help for anxiety

Male Anxiety (“Manxiety”): The Lesser Known of the Anxiety Genders

Despite driving a pickup and owning steel-toed boots, I’m not a “man’s man.” I don’t look or sound tough, and I feel awkward at Home Depot. I own a gun, but it’s for caulking bathrooms. My life is a dichotomy in that I’ve spent years in Taekwondo, love football and rodeos, but have an affinity for frozen yogurt and watching Netflix with merlot and soy vanilla candles next to my cats, Thelma & 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 (aka, “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 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 wellbeing, 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 visit the hospital countless times per year while spending the equivalent of a Range Rover 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 pee’d 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.

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 disorder 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 appear 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,” cites Sammie LaMont Moss, MD, 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.

How anxiety presents in men:

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 Aqua Net. I expend great effort trying to determine when I’m feeling anxious before it defaults to a felony persona. But distinguishing between anxiety and petulance 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 and singer/songwriter, Dr. Bruce Thiessen. “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.

Chicago-based clinical psychologist and founder of the LEAP Center for Anxiety, Dr. Dustin Siegel, 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. People’s secrets were always safe with me because I was never listening. Distraction is an effective but equally short-term, non-curative technique in countering stress or discomfort, in that it avoids addressing the core issue.

How does chronic anxiety for men differ in anxiety for women?

“The most obvious signs of male anxiety are the physical ones,” says Psychiatrist and Chief Medical Officer at Success TMS, Dr. Lindsay Israel. “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 Israel. As men, we need to save our hearts for red meat and breakups.

Though anxiety is an equal opportunist, 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.”

Dr. 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 wellbeing. 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 sativa edibles leads to a nauseous, frenzied panic that is ruefully memorable with a hangover that rivals 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 men 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 long way to help normalize what you’re experiencing,” adds Moss. Anxiety doesn’t always love company, but it loves perspective.

Thiessen upholds this tenant. “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 not that I only talk with guys at wine bars or waiting outside Zara stores at malls. Rather it’s indicative of the ratio and cross section of men silently suffering from anxiety.

You don’t need a panic room; you need a panic plan.

There are simple and clinically effective things men can do to lower their anxiety:

Talk to your primary care provider who could potentially prescribe medication or refer you to other specialists who can help. “This is also an area where group therapy, segregated by gender, may help – particularly for men who are stigmatized and think they’re being seen as weak or as a victim. Learning what other men experience can help break that stigma,” highlights Moss.
There are phone apps for anything from interpreting your cat’s meows, to fermenting mead in your man-shed, to treating your anxiety while preserving your privacy. Moss encourages his patients to leverage smart phone apps like Calm, myStrength, and Headspace. Digital therapeutics are a thing now.
Biofeedback, medications such as SSRIs, SNRIs, and in more recent years, neuromodulation such as TMS (transcranial magnetic stimulation) are all effective options of treatment for anxiety disorders. “Typically, it is not any one modality that targets these symptoms for a person, it is more often a combination of various modalities that gives the most optimal results,” says Israel.
Physical exercise is an exceptional way to relieve anxiety. “Exercise prevents an excessive buildup of cortisol in the body, while increasing levels of epinephrine and norepinephrine, neurotransmitters that modulate of anxiety, and regulate mood and emotion, yielding a sense of peace of mind,” cites Thiessen. Hakuna Masquata, fellow men. Moss suggests also integrating healthy lifestyle choices, nutritious eating, and limiting harmful substances like alcohol and cannabis.

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.”

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101 Ways to Conquer Teen Anxiety made it to the Best Panic Attack Books of All Time

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The Relationship Between Anxiety and Grief

It’s no surprise that levels of anxiety are surging right now. Repeated waves of COVID-19, and the lockdowns they bring in their wake, make this an incredibly difficult time for our mental health. There are many contributing factors to anxiety – with our lifestyle, environment, genetics, and even hormonal imbalances all having their part to play.

What’s not always acknowledged for its role in anxiety, however, is grief.

Discussions about grief tend to focus on the feelings of sadness, loss and desolation that can follow the death of a loved one. What they rarely touch upon is how anxiety and grief are intrinsically bound up with one another. Even someone who has previously enjoyed low-levels of anxiety can be hit with a sudden unexpected tsunami of worry as they come to terms with their loss. In fact, many grief counsellors suggest that anxiety should be included as one of the stages of grief that we all have to go through.

Why do anxiety and grief so often go hand in hand? There are many reasons behind this, of course, and it’s impossible to cover them all, but the following points are some of the most important.

Bereavement is the most stressful event we will ever experience. Anxiety is exacerbated by stressful life events. These can be any number of things, with both marriage and divorce scoring highly as a potential stressor. Beating them all on the Holmes-Rahe Life Stress Inventory is the death of a spouse, with the death of a close family member a little further behind.

The death of a loved one reminds us that we are mortal. When we lose someone we love, we’re reminded just how little control we have over our lives. We’re all going to die at some point, and this realisation hits particularly hard after our first significant bereavement. How we come to terms with the fact of our own mortality will play a key role in the future quality of our lives.

Credit: Sandy Millar

We fear more loss. As well as bringing our own mortality into focus, grief reminds us that we may lose other people who are close to us. If we lose one parent, we may then be excessively anxious about losing the other. Intense anxiety may make it difficult to enjoy what time we have left with those we love.

Trauma teaches us to be anxious. Traumatic events can lead to what’s known as classical conditioning. If the news of our loved one’s death came in a phone call, then every time the phone rings we may fear the worst.

