In a world that celebrates "power couples" and constant achievement, emotional fragility often hides behind curated smiles and late-night deadlines. Many Indian couples today live with a quiet companion in their relationship - anxiety. Sometimes it sits between them in arguments that spiral too fast. Sometimes it lives in silence, under the same roof. A recent study found that partners frequently mirror each other's mental health patterns, including anxiety disorders, over time. Shared stress, financial strain, social expectations, and gendered roles make this emotional contagion even stronger in Indian households.
But there's another layer most conversations miss - how gender and culture shape anxiety itself. From shame and fear of judgement to culture-bound syndromes, Indian men and women experience, express, and cope with anxiety very differently. And those differences affect how they relate, communicate, and recover.
To understand these nuances, Dr Trideep Choudhury, Consultant Psychiatrist, Department of Mental Health and Behavioural Sciences, Fortis Healthcare, spoke to NDTV about the social, biological, and cultural realities behind gender differences in anxiety and how couples can navigate them together.
Why Gender Matters In Anxiety Disorders
"The concept of normality itself differs across cultures," Dr Choudhury explains.
"In Indian (Asian) societies, we live in a collectivist culture that values family ties and social harmony, whereas Western systems prioritise independence. In such collectivist settings, there is a close relationship between shame and anxiety. Because Indian culture emphasises connectedness, fear of negative evaluation and shame strongly correlate with anxiety disorders."
According to Dr Choudhury, women consistently report greater degrees of shame than men, a pattern confirmed by international research. "Gender-specific roles, hormonal fluctuations, and societal expectations influence how anxiety presents," he says. "Studies also show that women demonstrate greater sensitivity to unpredictability of threat, while men may under-report emotional distress."
In practice, this means women are more likely to describe multiple physical symptoms, like headaches, fatigue, palpitations, rather than overt emotional worry, whereas men may frame the same distress as "stress" or irritability.
Culture-Bound Syndromes: How Anxiety Speaks Through Tradition
Culture not only colours perception but also dictates expression. Dr Choudhury notes: "Culture-bound syndromes are culture-specific ways of presenting psychological distress, including anxiety. They help individuals express suffering within a framework their community recognises."
He cites two examples unique to the subcontinent:
- Dhat Syndrome - seen mostly in Indian men, it involves anxiety and uneasiness linked to nocturnal emissions believed to represent semen ("dhat") loss. Patients often complain of fatigue, poor appetite, excessive worry, and low mood.
- Bachadani (Uterine) Syndrome - described in women who believe their uterus has "displaced," causing anxiety and physical discomfort.
"These culture-bound syndromes," Dr Choudhury explains, "underline the interconnectedness between psychological processes and cultural realities. They remind us that anxiety is not just biological, it's deeply social."
When Anxiety Moves Into Relationships
A recent study on couples highlights how partners often share mental-health vulnerabilities due to mutual influence, shared stressors, and emotional synchrony.
"In clinical practice," says Dr Choudhury, "we frequently see couples where one partner's anxiety amplifies the other's. The distress can affect both individuals and the relationship as a whole."
He emphasises that treatment should address not only the person but the couple as a system. "Therapy works best when we evaluate factors within each partner, within the couple dynamic, and within the larger environment that may predispose them to anxiety."
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How Anxiety Looks Different And How Couples Can Recognise It
In women, heightened worry, restlessness, fatigue, and numerous physical complaints are common signs. Their anxiety is often linked to interpersonal or evaluative fears.
In men, it usually presents as agitation, irritability, avoidance of emotional discussion, or substance use to cope.
Within relationships, these patterns can cause tension. One partner may seek excessive reassurance, while the other withdraws or reacts defensively, fuelling cycles of misunderstanding.
"It's vital that couples recognise anxiety as an illness, not a personality flaw," says Dr Choudhury. "When both partners acknowledge what's happening, empathy replaces blame."
Anxiety Treatment And Coping Within The Couple System
According to Dr Choudhury, "Treatment usually involves medication to relieve the physiological symptoms, like tremors, sweating, palpitations, breathing difficulty, combined with psychological sessions to build adaptive coping." He outlines several steps couples can practise at home, echoing therapeutic principles:
- Be aware of your difficult emotions and physical sensations.
- Prioritise self-care with balanced meals, adequate sleep, daily movement.
- Show empathy when your partner exhibits symptoms; avoid reacting instantly to negative emotions.
- Reflect together later on what triggered anxiety and how the body responded.
- Challenge avoidance loops. If one partner avoids certain situations, don't reinforce that pattern.
- Develop personal coping skills to manage frustration while supporting your partner.
- Practise problem-solving for daily conflicts before they snowball.
"These small behavioural shifts," Dr Choudhury notes, "help couples rebuild safety and resilience."
Seeking Help: Barriers Unique To Indian Culture
India's social fabric adds layers of resistance to seeking help:
- Stigma: Mental illness is often viewed as weakness, especially for men.
- Gendered silence: Women may suppress distress to maintain family peace.
- Access gaps: Many families lack affordable or confidential mental-health support.
- Mislabeling: Anxiety is brushed off as "nerves" or "stress," delaying diagnosis.
Dr Choudhury urges cultural sensitivity in therapy: "Clinicians must understand local beliefs, family structures, and gender expectations. Only then can treatment truly work."
On World Mental Health Day 2025, it's time to see anxiety not as a personal failure but as a shared emotional challenge shaped by biology, gender, and culture. Indian couples live at the crossroads of tradition and transition, balancing ambition with belonging. Anxiety often enters this space quietly, disguised as overwork, irritability, or perfectionism. But when partners understand the cultural and gender dynamics behind it, healing becomes a team effort.
As Dr Choudhury concludes, "When one or both partners have an anxiety disorder, continuing treatment and communication is essential. Awareness, empathy, and shared coping can transform distress into strength." Understanding each other's fears, instead of fearing them, may be the most powerful act of love this World Mental Health Day.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
