Anxiety disorders are among the most common mental health conditions worldwide. While they tend to affect women more than men, men are still widely affected. Due to differing social and biological factors, men’s experiences of anxiety, from coping styles to treatment-seeking behaviors, differ from those of women.
Anxiety disorders are characterized by excessive fear and worry, and behavioral disturbances. They include:
In 2019, 301 million people around the world were living with an anxiety disorder, including 58 million children and adolescents. Estimates suggest that females are more affected than men; 23.4% of females have anxiety in a given year in the United States, and the same is true for 14.3% of males.
While common in men, anxiety disorders have largely been overlooked in men’s mental health literature, meaning there is little high-quality research on the subject.
Medical News Today spoke with four experts in mental health on topics ranging from how anxiety expresses differently in men and women, to how men seek treatment, and what could improve the way they think about the condition and seek support.
A 2021 review of 25 studies investigating anxiety among men found that symptoms of anxiety differ between men and women.
The researchers found that men report increased anxiety severity and are more likely to report physical symptoms such as headache, loss of appetite, and body tremors, alongside sensations of losing control when compared to women of the same age.
They also found that anxiety among men tends to center on feelings of a lack of control and the perception of “being a failure” if unable to regain control of anxious states. Men also often depict their symptoms as “enduring, ever-present and sometimes life-long.”
While mild anxiety has been linked to better cognitive performance, severe anxiety has been linked to reduced cognitive function. Other research suggests that anxiety disorders are linked to a lower quality of life and reduced social functioning.
Research has sometimes found differences in the emotion regulation strategies of men and women. Thus, it suggests that some men may tend to revert to problem-based coping more often, while some women might opt for more avoidant coping strategies, such as seeking emotional support.
Although problem-based coping strategies may be effective in situations that are controllable or adjustable, they may fall apart if these conditions are not met. At this point, men are more likely than women to “self-medicate” as a form of avoidance behavior.
“Often men may use alcohol, tobacco, and other non-prescription and prescription drugs to reduce or control the experience and symptoms of anxiety,” Dr. Derek M. Griffith, founder and director of the Center for Men’s Health Equity, and professor of health systems administration and oncology at Georgetown University told MNT.
“Men may imagine the worst possible scenario and reason that it is wiser for them to avoid a situation because that scenario may be possible,” he added.
When asked why men may utilize problem-based coping more than women, Dr. Thomas Fergus, associate professor in the Department of Psychology and Neuroscience at Baylor University, told MNT that the way boys and girls are taught to manage emotional states may play a role in coping styles.
He noted that women are generally socialized to focus on emotional states more frequently than men and that men are more socialized to focus on problem-solving and gaining control over their negative emotions.
“Men are less likely to access treatments for anxiety through the typical medical pathways and less likely to seek initial treatment,” said Lee Chambers, psychologist and well-being consultant in conversation with MNT.
“Stereotypically masculine traits play a role in lowering the chance of a man expressing their challenges, seeking further support, and staying connected to the treatment provided,” he added.
One study found that reluctance of young men towards seeking help for anxiety stems from confidentiality concerns, perceived stigma, judgment by self and peers, and the assumption that it will not help.
The same study also found that young men report a lack of understanding of anxiety disorders, which translated into limited awareness of treatment and health-seeking options.
Dr. Griffith said:
“Only in recent decades have men’s low rates of seeking medical help been seen as a problem. Historically, men’s rates of help-seeking were considered to be the norm, and women were thought to be overusing services. While not unique to anxiety, men are more likely than women to delay help-seeking and put up with minor symptoms fearing wasting the doctor’s time or failing as men.”
“Part of the challenge of understanding how men think about anxiety and other aspects of mental or physical health. For many men, anxiety is something they would seek help for only when it hinders their work performance or their ability to fulfill other roles and responsibilities. Even then, it is not uncommon for men to view anxiety as something they just have to deal with rather than something that is treatable by a professional,” he added.
Encouraging men to seek treatment
“From a proactive standpoint, men can look to foster emotional resilience by working to communicate and express emotions healthily, manage their stress levels, and improve their self-esteem,” said Chambers.
“Developing healthy relationships gives more space to express, and focusing on the fundamentals of eating well, sleeping optimally, and moving their bodies can provide the emotional balance to increase self-care and compassion,” he continued.
Dr. Danielle Cooper, assistant professor of clinical psychiatry at the University of Pennsylvania, told MNT that working to remove the stigma around mental health could help more men seek treatment.
“Given some existing stigma surrounding mental health, some people may be holding on to unhelpful beliefs that asking for help or having anxiety is weak or believe psychotherapy won’t be helpful,” she noted.
“People may benefit from learning that anxiety itself is adaptive and can be helpful, such as to enhance performance or motivate behavior. When anxiety becomes less helpful and more interfering, seeking treatment is important. Anxiety disorders are often maintained, in part, by avoidance. It takes a lot of strength and courage to face fears, not weakness.”
– Dr. Danielle Cooper
Chambers agreed that removing the stigma around mental health is crucial: “More men are speaking openly about anxiety in society and sharing their stories, and this can so often be a flag in the sand for other men to step forward and be honest about their current feelings.”
“Seeing opening up as a brave step into the strength of being vulnerable is at the heart of projects across the globe, and there is more strength in sharing than we often realize,” he concluded.