We may be anxious about our ability to cope. How will we manage without our loved one? We may fear that we won’t be able to take care of the practical and emotional challenges that we may face now that we’re on our own. In a particularly challenging year like 2020, these worries become even more pressing.

Credit: Thomas Bormans

You fear the intensity of emotions that grief can bring. Grief is a deeply unpleasant state to be in, and it can be overwhelming. Going through it, however, is vital if we’re to move forward in life. Many people, particularly if it’s their first experience of grief, work hard to push it away and move on. This creates anxiety around their own emotional responses.

You begin to overestimate the risk of negative life events. Before a significant loss, you might have had a generally benevolent view of life. Bereavement, particularly when you’ve lost someone who was relatively young or who died in tragic circumstances, can radically unsettle that world view. You may now overcompensate by overestimating the risk of accidents, serious illness or early death, leading to increased levels of anxiety.

Grief, whenever it comes, is a complex and, to a degree, mysterious state. It’s unavoidable for most of us, and how we respond to it can determine the future course of our lives as the pain starts to heal. Understanding the role our anxiety plays can be a valuable part of the grieving process. It can help us to accept, then begin to move through the painful emotions we are experiencing.

Myths We Tell Ourselves and Others to Ease Suffering

We tell people in the throes of adversity silly things in attempts to placate their angst. We also bask ourselves in a litany of clichés during stressful times to counter emotional suffering. We post them to social media, or tape them to our fridge next to that “Live, Love, Laugh” trope and the grocery list.

It’s not that we mean to be trite – it’s that we often don’t know what else to do or say to offer support.

Classic standby platitudes include the following:

God will never give you more than you can handle.
God never actually said this. Just ask Moses or Job. But it sounds nice, while imparting just enough hope to accept that spilled $6 latte or another mass shooting.
What doesn’t kill you only makes you stronger.
Tons of stuff can make you weaker … just before killing you. Have you ever seen someone bleed out?
Pain is weakness leaving the body.
What a cute little absurdity. Excrement, sweat, and urea are weaknesses leaving the body. Pain can stick around indefinitely.
Opportunity often comes disguised as adversity.
Opportunity doesn’t think this far in advance. Maybe it’s just shy, or likes surprising us. Either way, opportunity and adversity are as discernible as love and hate, or Michael Jackson skin tones through the decades.
The Serenity Prayer.
Maybe this one helps, I don’t know. I can never remember the words.
We have nothing to fear by fear itself.
FDR married his fifth cousin … do his mantras have any credibility? Also, there are plenty of things to fear, like dating apps, light beer, or former child actors. His point is moot.
God helps those who help themselves.
I fell for this one too. Stand back, mere mortal – God doesn’t need our help.
In three words I can sum up everything I’ve learned about life. It goes on.
I’m a rabid fan of Robert Frost, but his death in 1963 negates this proverbial gem.

There’s a reason canned, verbal peps don’t work: They’re simply not true. Can you think of a single instance of personal suffering where you recited anything similar, and felt a change in your emotions or mindset? We aren’t The Little Engine that Could.

When my grandmother, Hazel, my mom, and I were all diagnosed with cancers within the same year, I was emotionally spent and, honestly, pissed-off at the cosmos … or whoever made-up that “God will never give you more than you can handle” puff-slogan.

The topper of that time, however, was that from all the night-grinding of my teeth from stress, I had bone loss and gum recession in my lower jaw, requiring a $2,000 gum surgery. Human cadaver forearm skin was grafted to the inside of my lower gumline, while using growth factor from my own blood to lessen the tissue rejection. This prevented me from cursing aloud at life for wronging me, as I risked the piece of dead arm flying from my mouth.

No enemy is worse than bad advice. – Sophocles

I can assure you that there were no cute motivational quips that could fix all that ailed me that year. Yet, friends would dispense asinine “pick-me-ups” while I fake smiled over gritted teeth and gums that weren’t mine.

Some of their trivial well-wishes included, “Just put one foot in front of the other;” “Tomorrow is a new day;” or “It’ll get better!” (the last person wasn’t even trying). The advice my friends gave me was as useless as the “ueue” in queue.

I knew they meant well, but had no offerings beyond the preceding hollow citations. And, I can’t blame them. I have a friend whom recently lost his mom to Covid in an ICU. I too struggled to placate his suffering with the right spoken Band-Aid.

It’s not that we don’t want to assuage the angst that we or someone we care about is feeling – it’s that doing so is a skill so few of us are trained to do.

**So, What Can You Do For Someone (or, Yourself) Who is Going Through a Tough Time?**

In absence of helping a friend sponge-bathe their infirmed parent, or donating your own arm skin for their mouth, there are simple but surprisingly helpful things you can do.

1. If it’s you going through a difficult time, radically accept what is happening to you. Radical acceptance doesn’t mean you have to agree with what’s happening or how you feel about it – but you accept it as it is, no matter how painful or inconvenient it is. C’est la vie. Whatever will be, will be. It is so, so it is. There is incredible freedom in merely accepting how things are.

2. Regularly check-in with yourself and your feelings. If you’re feeling irritable, for example, take tangible steps to lessen your angst. This might include taking regular long walks or working-out, watching a comedy, turning-off your phone and reading some Dave Barry or David Letterman, or doing some guided meditations from YouTube.

3. If it’s a friend hurting, simply ask them how they are doing. Then be present and listen. You don’t need to offer nuggets of life-altering advice. It’s actually best that you don’t. Just listen.

4. Ask how you can best support them during this trying time. If it’s you who is hurting, how can you be your own best advocate? Hint: regular sleep, healthy eating, and not self-isolating.

