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Mitch: You're listening to "Who Caress About Men's Health," where we aim to give you some information, inspiration, and maybe a different interpretation of your health. I'm Producer Mitch. Scot, Troy, and I are taking a little bit of a summer break, but we'll be back with new episodes soon enough. In the meantime, we've put together some best-of episodes highlighting some of our very favorite moments and topics over the past 145 episodes.

Last week, we shared a bunch of what we like to call tools for your mental health toolbox, simple mental strategies and techniques to minimize your stress, be a little more present in your own life, and it could be a great first step towards improving your mental health.

Today, we're going to dive a little bit deeper into some of the most common mental health conditions people face. According to the CDC, more than one in five U.S. adults live with a mental illness, and many of these people, particularly men, may not even be aware that they have a condition.

is a professor of psychiatry who specializes in anxiety and mood disorders. And on our show, his every-man approach to mental health makes it so easy to understand, especially for folks like me.

He has shared some of the most impactful analogies for mental health that I have ever heard. And as someone who lacks some foundation of knowing my own emotional health, his explanations and perspectives have been pivotal to improving my own situation.

So, to start, let's dive in with the most common mental health condition, anxiety. It is so common that over 40 million Americans a year are struggling with it. And as one of them, I personally have been dealing with anxiety for years. So on Episode 113, "Anxiety: The Tiger Of The Mind," Dr. Langenecker explains what anxiety is and why it can be so hard to manage.

Dr. Langenecker: I think I'd like to start out with this concept of pain. So why do we tell kids when they're young not to put their hand on the stove, right? Why do we have pain receptors in our hands? It actually keeps us from harming ourselves.

And so anxiety at its core is a danger warning system in your brain. And it turns out it's a pretty old system. It developed a long time ago. Many animals have anxiety. We humans have anxiety. It's not really a fine-tuned system. And so it's pretty easy for it to go a little bit awry.

Mitch: And when you say old, it's pre-caveman? We're talking way down the line in the evolutionary line, or what?

Dr. Langenecker: It depends who you ask, but if you ask somebody who likes to be contrary, they will say, an amoeba can have anxiety because it can move . . .

Scot: Wow. Really?

Dr. Langenecker: . . . toward or away something based upon the danger of that object to the amoeba.

Now, obviously, that's a bit of hyperbole. We like to think of anxiety as having a little bit more sophistication than that. But that's sort of at the far end of the spectrum on what we think of anxiety, is moving toward or away things that may be dangerous to us.

Mitch: Is anxiety an emotion or is it a biological response?

Dr. Langenecker: I would opt for a biological system or a biological response that can lead to a host of emotions. Most often when we think of anxiety, we think of it going along with the emotion of fear, but there are other emotions that can come with it, like excitement or anger, disappointment, disgust. It doesn't have to be that specific.

Mitch: Before we started the interview, you mentioned that you kind of like to think about anxiety as the tiger of the mind. Do you want to explain that a little bit to me? That sounds very exciting and interesting.

Dr. Langenecker: Sure. This is the way that I make anxiety real for patients of all ages. But it's really helpful for talking with kids too, because kids have lots of fears. Some of them are useful, some of them not so useful. As we move into adulthood, we get better at managing them, by and large, not always.

So when I think of tigers of the mind, I think of "What is the evolutionary purpose of anxiety?" And the evolutionary purpose of anxiety was literally to keep us from eating that poison mushroom, from going out in the dark and being eaten by tigers. And so anxiety was a good thing, right? It made us cautious. It made us think rather than feel.

And those people who were more cautious and did the thinking rather than the acting impulsively are the ones who passed their genes onto their kids. So anxiety has been preserved and I would say even strengthened as we've evolved.

Mitch: At what point does that become, say, an anxiety disorder? And what kinds of anxiety disorders are out there?

Dr. Langenecker: Yeah, so that's a whole thick book. The best way I've heard it described is anxiety is about a loss of control. So control about safety, control about your social status. It could be control over a number of things.

So we think of social anxiety as one, right? So that's potentially a loss of status. That goes back to Scot's anxiety around his performance in exams and projects and so on. "If I don't do well, I may not gain the social status that I'd like, or I might lose some social status."

When Troy was talking about it, it might actually be related to danger. "If I don't find a way to manage the anxiety there, there might be some danger to me."

And then we have sort of fears/phobias of various things.

