When most people think about anxiety, they probably inherently think women.

When some men think about therapy, they picture mining their past and endlessly talking about “how they feel about that.”

Both are false. And both may be preventing men from seeking the help they need.

At any given time, about 40-70% of my own clients have been men. I have no idea why, and it doesn’t really change how I approach anything, but it does give me unique insight into how men cope (or don’t) with anxiety and OCD.

According to The Wall Street Journal, about one in five men will develop an anxiety disorder during their life. That’s compared to one in three women. The concern in the psychology community is that the difference is due more to men under reporting than actual facts. Most of us know the story: emotional vulnerability and asking for help are seen as weaknesses.

There are some differences in how anxiety shows up in men vs women. For men, it’s often anger and irritability. Men also tend to abuse things to escape their worry pain: drugs, alcohol, gambling and pornography.

In my own therapy practice, I have yet to work with a man who doesn’t struggle with shame- shame that they are struggling, shame that “something is wrong with them,” shame that they can’t fix it and shame that they’re a “freak” for having these thoughts. For those with OCD, if their obsessions center around a taboo theme such as sexual orientation, harm or religion, their shame intensifies.

What I’d like men to know is that their anxiety isn’t their fault. We cannot control how we feel or the thoughts that may show up in our head. We do, however, have agency in how we respond. Treatments such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and exposure and response prevention (ERP) are actually more behavioral and practical than they may think. I think of my work as helping people have good mental fitness.

With the world events of the last couple of years, we’re all feeling more anxious. And while women may be more likely to seek help, men need help equally. Hopefully, we’ll continue to have these discussions to break down the stigmas that keep that from happening. If you or someone you love needs help, please reach out.