Anxiety Workbook for Men: Evidence-Based Exercises to Manage Anxiety, Depression, and Worry

CHAPTER 1

Deciphering Anxiety

Before embarking on any new pursuit, it’s best to get a lay of the land. In this first chapter, you’ll be introduced to a number of key concepts aimed at helping you understand what anxiety actually is, what causes it to develop, and which techniques are most successful at mitigating it.

We’ll examine the unique and often creative ways men respond to and manage anxiety, as well as how anxiety impacts men physically, cognitively, emotionally, and behaviorally. We’ll also look at various contributing causes, such as environment and genetics.

Ready to kick things off? Let’s go.

Anxiety and Men

Anxiety is a universal yet highly subjective personal experience. Anxiety impacts people regardless of their age, gender, and cultural or socioeconomic background. While researchers acknowledge that the causes of anxiety may differ for men and women, how they experience physical and psychological symptoms is relatively the same.

Research also highlights that while a greater number of women report experiencing anxiety, men are less likely to seek professional help. According to the National Survey on Drug Use and Health, women are almost twice as likely to utilize mental health services as men (17.7 percent of women versus 9.5 percent of men).

The report also highlighted that men are less likely than women to use outpatient mental health services and less likely to use prescription medication for mental health issues. The reasoning is twofold: First, men are not typically well versed in recognizing the signs of anxiety. Second, many men do not seek help because they think sharing or disclosing their experience is not considered masculine behavior. This lack of knowledge and reluctance to go public with a problem places men in a precarious bind.

When they do seek help, they often downplay or misrepresent their symptoms, resulting in misdiagnosis and ineffective treatment outcomes. This is because men respond to and express anxiety in very different ways than women. Men are often inclined to present anxiety in secondary emotional, physical, or behavioral ways. In other words, anxiety often sits beneath some other form of presentation; for example, expressing anger or aggression (a secondary emotion) rather than conveying fear or apprehension (a primary emotion). This is because anger is, hypocritically, a more socially accepted form of emotional expression for men than for women.

In men, anxiety may express itself in secondary emotional or physical forms such as:

•Anger

•Irritability or being on edge

•Restlessness

•Depressed mood

•Fatigue and/or burnout

•Difficulty concentrating or being present

•Sexual health issues (such as erectile dysfunction)

Men are also more inclined to adopt compensatory behaviors that serve as coping strategies for their anxiety, such as:

•Antisocial behavior or withdrawing

•Risky behaviors or activities

•Addictive behaviors (such as pornography or gaming)

•Substance abuse

These secondary and compensatory behaviors are often what lead men to seek help, either through their own volition or at the urging of a partner or colleague. So what’s behind the fact that men are less likely to seek help for anxiety? Let’s explore more deeply some of the very real reasons this happens.

Insecurities

There are many reasons men are reluctant to seek professional help for their anxiety (or any other mental health issue), including that they often struggle to identify the underlying issue and find it difficult to verbalize what’s going on.

Here’s what else: Many men are coached from a very young age that emotional expression or vulnerability is a weakness. This hypermasculine narrative is cultivated by conventional social and cultural systems such as education, sports, media institutions, and even family. These systems have made it very challenging for some men to accept that they can’t do everything on their own. The expectation to be overly independent, strong, and self-reliant can cause discomfort and shame for a man who finds himself in a struggle he can’t resolve alone, leading him to feel like a failure. In reality, he simply lacks the knowledge and resources required to identify and solve his problem.

Further adding to men’s insecurities is the fact that many men are simply not accustomed to feeling like it’s okay to open up to anyone about their struggles the way women do. Their network is also typically much smaller.

Social Stigmas/Norms

Society also plays a role in the stigma around men and mental health. According to the World Health Organization, the cultural stigma surrounding mental health is one of the chief obstacles to people admitting they are struggling and seeking help, and this stigmatization is particularly pronounced in men.

It’s culturally acceptable to enlist the help of experts in many fields—men turn to physical trainers for their physique, mechanics for their automobiles, and financial advisers for their money management. While it makes sense to call upon a mental health professional when that kind of support is needed, cultural norms condition men to reject help in favor of remaining emotionally in control and self-reliant.

Finding adequate help can also be problematic due to the lack of available mental health services focused on the needs of men, particularly men belonging to minority groups. Part of the problem is that many forms of mental health support run in direct opposition to how some men prefer to receive support. For example, talk therapy emphasizes the significance of sharing and experiencing emotions, something that a lot of men feel uncomfortable doing. Men also prefer mental health support to be solution- or action-oriented. For many men, the idea of engaging in an unstructured, continuous conversation doesn’t align with their vision of getting better.

By the time a man does make it into a therapist’s office, he’s typically endured a lot of suffering and loss. This suffering and loss impacts the people around him—his partner, children, parents, and colleagues. During such vulnerable times, it’s important to remember that asking for help is not a weakness; conversely, it’s a sign of strength and courage.

Judgment-Free Zone

For some men, considering support for anxiety may feel like a daunting, even impossible task. The thought of reaching out evokes ambiguous thoughts and uncomfortable emotions. It’s important to know that you’re not alone. These thoughts are universal and valid.

Please take a moment to reflect on the possible reasons it’s been challenging to seek help. Remember, this is a judgment-free zone. Answering the following questions openly and honestly goes a long way in helping you seek the change you envision for yourself. Write your answers in the lines provided.