5. Be consistent. Don’t check-in once and fade to black. Check-in regularly, even if via text.

6. Lastly, avoid the trite prose fails we often default upon. And, the next time someone gives you useless advice, convince them that having another baby will save their relationship.

Is that a Pachyderm On Your Chest?

We Are the Unhappiest We’ve Been in 50 Years…

Many of us are one wobbly-wheeled grocery cart encounter away from arm-barring someone’s maskless, selfish face. Especially here in California, where heat, wildfires, high Covid rates, and a hyper-contentious looming election add further anxiety, anarchy, and possibly more monster truck rallies into our collective future.

Like you, I’m facing notable levels of grief and apathy – as indicated by my 2 am binge-watching of Cobra Kai, eating weed gummies, and hitting snooze until lunchtime. Then taking a nap around 4:00. I even lack the energy to thumb scroll and judge people on social media. I’m filled with a general malaise where I can’t focus on anything beyond licking a stamp or overeating.

With over a month of West Coast wildfires, leaving the house means chewing through the chowder thick, carcinogenic air. It has even crept into the house where I have to regularly rinse my eyes with cold water. There is no escape beyond driving hundreds of miles east. Which I’m too apathetic to do. I often find myself standing in a window searching for the glowing orange orb of a sun through the claustrophobic haze. When I find it, I stare too long.

With all the adverse events unfolding, I’ve traded the great outdoors for brief, masked interactions at Trader Joe’s or Petco. My hikes replaced by long, boring spin bike rides and carpet push-ups.

I’m hearing a common theme about not just a general malaise, but something more concerning: An overall feeling of hopelessness. It’s not normal for so many Americans to feel this anxious or depressed.

A third of Americans are now showing signs of clinical anxiety or depression.

For every 100 American adults, 34 show symptoms of anxiety, depression … or, both. The data is directly from a Census study titled, Measuring Household Experiences during the Coronavirus (COVID-19) Pandemic.

Here’s the drop-kicker: Deep within that 20-minute survey, savvy U.S. officials included four questions taken from a form used by physicians to screen patients for depression and anxiety. The responses provide an alarming view into the country’s mental health after months of distress, seclusion, unemployment, and doubt.

The Census Bureau finding supports the mounting evidence of an increasing mental health crisis among Americans. Sadly, experts say that without intervention, the nation will experience a rise in suicides, substance abuse and overdose deaths.

And, what is our government’s response to this looming mental health catastrophe? Zero f#cks given. When asked how they would follow-up with respondents to the Census Bureau survey, the CDC said in an emailed statement:

“It is not feasible, nor would it be appropriate, to provide any health advice to respondents on the basis of their responses.”

The government actually has a responsibility to address the problems revealed by the survey. “If you measure a problem, presumably it’s because you want to do something about it,” said Maria A. Oquendo, former president of the American Psychiatric Association (APA). Doctors don’t diagnose patients with cancer only to send them back into the asbestos mine.

So, why should you feel hopeful?

Go easy on yourself. It would be weird for you to not feel jacked-up over all that’s happening. Current events are heavy and creating an unavoidable wake of despair for the majority.

Sonja Lyubomirsky, psychology professor at the University of California, Riverside, says that re-imagining happiness is almost hard-wired into Americans’ DNA. “Human beings are remarkably resilient. There’s lots and lots of evidence that we adapt to everything. We move forward.”

Source the humor! It’s always there. As Erma Bombeck once said, “There is a thin line that separates laughter and pain, comedy and tragedy, humor and hurt.” It seems personally blasphemous to laugh at our current misfortunes. But sourcing the humor is precisely what we need to do in order to cope. When you are overwhelmed by tragic events, humor is a useful defense mechanism. Time may not enable us to laugh at everything. But, tragedies and humor go together like cashiers and plastic sneeze guards.

When facing adversity such as illness or even death, humor serves as a buffer. In fact, people who think about death are actually funnier. The notion is appropriately called Terror Management Theory. Studies suggest that humor functions as a natural and often effective means of down-regulating stressful or traumatic experiences

Humor is embedded in tragedy, pain and struggle in ways we cannot grasp. And possibly, humor is also what will save us in all this mess. If not, NASA said there’s a 1 in 240 chance that an asteroid the size of a small car will hit Earth the night before the election

**Anxiety Disclaimer: Don’t worry. Asteroids of this size burn-up in the atmosphere long before they hit our ground. This won’t be the thing that does us in.

There is No “New Normal” Because There Was Never a “Normal.”

If you were to ask the general public what specific outbreak might wreak mayhem within our lifetimes, you’d likely hear Flu, locusts, boils, frogs, politicians or something similar from social media prophetics or the Book of Revelations.

Even when news of another coronavirus hit, it was in a far away land impacting only “other peoples.” It would seem hyperbole that cruise ships would become the vector ferrying tiny, spiky, murder spheres to our own shores.

Our sole defense was keeping the potentially contagious temporarily adrift on floating petri dishes, while enjoying 24-hour buffets and sequined ABBA and NSYNC cover bands.

But we’d soon be worried over parents, grandparents, and ourselves as we came face-to-face with our vulnerability and the inter-connectedness of our Planet. Moreover, we realized that nothing was ever “under control” – an illusion we had believed and subscribed to for a generation. And we became angry at the thin veil through which life was sewn.

Didn’t Someone’s God assure us we’d never be given more than we can handle?

Actually, no. This guarantee isn’t in the Bible, Quran, Torah, Guru Granth Sahib, Vedas, Tripitaka, or Kojiki. It’s a motivational quip we like to keep next to those Live, Love, Laugh prints from Bed, Bath & Beyond.

