General Medical Information

  Anxiety and Stress
Fear and anxiety are two emotions that are almost identical in their physiological responses, but while fear is a natural response to actual or perceived dangers, anxiety often involves stress produced from worrying about past or future dangers. Anxiety and stress is part of every day living but when it goes beyond worry and nervousness that makes coping with daily life difficult or impossible it is called “pathological anxiety” or generalized anxiety disorder (GAD). GAD involves severe stress, phobic or anxiety disorders (like panic attacks) and post-traumatic stress disorder (PTSD).

Anxiety disorders are the most common group of psychological disorders and are particularly prevalent among gay men because of various additional sources of stress not experienced by the general population. The symptoms, diagnosis and treatment of anxiety disorders varies greatly so consult a medical or psychological professional if you think the stress and anxiety in your life is unmanageable or overwhelming.

For more information on anxiety and stress disorders, go to the following sites: or

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  Bipolar Disorder (Mania)
Bipolar disorder is also known as manic-depressive illness and is a brain disorder that involves extreme shifts in mood, energy and ability to function without any apparent cause. This condition is different from the “ups and downs” of everyday life but can be confused with the effects of certain medications and party drugs that are commonly used by gay men. Bipolar swings in mood can result in poor job performance, damaged personal relationships and even suicide but the condition is treatable.

Because bipolar disorder involves an extreme swing between moods, the symptoms for the manic phase are different from the depressive phase of the disorder. The important thing in determining if bipolar disorder might be present is the rapidity of the shift between the two phases or moods involved without any apparent reason for the change.

Signs and Symptoms of a Manic Episode
A manic episode may be involved if three or more of the following symptoms are experienced nearly every day for one week or longer:

  1. Increased energy, activity and restlessness
  2. Excessively good or euphoric mood
  3. Extreme irritability
  4. Talking very fast and jumping from one idea to another
  5. Inability to concentrate, easily distracted
  6. Needs little sleep
  7. Unrealistic beliefs in personal abilities
  8. Poor judgment
  9. Spending sprees
  10. Greatly increased sex drive
  11. Lasting period of radically different behavior
  12. Drug abuse, particularly cocaine, crystal meth, alcohol or sleeping medications
  13. Provocative or aggressive behavior
  14. Denial that anything has changed

Signs and Symptoms of a Depressive Episode
A depressive phase may be involved if five or more of the following symptoms are present nearly every day for a period of two weeks or longer:

  1. Lasting sad, anxious or “empty” mood
  2. Feelings of hopelessness or pessimism
  3. Feelings of worthlessness or helplessness
  4. Loss of interest in activities, including sex
  5. Fatigue, decreased energy
  6. Difficulty concentrating, remembering or making decisions
  7. Restlessness or irritability
  8. Sleeping too much or inability to sleep
  9. Change in appetite or unintended weight loss
  10. Chronic pain not caused by illness or injury
  11. Thoughts of death or suicide, suicide attempts

Friends and family may notice dramatic shifts in mood but to diagnose and treat bipolar disorder a medical professional needs to be consulted. Mild to moderate levels of mania may actually increase functioning and productivity but if bipolar disorder is present and left undiagnosed and untreated it can progress to severe episodes of mania and depression that may include psychotic symptoms. When such psychotic symptoms such as severe depression or delusions appear the condition may be incorrectly diagnosed as schizophrenia or other severe mental illnesses.

For more detailed information on bipolar disorder, click on the following links: or

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  Panic Disorder (Panic Attacks)
Panic attacks involve periods of extreme anxiety or fear that come on suddenly, appear to be unprovoked and can be disabling. It is thought that panic disorders are caused by the body’s alarm system that helps us respond to threats is triggered when there is no danger. Panic attacks can happen at any time, even during sleep and typically passes within ten minutes. Such events can be one of the most distressing feelings that a person can experience. Left undiagnosed and untreated, panic attacks can lead to the development of irrational fears called “phobias” associated with the places or situations when panic attacks first appear. Eventually in an attempt to avoid the attacks, persons may have so much anxiety that they may be unable to drive or even leave the house. Because of this, panic disorder can have as big an impact on one’s daily life as any other major illness. First attacks are often triggered by physical illness, major life stress or medications and party drugs like crystal meth that increase activity in the part of the brain involved in fear reactions.

