In recent years, there’s been a lot of progress around the de-stigmatization of mental illness—however, a certain demographic still carries a heavy stigma behind mental health: Men.

Let’s look at the numbers:

– Men are less likely to seek professional help for mental health related issues (approximately only 1 in 4)
– Over 6 million men suffer from depression each year
– Approximately 19 million men struggle with anxiety each year
– Around 3,020,000 men experience panic attacks

But why is there a stigma around men’s ability to address these issues? One possibility could be the stereotype that men aren’t emotional beings. Mental health concerns affect both men and women, but men may be less likely to talk about these feelings or seek help, especially if their symptoms appear to be different from others.

According to the National Institute of Mental Health, men can show different symptoms than women when experiencing a mental health challenge. “Some men with depression or an anxiety disorder hide their emotions and may appear angry or aggressive while many women express sadness.” Additionally, mental health symptoms can sometimes appear to be physical such as a racing heart, tightening chest, reoccurring headaches, or digestive issues.

In our ongoing effort to reduce stigma around mental health, it’s important that we encourage men to be open to talking about their feelings and aware of their symptoms as we work towards including mental health as part of our overall well-being.

When we’re in a stressful situation, either mentally or physically, our bodies respond by activating several hormones and go into “survival mode.” Research tells us that the body does this because it treats many different stressors the same. Whether the stress is related to a severe car crash or stems from intense anxiety over something you’re worried about—the body responds in similar ways to very different scenarios.

Now that we understand the connection between mind and body, we can recognize that by working on our mental health, we’re also indirectly helping our physical health. One very essential piece of thriving mental health is resiliency, or the ability to look adversity in the face and “bounce back” from it.

It’s important to remember that adversity is inevitable in life and is an essential part of building resiliency. Just like it’s impossible to learn to ride a bike without the bike itself, resiliency can come with struggles and hardships. The true growth comes from how you approach these adversities and conquer them. Studies show that people who focus on eliminating stress rather than interacting with it in a constructive way are far less capable of fostering their resilience.

The good news is, there are several effective methods to help you practice being more resilient in times of stress:

• Meditation
• Goal setting
• Reframing your situation
• Cognitive Behavioral Therapy (CBT)
• And many more

It’s okay if resiliency doesn’t come easily right away—it’s something that will take time to develop and grow. The more you focus on building your resiliency, the more you will be able to overcome and bounce back during stressful periods of time.

The four most commonly recognized communication styles are:

1. Passive
2. Passive-Aggressive
3. Aggressive
4. Assertive

Passive communication often comes from a place of low self-esteem. Passive communicators frequently don’t speak up for themselves or assert their wants or needs. They may feel as if their feelings and opinions don’t matter, may not look people in the eye, and may even apologize for speaking up. Over time, being passive may lead to built up frustration or anger.

An example of Passive communication:
Sarah disagrees with Mark, but doesn’t want to speak up because she doesn’t like conflict. She looks down and nods her head in agreement, even though inside she dislikes how he is always getting to state his opinion.

Passive-Aggressive communication involves expressing negative feelings in a hidden, or indirect way. The person is still trying to avoid conflict, but the feelings come out in a roundabout way.

An example of Passive-Aggressive communication:
Sarah asks Mark, “Are you wearing that to the party?” triggering hurt and embarrassment for Mark. But rather than tell Sarah that he was bothered by the comment, Mark retaliates by slowing his efforts to get ready for the party, knowing it is important to Sarah that they get there quickly.

Aggressive communication has unfortunately impacted most people at times. The person who has been aggressive often expresses him or herself in a way that hurts others, often in response to their own anger or drivenness. Can you think of such an interaction? You probably ended up feeling hurt or insulted.

An example of Aggressive Communication:
Sarah is upset with Mark’s choice of restaurant for the night: “I can’t believe you chose this place again. You have the worst taste! How could you be so stupid? Why would I want to go here?”

Assertive communication is often the most effective and kind way to communicate. You are able to express your feelings and opinions directly, without deliberately offending or hurting others. This type of communication can be challenging, because you often must be brave (you are sharing your own wishes) and honest (sharing your true feelings can be hard). If you practice, communicating assertively typically becomes easier over time.

An example of Assertive communication:
Sarah wishes that Mark would put down his phone when they are having an in-person conversation: “Mark, I would really appreciate if you would put your phone down when we’re having a discussion. When you are looking at your phone, I have a hard time knowing if you’re listening to what I’m saying, and I wonder if what I’m telling you just isn’t important to you.”

Sarah probably felt a little nervous telling Mark how she felt, but she expressed herself honestly and in a respectful way. Hopefully, Mark will put down his phone and listen to Sarah during their next conversation and they will both feel better about how they are communicating.

Being assertive doesn’t come naturally to everyone. Sometimes it seems easier to give in to others, or more natural to get what you want by ordering people around. If your parents communicated this way, then it may seem normal to you. These types of behaviors are learned. The good news is that we can unlearn unhelpful behaviors. Persisting in problematic communication strategies—communicating passively, passive-aggressively, or aggressively–often leads to feelings of anger, resentment, irritation or isolation. Assertiveness can be learned through repeated use. There’s always time to change…here are some things to think about when you are interacting with someone with whom you have a relatively good relationship:

• Tell the other person what they’re doing.
• Tell them how it’s affecting you.
• Tell them how you feel about it. (Try to use “I” and express feelings rather than thoughts)
• Respectfully, tell them what you’d like them to change.

