—must be present. Therefore, Wu Zhiguo and his colleagues had intense debates about whether he was depressed. So Wu Zhiguo changed his approach, \"I asked him, 'Do you feel that life has been hard for you recently?' and his tears started to flow.\" \"When you ask him if he feels low or happy, he doesn't know how to answer,\" he speculated that some men with depressive symptoms might be misdiagnosed due to inadequate questioning during clinical consultations.
尹冬青是北京安定医院精神科的医生，工作已有十余年。在他的经验里，很多男性面临情绪问题时都会像韩风一样，通过工作来疏解，到最后发现工作无法疏解后，再慢慢地出现躯体症状。
Yin Dongqing is a psychiatrist at Beijing Anding Hospital and has been working for over ten years. In his experience, many men, when facing emotional problems, tend to relieve them through work like Han Feng, only to find that work cannot alleviate them, eventually leading to physical symptoms.
“很多患者的首站就诊并不在精神专科医院，也不在精神科或心理科，而在综合医院的消化科、心内科、睡眠科等科室。”他解释，这是因为，情绪问题常常先表现为躯体化症状，比如头痛、食欲不振、肌肉酸痛等。“大概有不到百分之二十的患者是从其他科室转过来的”，尹冬青表示，在这些患者里面，男性不在少数。
"Many patients do not initially seek treatment at psychiatric hospitals, nor in psychiatry or psychology departments, but rather in departments like gastroenterology, cardiology, and sleep medicine at general hospitals," he explained. This is because emotional issues often first manifest as somatic symptoms, such as headaches, loss of appetite, and muscle aches. "About less than twenty percent of patients are referred from other departments," Yin Dongqing stated, noting that among these patients, there are quite a few men.
他曾接诊过一个四十多岁的男性患者，从二十多岁开始就常常心绞痛、难以呼吸，还伴随有头晕、浑身乏力等症状，去不同的医院检查显示心脏和身体其他部位都没问题。为了治病，他从老家东北来到北京，找了一份离医院很近的保安的工作，“多的一年曾去医院拍过30次片子”。折腾多年仍未查出病因，有医生提醒他可以去精神科看看，才“带着厚厚一沓化验单” 辗转到尹冬青的门诊。
He once treated a male patient in his forties who had been experiencing angina and difficulty breathing since his twenties, along with symptoms like dizziness and fatigue. Various hospital examinations showed no issues with his heart or other parts of his body. To seek treatment, he moved from his hometown in the northeast to Beijing and found a security job close to the hospital. "In one year, he had as many as 30 X-rays taken." After years of struggle without finding the cause, a doctor suggested he visit a psychiatric department, and he finally arrived at Yin Dongqing's clinic "with a thick stack of test results."
和患者深入聊天后，尹冬青了解到，20岁出头时，患者的父亲突然去世，“生活重担一下就落到他头上，从那之后他就很不舒服”。在综合对身体部位疾病的排除、患者的精神状态及持续时长等原因后，尹冬青判断他是抑郁焦虑，“吃了两个月的药，再没出现过心脏不适的症状。”尹冬青还是觉得惋惜，因为身体的缘故，这名患者一直没有成家，也没办法干重活赚钱，二十多年就这样过去了，患者很少向人吐露自己的情绪，也不曾意识到身体不适可能与心理压力有关。
After in-depth conversations with the patient, Yin Dongqing learned that when the patient was in his early twenties, his father suddenly passed away, "the burden of life suddenly fell on his shoulders, and he hasn't felt well since then." After ruling out physical diseases, considering the patient's mental state and the duration of symptoms, Yin Dongqing diagnosed him with depression and anxiety. "After taking medication for two months, he never experienced heart discomfort again." Yin Dongqing still felt regretful because, due to his physical condition, the patient never started a family or was able to do heavy work to earn money, and over twenty years had passed like this. The patient rarely expressed his emotions to others and never realized that his physical discomfort might be related to psychological stress.