The problem with living such a comfortable existence for so long, is the depth of the fall to a life of discomfort.

Thankfully, we’re buoyed by the frontline workers in healthcare, at nursing homes, behind badges, delivery personnel, pharmacists, grocery employees, and perhaps the most unexpected superheroes: undocumented agriculture workers – without whom we’d lose a vital tier of the food pyramid.

Mid 2020 has seen the indoctrination of millions of newcomers into the anxiety and depression clubs – the steep dues paid with inner chill and peace of mind. Though many of us (i.e., the anxious) have been mentally prepping for a lifetime, we too found ourselves ill-equipped for an epidemic. You can’t train for a contagion that exists only in one’s mind (another reason why worry is a useless endeavor). But suddenly it’s not so weird to clean an apple with a bleach wipe.

Find the humor, find the cure.

It’s always there. This might not be the best time to ponder Dostoyevsky’s Poor Folk or The House of the Dead – though I’m a huge proponent of the man otherwise. A pandemic calls for some light and cheery reading to facilitate levity and laughs. Consider anything from Dave Barry or Augustin Burroughs. And don’t overlook works by other great contributors like Erma Bombeck and Dorothy Parker.

Mark Twain knew it best: “The secret source of humor itself is not joy but sorrow.” Studies confirm that laughter lowers blood pressure and releases beta-endorphins, a chemical in the brain that creates a sense of joy. Moreover, humor is clinically validated to reduce stress long-term by improving the immune system through the release of neuropeptides, relieving pain, increasing personal satisfaction, and lessening depression and anxiety. The simple act of smiling causes the brain to release dopamine, which in turn makes us feel happy. But don’t worry about the science. Just YouTube “Sebastian Maniscalco” or “cat videos” and away you go.

Humor = Calamity + Time.

Humor will change your relationship to the problem of stress, worry, or anxiety. It reduces stigma, promotes wellbeing, helps you to cope with difficult situations, reduces tension, discomfort and stress; and strengthens your immune system. It’s pretty much a miracle elixir.

Austrian neurologist, psychiatrist and Holocaust survivor, Viktor Frankl, sourced and used humor as one tactic to survive German concentration camps, and he highlighted humor as ‘another of the soul’s weapons in the fight for self-preservation.’ “The attempt to develop a sense of humor and to see things in a humorous light is some kind of a trick learned while mastering the art of living,” cited Frankl.

Humor produces endorphins that soothe the body and allows a responsive brain to take charge – like a legal massage somewhere with no blacked-out windows.

There cannot be a “normal” in an unpredictable world. We use terms like “new normal” to instill an element of control over things. Control is an illusion.

But radically accepting the randomness of life, while staying mindful in the present is damn liberating. We don’t like to admit that we actually have little control over anything – especially our own fates – yet we do things that impact our longevity. You can now observe the rampant OCD taking place nearly everywhere by those not accustomed to proper OCD’ing. For example, shaking hands during Flu season (or otherwise) has always been an archaic practice in the transmission of filth. Have you seen what you do with your hands?! Despite lacking opposable thumbs, even dogs know that sniffing butts is a more hygienic “hello.”

And consider a University of Arizona study revealing that cellphones carry 10 times more bacteria than most toilet seats. Yet we don’t hesitate to pinch zoom a pic when someone hands us their toilet phone.

And, how many times have you eaten birthday cake blown on by someone you didn’t like or barely knew? Well, you might as well have them blow directly into your open mouth. A study in the Journal of Food Research determined that blowing out candles over that sweet, sticky icing resulted in 1,400% more bacteria compared to icing spared the puff (The study was aptly titled “Bacterial Transfer Associated with Blowing Out Candles on a Birthday Cake”).

Black-light most any hotel room and it will look like a Jackson Pollock painting.

Hotels will charge $250 for smoking in your room, but you can leave a bodily bio-hazard at no charge. This serves to heighten my perception of hotels as wildly filthy. And do you think the card keys ever get cleaned? I question the entire arrangement altogether. Most of us make that room as cozy as our own, in full denial that few people tip the maids upon checkout.

Hotels are where people go to cut their toenails, trim body hair, or bleed. The mattresses are literal smut sponges. But we gladly pay for the privilege of rubbing our faces into the pillows and bleach-infused towels.

Humor is ever present. You just gotta peek through the dank mental hues of your angst. Sourcing the lighter side of your emotions is vital – particularly when a third of Americans are now showing signs of clinical anxiety or depression.

Covid created a massive wake of anxiety and depression across the globe, along with budding terms like “immunity privileged” and “vaccine nationalism.”

Understandably, as most of us had not incurred a life disruption of this magnitude prior. During the initial stages of the pandemic, I spent most of my time hiding from humanity to avoid the contagion. My sole activity was sterilizing everything I ordered via Instacart and Amazon with disinfectant wipes. I wondered if anyone else was using hospital grade wipes on their organic lettuce.

There are a handful of things I’ve done to maintain internal peace and manage my anxiety during the quarantines and isolation. One of the most vital was distraction afforded by Netflix binges, naturally. But I also read a lot. At any given time during the pandemic, I’ve been concurrently reading five to six books depending on mood.

I also attend live or archived online church and devotional sessions to feel grounded. This is where I learned specific scriptures that also helped carry me through the salty times. Isaiah 41:10-13, Isaiah 53, Psalm 23, Psalm 40:1-3, Psalm 91, and particularly Philippians 4:6-8 were pivotal in smoothing the frays. Memorizing scripture is also a form of meditation. And it helps train the brain for other things – like remembering to brush your teeth or what day it is.