Each time you’re assertive, it will likely become a little bit easier. Gradually, you may start to notice that you feel better about yourself, and the relationships you have with others will be more satisfying. Change isn’t easy, but being assertive is worth it.

Life can be overwhelming at times. If you’re struggling with depression or anxiety, or feeling stressed by juggling too many things at once, it’s easy to forget about taking care of YOU. For many of us, our jobs, spouses, children, aging parents, or even hobbies take priority. It’s easy to focus on these people and things because you need to or want to, but it’s important to leave room for yourself, even if it’s just 15 minutes a day.

Here are some ways to show yourself a little love during this holiday dedicated to amour:

1. Think of 3 things you love about yourself. We all have flaws, and people struggling with anxiety or depression are usually excellent at acknowledging them. Give a shout out to your strengths instead. Maybe you’re a great friend, or have mad breakfast making skills, or a voice sort of like Adele. Enjoy it, be grateful for it, smile about it, and give yourself a little pat on the back.
2. Move your body. Not because you want to fit into smaller clothes or win a race, but because it’s good for you. Exercise is like a love note to your body and your brain – from you.
3. Practice . Harboring anger and holding on to past grievances can eat you up inside. Letting go of anger is a gift to the other person but also, and more importantly, to you.
4. Have fun. Just because you’re older than 12 doesn’t mean everything has to be serious. Laugh aloud, do karaoke, play a board game, have a dance party in your kitchen.
5. Reward yourself. Maybe you reached a goal you’ve been striving for, or maybe you just made it out of bed this morning (and that may have been a big accomplishment for you). It doesn’t have to be something big or fancy, but go ahead and splurge on the latté, the hot bath or an extra 20 minutes of your favorite show.

We can get hard on ourselves when life gets busy and everyone and everything is competing for our time. It is precisely during those times when those of us struggling with anxiety or depression need to take a step back, breathe and think about our own needs as well. This Valentine’s Day don’t forget to show some love to yourself.

“It’s not that I was no longer afraid, but as it turns out, you can practice being afraid. The more you do it, the less daunting scary things feel. Also, I learned that nothing is as scary in reality as it is in your head.”

Below is an excerpt from her blog post, Psychologist Dr. Russell Morfitt on How to Deal with Social Anxiety:

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What can a Learn to Live member expect from the program? How long does it last? What’s the commitment like?

Dr. Russ: Structurally, the Learn to Live Social Anxiety Program consists of eight interactive, multimedia lessons with practice exercises to complete in between. We recommend completing about one lesson per week. Periodic assessments help members to set goals and track their progress along the way.

Members quickly learn that they are not alone, which is very powerful. Throughout the program, they learn the key tools of CBT and how to apply them in their personal situation. Members also learn how to build up their social support network, a trusted group of friends or family that may support and encourage them throughout the program.

And it’s not just thought-challenges and fear-facing exercises. These are important, no doubt. But sometimes it’s the small things in our lives, the tiny avoidant habits that add up to unhelpful thoughts and behaviors. Members learn to identify these habits and work toward changing them. The overall process involves learning online, then applying that learning to one’s life. It’s really the real-world practice that creates results.

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If you want to find out more about CBT, the Learn to Live story, and social anxiety, here’s the full interview – Psychologist Dr. Russell Morfitt on How to Deal with Social Anxiety.

Molly has done a great job of connecting with other people who have faced their fears, like Jaimal Yogis of The Fear Project, and has even started her own #HeyEleanorChallenge, “a weekly email encouraging you guys to take itty-bitty steps (and the occasional big leap) outside of your comfort zone.” Sign up for the email list here. You can also like “Hey Eleanor” on Facebook or follow along with Molly on Twitter.

CBT stands for Cognitive Behavioral Therapy and is a form of psychotherapy that has been around since the early 1960’s. (There’s an interesting story about how the two most prominent founders of the model, Aaron Beck and Albert Ellis published their seminal books about the same time in the same year – so there has been some dispute over who was the first to formally present some of the key ideas.) CBT takes into account a person’s thoughts or perceptions, and how those thoughts or perceptions affect emotions and actions. We learn to identify our automatic thoughts or distorted thinking, after which we are better able to change those thoughts to something more logical or more useful. We can then begin changing our patterns of behavior, facing fears and eliminating unnecessary precautions, getting more active, or applying new alternative behaviors in place of the old actions that kept us stuck.

The skills of CBT can be applied immediately to problems we are suffering from in the present. And these skills become a helpful set of tools that can be applied to new situations as the challenges of life arise. CBT can be applied to work, school, relationships, and social situations – almost anything!

Among the most common reasons someone may seek out CBT are depression, anxiety, obsessive-compulsive disorder, social anxiety, and post-traumatic stress disorder (PTSD). What many people don’t realize is that CBT can be applied to a whole host of issues we face in our daily lives: pain conditions, sleep disorders, life stress, eating disorders…the list goes on.

