We need to talk about anxiety in men

Do you think we need to talk about anxiety in men?

Are you about to explode? You may suffer from anxiety.
Anxiety in men is real — Image from Irishtimes.com

An article by Madeline R. Vann, MPH caught my eye recently. She wrote: “Anxiety disorder in men is real and treatable through therapy and medication.” She’d written about a young man who, although aware he’d had anxiety since childhood, he never actually tackled it until well into his twenties. I just thought, what a long time to suffer. This, and the fact that it’s Men’s Mental Health Week, is why I think we need to talk about anxiety in men.

So what is anxiety?

Are you aware of the effect stress has on your body, mind and spirit?
What do you know about anxiety?

Anxiety is a type of fear usually associated with the thought of a threat or something going wrong in the future, but can also arise from something happening right now.

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe, according to the NHS. Everyone has feelings of anxiety at some point in their life. For example, you may feel anxious about sitting an exam or a job interview. During times like these, feeling anxious can be perfectly normal but some people find it harder to control their anxieties. Their anxiety is more constant and can often affect their daily lives.

Anxiety is a feeling that lets us know when we might be in danger, at risk or under threat. However, anxiety disorders occur when our fears and perceptions of danger are greater than they need to be.

The following information from the NHS is about one specific condition called generalised anxiety disorder (GAD). GAD is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event. People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue.

Symptoms of generalised anxiety disorder (GAD) in men

GAD can cause both psychological and physical symptoms. These can also occur in other anxiety disorders but for brevity, we’ll just talk about GAD. These symptoms vary from person to person, but can include:

This guy is about to have a nervous breakdown
Symptoms of generalised anxiety disorder
  • feeling restless or worried
  • having lots of negative thoughts, feeling guilty, angry or shame
  • having trouble concentrating or sleeping
  • dizziness or heart palpitations
  • feeling like you’re having a heart attack – if you suspect heart attack, seek urgent help
  • sweating, sticky palms
  • shaking
  • fidgeting or pacing
  • feeling faint
  • feeling like you can’t breather, choking
  • fingers or toes tingling (this happens when the blood runs from your extremities to your heart and muscles, where it’s needed to prepare for fight or flight

What causes anxiety disorder in men?

The jury’s out on this one. The exact cause is not fully understood, tho’ it’s likely that a combination of several factors plays a role. Research has suggested that these may include:

When stressed out your brain activity increases
Does over-activity in the brain cause anxiety
  • over-activity in areas of the brain involved in emotions and behaviour
  • an imbalance of the brain chemicals serotonin and noradrenaline, which are involved in the control and regulation of mood
  • hereditary – you’re more likely to develop an anxiety disorder if you have a close blood relative with the condition
  • having a history of stressful or traumatic experiences, such as domestic violence, child abuse or bullying
  • a painful long-term health condition, such as arthritis
  • having a history of drug or alcohol abuse
  • but many people develop anxiety disorders for no apparent reason.

Who is affected by anxiety?

Absolutely anyone. You might’ve noticed someone constantly drumming their fingers or tapping their foot annoyingly? Maybe you’ve seen that irritating colleague who constantly fidgets during meetings or spits out the nails she’s chewed for the last half hour?

Anxiety in me

Swimming helps reduce anxiety in men
Anxiety in men — image by featurepics.com

I’ve experienced mental health problems, including anxiety and I know how horrendous it feels (you can read it here). The dread when going to watch my sons swimming because of the steep seating area. I hated all those stairs looking over the pool and had a terrible fear of tumbling down them all. I’d start to sweat in fear, and my heart would be pounding through my heart and in my ears. It was the same in the cinema, those damn stairs, and in the dark!

Tube stations soon became a problem too, the further down the escalator went, the more anxious I got. (Hence my love of driving and the famous London black taxis.)

Vicious circle of stress and anxiety
Vicious circle of anxiety

See, the thing with an anxiety disorder is that once you’ve had a panic attack, you get anxious about being anxious. You only have to think about, let’s say, the tube station, and your anxiety levels shoot through the roof. And then it becomes a vicious circle of thoughts, feelings, behaviours.

Take a look at the diagram. You might have the thought “I’m dreading the tube station,” and you begin to feel anxious, so you avoid the tube (behaviour). After this, you might think “I’m so weak,” and feel sad, alone, angry…….. and so on…….