The generalized anxiety that you referred to before, Mitch, is kind of . . . I'm going to use the word unsettled, right? Unsettled, like things don't seem to be settled often, and your brain is constantly looking for, "Why? Why are things not feeling settled?" And so it becomes generalized and you're looking for the monster under the bed, even when the bed's not there. That's what your brain is doing to you when you have sort of more of a generalized anxiety.

That's just a couple. There are more complicated ones around trauma and obsessions. And I think just in the interest of time, let's get past those for now.

Mitch: And while everyone experiences a bit of acute anxiety occasionally in one way or another, for some people, like myself, I've been dealing with one of these more severe or chronic conditions Scott mentioned. I shared a little bit about my own situation, and Scott gave his own non-therapist therapist perspective on anxiety disorders, and how to identify if your anxiety may be something you need some professional help with.

My generalized anxiety may be connected to maybe some childhood trauma. It might be connected to some instability in my life for a long period of time when I was jumping from job to job doing freelance stuff, etc., whatever. But he explained it to me and generalized it.

My particular case that just . . . I'm super duper sensitive, right? My whole system is constantly searching for what is danger, and it is starting to create danger where there is none, right? And it would be everything from like Scot would end an email with a period rather than a smiley face.

Scot: Wow.

Mitch: And I would just be like, "Scot hates me. He's going to fire me. What am I going to do?" No, it's real.

Dr. Langenecker: Periods should be banned from sentences.

Mitch: And so it was that kind of stuff. And it's been really interesting kind of viewing it from that side, right? It's not, "Hey, you're not crazy. Because of one reason or another, your system is hyper wired and very responsive to these things. It's trying to protect yourself." And that gave me kind of a different, I guess, appreciation for what I was experiencing.

Dr. Langenecker: One way to think about it is our DNA is super complex and it's designed to create variability. And so if you think of trying to find the sweet spot for anxiety, our DNA is actually going a little bit high sometimes and a little bit low sometimes. And unfortunately, you and I actually end up a little bit high on that scale. The non-therapist therapist advice here is the biggest part of managing it is actually just calling it what it is, like, "I'm high on the scale."

Mitch: And that has been, for me at least, one of the biggest changes because I'm finally able to be like, "No, you're not scared. Your body is overcompensating. This is where you're at. Calm down." The higher brain can kind of talk me down a little bit, which I appreciate.

Dr. Langenecker: Yeah. And the trick then is if your system is super sensitive . . . If we just think about tests, there are false positives, false negatives, true positives, and true negatives. If your system is super sensitive, you're going to end up with a lot more false positives, which means you're going to feel anxious when there actually is absolutely no reason why you should feel anxious.

The big grab bag category we use is "Does it affect your functioning in your life?" So, for example, if I have social anxiety and therefore I can no longer go on a podcast because I'm afraid people are going to send me hate mail, that's where it moves into, "Oh, boy, that's leading to some dysfunction." If it makes me uncomfortable and I do it anyway, that's sort of in a gray category.

If I have a fear of fire in my house, and I'm constantly checking the smoke alarms and making sure that the oven's off, and it takes me an hour or two a day to go through those loops 17 times in the morning, 5 times at lunch, and 5 times before I go to bed, that's moving into a dysfunctional area.

So when we talk about anxiety and dysfunction, we say, "Well, does it change the way you pursue your goals? Does it prevent you from pursuing your goals?" And when it does, then it's time to get some help.

But there's a darker side to it as well, which is people who have experienced adversity and trauma, their brain is actually changing and adapting to that. I use the analogy of tigers of the mind, because tigers are sneaky and tigers are dangerous. There's a bit of mindfulness we can do with anxiety, but there's also a bit of, "Hey, this is a real thing. You went through some real trauma and your brain has changed because of it." And so then what are we going to do next?

Scot: Could somebody who's more sensitive or who has had trauma that's experiencing this type of anxiety . . . That sounds exhausting. So beyond just it impacting the goals that you're trying to achieve, does it just mentally wear you out, tire you down to a bad place?

Dr. Langenecker: Yeah, it can. So one of the things that I focus on a lot in my therapy with patients is, "Is it affecting your sleep? Is it affecting your energy level? And is it affecting your mental focus?"

So you can run into this situation where people are sleeping, but they're not sleeping well. And they go through an entire day, every day thinking, "I just need to take a nap."