在吴志国和尹冬青的共同经验中，无论是抑郁症状非典型还是躯体化症状严重，都与男性患者相对不会表达情绪有关。2016年，悉尼大学心理学院的研究者曾用男性气质、抑郁、求助等术语搜索出1927篇文献，并对此进行分析。研究发现，与女性相比，男性向全科医生或心理健康专业人士寻求心理健康帮助的可能性只有女性的一半，这一发现在不同国家、种族和民族群体以及整个生命周期中都是一致的。
In the shared experience of Wu Zhiguo and Yin Dongqing, whether depressive symptoms are atypical or somatic symptoms are severe, it is related to male patients being relatively less expressive of their emotions. In 2016, researchers from the University of Sydney's School of Psychology searched for 1,927 articles using terms like masculinity, depression, and help-seeking, and analyzed them. The study found that compared to women, men are only half as likely to seek mental health help from general practitioners or mental health professionals. This finding is consistent across different countries, races, ethnic groups, and throughout the life cycle.
从国家二级心理咨询师、家庭治疗师郑玫的经验来看，这一比例可能会更低。今年是她成为心理咨询师的第11年，在她这里做长程（一般是一年以上）心理咨询的成人来访中只有四五个是男性，相比之下，女性成人来访要“多得多”。接受采访前，她还专门去问了六七个同行，“有些同行几乎就没有接待过过成年的男性抑郁来访者”。
From the experience of Zheng Mei, a national second-level psychological counselor and family therapist, this proportion might be even lower. This year marks her 11th year as a psychological counselor, and among the adults who come to her for long-term (usually over a year) psychological counseling, only four or five are men. In contrast, there are "many more" female adult visitors. Before the interview, she specifically asked six or seven colleagues, "Some colleagues have almost never received adult male depression visitors."
不被允许的“矫情” The "sentimentality" that is not allowed
表达情绪对一名男性来说有多难？王挺反问，你看到一个男人哭会有什么感觉？不等我回答，他接着说，“太矫情了”。王挺今年37岁，2018年，从事公关策划工作的他辞职，自己创办了一个公司。一年多后，公司刚有些起色就遇上了疫情。他坚持了四个月，最终还是没能撑下来。等到2020年破产时，父亲重病刚出院，还有一个3岁的儿子，再加上“小一百万”的债务。
How difficult is it for a man to express emotions? Wang Ting retorted, what would you feel if you saw a man cry? Without waiting for my answer, he continued, "Too sentimental." Wang Ting is 37 years old this year. In 2018, he resigned from his job in public relations planning and started his own company. Just over a year later, when the company was starting to show some promise, it encountered the pandemic. He held on for four months but ultimately couldn't sustain it. By the time he went bankrupt in 2020, his father had just been discharged from the hospital with a serious illness, he had a 3-year-old son, and nearly a million in debt.
过年回老家，母亲得知他卖房还债，忍不住骂他“败家子”。王挺记得那一刻自己的感受是“想死”，但他不想在父母面前过多表现，厚着脸皮、开开玩笑混了过去。然而，对父母的愧疚和养家的压力终究混不过去。王挺家在河南农村，父亲因为身体不好一直没办法干活，母亲靠着种地、打石子、卖鸡蛋养大了他和姐妹三人。为了帮他还债，近70岁的父母这两年又重新开始工作。
Returning home for the New Year, his mother couldn't help but scold him as a "prodigal son" upon learning he sold the house to pay off debts. Wang Ting remembers feeling "like dying" at that moment, but he didn't want to show too much in front of his parents, so he put on a brave face and joked his way through it. However, the guilt towards his parents and the pressure of supporting the family couldn't be brushed aside. Wang Ting's family is from a rural area in Henan. His father has been unable to work due to poor health, and his mother raised him and his three sisters by farming, breaking stones, and selling eggs. To help him pay off his debts, his nearly 70-year-old parents have started working again in the past two years.
王挺自己也不得不离开老家去到外地挣钱，他渐渐“害怕收到老婆的消息，因为可能是要问我要钱，也害怕给父母打电话，因为总觉得对不起他们。”
Wang Ting himself also had to leave his hometown to earn money elsewhere. He gradually "became afraid of receiving messages from his wife, because it might be asking for money, and also afraid of calling his parents, because he always felt guilty towards them."
高压之下，王挺唯一的发泄方式是下班回到家里大哭，伴随着扇自己巴掌、咬自己的自残行为。在王挺的认知里，脆弱是不被允许在人前表达的，他强调，尤其自己已经37岁了，“一个成熟的男人应该是能扛得住事儿的”。
Under high pressure, Wang Ting's only way to vent was to come home from work and cry, accompanied by self-harming behaviors like slapping himself and biting himself. In Wang Ting's perception, vulnerability is not allowed to be expressed in front of others. He emphasized, especially since he is already 37 years old, "a mature man should be able to handle things."
