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The Subtle Signs You Have High-Functioning Anxiety
MY LIFE IS a dichotomy, in that I've spent years in tae kwon do, love football and rodeos, but have an affinity for frozen yogurt and watching Netflix with a good cabernet and wood wick candles next to my cats, Thelma and Louise. I attribute my temperament to genes and California hippy tap water.
The origins of personal traits, to include anxiety, can be biological, environmental, or inadvertently "seed-planted" by anxious parents. Male anxiety (a.K.A., "manxiety") is clinically contagious if you're around it long enough. My dad, a manly victim of indecisiveness, often had me second-guessing my own life choices, or not making one at all. To this day, I'm often paralyzed by an Applebee's lunch menu or a yellow traffic light.
Men are stalwarts of resolve with an uncanny ability to chug beer, char meat, and kill one another. We recognize that our cars and lawn mowers need tune-ups and diagnostic tests, but we rarely wash our feet in the shower, let alone visit a physician for our own check-ups—especially for anything regarding the brain. And when we don't prioritize our own well-being, neither do others. If you're a man with anxiety, however, the norms become skewed and irrational.
I grew-up a hypochondriac certain that every pain, rash, bump, or twitch was something malignant or terminal. I visited the hospital countless times per year while spending the equivalent of a Range Rover full of backup dancers on annual copays. What I thought was testicular cancer was an inguinal hernia from doing deadlifts. What I was certain was genital herpes was an ingrown hair. What I feared was Lyme disease was an allergic reaction to grass. And what I accepted as a heart attack turned out to be…anxiety.
Only twice did I not go to a hospital when I should have. The first was at 18 while suffering intense chest pains and labored breathing because I had unknowingly collapsed a lung. In my defense, I thought it was heartburn. The second was when I intermittently peed blood over a 10-month stint. A rational man would interpret hematuria as the ultimate motivation for a hospital visit. But the only thing worse than my fear of potential hospice was the anxiety of a pending cystoscopy.
Consequently, I settled on platinum-level denial until I landed in surgery and chemo. Ignorance is a prickly muse. With chronic male anxiety, it's torturous to determine what warrants an ER visit versus antacids. And when it came to my mental health, I handled it like most men: denial, distraction, and drugs. In that order.
"Men are MUCH MORE STIGMATIZED by any admission of a psychiatric illness and are much LESS LIKELY TO SEEK TREATMENT."
Most men with anxiety have no idea what's wrong with them—like Bill Bixby in The Hulk, they just feel "off." Denial and distraction are why so many men walk around as functioning alcoholics or addicts. In the absence of knowing any better or a willingness to seek help regarding male anxiety, we plug the holes however we can. But if you treated any other ailment by ignoring or avoiding it, the outcome would be similarly grim. You can ignore asthma and diabetes for a while too. But every disorder has its dues.
Since anxiety, depression, and all disorders of the mind are still largely stigmatized among men, my first coping tactic was denial, lest I appeared weak and vulnerable among my peers. "While some may consider this a stereotype—that men do not seek help for mental health issues—it is statistically correct…men are much more stigmatized by any admission of a psychiatric illness and are much less likely to seek treatment," says Sammie LaMont Moss, M.D., a psychiatrist at Kaiser Permanente in Denver.
This is particularly troublesome as depression and anxiety in men are more likely to manifest in substance abuse and suicidal behavior. "We often see in the clinical setting that an attempt to address anxiety can manifest in different ways. For example, men will turn to substances like alcohol or cannabis for some immediate relief, which can cause long-term, harmful effects," says Moss.
I'M AN EXCEPTIONALLY kind and empathetic guy, but anxiety makes me irritable and angry. If I'm forced to socially interact or deal with a rude stranger, I become a chupacabra with a flashpoint of WD-40. I expend great effort trying to determine when I'm feeling anxious before it defaults to a felony persona. But distinguishing between anxiety and irritability requires Maharajah-level introspection.
"Due to the social pressure that men experience based on the unwritten rule that men are to be strong and in control at all times, anxiety is not easily identifiable in men, even if that man's anxiety has reached overwhelming levels" says San Diego psychologist Bruce Thiessen, Ph.D. "Many of the symptoms may express somatically, in the form of medical problems or conditions, such as ulcers, back pain, hypertension, and the like," he says.