And there are actually some biological reasons for this. If we trigger the stress response over and over and over again, that stress response actually loses some of its elasticity. It loses some of its ability to recover over time.

So let me give you sort of an example. We're going back to tigers again. I find myself unfortunately in a jungle and there's a tiger there. And there's a huge surge of cortisol that comes through my system to help me, probably unsuccessfully, fight against this tiger. That cortisol surge is to actually assist me in getting more strength, more agility to heal faster, but it's supposed to last maybe 20, 30 minutes.

But what happens if that gets triggered with the tigers in your mind 50, 100, 150 times a day? That response after a while is going to get a little bit worn out. And I know that's not a technical description, but yeah, you can end up being pretty worn out from that constant stress.

Mitch: I was. I was getting real tired, real fast, and it was leading to inability to sleep, inability to work out. I just was exhausted all the time.

Dr. Langenecker: Yeah. And it ends up being a bit of a trigger for depression actually. Folks with anxiety are at twice the risk for depression, probably because of that very mechanism of getting hyped up so often and then getting worn out.

Mitch: And when it comes to treatment and management of anxiety disorders, talking to a professional and improving your physical health can go a long way. But in some cases, anti-anxiety medications can be extremely helpful. I can tell you from personal experience.

Dr. Langenecker took some time to kind of dispel some of the fears that often come around these kinds of mental health drugs and how they can actually be really helpful in your journey to better mental health.

Dr. Langenecker: Yeah. So this is the really uncomfortable part of this discussion for me, in that for most people, anxiety is not like an infection, right? You don't treat it and then it goes away. It's more kind of along the lines of diabetes, which is once you have it, you probably have it for life.

And then the question is how do you manage it? And by manage it, there are things that you can do in your life. Exercise, mindfulness, sleep hygiene, diet even are things that can help. But for many or for some, we have to go one step further and pursue medication.

And that makes I think everybody, including myself, uncomfortable, which is, "Do I have to take these medications for the rest of my life?" It's an uncomfortable conversation.

And so that's why I like to use the analogy of diabetes, which is the medications are there to help balance out your system. You would never say to a diabetic, "Hey, let's try not using the insulin this week. Let's see what happens." We wouldn't do that. That would be a bad idea. And so, for some folks, their anxiety is just at a level right now where medication's a good idea.

Mitch: So I actually started taking some anti-anxiety meds last year, and it took a little bit to get used to them, but it is night and day for me. It feels like the system has calmed down. It feels like I can actually do some of the mindfulness kind of activities and cognitive behavioral self-talk type stuff. And it's gotten significantly better.

But it did take me a while to kind of find a guy, a mental health person, and then on top of that to just straight up say, "Hey, I think I have anxiety and I think this is impacting my life."

So I think just kind of to wrap things up a little bit, is there anything that you would want to tell maybe a guy out there who's like, "Maybe I have anxiety. I don't know"?

For me, sometimes it feels like, especially with my upbringing and everything, mental health is a mystery and a foreign language, and the people in it are not me, right? That's the ideology that kind of comes behind it. What would you tell someone out there that maybe would be curious and what they should do to kind of address the issues?

Dr. Langenecker: Let's start with a miss right up front. These medications, with titration, with maybe some switching and augmentation, will help about 60% of folks who have anxiety live better, more fulfilling lives. Will they make anxiety go away? No, but maybe it takes the edge off a bit. So that's the first thing.

The second thing is, it does take a bit of time to figure out the best mix for you. Sometimes that's months. Hopefully not years.

The third thing I would point out is that people . . . there's a bit of machismo here, which is, "I can do it on my own. I don't need medications." And I get that. I hear people when they say that, and I just ask myself a simple question, which is, "Does it need to be that hard?" And the answer is no. It doesn't need to be that hard. You can take a shortcut.

And the shortcut here is actually helping your brain to do what it wants to do anyway, which is to give you the goods, which is to make your life fulfilling and meaningful and allow you to connect to other people. And if anxiety is getting in the way, medications are worth a shot. They're worth a shot to try out.

Mitch: If you're curious about my experience with mental health medication, I'd highly suggest to check out Episode 117, "It's complicated: Mitch Gets Medicated." We have a full discussion with Dr. Scott Langenecker about mental health medications and what sorts of benefits and experiences you can expect. It's a discussion I wish I had heard before I started taking medication.