这和王挺从小到大的成长环境有关。因为条件不好，王挺一家受到其他叔叔伯伯的排挤，“我爸妈都特别要强，我和我姐姐也是这样的性格”。他记得，父亲总是告诉自己，“男子汉大丈夫流血不流泪，有泪不轻弹”。从小到大，王挺也的确没有见过父亲流泪。这样的反馈还来自于姐姐、老婆。在最艰难的时刻，王挺无力按时给银行还款，接完催款电话后，他站在楼顶，拨通了姐姐的电话，“我说不出口自己撑不下去了，我只是和她说我好累”，姐姐和以前一样训了他一顿，“一个大男人一天到晚都哭哭唧唧干嘛”。
This is related to Wang Ting's growth environment from childhood. Due to poor conditions, Wang Ting's family was ostracized by other uncles, "My parents were very strong-willed, and my sister and I have the same personality." He remembers his father always telling him, "A real man bleeds but doesn't cry, and doesn't shed tears easily." From childhood to adulthood, Wang Ting indeed never saw his father cry. This feedback also came from his sister and wife. In the most difficult times, Wang Ting was unable to repay the bank on time. After receiving a collection call, he stood on the rooftop and called his sister, "I couldn't say that I couldn't hold on anymore, I just told her I was so tired," and as usual, his sister scolded him, "Why is a grown man whining all day?"
在几年的挣扎里，王挺没有想过自己“有问题”，他认为自己只需要找点事情干就可以。这里面也包含着他此前对抑郁症的认识：“闲得没事干，把生活充实起来就好了”。最终让他觉得难以承受的，也是“没办法控制自己的情绪”。和朋友一起出去玩，坐在副驾的他突然崩溃大哭，一个下午哭了两次。“他（朋友）一边开车一边不停地回头看我，但他也不知道说什么，我能感觉到他很无措”。和王挺的大多数朋友一样，这位朋友平常沉默寡言，更别说当众哭泣了，这让王挺更加觉得难为情。
During years of struggle, Wang Ting never thought he "had a problem." He believed he just needed to find something to do. This also included his previous understanding of depression: "Being idle with nothing to do, just keep life busy and it'll be fine." What ultimately made him feel unbearable was "not being able to control his emotions." While out with friends, sitting in the passenger seat, he suddenly broke down and cried twice in one afternoon. "He (the friend) kept looking back at me while driving, but he didn't know what to say. I could feel he was at a loss." Like most of Wang Ting's friends, this friend was usually taciturn, let alone crying in public, which made Wang Ting feel even more embarrassed.
10月底，王挺终于下决心去医院检查，初步诊断为重度抑郁。他已经有了心理准备，但还是不敢告诉自己的朋友，除了不想麻烦别人外，“也担心会被看不起”。
At the end of October, Wang Ting finally decided to go to the hospital for a check-up and was initially diagnosed with severe depression. He was mentally prepared, but still didn't dare to tell his friends, not only because he didn't want to trouble others, but also "worried about being looked down upon."
郑玫告诉本刊，“矫
Zheng Mei told the magazine, "Words like 'pretentious' reflect a reality: society believes that men must be strong and cannot be weak. This characterization is imprinted on men through family and social environments, which also creates a form of oppression and limitation for them. It causes men to feel a strong sense of shame and avoidance when it comes to expressing emotions. The male adult clients she receives have a noticeable characteristic: they generally are not willing to use expressive methods like sandplay therapy, painting, or music for counseling, preferring instead to use conversation. Male adult clients focus more on thinking and rational analysis, often 'starting with discussions about their work, interpersonal relationships, and life realities,' and it takes a long time before they can slowly explore the deeper emotional world within."
