Anxiety affects millions of people but did you know that it can often show up differently between men and women? In fact, men are half as likely to ever even receive a diagnosis of anxiety compared to their counterpart. Women tend to express their worry in the form of people-pleasing towards others or feeling powerless. This can often lead to more eating-related problems in an attempt to regain a sense of control. They’re also more likely to go to the doctor in the first place when they begin to feel distress.

Men, on the other hand, frequently have their anxiety masquerading in the form of anger. While he may be seeming like a jerk on the surface, bubbling underneath could a very large reservoir of anxiety. From childhood on, men have received the message that aggression is seen as more socially acceptable behavior than anxiety and emotional vulnerability is seen as a weakness. Men are more likely to complain of headaches, trouble with sleep, and muscle tension. More notably, they’re much more likely to abuse alcohol and drugs to cope. In regards to suicide, while depression is associated with having more suicidal thoughts, those struggling with anxiety are more likely to actually make attempts. And men are three times as likely to die by suicide than women, with rates on the rise.

So what do you do if you or a male loved one are struggling with anxiety? Here are some tips:

1) Highlight what you see. Take notice and share how you observe that things have changed within him. His quality of life has been down and you see him suffering. For example, he doesn’t spend as much time pursuing hobbies, complain more about work, and you see that his alcohol consumption has been steadily rising over the past few weeks.

2) Plant curiosity seeds. Our emotions are complex and often multi-layered. We have what are called ‘primary’ and ‘secondary’ emotions. Secondary emotions are often what we see on the surface while an additional and often more accurate emotion is underneath. So when he gets upset about not wanting to go to the party with his friends or seems overly grumpy about his increased workload, plant the seed that there might be another feeling germinating inside of him aside from agitation. “When I hear you say you’re really upset about having to go to the party this weekend with your friends, it makes me wonder if you’re feeling something aside from anger?” You’re not accusing, judging, or nagging. You’re just holding a neutral stance from a place of caring and concern. Then back off, or if need be, change the subject so he doesn’t feel like he’s being interrogated. The more of these curiosity seeds you plant over time, the more likely they are to take root and have him start exploring them himself.

3) Give him a status update. Explain to him how his moods and actions have made you worry more, how you’re not sleeping, etc. You’re inviting him into your world to offer him a glimpse of how his behavior is impacting more than just himself. And when you come from a place of being authentic and compassionate it won’t come across as a guilt trip either.

4) Offer counseling as an option. Emphasize how there’s a reason why this profession exists. Therapy has come a long way from sitting on a couch and talking about your dreams. Cognitive-behavioral therapy, or CBT, in particular is not only extremely effective but can be well-suited for those who are more resistant to therapy. Treatment can often be short-term (roughly 12-15 weeks), too. I’ll often describe to folks who are more uncertain about discussing their feelings that this is more ‘coaching’ than “therapy” and how it’s not much different from getting a golf lesson. But remember, no ultimatums! The ‘you better go to therapy…or else’ approach not only won’t work but will just create the opposite reaction because now he’s resistant.

5) Emphasize bravery. Reframe for him how that by reaching out to others, whether that be opening up to friends or pursuing therapy, actually takes courage and is therefore not a form of weakness. It can provide tremendous relief to talk to someone about anxiety, to know he’s not alone, and feel connected to others on such a deeper level. When you see him slowly taking these steps towards others, praise him authentically noting how difficult the process must be.