Robert Enke may have appeared to have it all, but depression can fell the mightiest of men and his struggle to maintain a veneer of normality while battling inner demons will be sickeningly familiar to anyone with first-hand experience of the condition. His eventual demise was not that unusual, either.
Suicide is the biggest cause of death in men under 45, with about 30 killing themselves every week across the United Kingdom and many more making serious attempts.
There are a number of factors thought to explain why young men are at such particular risk, but pressure to fit the macho male stereotype, and the methods they choose to end their lives, are two important ones.
Men are notoriously bad at seeking medical help or the counsel and support of their peers, and often find it particularly hard to discuss emotional and psychological issues such as bereavement and depression. “Real men” are not supposed to cry, particularly professional goalkeepers.
When they do plan suicide, men tend to choose a more violent and certain method than women.
Advertisement
While women are more likely to opt for an overdose, giving them time to reconsider what they have done or be found by others, men are more likely to jump from a bridge, lie in front of a train or hang themselves.
Less than half of all men who commit suicide will have consulted a doctor about their feelings and in those, such as Enke, who do seek help, it can be difficult to identify which of your patients with depression and/or suicidal thoughts are most likely to harm themselves.
Pointers include a history of serious depression or attempted suicide; being single; drug and alcohol abuse; and unemployment. But these are very non-specific and not always that helpful.