《武法律师》剧照 Still from "Lawless Lawyer"
周星今年25岁，五年前被诊断为抑郁症，后来又被诊断为双向情感障碍。他对于表达情绪同样回避。在朋友中，他是“大哥”的角色，是聚会的组织者和中心。有次参加饭局，“酒还没开，我就坐立不安、嘴哆哆嗦嗦的，腿也一直在抖”，旁边的人察觉到异样问他是否不舒服，他强撑着说没事。回去的路上，周星反复思量，觉得饭桌上朋友看他的眼神充满了疑惑，“朋友们可能不是这么想，但是在我心里就是如此，那天晚上回到家，我感觉自己特别懦弱，特别责备自己展现出了柔弱的一面”。从那以后，每次和朋友出去玩，周星都会吃双倍的药，保证自己是“正常”的。
Zhou Xing is 25 years old this year. He was diagnosed with depression five years ago and later diagnosed with bipolar disorder. He also avoids expressing emotions. Among his friends, he plays the role of the "big brother," the organizer and center of gatherings. Once, at a dinner party, "even before the drinks were served, I was restless, my mouth was trembling, and my legs kept shaking." People around him noticed something was wrong and asked if he was uncomfortable, but he forced himself to say he was fine. On the way home, Zhou Xing kept thinking about it, feeling that his friends' eyes were full of doubt at the dinner table. "My friends might not have thought that way, but in my heart, that's how it felt. That night when I got home, I felt particularly weak and blamed myself for showing a vulnerable side." Since then, every time he goes out with friends, Zhou Xing takes double the medication to ensure he appears "normal."
最后一步 The Last Step
对
The worst outcome of suppressing emotions is choosing to give up life. Yin Dongqing told the magazine that it is not actually that the male suicide rate is higher, but that the success rate of male suicides is higher. "Not expressing emotions leads to them neither seeking help nor being easily noticed by those around them, and by the time they are discovered, the situation is already quite serious."
周星的手上曾经两次尝试过自杀，他拍了一张右手腕的照片，黝黑的手臂上五六条白色疤痕清晰可见，粗细不一，证明了当时的决绝。周星在机缘巧合下组建了一个精神疾病类患者的群，群里总共有六十多人。他会在里面分享自己的经验和查到的知识，病友经常找他倾诉。“女生来找我一般都还好，可能她的情况很难受，打电话聊一下、哭一下，能劝住一点儿，男生来找我我就很害怕，一般都是撑不住了”。
Zhou Xing had attempted suicide twice before. He took a photo of his right wrist, where five or six white scars of varying thickness were clearly visible on his dark arm, proving his determination at the time. By chance, Zhou Xing formed a group for people with mental illnesses, which now has more than sixty members. He shares his experiences and the knowledge he has found in the group, and fellow patients often confide in him. "When girls come to me, it's usually okay. Maybe they're feeling really bad, but after a phone call and a cry, I can persuade them a little. When boys come to me, I get really scared because they're usually at their breaking point."
他边说边给我发来一张照片，照片里手臂上的缝合线交叉在一起，伤口有四分之三个小臂长。这是一位27岁的群友，“前几天还在和你一起打游戏，几天后突然给你发一张自己手臂缝针的照片，说‘哥我没事了’。”每次收到这样的照片，周星都不知道该如何回复。
As he spoke, he sent me a photo. In the photo, the stitches on the arm crisscrossed, and the wound was three-quarters of the forearm long. This was from a 27-year-old group member. "A few days ago, he was still playing games with you, and then suddenly he sends you a photo of his stitched arm, saying 'Bro, I'm okay now.'" Every time Zhou Xing receives such photos, he doesn't know how to respond.
某种程度上，周星理解这些病友。男性抑郁症患者常常感到自己无人可以求助。“我身边的朋友也是如此，如果是女生抑郁，他们会觉得很心疼能理解，如果是男性，他可能会不相信也不知道怎么表达”。周星曾在一次崩溃后鼓起勇气告诉了自己亲近的大哥，对方回他“有什么可抑郁的，晚上带你出去风花雪月，你就是没运动，哥带你出去转一圈”。那天晚上，坐在ktv里，身边的人在唱歌跳舞，周星却感受不到这种兴奋，“尤其是别人都能快乐而你快乐不了的时候，那又是一种痛苦”。
In some ways, Zhou Xing understands these fellow patients. Male depression patients often feel they have no one to turn to for help. "My friends are the same. If a girl is depressed, they feel sympathetic and understanding. If it's a guy, they might not believe it or know how to express it." After a breakdown, Zhou Xing once mustered the courage to tell his close elder brother, who replied, "What's there to be depressed about? I'll take you out for some fun tonight. You just need some exercise. I'll take you out for a spin." That night, sitting in a karaoke room, with people singing and dancing around him, Zhou Xing couldn't feel the excitement. "Especially when everyone else can be happy, and you can't, that's another kind of pain."
