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NBC family drama explores range of male mental health issues

Palm Beach Post - 1/5/2021

After a seven-week-long winter hiatus, "This Is Us" returns tonight with an original episode.

Fans of the hit NBC family drama — whose events occur in present-day as well as flashback and flash-forward scenes — know that the show is especially adept at depicting male mental health issues that rarely get explored in primetime dramas.

Randall’s panic attacks.

Toby’s depression.

Kevin’s alcohol and drug addictions.

In an episode earlier this season, 40-year-old Kevin (played by actor Justin Hartley), who is a former star athlete and now a hunky successful actor and bona fide celebrity, reveals his lifelong body insecurities, exercise addiction and disordered eating to his pregnant fiancée Madison — who herself is a recovering bulimic currently struggling with body image issues because her figure is expanding with the twins she’s carrying.

(Incidentally, women with eating disorders often suffer with conflicted emotions while pregnant. As psychologist Susan Albers, a specialist in eating disorders and admitted fan of "This Is Us," recently explained in Psychology Today, “On one the hand, [Madison] is happy to be pregnant. On the other, she is extremely uncomfortable with her expanding body. She admitted that it is triggering when people comment on her body like, ‘Look how big you have gotten.’ Also, when going to doctors' appointments, the first thing required is to step on the scale. Her weight is often announced out loud. There are so many sudden and unpredictable changes to one’s body during pregnancy. For a woman who has had an eating disorder, this can be traumatic or difficult.”)

The multi-timeline structure of "This Is Us" enables viewers to see the origins of its main characters’ mental health struggles.

As a pre-adolescent, Kevin and his father — a recovering alcoholic himself — bonded over football and weightlifting in the garage of the family’s home.

The harder Kevin worked pumping iron, the more love and approval his father gave him.

Pretty soon, Kevin internalized this message and worked out ferociously on his own — at all hours of the day and night.

And thus the seeds of lifelong addictive behavior — to exercise … to restrictive eating … and eventually to drugs and alcohol — were born.

Being an actor only has only heightened Kevin’s concerns about his appearance — and given the show an opportunity to further explore body and self-esteem issues men are often reluctant to talk about or even acknowledge.

“Eating disorders are not simply about food, body or weight, but are complex mental illnesses. This is as true for males as it is for females, who both tend to have tendencies toward depression, anxiety, substance use, perfectionism and/or low self-esteem,” said Christie Caggiani, a nutrition therapist and registered dietician with Therapeutic Oasis in Boca Raton.

According to recent research, males comprise an estimated 35 percent of all diagnosed eating disorders.

But this likely doesn’t represent anywhere near the number of men who struggle with eating and body-image disorders.

“Because of the longstanding, erroneous stigma around these issues, men are less likely to believe they have a problem or ask for psychological help,” explained Caggiani. “In addition, screening assessments, initially designed for females, often include language that may not accurately identify disordered behaviors in males.”

Throw in the fact that both society and the medical community rightly reinforce the benefits of exercise and muscle-building and it’s not surprising that many men with addictive personalities are vulnerable to the “some is good — more is better” way of thinking.

“In short, men may be praised for the eating and exercise behaviors that are actually part of their illness,” noted Caggiani.

Another complicating factor for those with depression, anxiety, eating and/or exercise disorders has been the effects of the pandemic.

Pandemic stress has affected everyone and may give folks the need to feel they’re in control of something.

“We’ve seen a significant rise in individuals reaching out for eating-disorder treatment and support during the pandemic,” said Caggiani.

She added that “telehealth psychotherapy and nutrition therapy are highly effective for people meeting criteria for outpatient care, which is the majority of those with eating disordered diagnoses.”

The reasons why people develop eating, exercise and body-image issues are as varied as the folks suffering from them.

They span all races, ages and cultural and socioeconomic backgrounds.

But according to Johanna Kandel, founder of The Alliance for Eating Disorders Awareness in West Palm Beach and one who recovered from her own decade-long battle with various eating disorders, there’s one thing they all have in common: “Nobody chooses to have an eating disorder. Your genes ‘load the gun’ and your environment or circumstances ‘pull the trigger.’”

This article originally appeared on Palm Beach Post: NBC family drama explores range of male mental health issues

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