Panic attacks can arise early or late in life and once they begin can continue intermittently for months or years. Some symptoms of panic attacks can be mistaken for heart disease or other serious illnesses. Many people to emergency rooms when having a heart attack and extensive medical tests may be needed to rule out other serious conditions. Symptoms appear suddenly and without any apparent cause. Symptoms may include:

  1. Racing or pounding heartbeat
  2. Chest pains
  3. Dizziness, nausea
  4. Difficulty breathing
  5. Tingling or numbness in the hands
  6. Flushes or chills
  7. Dreamlike sensations or perceptual distortions
  8. Terror/sense that something horrible is about to occur
  9. Fear of losing control and doing something embarrassing
  10. Fear of dying

Specific forms of psychotherapy are effective in treating panic attacks as are a variety of effective medications. Untreated panic disorder can result in debilitating phobias which can destroy whole lives. In addition, those with panic disorder may need treatment for other emotional problems or addictions. Depression, substance abuse and even suicide attempts are closely connected to panic attacks for many people so these other conditions often need to be dealt with in order to resolve panic disorder.

For more complete information on panic disorders, click on the following link:



Major or “clinical” depression is a common but serious condition that affects gay men at a higher rate than the general population. Some of the symptoms of depression include:

  1. Feelings of hopelessness, pessimism
  2. Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  3. Feelings of guilt , worthlessness, helplessness
  4. Decreased energy, fatigue, being “slowed down”
  5. Difficulty concentrating, remembering, making decisions
  6. Insomnia, early-morning awakening, or oversleeping
  7. Appetite and/or weight changes
  8. Thoughts of death or suicide or suicide attempts
  9. Restlessness, irritability

If five or more of these symptoms are present every day for at least two weeks and interfere with routine daily activities such as work, self-care, and care of others or social life, seek an evaluation by a professional psychiatrist or psychotherapist.

For more information on depression go to the following sites: or




Schizophrenia is a serious psychological illness which affects the brain and is often confused with other, very different conditions such as bipolar or multiple personality disorders. It usually appears during adolescence or early adulthood, is much more prevalent among men and is NOT caused by stress or drug or alcohol abuse.

Symptoms of schizophrenia include visual, but most commonly, auditory hallucinations usually described as “hearing voices”. Symptoms can include paranoid delusions, disorganized speech or behavior and inability to focus, all of which can be easily confused with the effects of alcohol or party and prescription drug use. People with schizophrenia can appear withdrawn or emotionally flat and so the condition is often confused with depression. The symptoms of schizophrenia can be controlled very well with medications but the condition is not “curable” in the strict sense. Diagnosis of schizophrenia must be done by a qualified health professional, usually a psychiatrist, who can also prescribe the appropriate medications.

For more information on schizophrenia, go to the following sites: or




High rates of suicide have been consistently reported among gay men at all ages but especially among adolescents and young adults. Gay youth are anywhere between 3 and 7 times more likely to attempt suicide than other young people depending on the specific research or news report that is being read. Ninety percent of all suicides are highly correlated with depression, other serious mental disorders and addictions, so it should be no surprise that suicide is more prevalent among gay and bi-sexual men than among straight men who have much higher rates of severe depression and other mental disorders and addictions than other groups. There are 30,000 suicides in the United States every year and a disproportionate number of these are gay and bi-sexual men and women.

Suicide Prevention
Not all people who kill themselves are obviously depressed but most who commit suicide have given some verbal clues or warning to their friends and family of their intentions. Talking with someone who is suicidal about their intentions will not encourage them to kill themselves. On the contrary, talking about it is far more likely to lower their anxiety levels and will actually act as a deterrent by allowing them to vent the pent-up emotions that may be pushing them to think about killing themselves. Research has consistently shown that 75% of suicidal people will visit a physician within the month before they kill themselves, so talking about it with friends who are suicidal might be just what the person needs to encourage them to seek help from a professional. Alcoholism and drug addictions often go along with depression so that suicidal people who are “self medicating” to cope with the stress and pain in their lives should be listened to and encouraged to seek professional help.

There are a number of websites to go to for more information on suicide. A few of these include:,,,




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