《年少日记》剧照 Still from "Youth Diary"
于是，很多男生“求助的信号都会非常隐喻”。周星举了自己的例子，在最难受的时候，周星会给自己的朋友发一句话：“哥们明天出去玩不玩？”如果对方回不出去玩怎么办？“那就算了，求助失败”。在最严重的时候，他靠写日记来完成表达，“我就像一架厚重且只有低8度的钢琴，任何能代表欢快的音乐都不会出现。我常常想着把手伸进自己的脑壳里，取出让我抑郁的零件”。
So, many boys' "signals for help are very implicit." Zhou Xing gave his own example. When he was feeling the worst, he would send a message to his friend: "Bro, are we going out to play tomorrow?" What if the friend replied that they couldn't go out? "Then that's it, a failed attempt to seek help." At his worst, he relied on writing a diary to express himself. "I feel like a heavy piano that can only play in a low octave, and no joyful music will ever come out. I often think about reaching into my own skull to remove the parts that make me depressed."
回忆起抑郁时的经历，韩风觉得就像是溺水，“溺水时什么都想不了，只有濒死感。水深还没有超过自己身高的人也能被淹死，很多人会说只要站起来就死不了，但事实是他就是站不起来。”对于很多抑郁症患者来说，“赴死就像是魔鬼一样随时都在召唤”。在过去的三年里，韩风失去了3位因重度抑郁而离去的男性朋友。在看过各种各样的故事后，韩风有一个感受：很多人并没有意识到男性抑郁症患者面临的危险。
Recalling the experience of depression, Han Feng felt like drowning, "When drowning, you can't think of anything, only the feeling of impending death. Even people in water not deeper than their height can drown. Many people say that as long as you stand up, you won't die, but the fact is that he just can't stand up." For many depression patients, "going to death is like a devil constantly calling." In the past three years, Han Feng lost three male friends who left due to severe depression. After seeing various stories, Han Feng has a feeling: many people are not aware of the dangers faced by male depression patients.
其中一位是他2020年结识的病友，原是互联网大厂工作的高管，老婆在外企工作没办法看护老公，便让韩风去医院陪着同吃同住。“那时候我很有信心，我见了这么多病友，自己也有恢复的经历，可以鼓励他、劝他吃药，陪着他到医院下面走一走。”出院后，病友的老婆说他状态还行，每天在家休息，还会在家小区河边走上一个小时，慢慢恢复体力。几个月后的一天，当晚凌晨两点多，病友还在提醒女儿早睡，一个小时后，就从家中的窗户跳了下去，“两边分别是他老婆和女儿的房间，我想他肯定是有过犹豫的，但最终还是选择了这条路”。
One of them was a fellow patient he met in 2020, who was originally an executive at a major internet company. His wife worked at a foreign company and couldn't take care of him, so she asked Han Feng to accompany him in the hospital, eating and living together. "At that time, I was very confident. I had seen so many fellow patients and had my own recovery experience, so I could encourage him, persuade him to take medicine, and accompany him for a walk under the hospital." After being discharged, the patient's wife said he was doing okay, resting at home every day, and would walk for an hour by the river in the community, slowly regaining his strength. A few months later, one day, at around two in the morning, the patient was still reminding his daughter to go to bed early. An hour later, he jumped out of the window of his home, "On either side were his wife's and daughter's rooms. I think he must have hesitated, but ultimately chose this path."
2019年，一个偶然的契机，韩风成为了抑郁科普互助平台“渡过”在北京同城群的群主，网名为“国宝贝”。不断地有病人或家属来找他倾诉，而他也会经常主动地去分享。相
In 2019, by chance, Han Feng became the leader of the Beijing local group of the depression science popularization and mutual aid platform "Duguo," with the online name "Guobao Bei." Patients or their families constantly came to him to confide, and he would often take the initiative to share. Compared to before he got sick, Han Feng felt that his biggest change was learning to communicate, "When chatting with people, I can see my emotions in them, interpret my emotions. I can also feel the sincerity of others, with much less self-guessing, I can naturally express my emotions instead of just avoiding and enduring."
（受采访者要求，文中除吴志国、尹冬青、郑玫外为化名）
(At the interviewee's request, except for Wu Zhiguo, Yin Dongqing, and Zheng Mei, all names are pseudonyms)
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排版：布雷克 / 审核：米花 Typesetting: Blake / Review: Mihua
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