In recent years, we have learned that CBT has another asset – learning how to change our thoughts and behaviors can be done from the privacy of our own homes. Internet-Delivered Cognitive Behavioral Therapy, (iCBT) has been demonstrated to be as effective as face-to-face therapy. The iCBT option means that those of us who may not otherwise choose face-to-face therapy – because of cost, stigma, or lack of options nearby – can still get the benefits of CBT.

CBT may sound like just another acronym in a world full of TLAs (three-letter acronyms). But really, it’s shorthand for a proven strategy for reshaping our unhelpful thinking and changing our unhealthy behaviors. Whether you need help with the stress of a new job, handling college life, or speaking in front of a group, CBT is a tool that can help you change your thoughts, your behaviors, and your life!

It’s a staggering statistic: 1 in 4 adults living in America have a mental health problem, such as anxiety, social anxiety, or depression. Given this, it would be natural to expect that it would be relatively easy to get help for these mental health challenges. But, curiously, it’s not. Here are a few reasons I have observed that help explain why:

1. Stigma or the fear of stigma. Despite the progress made through the #stopthestigma campaign, stigma has been a strong force over the years. Mental health problems have, at times, not been viewed as the real, treatable, health problems they often are. Talking about them has not been the norm. Whispers, awkward glances, and hushed conversations about something “not being right” have historically been commonplace.

We frequently fear being stigmatized when, in truth, we don’t really know if others will accept us or not. None of us wants to be labeled, but sometimes the fear itself—of being judged or labeled—is our biggest foe. Often, the best step we can take is to reach out and get the help we need, regardless of what others think. Often people find that others are compassionate when they learn of these struggles.

2. Cost. Mental health care, like any health care, costs money. Whether it means an office visit and the cost of a monthly prescription or 3 months of face-to-face Cognitive Behavioral Therapy (CBT), mental health care is not cheap. For many years, stigma and cost have prevented a large number of people from seeking help. With the enactment of the Affordable Care Act (ACA), cost has become less of an issue. The ACA has expanded mental health and substance use disorder benefits for 62 million Americans. Most health plans must now cover depression screening and behavioral health assessments at no cost, and plans are no longer able to deny coverage based on a pre-existing mental health condition.

Not all providers participate in insurance plans, but many do, so it is definitely worth looking into.

3. A shortage of mental health professionals. For many people choosing to seek care, distance and waiting lists pose an additional hurdle. While some areas may have a sufficient number of providers, there are many mental health provider shortage areas that continue to face growing needs, especially with the expansion of coverage under the ACA.

Sadly, even when therapists are accessible, they often fail to provide evidence-based care so the impact of the treatment is disappointing.

4. Fear is a pervasive obstacle. Fear of being labeled. Fear of therapists or therapy. Fear of admitting the problem itself.

Fear is a normal emotion with any challenge in life, but in many cases, working through that fear is a step in the right direction, a step toward help and healing. Many people have found that, if they can just take that first step, the fear becomes more manageable.

5. The nature of the beast. Anxiety and depression are, by their very nature, obstacles to finding a solution. In severe instances, many sufferers can hardly get out of the house or even out of bed. Other times people rationalize their thoughts and behaviors as “just my personality.” Coming to a point of acceptance about needing help and having the energy and courage to take a first step of asking for help are all part of the picture.

These factors are complicated and often compound one another. But our hope is that through awareness, accessibility, innovation, and courage, we can start to roll back this beast. Our #mentalhealthmatters.

Just this week in California, 2,600 Kaiser Permanente clinicians announced an upcoming Kaiser Permanente mental health clinician strike. The clinicians plan to strike to “protest Kaiser’s chronic failure to provide its members with timely, quality mental health care.” Under question are Kaiser’s alleged failures to appropriately fund and staff their psychiatry department, leading to understaffed clinics and hospitals, unacceptable appointment wait times, and adverse outcomes related to not having access to care. They have been fined $4 million for “failure to provide mental health treatment in a timely manner.” The demand is simply too high and the resources too scarce.

As large and profitable as the Kaiser organization is ($3 billion in profits in 2014), it is not immune to the burden of increased mental health demand. Decreased money being allocated toward mental health, a shortage of trained mental health providers in certain areas, and a very large demand for services pose significant challenges, not only in California, but all across America. We can expect to see more tension in the healthcare sphere, and especially in the mental health space, as more people are given access to covered services through programs like the ACA.

The hope is that difficult situations like this one in California will get us thinking more broadly about innovative solutions in our search for affordable and effective options to meet the pressing needs. Creative solutions like Internet delivered Cognitive Behavioral Therapy, for example have been proven through years of research but remain underutilized. Any solution that addresses the major barriers to treatment to like stigma, cost, and accessibility should be considered.

See also: PsychCentral: Dr. Russell Morfitt Discusses Online Counseling for Anxiety

2,600 clinicians will be striking in order to raise awareness about the situation in California. Let’s hope the strike creates a dialogue about other treatment options as well.