A good chunk of my Covid coping time was spent on building an in-home gym since my fitness center closed. This was exceptionally challenging as millions had the same idea, and every dumbbell, kettlebell, and old-school cement-filled, vinyl prison weight was sold-out everywhere.

Over weeks, I slowly accrued a Frankenstein gym of mismatched heavy things.

I converted my living room into a carpeted fitness studio where I performed calisthenic and plyometric feats of athleticism, such as 3,000 burpees and push-ups per month. I also fast-walked like a soccer mom late to A.A. 25 miles per week. Sadly, my ”nothing succeeds like excess” mindset and compromised shoulders reminded me why my body was made for writing in an ergonomic chair. I was soon too injured from one of the physical endeavors to do anything else, and I had to take two months off. But my anxiety did not.

Anxiety and depression can pique in the absence of coping skills. When we assign value or validity to intrusive thoughts and fears, it’s like mental Miracle-Gro. Talking to a therapist via phone or teletherapy is a measurably effective adjunct tool during stressful times.

There is a little-known dichotomy about mental health issues that makes seeking treatment difficult:

When you’re feeling anxious or depressed, it’s often hard to do what’s best for your welfare – this includes seeking help. My anxiety doesn’t want me to pay bills until I’m getting hate mail from creditors, fold laundry until I have no room on my bed to sleep, get groceries until I’m down to ramen and a jar of crusted mayo, or wash my car until stranger’s spell profanities on the windows.

There are two incidences when you should seek out a professional.

If you are in danger of hurting yourself or others, or if you are having passive thoughts about hurting yourself or others (even if you don’t have a plan or any real intent to follow through with these thoughts).
If your symptoms are starting to interfere with your daily life. Such symptoms could include suddenly not getting along with friends or family, difficulty with sleep, problems eating, doing poorly in school or work, or starting to use alcohol or drugs to cope or feel better.

How to choose a therapist

There are many different types of talk therapies available, and many types of therapists to choose from. So which therapy and therapist is right for you? When it comes to treating all mental health issues, especially anxiety or depression, you want to make sure you chose a therapist that uses an approach that is evidence based or empirically validated. This means that they say and do things to treat your symptoms that have been proven by research to be effective. It doesn’t mean watching episodes of Dr. Phil or Dr. Oz.

Client: “What should I do?”
Therapist: “What do you think you should do?”
Client: “Alright then, keep your secrets.”

When choosing a therapist, there’s an array of therapy degrees that include psychiatrists (M.D.), psychologists (PsyD.), and masters level therapists (LCSW, MCSW, etc.). Don’t get hung-up on the pedigree. Just make sure the person is licensed – meaning s/he went to a school that was accredited, received training that was accredited, and have passed both a national and state licensing examination to prove they know what they are talking about.

Equally important, you want to see someone that you like. If you’re going to see a therapist, the type of degree is less important than making sure they are licensed, using techniques that are supported by research, and are someone you can trust and get along with. I personally know some smart but ~~asshole~~ jerk psychologists that shouldn’t be advising anyone on anything, despite their diplomas. Remember who’s paying whom, and hire/fire accordingly.

How long will you need to attend therapy?

The duration of therapy needed is unique for everyone. Many people experience improvement within only a few sessions, while others reap benefits through months or even years of seeing a professional. There’s no commitment required. The goal is simply helping you achieve measurable improvement.

You can also access the “Managing Covid-19 Anxiety” resource page by the reputable Anxiety & Depression Association of America (ADAA).

Just come away from this knowing that you never need to white-knuckle things alone. Your state-of-mind can make it hard to reach-out, which is precisely when you should.

What to Do If Your Ex Contacts You After You’ve Said Goodbye

Ignoring your ex
How to handle an ex you want to keep in the past when they want to be in your present.

As you read this, there are millions of people across the world suffering from a love-rift somewhere while sending ill-fated texts. Studies show that to the brain, quitting love and heroin are the same. Our brains cannot differentiate another human from smack.

The initial stage of a breakup often includes regular and methodical text diatribes (aka, “terror texting”), along with emails and beguiling emojis in vain attempts to recon the defector, each time, vowing not to send another – only to do so within days … or, hours. This phase is rife with the fuzzy logic that there is just the right mix of words and pleading to get you to reconsider.

Why does My Ex Keep Contacting Me?

In short? Denial and the hope for a different outcome. Denial is a coping mechanism that gives us time to adjust to distressing situations. Being in denial gives your mind the opportunity to unconsciously absorb shocking or distressing information at a pace that won’t send you into a psychological tailspin (Mayo Clinic, Denial: When it helps, when it hurts, 2011). When the reality hits that you’ve been dumped, denial is a great tool; as in “If I don’t think about it, then it’s not happening,” or “I can totally fix this, I just need another shot.” A less obvious way denial presents could be as a denial of inner strength: “I can’t handle this sh#t!” The issue with denial as a coping mechanism is that it’s not a long-term solution. Remaining in denial is not healthy, and it’s unnerving to onlookers.

The agony following a broken relationship is an evolutionary adaptation that ensures the maintenance of close social ties. Rejection hurts so that we are hesitant to enter social situations in which rejection is likely. It’s also why hot people are crazy. It’s a deterrent for our own safety. But, breakups often include record-setting pleading; a deluge of one-way, restraining-order-level communications; panic that borders on neurosis; and trying to resuscitate the relationship pulse through text and social media.

Exes usually continue to talk because they miss having someone around. It’s old habit to say “goodnight,” or sext on a random weeknight to someone who won’t call the cops.

