Managing Symptoms in Gay Men’s Mental Health: A Path to Empowerment

Managing Symptoms in Gay Men’s Mental Health: A Path to Empowerment

As a psychotherapist and coach specializing in gay men’s mental health for over 32 years, I’ve seen firsthand how dealing with mental health symptoms can feel like a maze with no exit. Whether you’re grappling with anxiety, depression, relationship struggles, OCD, ADD, the intrusive symptoms of trauma, substance recovery, grief, or general life stress, understanding your symptoms is the first step in regaining control over your mental well-being. But what do you do after identifying your symptoms? What’s the best way to manage them?

In my Telehealth practice, I guide gay men through a structured approach that I call the TFID model: understanding symptoms through Type, Frequency, Intensity, and Duration. This model, combined with practical management techniques, has helped many clients worldwide feel more empowered in their mental health and life functioning journey. Let’s explore this model in more depth, and see how it could make a difference in your life:

Step 1: Awareness and Identification

Awareness is the foundation of mental health work. Many clients feel a huge weight lifted just by being connected with someone who can really listen, hear, and validate them.  Together, I help you accurately identify the specifics of what you’re experiencing. With TFID, we dig deep:

• Recognizing Triggers: I help encourage clients to make a mental note of awareness about what situations or events tend to precede symptom flare-ups, whether those are external events, internal thoughts, work or social situations with others, relationship interactions with a partner, or physiological states relating to your body and overall health.
• Tracking Patterns: You might find it helpful to keep a symptom journal to record the Type, Frequency, Intensity, and Duration (TFID) of symptoms to help you, over time, to recognize some patterns that emerge. This also empowers you to notice improvement over time, that incremental gain in subjective experience of symptoms, and your functioning, as our sessions progress over time and build on one another.

• Practicing Mindfulness and Reflection: Practicing Mindfulness helps individuals you tune into your emotions and bodily sensations, just recognizing symptoms as they arise without judgment, which is particularly useful for managing both physical and mental symptoms.  When you know your triggers, you can prepare yourself to respond rather than just react, impulsively.  You want to put some slow-motion time between impulse and response.  I teach Mindfulness exercises that help clients recognize early signs of distress and develop the inner calm to make choices aligned with their well-being.

Through this process, you gain a sense of control and “self-empowerment” (the name of my 2013 book!) and start seeing a path to recovery and growth.

Step 2: Short-Term Coping Strategies

After identifying symptoms, we start building your “mental health toolkit.”  These short-term relief strategies work wonders for managing symptoms in real time. Here are a few I often recommend to clients, of so many ages and situations, in psychotherapy in Los Angeles/West Hollywood where I’m from, in California, or even worldwide when I’m doing Coaching.

• Breathing and Grounding Exercises: These techniques bring down stress instantly and allow you to focus on your body’s natural rhythms, rather than on negative thoughts or emotions.
• Visualization: I can help you create an Inner Safe Place through a visualization exercise that becomes and mental tool to call on whenever you need it.  Imagining a calm place or safe person can quickly help reduce the intensity of certain symptoms, such as anxiety, frustration, fear, stress, or emotional overwhelm.
• Behavioral Activation: For depressive symptoms, I often encourage scheduling for yourself small, pleasurable activities to help break cycles of inactivity, such as a quick walk near your home or office, chatting with a friend via text or on the phone (or maybe a quick coffee meeting or Happy Hour), or listening to favorite music, especially for those managing depressive symptoms (I had another blog/podcast episode on “Self-Empowerment Through Music: The Power Playlist”, because there are so many songs that fit very specific emotional situations, especially show tunes, about a character in a time, place, and situation).

Together, we find the immediate, short-term techniques that work best for you, helping you feel more in control of difficult moments.  That can buy you some time and stabilization to explore deeper meanings and implications in your sessions, when we get deeper into the heart of why these symptoms come up and the patterns you can discern about your life challenges.

Step 3: Long-Term Management and Lifestyle Adjustments

Managing symptoms is a long game, but making consistent lifestyle adjustments can greatly reduce their intensity and frequency. These adjustments are what I help clients integrate sustainably into their lives:

• Routine and Structure: I’ll often encourage designing, and creating, a routine to provide stability, especially when dealing with mood-related symptoms. This could include a consistent sleep schedule, regular meals on a desired eating plan (especially for health and fitness goals), and dedicated times for relaxation or socialization, within each day, and also on the weekends or vacation times.

A consistent routine can ground you, creating stability in an otherwise unpredictable world. We explore ways to design a daily structure that’s flexible but firm, so you feel safe and steady to focus on your most important goals.

• Exercise and Physical Activity: Exercise can help reduce the intensity of symptoms by releasing endorphins and improving mood regulation. Even low-impact activities like walking, stretching, or yoga can be beneficial, and more strenuous sessions can do even more, like running or weight-training.
• Healthy Boundaries: For symptoms tied to relationships or social situations, like anxiety, setting boundaries with others helps prevent overwhelming feelings and situations from escalating into real discomfort.  Clients often come to me with symptoms tied to difficult relationship conflicts about sex, or money, or housekeeping, or family, or overwhelming work environments like unreasonable bosses or sabotaging colleagues. Together, we identify where stronger boundaries are needed.  We can even role-play a script of how to set them, so your emotional energy for longevity is protected.  This is especially important for more introverted people with Social Anxiety/Social Phobia, Generalized Anxiety Disorder, ADD, OCD, or just low self-esteem or self-confidence.
• Goal-Setting: Together, we design a list of small, achievable goals to help with feelings of accomplishment and motivation, particularly for symptoms that affect productivity or self-esteem.  Depression is a big motivation-killer, and sometimes it takes discussion about where your ambivalence is about doing something, versus not doing something, and the reasons why.  Many guys I work with have an unconscious avoidance about doing certain things, which creates this Approach-Avoidance inner conflict that I’ve written about before, that can cause inertia.  Small goals helps to reduce the overwhelm we might feel about larger goals, about school, work, relationships, or creative endeavors.