Anxiety in men close to home

Black belt anxiety management
Black belts can have anxiety – Image by jahir-martinez-unsplash

My two adult sons experienced anxiety and panic attacks in the past. They’re both black belts in Karate, they’re club swimmers and play football each week.

So, although they both claim to be geeky in a science-type way, they’re not weedy or wussie; nor do they come across as lads who’d have anxiety.

Some family and friends have been shocked, like “Wow, I didn’t think they’d have mental health problems.” and “Never? I’m really surprised.”

Several younger male family members were encouraged by this and sought support themselves, with some having gone into talking therapy. They’ve all said they’re so glad they did.

So, what I’m really saying here guys is, it doesn’t mean you’re a weak person, anyone can experience anxiety. It doesn’t care where you’re from, what class, faith, creed, race, gender you belong to or what job you do.

Anxiety statistics

Biting nails can be a sign of anxiety
The anxious and pacing nail biter
  • In 2013, there were 8.2 million cases of anxiety in the UK.
  • In England women are almost twice as likely to be diagnosed with anxiety disorders as men.
  • the condition is more common in people from the ages of 35 to 59.
  • 5.9% of people suffer with a generalised anxiety disorder.
  • mixed anxiety & depression is the most common mental disorder in Britain, with 7.8% of people meeting criteria for diagnosis.
  • 7.2% of people aged 5 – 19 have been diagnosed with an anxiety disorder
  • In 2017 13.1% of people aged 17 – 19 had an anxiety disorder

As you’ll have noticed, anxiety and depression are closely linked so if you have one, you’re more likely to be experiencing the other. You might also find that some form of agoraphobia, a fear of doing certain things, or going to certain places quite often occurs with anxiety.

How is anxiety disorder treated in men?

Anxiety disorders can have a significant effect on your daily life, but several different treatments are available that can ease your symptoms. These include:

Colour image of scrabble saying recovery
Recovery from anxiety — image from Psychcentral.com

With treatment, many people are able to control their anxiety levels and lead normal lives. But some treatments may need to be continued for a long time and there may be periods when your symptoms worsen.

Self help for generalised anxiety disorder (GAD)

Regular exercise can keep anxiety at a distance
Exercise for anxiety – Image by Pexels at Pixabay.com

There are also many things you can do yourself to help reduce your anxiety, such as: 

  • reading a previous post 19 free mental health apps just for you here
  • or Tips to help with your anxiety and panic attacks here
  • attending a self-help course in person or online
  • exercising regularly
  • stopping smoking
  • cutting down on the amount of alcohol and caffeine you drink
  • trying 1 of the mental health apps and tools in the NHS Apps Library

Over to you

What do you think?
Clipart.com

When it comes to talking about mental health problems, do you think it’s necessary to separate the men from the women? Or should we just be inclusive and talk about mental illness as a whole? What about the men; should they just man up? I look forward to your thoughts and comments, and of course, I’ll answer any questions.

Related: A look at mental health during men’s health week (1). 8 symptoms of anxiety in men (2). Men and anxiety (3).

What on earth is smiling depression?

I’ve heard it called many things, but “Smiling Depression”? Come on, it can’t be real. Or can it?

Have you ever heard of smiling depression?

Coloured female with psychotic depression smiling at the psychiatrist
Is this smiling depression? Image by Unsplash.com

No, me neither. I came across it while researching for a completely unrelated post. I was actually trying to find the words to describe a mental health professional’s fake smile. However, the more I read about smiling depression, the more it resonated with me, and I thought it might interest you.

What about the lady in the picture (right)? Is this a real smile or is it covering something else? Would you be able to tell the difference?

I remember several occasions, being depressed and so angry with my now ex, and having to put a bright face on for my sons’ birthday parties. Once the soggy streamers were binned, the guests had gone on their merry way and the boys were comatose, my mood immediately plummeted down to my little size three’s. I bet most of you have had something like this occur?

Depressive Disorders

The most common and typical form of depression is the depressive episode, but there are other subtypes of major depressive disorder. When the depressive episode recurs we speak of recurrent depressive disorder. Then there is Dysthymia which is characterized by milder severity of depressive symptomatology compared to depressive episodes or recurrent depressive disorder. We have manic depressive disorder, atypical depression and psychotic depression, and last but not least seasonal affective disorder. And then, of course, there is smiling depression.

Think about someone with depression for a few moments

Typical example of seasonal depression. Crying and blowing nose.
Sad and crying —Image by dlpng.com

Did you imagine someone who always looks miserable, down or sad? Someone who’s sat in their pj’s, wrapped in a duvet, crying on the sofa all day? Someone who can’t be bothered to attend to their hygiene needs or their scraggy bed hair? You might have thought any of that.

