The person I was talking to was not the confident, I-can-handle-anything, king-of-entrepreneurs I had known. His voice was cracking. He said he felt useless and empty inside. He was depressed.

It is hard to understand how those who seem to have it all can find life so empty. But "corporate executives, and especially entrepreneurs, may in fact be even more vulnerable to depression than others," says Hara Estroff Marano in Psychology Today.

It's not that times are suddenly tough for CEOs, who, as she says are at this moment enjoying "as much trust as a car salesman." It's a combination of forces from within and without that are particularly durable and deeply embedded in men.

"The very qualities that propel them to success can arise from an extremely dark place in the psyche," Marano writes. "The tendency to build their identity on achievement makes a downturn unbearable."

Calling the recent events of this man's life "a downturn" is putting it mildly. He experienced four deaths in his immediate family, the closing of his business and loss of steady income. From the outside, he seemed to be coping.

This is partly what makes people like him such a distinguished species. They're smart, charming and have extraordinary coping skills, says Marano.

"But the orientation to action that so distinguishes them can work spectacularly against them when problems arise, preventing them from getting help or even recognizing they need it, ultimately pulling them into a depression so subterranean it resists treatment."

Other executives have come before him. In 2001, 59-year old entrepreneur Heinz Prechter, who struggled with depression for 30 years and sought treatment, committed suicide.

It's a disease with a high level of treatment success, "if people only would recognize it and seek help," said behavioral-health consultant Lynne DeGrande in Crain's Detroit Business.

Executives are among the most difficult groups to reach, says the article. They're used to being in control. They tend to think if they can't solve their own problem, nobody else will. There's also a stigma attached to admitting you have an emotional disorder, let alone any weakness.

I was relieved to find other executives who have depression talk openly about it — a key to getting better.

The Psychology Today article discussed Philip J. Burguieres, a successful CEO who collapsed from depression and in his search for a cure went to a mental health facility and took a slew of antidepressants that didn't help. Then he had a chance encounter with another executive, John Sage, who had suffered from depression. Burguieres couldn't believe it. Sage seemed so tough, so successful.

The two forged a friendship and talked regularly. Sage says he came to see that external achievements "were not the sole measure of who I was." Depression, in part, he says, came from denying his and others' pain, destroying the ability to have empathy.

When Burguieres and Sage first met, they didn't think they'd ever do significant work again. Today Burguieres divides his time between running a family business and serving as vice chair of the Houston Texans football team, according to Texans Working Together. He is also chairman of the Advisory Council of the Mental Health Association of Greater Houston and an advocate of creating mental-health-friendly work practices.

He also runs a "secret network" of CEOs with depression, where they can "come out" among their own. It's part of his cure to reach out to others, saying, "the only way out of it is by paying attention to others."

My hope is that the man I know — or someone you know who needs help — will discover and reach out to someone like Philip Burguieres.

For resources in your community, contact the National Mental Health Association (www.nmha.org) or the National Alliance on Mental Illness (www.nami.org).

Reach Andrea Kay at andrea@andreakay.com.