Dustin Siegel, Psy.D., a Chicago-based clinical psychologist and founder of the LEAP Center for Anxiety, agrees. "A lot of men have been told their whole lives to 'man up' or 'be tough.' It's hard for many men to talk to someone else about their vulnerabilities, and one of the paradoxical truths about mental health is that the more a person—male or female—tries to bottle-up their feelings, the more likely they are to develop a problem."
If I simply ignored my feelings of angst, I could pretend anxiety didn't exist for me. But denial wasn't designed nor intended to work long term. And when denying anxiety exacerbated problems, I turned to distraction. Distraction is an effective but equally short-term, noncurative technique in countering stress or discomfort, in that it avoids addressing the core issue.
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How Does Chronic Anxiety for Men Differ in Anxiety for Women?"THE MOST OBVIOUS signs of male anxiety are the physical ones," says Lindsay Israel, M.D., psychiatrist and chief medical officer at Success TMS. "Men might find themselves going to the emergency room or their primary care provider with complaints of chest pain, fearful they are having a heart attack," adds Dr. Israel. As men, we need to save our hearts for red meat and breakups.
Though anxiety is an equal opportunist, Dr. Israel shares that "women are twice as likely to develop an anxiety disorder as compared to men, and women are more likely to seek help for their anxiety symptoms. Therefore, men are more likely to develop severe symptoms of anxiety and possibly develop an additional depressive disorder due to the lack of treatment intervention."
Thiessen confirms this assertion adding that, "men are also more likely to become aggressive, and to develop problems in their relationships, due to dysfunctional ways of expressing their anxiety. Many men turn to drugs, alcohol, gambling, and personally destructive sexual addictions to relieve chronic stress through escape," says Thiessen.
In my case, I wielded distraction like artillery over my physical well-being. I over-trained in the gym, over-ran the trails, and over-swam in the lap pool. But I also over-imbibed alcohol. Drinking to distract is a futile endeavor. I would later harm-reduce to cannabis edibles, tinctures, and vapes. And on a few occasions, I casually overdid those too. Overdosing on THC edibles leads to a nauseous, frenzied panic that is ruefully memorable, with a hangover that rivals what you'd experience if you sniffed kerosene.
So, What to Do With All This Male Anxiety?MEN ARE FIXERS. We often try to fix things and people that aren't broke. It's important to note that acute anxiety that prompts us to do our taxes or flee a K-pop mob is healthy. Once it becomes long term or chronic, however, it's detrimental to one's physical and mental health.
"One of the best ways for a man to become comfortable with accepting that he has a mental health issue is to speak to other people," says Moss. "Quite often a man will be surprised to learn how many other people are suffering similar difficulties. Finding out that you are not alone can go a long way to help normalize what you're experiencing," adds Moss. Anxiety doesn't always love company, but it loves perspective.
Thiessen upholds this tenet. "Men need to feel accepted, and not judged, for showing both strength and weakness. Society might judge them; mental health providers will not," he says. In almost every instance where I've revealed my anxiety struggles to another man, he has replied in commiseration with his own. It's clearly indicative of the ratio and cross section of men silently suffering from anxiety.
You Don't Need a Panic Room; You Need a Panic PlanTHERE ARE SIMPLE and clinically effective things men can do to lower their anxiety:
More than just the "greatest hits" to contest male anxiety, this is my own triage to maintaining a career, relationships, and a life largely unfettered by the cerebral minesweeper of anxiety. Because there's no place like "om."
This article originally appeared in our Men's Health Aging Guide.
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Related StoriesThe Causes Of Anxiety
The true cause of anxiety is being a human being, gifted with the capacity to imagine a future. As a mental state of apprehension about what might, or might not, lie ahead, anxiety reflects uncertainty about future circumstances, whether regarding one's own health, job, or love life, or climate change or a downturn in the economy. It can be triggered by events in the real world—an upcoming doctor's visit, relationship conflict, a rent increase—or generated wholly internally, through thoughts of real or imagined threats (not knowing what to say when the boss calls on you in a meeting).
Occasional bouts of anxiety are entirely normal and one of the unavoidable costs of being alive; anxiety alerts us to danger, compels our attention, and urges us to make necessary preparations to protect ourselves. But sometimes worries intensify or persist, endlessly caroming through the brain without engaging problem-solving mechanisms, or overwhelming them, and impairing the ability to function. Many factors can contribute to prolonged rumination—worry, the cognitive component of anxiety— over uncertain outcomes.