However, and unfortunately, some people with what’s known as smiling depression don’t have those obvious symptoms of depression. They often come across as happy, upbeat, and look cheerful or even on top of the world, on the outside. Yet, they might feel dreadful, like they’re just treading water, sad, hopeless or worthless on the inside.

So, what is smiling depression?

Severely depressed subject hides face behind cardboard while struggling with feelings of sadness.
Struggling with sadness Image by Pixabay.com

According to Medical News Today, smiling depression is a term doctors use to describe when a person masks their depression behind a smile.

While smiling depression isn’t a technical term that psychologists use, it’s definitely possible to be depressed and to successfully mask your symptoms. Also, though it’s not a clinical diagnosis, trust me, smiling depression is real. Surprisingly, it affects more people than you might think.

Likewise, people living with smiling depression are in all probability, perfectionists, high achievers and very successful. Their mood is likely to worsen considerably if they don’t meet their own impossibly high standards.

What are the risks of having smiling depression?

.Despite the worldwide prevalence of mental ill health, it’s still really difficult for some people to open up and ask for help. Furthermore, current research shows that harmful stereotypes about mental illness often prevent people from seeking treatment or speaking out at all (Olivia Singh, Insider, 2020).

Sadly, these people who can’t or don’t talk about their feelings might be more vulnerable to suicidal ideation. And because spotting the signs of smiling depression isn’t easy, it can be missed.

People with a major depression sometimes feel suicidal but many don’t have the energy to act on these thoughts. But someone with smiling depression might have the energy and motivation to follow through (T.J. Legg, Insider, 2018)

Who might have smiling depression?

Quote saying Sometimes the prettiest smiles hide the deepest secrets
Quote of the day

Absolutely anyone! It could be someone you know who, when you greet them, they smile brightly and engage in conversation.

It might be a family member who when you call, they sound chipper and tell you everything’s going well. How about that annoying colleague who’s always, always cheerful, who brings in homemade goodies for everyone and tells you how wonderful life is?

Despite how they appear or sound, you might want to watch and listen just that little bit closer. You could notice that the lips smile but there are no creases around the eyes, or that their smile fades too quickly. Maybe their body is tense or their shoulders are up round their ears. And you could get the “Oh, yes, I’m fine.” with a great big hearty grin but would you be smiling if you just felt fine?

Someone with smiling depression might sound ecstatic but does it sound over the top, cos we quite often overcompensate for feeling down by trying too hard? Listen for the heavy huff or puff at the end of their sentences which may be incongruent with their cheerful quips. Pay attention if they’re less interested in spending time together or they don’t communicate as much as they used to, despite what they tell you.

Do I have smiling depression?

Alcoholism is a common mental illness among subjects with chronic depression
Image by mgg-vitchakorn at Unsplash.com

It’s possible? Only yesterday we were visiting friends for a bbq and all morning I felt absolutely awful, almost to the point of cancelling. Even throughout the drive there I was having suicidal ideation.

Yet as soon as I walked in the door and saw my friends I was all smiles and hugs (okay, I get the social distancing thing). The afternoon was terrific, with scintillating conversation, food that was amazingly different and cold sparkling wine to wash it all down with.

Then crash, and without warning, my mood nosedived. I felt it immediately I put my first foot out the door, amidst the goodbyes and more hugs. Then I cried silent tear all the way home and I remain low, tearful and hopeless today as I type. I know this particular bout of my persistent depressive disorder is situational and reactive so hopefully it will pass, soon.

Final thoughts

I know that we can’t all be happy every minute of every day, it’s almost impossible, but it’s certainly not normal to feel blue or sad all the time either. It feels excruciatingly exhausting and it’s where I am right now. It’s taken around seven hours to write this post, reread and edit lol.

Over to you

Large red question mark with white character of a man leaning against it
Clipart.com

What do you think about the term smiling depression. Is it just another elaborate term dreamt up by our silver-spooned or pretentious psychologists? Do you think maybe you or someone you know is experiencing smiling depression? I look forward to reading your comments and will answer any questions.

You might want to read about depression, 10 thinking errors of depression here. Or a guest post about a fellow blogger’s depression and anxiety here.

Related: Data-driven subtypes of major depressive disorder (1). The dangers of smiling depression (2). Let’s talk depression (3).

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