So moving on to the second most common mental health condition in the U.S., depression. Depression impacts as many as 21 million Americans a year. And if left undiagnosed and untreated, it can lead to some pretty serious disruptions in life and relationships, and in more severe cases can even be life-threatening.

Now, we all feel down from time to time. So how are we supposed to even identify if we are depressed in ourselves or in others? On Episode 108, "The Sneaky Scoundrel Of Depression," Dr. Langenecker explains what depression is, how to identify it, and what exactly might cause it.

Dr. Langenecker: I want to put it in two big categories to start out with. The first big category, and you all alluded to that, is sort of feeling sad for more than just a day, maybe a couple of weeks. So that's one big bucket.

The other big bucket is, "Man, I used to really enjoy hiking or skiing or running or playing basketball. And now it's kind of like ugh. It doesn't give me that jazz anymore." And it could be one of those things. It could be one of the other things.

There are another seven symptoms that can be part of it, but those are the two big ones that sort of tip people off. But if you're not looking forward to things coming up in the future, or you look at your schedule for the day and you're like, "This is objectively a good day and I still feel sad," that's probably a tip-off.

Scot: Is it really sadness, though? I mean, how do we even define what sadness is?

Dr. Langenecker: Well, that's a great question, because I'm not sure men are allowed to feel sad. Did I say that?

Mitch: Only anger.

Troy: Scot, you've never felt it, so you wouldn't know.

Scot: Right. The eternal optimist.

Dr. Langenecker: Sadness isn't a man thing.

Scot: Yeah, I think about depression and I don't know that I think about sadness necessarily. Maybe something like overwhelmed with some emotion. Maybe it's overwhelmed with sadness.

Dr. Langenecker: Yeah. So let's talk about sort of the male interpretation of sadness, which is, "I've got people counting on me and I can't cut it. I can't do what I'm supposed to do, and I'm letting them down. I feel this pressure and I can't do what I'm supposed to do as a man, supporting my family, supporting my job at work." So it comes across as that. That's one way.

The other way is irritability and anger, which is like, "Ugh, that person just drives me crazy all the time." And maybe it's true, maybe they are. Or maybe it's just that you're feeling a bit depressed and anything is going to set you off. Those are kind of the two big ones for men.

I would add there's sort of this classic trope about the middle-age crisis for men and getting a new wife and getting a sports car and buying new golf equipment. There's a premise for that that's sort of rooted in depression, which is, "Man, the things that used to really interest me just don't anymore. I feel kind of flat. I feel kind of not into it anymore."

Every time you go into that sort of stereotypical midlife crisis mode for men, is that depression? No, but it is some clues, right?

Troy: And you also mentioned it's not just a day. It's not just one day, "I feel irritable today. Maybe I didn't sleep well last night." You're talking about something sustained over weeks to really diagnose depression.

Dr. Langenecker: Yeah. And I should add one more thing. I know you've all talked about sort of the interface between the brain and the body. Sometimes depression comes out not just in men, but in women too, in the body. So people are like, "My back is just driving me crazy. I can't get comfortable. I can't sleep," or, "Man, my knee's just bothering me lately." And it turns out that there's actually a reason for that.

So some of the neurochemical systems that interface between the body and the brain are sending some of those signals both directions. And so it comes out sometimes as pain.

Troy: Yeah, and I will absolutely second that. So many people, a very large percentage of people I see in the ER with chronic abdominal pain, back pain, even chest pain, there are clearly underlying emotional health issues. And a lot of that is depression.

So that's a good point of being aware of maybe some of the physical symptoms we're seeing. Certainly, not to blow those off as just writing those off without getting those checked out, but it makes sense that a lot of that does relate to depression or mental health.

Mitch: Do we know what causes depression?

Dr. Langenecker: We have clues.

Mitch: But no answers. Just clues.

Dr. Langenecker: But no answers. Yeah. So the easiest way to think about it is our brain is really, really sensitive to things that are dangerous to us. We grew up evolutionarily in a place where it was really a bad idea to not be afraid of a tiger or of a rattlesnake. And it was really a bad idea to sort of go wandering out in the dark at night.

And so our brains adapted over time so that, for many reasons, we would sleep, but also so that we would have a healthy fear of things that could kill us. Well, it turns out in the United States today, it's a pretty safe place.

Part of the evolutionary makeup that we had, too, is that we had to form small groups to protect each other. And so social connectedness was a super huge important part of sort of being healthy and staying alive.

