I sat in high school French class, listening to the incomprehensible words spoken by the teacher. My own thoughts were easier to understand: Katie. She sat directly in front of me. Every day I thought to talk to her; every bus ride home I chided myself for not doing so. The cycle repeated for most of my freshman year—and then far beyond.
That was 25 years ago, and I chalked it up to adolescent nerves. Only recently did I learn that being racked with self-doubt and frozen with fear isn’t a character flaw. And it didn’t have to be this way.
For years, my cowardice hung over me like a black, laughing cloud. Simple tasks were excruciating. Many were common, like not taking the big shot. Others were so specific they were funny: I once brought my didgeridoo to a lecture by a world-class didgeridoo player, only to keep it hidden under my chair for the whole talk. I blamed some part of myself.
I’d tried therapy twice—once as a teenager after my parents’ divorce and again with my spouse, to keep us from the same path. Both helped to a degree but were short-term fixes for immediate problems.
What began as inaction festered into a nagging concern about some unnamed and insurmountable issue. I’d notice a lump on my neck in the mirror. The next week it would consume me—this bump that was surely something invasive and deadly. It never occurred to me that I could feel like my body was breaking because of what was going on in my mind.
On the outside, I seemed to be doing fine, teaching writing classes at a local college and helping manage my household. But on the inside, I was distracted and terrified. One night, after my wife put our one-year-old to sleep and climbed into bed, our cat jumped up to nuzzle my face; I pushed her away with a shout. Adrenaline shot through my system. I suddenly had trouble breathing. My wife stroked my back to calm me down. This was my first panic attack. Weeks later, at the doctor’s office requesting an EKG for an imagined cardiovascular event, I mentioned the cat scare. “Have you ever thought about taking an SSRI?” my doctor asked.
I’d never been depressed, so why would I need antidepressants? My provider explained that the same class of drugs that helps millions stave off their darkest thoughts could also ease my mind from the catastrophic thoughts wreaking havoc on my life—in other words, anxiety.
The past few years have seen a predictable uptick in cases. According to the World Health Organization, anxiety and depression rose by 25 percent in the first year of the pandemic. A BMJ Global Health study found that men were greatly affected, with one third reporting an increased level of anxious and depressed feelings. Frankly, I’m shocked it’s not higher. Part of the problem with addressing men’s mental-health difficulties is their reluctance to admit to an issue in the first place. We pay attention to a man’s mental state when the stakes are high (a president’s mental faculties, a shooter’s assumed psychological challenges). What we ignore are the millions of daily, invisible obstacles within many of us: tiny frictions that, if eased, would enable our fullest potential.
For me, because I assumed my problem was an inherent part of who I was, I never addressed it. Gauri Khurana, M.D., a psychiatrist who teaches at Yale University, sees the negative outcomes of ignoring mental health firsthand. Whether physical or mental, “this is how the body expresses its pain; it hurts,” she says, explaining that anxiety is associated with high blood pressure, an increased risk of cardiovascular disease, arthritis, fibromyalgia, and more.
My spouse had been actively pursuing her own mental-health goals for years. She knew I needed help. Our life was rapidly becoming more complex. We already had a one-year-old and another kid was on the way. If I couldn’t handle a cat jumping on me, our growing family would break me, and us, apart.
So when my doctor suggested an SSRI, I was grateful and I accepted.
I still remember the day I took my first dose. My doc had referred me to a psychiatrist, who prescribed an SSRI along with a plan for self-mediated relief, including exercise and deep breathing. I’m sure the plan was helpful, but it was the pill that made me feel different and new.
I’m on the campus where I teach only a few days a week, so I have limited interaction with colleagues. While walking out of my last class of the day, I see a fellow instructor’s office door ajar. I should pop in and chat, I think.
I’d been here hundreds of times: An opportunity arose; I thought about acting; I overthought a potential outcome; and before I knew it, I’d moved on, regretting my indecision. Next time I won’t blow it. Yet the cycle predictably continued.
Now, with 10 milligrams of an SSRI flowing through my bloodstream, I don’t hesitate. I knock on the door, she smiles, welcomes me in, and we chat.
It felt like a small miracle. Or so I thought. I’d go on to realize it takes several weeks or longer for the drug to become effective. My newfound confidence was kind of a placebo effect. “When you’re anxious, you’re hyper-suggestible,” says Dr. Khurana. And in this case, it was in a good way. “I think the most important thing about going to a doctor or a therapist is that you have hope that things are going to get better,” she says.
In time, the tiny drug became part of my mental-health regimen. Exercise, sleep, and eating well are important, too. But I now see how the combined effect of the drug in my veins and the perceived mental boost creates a kind of superpower. Before, I left my flawed self in a raw and frayed state; I now have a layer of armor against my fears.
It’s not that I’m no longer broken. I never was. Recognizing that has given me something impossible to get from a bottle: self-confidence, plus the freedom to do what anxiety kept me from doing.
This article originally appeared in the October/November 2023 issue of Men's Health magazine.
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