•What possible reasons may have prevented you from seeking help with anxiety?

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•What event(s) or occurence(s) prompted you to seek a solution now?

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•If you were successful in addressing anxiety, how would you envision your life? What would be different?

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•How do you hope this workbook will serve you in achieving this vision?

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How Anxiety Can Show Up Differently for Men

Anxiety affects all individuals, regardless of gender identity, largely in the same way. However, the difference is in the way that those who identify as men or as masculine manage, process, and express their anxiety.

While women are traditionally nurtured with the notion that it’s acceptable to show emotions, weakness, or vulnerability, men are typically not. Men are often socialized from a young age to suppress their emotions. Suppression refers to the internal prohibition of emotions. Emotional suppression can lead men to dissociate from what they feel. As a result, it can lead to dysfunctional or avoidant behaviors to keep uncomfortable or unfamiliar emotions at bay.

In individuals with an anxiety-related disorder, accompanying issues (also referred to as comorbid disorders) are more common among men. Studies show that men’s anxiety is commonly accompanied by an additional issue such as substance abuse, disruptive impulse control, or antisocial behavior.

Men develop these alternative ways of expressing themselves, but they will struggle to recognize that these behaviors are actually related to anxiety. This is because men often attempt to resolve anxiety using methods that are consistent with masculine constructs such as independence, strength, courage, and assertiveness.

There is nothing wrong with any of these masculine constructs—that is, until they are paradoxically used to avoid something that could be harmful. An example of this might be knowing that you’re sick and refusing to go to the doctor because you think that asking for help shows weakness.

To avoid anxiety, men will frequently divert their attention to various activities or pursuits, including work, education, leisure, watching pornography, and exercise. Others seek thrilling or risky experiences that place their safety and well-being in jeopardy.

Gents, don’t neglect your health because you believe you’re supposed to tough it out. Be the most formidable advocate for your own state of mind and well-being.

Let’s look at some of the more common ways men typically express anxiety.

Substance Abuse

Men often turn to substances such as alcohol or drugs to help numb their emotions or help them cope with the underlying experience of anxiety, even if the anxiety is not immediately apparent to them.

Substance abuse includes the persistent and harmful use of an ingredient or substance, either legal (such as alcohol, nicotine, or prescription medication) or illegal (such as heroin, cocaine, or methamphetamines), which can lead to significant long-term difficulties. While men may turn to these substances for temporary relief, the use of these substances can actually prolong symptoms of anxiety and, in many cases, exacerbate its effects and consequences.

Anger

One of the most predominant behavioral expressions of anxiety for men is anger. Like each of our respective emotions, anger surfaces when we face a perceived or actual threat to our well-being, which includes our sense of self and our view of fairness or morality. Anger is experienced in a variety of states and intensities, ranging from simple annoyance to frustration, exasperation, argumentativeness, bitterness, vengefulness, and fury.

Because of early-learned masculine constructs, anger is considered a socially accepted method for men to manage emotions such as fear and discomfort. For some, anger creates the perception of being in control, particularly when they feel helpless or hopeless, which evokes deep emotions such as vulnerability or fear.

Men who experience anger often report intense emotional flooding, accompanied by other physical symptoms such as an increased heartbeat, sweating, flushing (sudden reddening of the face, neck, or upper chest due to increased blood flow), and the sensation that their anger seems difficult to control or regulate. This becomes an issue when anger is frequent or expressed through verbal outbursts and/or physical aggression or violence.

Irritability

Irritability is considered a relative to anger. It is a frequent component of a number of mental health disorders and is particularly associated with generalized anxiety. With irritability, even minor things can evoke annoyance and agitation. When irritation persists over a prolonged period, the tension can lead to a greater sensitivity to stressful situations.

Men often report experiencing the physical symptoms of irritability as increased sensations of heat, tension, or restlessness, as well as a change in mental processes, often accompanied by an inability to cope or concentrate. Those close to men who struggle with persistent irritability will often describe these men as being grouchy, impatient, agitated, or argumentative.

Depression

Depression is a common mood disorder characterized by a persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. Also referred to as major depressive disorder or clinical depression, it affects how someone thinks, feels, and behaves and can lead to various emotional and physical problems.

Depression is usually accompanied by behavioral and physical symptoms, which may include changes in sleeping habits, appetite and weight, energy level, concentration, daily behavior, or self-esteem.

While the underlying cause of depression is still unknown, some consider anxiety and depression to be more closely related than is often medically recognized. It’s easy to see how anxiety, left untreated, can evolve into a depressed state or full-blown depression.

If you can relate, know that there is always hope. You don’t have to give in to anxiety and depression—there are surefire ways to address them both. By working through this book, you can learn to manage your anxiety to alleviate depression.

Developing Awareness

Developing an awareness of your own anxiety experience is a vital first step toward finding calmness and clarity. By completing this workbook, you can quickly become a master of this highly important skill.

Take a moment to reflect on your experience using the following questions.

•What happens to me physically when I experience anxiety?

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•What happens to me emotionally when I experience anxiety?

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•What do I find myself doing (my actions) or wanting to do when I experience anxiety?

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•What thoughts do I have when I experience anxiety?

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