And then the final thing is if we got sick, we needed a system to sort of keep us separated from other people so that we wouldn't necessarily get them sick as well. All of these things are great if you're running around in pre-historic times with sabretooth tigers and whatever, but it's not super helpful in our environment now. So we have these super sensitive, in-tune systems for detecting danger and stress and so on, and sometimes our system gets over-reactive to these triggers in the world.

Sometimes, however, we have experiences which I would put in the broad category of not being fair. And if I had a nickel for every time I said to a patient, "Hey, what happened to you was not your fault, and it wasn't fair, and let's see what we can do about it," I would be a very wealthy man and I wouldn't be talking to you right now.

Mitch: So you're saying that everyone is kind of maybe hardwired to have these kinds of responses. It's not like you are some sort of different. You're not some anomaly if you experience depression.

Dr. Langenecker: This is where I'm at today after 25 years of studying this. I think that apart from maybe 3% or 4% of humans, we all have the capability of becoming depressed. And I think that's actually an inherent part of being human. I think it's a good part of being a human. And if you don't have those signals working when things go wrong, people probably won't like you very much.

Mitch: You're unlikable if you can't get depressed. Is that what you're saying?

Dr. Langenecker: You're unlikable if you don't care about things and don't care about other people. And it turns out if you take that capacity to care and you combine it with bad experiences, a lot of times that's going to end up being maybe not depression, but some sadness, a couple days of sadness.

So you asked me the question "What is the cause of depression?" And that's the segue. The segue is a couple of days of sad to more than a couple days of sad.

I use this term professionally: perseveration of negative mood. What the heck is that? It means that the negative mood doesn't leave no matter how hard you try and shake it.

So it brings me back to Charlie Brown with the rain cloud over his head following him around. That is a beautiful example. And I know that Charles Schultz experienced depression because nobody else would draw that unless they experienced depression.

Mitch: And for people that are dealing with severe or chronic depression where you may feel extremely low and just can't seem to pull yourself out of it, I'm here to tell you it's not because you're weak. And Scott agrees.

He takes some time to explain that there's a biological and psychological reason that depression can be a saboteur to your health and, frankly, a sneaky, unpleasant fellow.

Dr. Langenecker: We have a feedback system from our brain to our body, and you sort of think in depression that system gets jammed up. It isn't working the way it's supposed to.

Yeah, I don't know about any of you . . . I joined the conversation about running late, but I don't like to run. I hate running, but I love how running makes me feel. And if all of a sudden I didn't feel that way after running, it wouldn't take long for me to say, "You know what? I don't want to run anymore." And that's what depression does.

So we kind of mentioned it before. Depression is this sneaky bastard that takes away the joy from things and then convinces you that that's a good idea, like, "Oh, no, I shouldn't seek out joy anymore. That's a great idea. I should just sit in my bed."

So we as humans . . . and I don't mean this in a negative way, but we as humans kind of have a lot going on, right? There's a lot of stuff going on in our heads, lots of stuff going on in our lives, and sometimes we just miss it. We miss it in ourselves. We miss it in other people. And that's not bad on anybody else. That's just sort of the complexity of being a human being.

But sometimes it's absolutely the case that you miss it yourself. Absolutely the case that somebody else is like, "Hey, I noticed that you're a bit off. What's going on?"

And then of course, as a man . . .

Scot: "No, no, no."

Dr. Langenecker: . . . your first response is, "No, we're not going there."

Scot: No, everything's fine."

Dr. Langenecker:"I just rubbed some dirt on it. It's fine."

Mitch: Right. Can we say sneaky bastard, Scot, or is that what . . .?

Scot: I don't know. Why sneaky bastard? Why is depression a sneaky bastard?

Mitch: Yeah, that's what I was going to say.

Scot: What's the definition of bastard?

Dr. Langenecker: Yeah. Unpleasant fellow. Let's use the sneaky, unpleasant fellow.

Scot: Oh. Yeah, I thought it meant something else, I guess.

Mitch: I love that.

Dr. Langenecker: So, in technical speak, we talk about cognitive distortions, like how depression changes the way you view the world. You view the world in more black and white terms, like things are all good or they're all bad, or people are out to get me or things are never going to work out for me.

Those cognitive distortions don't really work for a podcast or for actually talking to patients like real humans. And so I've come to think of depression as this sneaky inner voice.

