well away from the ivory tower, on the ground in maysville, wayne pendleton has lived the change. >> maysville when we moved here was a pretty well flourishing little town right here, but we've lived here what, 17 years? and you can just name the stuff that's left here. you can't take a job away from a guy 55 years old and expect him to start all over again. >> even at my age it's depressing not trying to do something. >> reporter: despite four heart attacks, sherman saunders still wants to work. >> that's not someone else's responsibility to take care of the family. it's supposed to be yours, you have to go to work to do that yourself. >> most of the men aren't working. >> reporter: marcy conner, a nurse specializing in substance abuse, has a close-up view of the downward spiral. >> all of a sudden you lose your job. so here is a male with no identity. he's not working, he's supposed to be a provider for his family, he can't even do that, so that low self worth along with that hopelessness feeling, we start seeing tremendous depression. so how do you relieve depression? you can reli