Now the breakupee stares thunderstruck at a silent phone, willing it to ding with a text from you, while feeling a dreadful void from losing that regular communiqué. If you reply to your late pursuer with anything less than F-bombs and the threat of legal action, it feels great to them. But it’s akin to another hit of heroin for a recovering addict. It will satiate the cravings for a bit, but you’re only resetting their recovery clock while adding to your own stress to keep them from teetering over an imperceptible edge.

What Does the Research Say?

Per a study published in the journal Review of General Psychology, just like the brain is hardwired to fall in love, it also has a mechanism that helps us fall out of love and move along. This is easier for some than others, however. Stalking is not cute, romantic, or funny. And, oftentimes it’s more than, “I was just bored and curious…” Conversely, an “I miss you” doesn’t equal “I want to get back together and adopt Russian toddlers.”

Take solace knowing that your ex’s love longings are quite normal – to an extent. Research eludes to a physiological basis to cravings for an ex. Lucy Brown, Ph.D., Professor in the Department of Neurology at Albert Einstein College of Medicine and her colleagues used functional magnetic resonance imaging (fMRI) to record the brain activity of adults who had experienced a recent unwanted breakup, and who reported still feeling love for their ex. “Upon viewing brain photographs of their former partners, there was activity in the areas associated with reward and motivation, specifically, the release of dopamine that is also seen in drug addiction. Therefore, people may experience cravings for their ex-partner similarly to the way addicts crave a drug they are withdrawing from.”

So, What Can You do About the Uninvited Contact?

In the throes of pain, the shortest route to ending heartache is seemingly with the source. It’s not. It is within us and not with our defector. Consequently, it is not your responsibility to ferry your ex to healing shores. Your takeaway is first to have empathy, followed by impenetrable boundaries and a steadfast “no contact” rule to the benefit of you both. Fully unplug from your ex – including from their social media. Until there’s a methadone for breakups, any reply keeps the dynamic going and prevents you both from moving on with your lives. It also exposes you to further distress, while hindering their emotional recovery and increasing their longing for reconciliation.

Required Steps for Managing an Ex Who Won’t Stop Contacting You:

Stop communicating with your ex unless you share custody of a mini human(s).
Repeat.

If for some reason you cannot block them – like maybe you’re keeping a tally of texts/calls for a judge, or you want your labradoodle back – then change their name in your phone to “Caution,” “Beelzebub,” or “Do Not Answer.” This is not a game; it’s not about punishment or revenge, or to make your ex mad while feeding your own ego. It’s self-care.

Do it for them. Do it for you.

Not everyone loves you enough to leave you alone. If you’re ever going to be friends, it will happen later. Or, never.

Breaking-Up Badly: 11 Tips to Avoid Self-Imploding Following A Breakup

“I’m sorry I annoyed you with my unconditional love.”

The early phase of a breakup is marred by feelings of inner turmoil, all-consuming grief, anxiety, low self-esteem, jealousy, lack of food or sleep and an indifference to personal hygiene, all peppered with moments of irrationality.

The exhausted brain loops re-enactments of the severed bond piece-by-piece in some macabre relationship forensics. You painstakingly dissect past conversations, events and nuances of the bond while cerebrally clawing towards a personal salvage strategy.

You become a pariah to friends and family who look upon you with pursed lips of empathy, while avoiding sustained eye contact or dialogue at the risk of triggering an emotional flare. People make tired comments like, “There are plenty of fish in the sea,” “You’re better off,” or “How long were you together?” so they can quickly determine if the number justifies your level of distress.

How long will the pain last? What is considered acceptable by friends … or society? Is the recovery period half the time you were together? No. There is no mystical breakup algorithm to yield your fixed emotional penance. It takes what it takes. And for everyone this is different. Everything you need to heal is already within you. Therein lies your freedom.

The pain of rejection is exacerbated by how we view and treat ourselves after it occurs. But rejection also causes physiological pain with an evolutionary purpose. Back in early times, being rejected by your people meant lone survival and imminent death. Now we have Netflix and DoorDash, and being alone for a period is an underutilized indulgence that too few learn to sit with and relish. Once we do, we glean how truly self-sufficient we are.

But, what does the research say?

Studies suggest that women experience more emotional anguish in the aftermath of a breakup, but it takes men longer to recover. A woman deals with a breakup head-on. By the time a woman is on the backside of a breakup, her ex-boyfriend is just coming to terms with what went down.

And contrary to widely held beliefs, closure is not necessary. Countless people never gain closure yet still move forward and heal. When we are broken-up with, our ability to reconcile who we are is upheaved. But you’re still in there … somewhere. You are whole. And you are grand. Despite what you might be thinking, you never need to know why your ex did anything they did. Your ex was never the reason you thrived.

Soulmate is what Satan puts in his coffee.

From an evolutionary perspective, if we were meant to be with only one person on Earth, society would collapse. You did not lose your soulmate. You can look for one of your other soulmates later. For now, any search for external breakup remedies and relief is rooted in a desire to short-circuit the recovery process. If evolution didn’t insert some physiological checks and balances in the form of heartache, we’d hook-up with the next thing in an Armani suit or Lululemon’s.

For those lacking breakup survival skills, the symptoms and manifestations associated with a breakup are measurably more self-defeating. So, here are some proven tactics to hasten your heal:

1. Don’t press “rewind” when you should hit “delete.”

Do not sleep with him/her one more time in the hope it will usher you back to better times. Delete your ex’s number from your phone — even if you have it memorized. Of all the things we lose during a breakup, keeping the locus of control is the most important and often ignored. The easiest way to control your current moods and keep your power is to not contact your ex.