Clients who incorporate these changes into their lives report back feeling more resilient, grounded, and capable of facing challenges not just right then, but for a lifetime by applying these Cognitive Behavioral tools whenever you need them from then on.  That can be a good investment in cultivating that personal skill set.

Step 4: Support and Professional Guidance

Sometimes managing symptoms is tough to do alone, which is why reaching out for support can be so valuable. As a licensed psychotherapist (in California) and an experienced coach (globally), I work with gay men all over the world to address mental health and life issues.

• Accepting Symptoms: Symptoms, while challenging, do not define you. Practicing self-compassion—acknowledging your symptoms without judgment—can be a powerful way to reduce the self-critical feelings that often accompany psychiatric challenges in mental health, or just life challenges in general.
• Practicing Self-Compassion: Many clients feel relief when they learn to approach themselves with compassion, rather than criticism; taming that ever-present Inner Critic voice, which is probably left over from the voice of a critical parent that we’ve internalized. Together, we’ll work building the Cognitive Tools to reshape negative self-talk and stop a second and acknowledge your progress, no matter how small.

• Through this compassionate, strengths-based approach, clients often find they have a far greater capacity to handle life’s ups and downs than they initially believed.

• Learning Resilience Skills: You build resilience by reflecting on past successes in dealing with symptoms, which can empower you to feel more capable of managing future challenges.

Part of my work with clients involves celebrating resilience and self-empowerment. Even the small steps forward count that you do differently within the day, or week, or month. Learning to view setbacks as part of growth, rather than as failures, can shift your entire perspective.  We don’t “want” things to go wrong, but we know that when they do, they are offering a unique opportunity for learning new skills and building resilience for future challenges.

• Building Community: I encourage clients to connect with supportive networks in their area or online.  LinkedIn might be one example, or alumni groups, or professional associations, or groups of people who share something in common with you where you can support each other, such as Twelve Step groups or Twelve Step alternatives like SMART Recovery and some new ones, which are often attractive to gay men who are religious abuse survivors and just want truly secular resources. Having peers who understand your experiences can be empowering to reduce feelings of isolation and gain adaptive coping tips.
• Books, webinars, YouTube videos, and even ChatGPT answers to prompts can all be external resources of support that aren’t as interpersonal as the others, but you can access them privately on your own time and see if what they’re saying, or recommending, resonates with you.
• Exploring Medication Options: If symptoms are particularly intense, I help clients get referral to MD psychiatrists who can evaluate you for medications that can help just with the practical issue of symptom reduction, and there are medications that can help lessen the Type, Frequency, Intensity, and Duration of the symptoms of Depression, Anxiety, Trauma reactions, ADD, OCD, and Bipolar Disorder.  These referrals are all to pre-vetted MD psychiatrists (my general preference over General Practitioners, specifically for psychiatric symptoms) who are LGBT-affirmative and have some skills in understanding the unique cultural needs of gay men.  I also refer to physicians for other specialties, such as medical disorder symptoms like chronic pain or Erectile Dysfunction, which can affect your mood.  Often, symptom management (or even full resolution) is some kind of combination of “people resources” like professionals, even people like attorneys or Certified Financial planners, resources like books or audio/visual material, medications, and community support.  It’s the combination of factors that tends to yield more enduring symptom relief.

Working with a therapist or coach who understands the unique challenges faced by gay men can provide you with support that resonates on a deeper level. Many clients have told me that this understanding alone makes a profound difference.  The “one size fits all,” I think including trying to lump all “LGBT” people together, is just not specific enough for gay men’s culture.  You need a specialist or someone who has had some opportunity, or interest, or skill developments in working with gay men, even if they’re not gay men themselves.  Too many “non-gay-male” providers “think” they know the differences to take into account in our culture, but then they “don’t know what they don’t know,” or they don’t “get it”; we’ve all been there with the odd question or the odd terminology that can have this tinge of either disinterest, misinformation, or subtle judgment, especially with relationship and sexual concerns, like my specific training in gay men’s Consensual Non-Monogamy and gay men’s kink culture.

This structure of approach to managing symptoms — Awareness, Coping, Management, Support, and Acceptance—can be customized to the needs of guys facing a wide variety of symptoms and across many mental health, relationship, career, health, or life challenges. This balanced approach can help you feel more empowered to take control of your developmental journey, at any age or phase or life, in a more proactive, but compassionate way.

A Path Forward, Together

Dealing with mental health symptoms doesn’t have to feel like an uphill battle. By applying this structured, practical approach to TFID symptoms, you can begin to transform your relationship to your own sense of mental health and well-being.  Whether you’re navigating anxiety, depression, or general life stress, know that there are actionable steps you can take to feel more in control and relieved.

If these ideas resonate with you, I’d love to be part of your journey toward greater well-being. Whether you’re in California or anywhere else in the world, I invite you to reach out for a consultation to explore how we can work together through Telehealth—psychotherapy or coaching—to support your growth, and I can explain more about those differences that are made for important legal and ethical reasons.

I can work with you from wherever you are, via Zoom.  We can dive deep into the issues you’re facing, using tailored techniques to improve well-being.

Contact me at 310-339-5778 or email Ken@GayTherapyLA.com or Ken@GayCoachingLA.com, to get started. Together, we can build a life where your mental health becomes a source of strength and empowerment.