Twenty-four years ago I met my very first client. He was an elderly man who presented with symptoms of depression and the beginnings of pulmonary disease. He had a long-standing marriage, but it was not a happy one. He had been a force in the business realm but had been retired for many years, sometimes doing consulting to add income and feel useful.

I will never forget the way he summarized his life: "quiet desperation" were the words he used. I tried to suggest ways to ease his loneliness- new involvements and possible interests to pursue. He rejected each attempt. His grandchildren were the only interests he had, and he wasn't strong enough to spend an extended time with them.

I didn't feel very useful to him in our work together, but I later realized that our relationship was the important part. He didn't have anyone else to speak to, to be able to feel vulnerable with, who could listen without a well-meaning opinion. He had to be "strong" in front of his family. His friends were a function of his wife's social circle, and his generation did not share easily with other males.

He stood out to me because he did not represent what I had learned about this stage of life, young as I was. I had attended a training for senior peer counselors taught by a woman in her late 70s. She had just finished her doctorate degree in psychology.

All the people in this program were elderly. Some had health issues. Some had lost life partners. What made the difference was that they were still vibrant, energized and invested in life. They wanted to help others, and they had the time and resources to make that happen. I was taught that the later years are productive ones for many people but that resiliency depends on affiliation.

The affiliation promoted by this program caused the group to grow together and make a difference in their community, counseling other seniors from their unique vantage point. I wonder sometimes what might have happened in my client's life had he had found such an opportunity.

Men seem still to struggle with sharing and allowing vulnerabilities to show with one another. The ones who are able to reach out in relationships do better with the inevitable physical and emotional losses of this time in life.

However, it is more true of men to "cover up" emotions or to use things like TV, alcohol or excessive work involvement to deal with painful issues. Depression can be shameful and represent a lack of strength to many men. Isolation may be preferable to having to admit to vulnerability.

Many men wear a mask, beginning early in life. They may have learned traditional male gender roles that emphasize being tough, not showing feelings, staying in control and handling emotional conflict privately. They may have shut down so often that they lose touch with the original, true issues of their lives. This can result in a progressive deadening of emotional range, depression or anxiety symptoms that often seem unattached to reality.

Research shows that relationships for men are often based on doing things rather than the emotional connection that forms the basis for female friendship. So the positive, sustaining and meaningful communication inherent in friendship, which lowers stress levels and risk for disease, is not so available to men.

Is it any wonder then that, in the later stages of life, men struggle? There may be no job to go to anymore. There may be a lifetime of competition with other men rather than connection. Family is only a partial antidote for social ties: Research recently published in the "Journal of Epidemiology and Community Health" suggests that a network of friends is more beneficial to health than family support, especially among the elderly.

Studies have long supported social involvement as a means of stimulating brain cells and connections between cells, decreasing boredom and loneliness. New on the horizon is the premise of a "cognitive reserve," where scientists believe that staying mentally active and socially engaged creates a larger stockpile of mental abilities for people and may reduce the impact of diseases such as Alzheimer's. Reasoning, wisdom and creativity remain strong, even as our bodies age.

By joining civic groups, religious organizations, sports or special interest clubs and other organizations, men can make valuable contributions to their own and others' welfare.

Quality of life can remain or even get better as we grow older. It is vital, however, to remain open to what we need to understand about ourselves and change, no matter how old we are. For men who have been shut down emotionally, who have poured themselves primarily into the provider role in families, who may have neglected the important affiliations of friendship and belonging, it's time to do something different.

Deborah Barber, PhD, is a clinical psychologist in Westlake Village. Contact her at (818) 5127923. Send questions/comments to askDrDB@yahoo.com or go to www.DrDeborahBarber.com for more information.