2. Therapist? You mean bartender?

A breakup can lead to depression, isolation, self-accusation, or worse. You don’t always need to make grief clinical, but it’s imperative to know when to seek outside professional help. The easiest index to use is if your emotions are starting to interfere with daily life functioning — including sleep.

3. Only the strong forgive.

Forgiveness is simply giving up the hope for a different past. They may not deserve your forgiveness; but you deserve peace. It’s about letting go of the outcome, rather than condoning any actions by someone whom inflicted the pain. Forgiveness takes only one person: You.

4. The power of three gratitudes.

Not only does gratitude increase how much positive emotion we feel, it just as importantly deprives the negative energy that is the driving force of why we feel so badly. There is omnipotence in gratitude. Focus on three gratitudes daily, no matter how small.

5. Exorcise all relationship mementos.

Emails, toothbrushes, photos, texts, his Apple Watch, etc. and change all venues you frequented together, such as bars, cafes, Urban Outfitters, etc. You could use the change of scenery, while avoiding needless reminders of his love for salmon shorts and craft brews.

6. The quickest way over one is not under another.

Rebounding is a brief distractor that invariably turns into sound-boarding your ex’s name and shortcomings onto some naked app prey beside this woeful version of you. A rebound won’t help you with healthy, long-term objectives. What will? Work with being solo for a bit to achieve self-improvement, reflection, and a righteous comeback.

7. But, veggies taste like dirt and sadness.

To counter the melancholic feelings inherent to any breakup, it is imperative to spend time outside, get regular sleep, exercise, and eat right. Wean off the Pinot Gris and cookie dough and get some nutrients. Studies have shown that foods can directly influence the brain’s neurotransmitter systems that are related to mood. (Hopf, 2010).

8. Better than an FWB is a BuB.

“He’s only ignoring my texts because I haven’t sent enough.” Utilize the exceptionally helpful camaraderie of a Breakup Buddy (BuB) to remediate poor decisions when reacting from emotions. These are dangerous moments of relapse; hence, the importance of someone who will think for you until logic is reengaged. Refer to them often.

9. Tweak small behaviors to dramatically shift moods.

If you change small post-breakup behaviors, it will change your thoughts, feelings and emotions. This is paramount in helping you to feel less anxious, worried, depressed, or experiencing an intolerance of uncertainty following a split. For example, if you do the opposite of what your emotions are driving you to do — such as checking-out their social media or driving by their residence — your anxiety, worry, and pain will subside.

10. “Cowabunga, dude(tte)!”

Ride those thought waves. The technique of urge-surfing involves riding an emotional wave and not responding to any part of it, but letting it swell and then wane. This is an extremely helpful tactic to use in dealing with the impulsivity associated with a breakup, because you are observing your emotions, rather than acting on them. And this prevents regretful actions.

11. Cuddle the friendliest ghost of all.

“Just gonna send him a message … Aaaaaaaannnnnd I’m blocked.” Going ghost is one of the most sagacious devices for self-preservation. Most breakup sufferers greatly add to their angst by not following this one, basic tenet. If you’re going to be friends with your ex, it’ll happen organically and only when you’re long over them. If you must see your ex, keep it cool and make it fast. Otherwise, ignore them so hard they doubt their own existence.

“Frankie says, relapse.”

A final note: Breakup recovery isn’t linear, but more a game of Chutes ‘n Ladders. Reverting and plateauing are common throughout the entire process. Healing is rarely direct in movement, but setbacks are temporary and short-term. You may feel stuck at the same level of muck for two weeks, only to suddenly leap forward in your progress out of nowhere. Your adherence to tactics such as the aforementioned will accelerate your imminent return to baller status.

How do You Know if You’re Depressed or Just Sad?

You might think you’re feeling lazy or unmotivated, but here are the signs that it’s something more serious

Is your two-day, Netflix binge of “Black Mirror” and “Stranger Things” a bout of laziness and apathy, a case of “the melancholies,” or … clinical depression?

Maybe you think you’re depressed, or you’re just using depression as an excuse to be lethargic – only to realize this itself might be a symptom of depression. It’s tough trying to figure-out your head with your own mind, right?

The brain is an organ that can malfunction like any organ. Mental illnesses are illnesses of that organ.

Brain scans show that there is a physical difference between a healthy brain and a sick brain. Telling someone with depression, “You don’t have an issue, it’s all in your head” is as inane as telling someone with diabetes, “You don’t have an issue, it’s all in your pancreas.” Any organ is susceptible to disease or disorder.

When you’re feeling down, it’s imperative to distinguish feelings of sadness versus depression because confusion can lead you to avoid evaluation and treatment of a serious condition. Alternatively, you might overreact to a normal emotional state of sadness.

“And, here’s why the distinction is crucial: If we (or a loved one) are depressed, it has huge implications for our long-term mental health, physical health, and longevity,” says NYC Psychologist and author Dr. Guy Winch. Sadness and apathy are normal emotions. “Sadness is usually triggered by a difficult, hurtful, challenging, or disappointing event, experience, or situation,” says Winch. This also means that when something shifts, or we’ve gotten over the hurt or event, the sadness also wanes.

“Whereas depression is an abnormal emotional state; a mental illness that affects our thinking, emotions, perceptions, and behaviors in pervasive and chronic ways,” says Winch. Depression can occur in absence of any of the triggers that cause sadness. Sadness is about something and depression is about … nothing.

Criteria for Depression

Depression is classified into different types using a book with diagnostic criteria for mental health disorders. Now in its fifth edition, the book is called the Diagnostic and Statistical Manual of Mental Health Disorders. But, everyone just calls it the DSM-5. Think of it as the owner’s manual for the brain but – like an iPhone user guide – you must make an appointment with an accredited genius to see one.