Anxiety Triggers: 11 Common Causes Of Anxiety
Many factors, like financial concerns or dealing with conflict, can trigger anxiety symptoms. Being aware of the cause can help you cope with stressors and manage your anxiety.
Anxiety can cause feelings of worry, fear, or tension. For some people, anxiety can also cause panic attacks and physical symptoms, like chest pain or shortness of breath.
What causes anxiety and anxiety disorders can be complicated. It's likely that a combination of factors, including genetics and environmental reasons, play a role.
But it's clear that some events, emotions, or experiences may trigger symptoms of anxiety to begin or may make them worse. These are called triggers.
Keep reading to learn about these anxiety triggers and what you can do to manage your anxiety.
Identifying your triggers is an important step in managing them. Anxiety triggers can be different for each person, but many are common among people who experience anxiety.
1. Health issues
A health diagnosis that's upsetting or difficult, such as cancer or a chronic illness, may cause or worsen symptoms of anxiety. This is a powerful trigger because of the immediate and personal feelings it produces.
You can help reduce anxiety caused by health issues by being proactive and engaging with a doctor. Talking with a therapist may also be useful, as they can help you learn to cope with your emotions around your diagnosis.
2. Medications
Certain prescription and over-the-counter (OTC) medications may trigger anxiety. That's because active ingredients in these medications may have side effects that cause your body to respond with certain symptoms of anxiety.
Those feelings can set off a series of events in your mind and body that may lead to even more anxiety symptoms.
Medications that could cause anxiety include:
Talk with a doctor about how these medications make you feel. They can help you find alternative options that may not lead to symptoms of anxiety.
3. Caffeine
Many people rely on their morning cup of joe to wake up, but it might actually trigger or worsen anxiety.
In a 2020 study involving 429 20-year-old adults over a 2-year period, consuming energy drinks increased anxiety in males but not in females.
4. Skipping meals
When you don't eat, your blood sugar may drop. This can lead to shaky hands and a rumbling tummy.
Eating balanced meals is important for many reasons. Nutritious foods provide you with energy and important nutrients. Plus, they keep those hands from shaking.
If you can't make time for three meals a day, healthy snacks are a great way to prevent:
5. Negative thinking
Your mind can impact how your body feels, and that's certainly true with anxiety. When you're upset or frustrated, the words you say to yourself can trigger greater feelings of anxiety.
If you tend to use a lot of negative words when thinking about yourself, you can learn to refocus your language and feelings when you start down this path. Working with a therapist can be incredibly helpful.
6. Financial concerns
Learning to manage these types of triggers may require seeking professional help, such as from a financial advisor. When you feel like you have a companion or guide in the process, it can ease some of your concerns.
7. Parties or social events
If a room full of strangers doesn't sound like fun, you're not alone.
Events that require you to make small talk or interact with people you don't know can trigger feelings of anxiety, which could be a symptom of social anxiety disorder.
When possible, bring along a companion to help ease your worries or unease. But it's also important to work with a professional to find coping mechanisms that make these events more manageable in the long term.
8. Conflict
Relationship problems, arguments, disagreements — these conflicts can all trigger or worsen anxiety. If conflict particularly triggers you, you may need to learn conflict resolution strategies.
Consider talking with a mental health professional to learn how to manage the feelings these conflicts cause. If you're in conflict with a friend or partner, you may be able to go to a counselor together.
9. Stress
Daily stressors like traffic jams or missing your train can trigger symptoms of anxiety. Long-term or chronic stress can even contribute to a person developing an anxiety disorder or worsening symptoms.
Stress can also lead to behaviors which may trigger or worsen symptoms of anxiety like:
Treating and preventing stress often requires learning coping mechanisms. A therapist or counselor can help you learn to recognize your sources of stress and handle them when they become overwhelming or problematic.
10. Public events or performances
Common triggers of anxiety include:
If your job or hobbies require this, a doctor or therapist can work with you to explore ways to be more comfortable in these settings.
Also, positive reinforcements from friends and colleagues can help you feel more comfortable and confident.
11. Personal triggers
These triggers may be difficult to identify, but a mental health specialist is trained to help you identify them. These may begin with a smell, a place, or even a song. Personal triggers remind you — either consciously or unconsciously — of a bad memory or traumatic event in your life.
Identifying personal triggers may take time, but it's important so you can learn to overcome them.
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