So you might remember back in the day long ago in cartoons where they had the devil on your shoulder and the angel on your shoulder. This is kind of the devil on your shoulder saying, "Yeah, things are terrible. They're always going to be terrible. And that person is not going to help you even if you ask them for help."

And so those kinds of cognitive thoughts are happening in the same exact system that does all of your problem solving. And it doesn't take long to figure out, "So the same exact system that is doing the problem solving is also distorting my perceptions of the world." That's the trap. That's the sneakiness of depression.

Scot: It's like a little saboteur.

Dr. Langenecker: It is absolutely a saboteur. And then to add insult to injury, in depression I will feel ashamed that my brain is doing this to me on top of that. So we come back to the question of "What is depression?" Depression is your own brain convincing you that things that are good for you aren't good for you.

Mitch: And for men, depression often goes underdiagnosed and untreated, which can explain why the deaths of despair and suicide rates for men in the U.S. are three to four times more likely than their female counterparts. So why is it that depression is just so hard for us?

Dr. Langenecker: There's another piece to this. So you take this maleness of, "I don't need help," and then you take this sort of cultural belief that we're doing the Horatio Alger thing and just pulling ourselves up by our bootstraps, and then you take this idea of positive psychology, which is literally "rub some dirt on it" or "rub the dirt off of it," I don't know what it might be, and for somebody who's experiencing depression, that's basically telling them, "You're an idiot. You can't figure it out. You should have figured it out a long time ago. Why are you such a moron?"

I'm using really strong language here because that's the saboteur. The saboteur can take really well-meaning, "Hey, maybe you could try this," or often, "You should do this," and it comes across as, "I'm incompetent and I'm making a big deal out of this. I should just get over it."

So part of the work with a therapist, honestly and truly, is getting folks to realize that they deserve better, and to believe that they deserve better, and to do things in the world to actually experience the better. That's how we beat the saboteur.

Mitch: That's interesting because on another episode, we kind of talked a little bit about the first couple of mental health workers I worked with. I was suffering from depression, and that was the very same thing I felt, right?

When that first person was like, "Oh, yeah, have you tried gratitude journaling?" the first thing I thought was, "I've tried it. It's obviously not working for me, Doc. You've got to help me here. I'm not going to open up the journal again. Things are obviously terrible." And I think looking back on that, he was probably giving decent advice and good advice. I just was not in the mood to hear it, right?

Dr. Langenecker: And that's why I use the analogy of a journey with some really comfortable shoes, because it's not just the what, it's the when. And there's a phenomenon in depression, the waxing and waning of depression, where as a therapist, I wait for windows of opportunity. I don't force windows of opportunity. And that has taken years to hone that skill, because if I force it at the wrong time, I'm going to be breaching some of that trust that I've worked so hard to build with my client.

Mitch: Again, anxiety and depression are both so common, there's a pretty good chance that you or someone you know has struggled with one of them.

If these clips have struck a chord in any way, I'd suggest checking out the full episodes on both anxiety and depression for a deep dive into the basics of those conditions.

Now, while having some background knowledge about mental health disorders can be extremely helpful and some of the strategies we shared last week can go a long way, if a person's mental health becomes dysfunctional and disruptive in their life, it may be time to seek out some professional help. But how exactly do you do that? How exactly do you find that professional help? I know I didn't know when I started.

So on Episode 101, "Finding The Right Mental Health Person For You," we discussed how you can actually find that help and the right kind of help to start living a better life with better mental health. To start, Dr. Langenecker explains at what point a person should start to consider therapy.

Dr. Langenecker: I think about it this way. What's the most complicated system you have in your body? The obvious answer is your brain. If your brain's not working the way you want it to, that's the time to find somebody to talk it out and figure it out and see if you can optimize what's going on.

It's not always about, "Things are terrible. I feel awful." Sometimes it's, "I just feel off," or, "That didn't go the way I wanted it to," or, "I got angry there and I really don't like it when I get angry." There could be all sorts of reasons why it might be a good idea just to chat with somebody and check it out.

Mitch: Is there something that men kind of deal with more than, say, anyone else that maybe that's a sign you should probably go talk to someone?

Dr. Langenecker: Well, the big one for most men is anger, and even acknowledging that sometimes anger gets the best of you. It may be that you got it under control. It may be that it doesn't really affect anybody else except for you. But if you walk around and you get home from work at night and you just feel off or irritable or angry, that's kind of a good sign that maybe it's a good idea to talk to somebody.