The DSM-5 outlines the following criterion to make a diagnosis of depression.

Note: These serve only as a guideline. You need to see a mental health professional for a conclusive diagnosis. The individual must be experiencing five or more of the following symptoms during the same 2-week period, and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.

Depressed mood most of the day, nearly every day.
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
Diminished ability to think or concentrate, or indecisiveness, nearly every day.
Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition. Afterall, a bottomless mimosa brunch or afternoon of beers is enough to spur a days-long depressive spell, as booze and other substances are known depressants.

Anxiety and depression disorders are often interlinked.

“It’s very hard to find patients who are depressed who don’t also have anxiety. It’s equally hard to find people with anxiety that don’t have some depression,” says Charles Goodstein, MD, a professor of psychiatry at New York University School of Medicine. So, don’t berate yourself if you’re feeling anxiety on top of everything else. It’s more likely than not to occur. And though signs of depression, anxiety disorder, and even bipolar disorder have similarities, each requires different treatments right down to the therapy and medications used. This is why a professional diagnosis is so important to obtain the correct treatment regimen.

A Quick Lesson in Sourcing the “Why” in Your Life…

One of the most poignant examples of suffering and sadness is the story of Viktor Frankl, a physician and psychiatrist who survived four Nazi concentration and death camps, including the infamous Auschwitz. Frankl epitomized the words of Nietzsche: “He who has a Why to live for can bear almost any How.” As a prisoner, Frankl kept himself and his hopes alive by a desire to see his wife again and one day teach about man’s quest for meaning.

Sadly, Frankl’s parents, brother, and pregnant wife were killed; but he was able to cope, source the importance of it all, and move forward with a renewed life purpose to include writing one of the most moving and significant books of our time, Man’s Search for Meaning. Frankl teaches us that “if there is a meaning in life at all, there must be a meaning in suffering. Suffering is an eradicable part of life, even as fate and death. Without suffering and death human life cannot be complete.”

We all face the opportunity to achieve something through our own suffering. Our unique opportunity lies in the way we bear our burden, and in our attitude toward difficulty while pondering our meaning. Make no mistake; you have a decisive and purposeful meaning in this world. For many of us – myself included – it takes suffering and hardship to find it.

We are supposed to feel like we can’t handle things alone sometimes. That’s when we find the grace or help through others. In times when life becomes unmanageable, we must be willing to ask for help and support one another. It’s by design. We can be with one another amid suffering, helping each other bear the weight. Part of life is the realization that sometimes we can’t make it on our own. For some, a spiritual leader is a person to whom you can turn and say, “I have a burden that I cannot bear.” All it takes is walking into a local church, mosque, synagogue, or temple and asking for help.

Live to the point of tears. -Albert Camus

Conquering Teen Anxiety

In this excerpt from “101 Ways to Conquer Teen Anxiety,” learn the difference between “normal” anxious feelings and those that interfere with daily life

Am I Losing My Mind, or Is This That Anxiety Thing?

Anxiety can make you feel different. As a teen, I never knew why no one else seemed to struggle with life the way I did. And it wouldn’t have mattered what diagnosis or label was put on me because it would not have changed how I felt. Sadly, teenagers can let anxiety steer them through most life decisions. Left untethered, anxiety will drive every choice and action you take.

So how do you know if you’re experiencing anxiety or something more insidious with a Latin name in the Physician’s Desk Reference? The type of anxiety we address in this book is not the healthy, normal varietal that prompts you to get important stuff done, like studying for an exam or running from prom date requests. According to the National Institute of Mental Health (NIMH), “Severe anxiety that lasts at least six months is generally considered to be a problem that might benefit from evaluation and treatment.”

Rather than motivating you to act and get things done, anxiety at this level interferes with daily living, activities, and relationships.

The Accoutrement of Depression

Like a salad bar and sneeze guard go together, anxiety and depression disorders are often interlinked. So, don’t berate yourself if you’re feeling depressed on top of everything else. It’s more likely than not to occur. And though signs of depression, anxiety disorder, and even bipolar disorder have similarities, each requires different treatments right down to medications used. This is why a professional diagnosis is so important in order to obtain the correct treatment regimen. Having anxiety doesn’t have the social stigma it once did. It just means you’re really living.

But, there is a little-known dichotomy about anxiety that makes seeking treatment difficult: When you’re feeling anxious or depressed, it’s often hard to do what’s best for your welfare – this includes seeking help. Anxiety is a narcissist that wants you to focus on … anxiety. Anxiety will cloud your mind and fill your consciousness with a perverse volume of thoughts, noise, feelings, and stressors that have no validity. Next thing you know, you’re not turning in homework on time, missing chores, and arriving late to work or practice, and everyone’s wondering why you can’t get your act or matching socks together. If they saw the thought carnival in your mind, they’d surely understand.

No medication will cure anxiety. Medication treats the symptoms of anxiety.

Every case of anxiety is unique. Unfortunately, many anxiety sufferers use prescription medication when therapy, exercise, or self-help strategies such as those taught here would work just as well – if not better – because they are actual skills with no side effects. Therapy and skills usage include development of the necessary tools to beat anxiety.

The goal we’d like you to adopt from this book is not to remove anxiety, but to bring it down to more manageable levels. That means working with it directly, in a nonjudgmental way, and not avoiding it or thinking it’s bad or weak that you feel this way. We’ll talk specifically about how to do this in the book.

For more on 101 Ways to Conquer Teen Anxiety click here.