Mitch: And what should you be looking for when you start your search for a mental health professional? Scott has an analogy that I think everyone can appreciate.

Dr. Langenecker: Finding a good therapist is kind of like finding a good pair of shoes. You've kind of got to know what you're looking for. Do I want running shoes? Do I want hiking shoes? Do I want dress shoes? But they've got to be super comfortable. You've got to be comfortable working with a therapist.

And the reason why I like using the analogy of shoes is once you put them on, you're going to go somewhere. If you're going to be successful, you're going to make some moves. You're going to make some changes.

Troy: See, that's a great analogy. There's nothing worse than a long walk or hike or run with a little rock in your shoe, and you think, "Oh, I can deal with this." But just that little thing in there, it becomes just intolerable. So I would imagine the same with these relationships. If things just are not quite right, it's just not going to work.

Dr. Langenecker: Yeah. We've all been on that walk with that pebble in our shoe or we don't have the right kind of shoes, and we're not enjoying the scenery. We're thinking about the blister we're about to have.

Mitch: That reminds me of the time I wore cowboy boots on the Vegas strip, and that was the worst decision I have ever made. I think I could not walk the next day. My feet were so broken.

Troy: Let me guess. That was probably the first time you'd ever worn cowboy boots.

Mitch: Oh, absolutely. I bought them for the Vegas trip.

Troy: "That's what people wear in Vegas. They wear cowboy boots."

Dr. Langenecker:I bet you they looked good, though.

Mitch: Oh, they were banging, but no, after walking up and down the strip all night, the next morning I was limping to Walgreens to get some flip-flops.

Troy: That sounds so horrible.

Mitch: It was.

Dr. Langenecker: And if I could carry the analogy further, there are some times where a person just needs somebody to talk to and they just need a super comfortable pair of loafers. They're not going anywhere. They just want somebody to hear them as a human and to feel the connection.

Mitch: But how do you actually find that perfect fit for you? What if the first professional you meet with just doesn't seem to be working out?

Dr. Langenecker: Well, to be completely frankly honest, this is a daunting thing for me. And I've actually been doing this for 25 years, so I do want to be completely honest with your listeners. Sometimes it takes a bit to find the right person.

And so when you start out, you might be entering something into Google, "I've got anger issues and I want to find somebody to talk to." And that may send you to a place that you don't ultimately end up going, but it may send you to somebody who can actually give you some advice on where you need to go next.

So one of the things that I say in the first meeting, when I meet with any patient, is I say, "You know what? I am a 51-year-old white male from rural Wisconsin. That may or may not jive with who you are and what you think of the world. We're going to talk for a bit, and hopefully you feel comfortable working with me, but if you don't, I want you to feel comfortable saying, 'Hey, Scott, I need to talk to somebody else. Can you help me find someone else?'" And then I do.

And that's where we get to some movement, get to the place where you actually find somebody who you can jam with and jive with and feel comfortable with, and do some meaningful work.

Troy: And you don't take offense at that, if someone's just like, "Hey, this is not working. I've got to find someone else"?

Mitch:"It's not you. It's me."

Dr. Langenecker: Yeah, to be completely honest as a therapist, I feel it too if things aren't quite going. I'm working my tail off to try and make it work, but if it's not and you are just being polite and saying, "Hey, let's work on this thing today," and it's kind of like nails on the chalkboard, let's not do that. Tell me so we can find somebody who will work with you and you get a good experience out of it.

Mitch: Now, these were just the very basics. If you're interested in more specifics about how to find a mental health professional for you and what programs are available, what to look for, etc., go check out the full episode.

But to finish out today, Dr. Langenecker has one piece of mental health advice for every person out there.

Dr. Langenecker: My best advice is don't delay. In your mind, especially for men, it's like, "Oh, I can deal with that later." And I know you've covered this in other health topics on this podcast, which is, sure, it can wait, but it doesn't have to. Things can get better and they can get better sooner.

Mitch: And if you liked anything you heard on today's best-of episode and want to hear more, a list of the episodes featured today is in the show notes.

And if today's discussion on anxiety and depression brought up anything for you, or you have mental health questions that you might want to ask our specialists, don't hesitate to message us via email at hello@thescoperadio.com.

Thanks for listening, and thanks for caring about men's health.