How do I know if I should be in therapy? | Help with Mental Health Issues That Impact You Life

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How do I know if I should be in therapy?

Couple reaching out for each other

Well, this is a very straightforward question with a no simple answer.

From time to time we all need support in dealing with life's challenges, but sometimes just asking for help can feel as overwhelming as our problems. Many people try to tough it out rather than seek help.

Waiting until it get so bad you cannot cope is not a good strategy. The rule of thumb is the sooner you seek help the better. That being said, people often put off seeking help against their own self-interest. The four items below are not meant to be comprehensive they only provide some simple and obvious guidelines. This list short and the bottom line is - if you are asking yourself “Should I be in therapy?”, the correct answer is, yes.

1. Someone said to you, “You should (need to) talk to someone.” Or “You need help.”
Your friend(s), spouse, relative(s), co-worker(s), or boss told you they are concerned about you. They may have even suggested you should be in therapy or recommended a therapist.

Often, there is a nagging thought [or we may have had a clear thought] that we need help of some kind. But somehow having someone say it out loud and to our face pushes a button and we fight back, “NO WAY!” This or something like it may be the first thought before we lash out against whoever had the audacity to suggest such a thing. The truth is, while they may have echoed a thought we have already had, it’s somehow different and hard to accept hearing it out loud.

Anecdotally, about 80% of the clients I see were told they needed help. Even though it was hard to hear, it gave them permission to move forward with seeking help. So who was brave enough to say it out loud? It’s often someone who is very close to them – close enough to risk the potential backlash. They take the risk, not because they despise them, are vindictive, or they don’t get (understand) them - the opposite is true – they care about them, want them to get help and understood that they may need help.

For many years I worked with AA in a support role and one thing was clear, everyone who walked through the door with the revelation that they needed help or even if they clearly understood that they were an alcoholic, someone close to them knew before they did. They may have expressed their concerns several times. They may have even experienced several indignant backlashes from the one they were concerned about. But they persisted. The same is true for other issues that bring people into therapy – others close to them understood they needed help before they did. If someone is telling you that you need help they may phrase it a little less directly:
  • You don’t seem happy.
  • You seem stressed; angry; unsettled; agitated; tired; not yourself; sad; depressed.
  • You’re not yourself.
  • Are you OK?
  • What’s wrong?
  • Why so _______? (angry, upset, sad, etc.)

You may notice that there is someone [or several people] who detects changes in you before you can pull all the information together to realize you need help.

Is someone in your life persistently stating that you should find help?

Is someone in your life in need of your persistence?

2. You are using a substance to cope.
Alcohol and drugs are coping mechanisms, but they are not good or healthy coping mechanisms. I recently read a great definition of the tipping point between using alcohol or drugs for recreational purposes and having an alcohol or drug problem. Terrance Real explains it this way:

“The difference between the recreational use of something and its abuse as a form of self-medication is very clear. When you are in a state of emotional health, you use something like alcohol to enhance your good feelings. You have a glass or two at a party and feel looser, more social, and a little bit euphoric. Why do you do it? Simple enjoyment. But when you are someone who self-medicates, your goal is to boost baseline feelings inside that are not okay. Because it doesn’t feel all that great to be in your skin, you turn to something like alcohol not for enhancement, but to right yourself, to bring yourself up from feeling bad. You have developed a psychological dependency.

Many people assume that you don’t have a physical dependency if you can choose not to indulge when you want to abstain, then you are in the clear. But it’s not that simple. Self-medication does not mean that you can’t do without whatever it is that makes you feel better. It’s that you can’t be very happy without it. When your “drug of choice,” the object of your dependency, is flowing, you have a sense of self-worth and well-being. All seems right with the world. But if there’s a crimp in the line between you and whatever you’re depending on, you go through a self-esteem, well-being crash. That crash can feel like emptiness, loneliness, depression, jaggedness, anxiety, coldness, or blackness.”

If drugs or alcohol are on the increase or have a prominent role in your life, you likely have or are developing a dependency.

3. You don’t feel like your old self.
You or others recognize that you are not your old self. You’re more stressed, more on edge. You may be feeling depressed, you’re not happy, you do not enjoy life or enjoy activities you used to enjoy or you are having difficulty getting up or out of the house. There may be a change in your daily routine – sleep, appetite, energy level, concentration, motivation, memory or interest in sex. You maybe sad and don’t know why or cry without reason.

4. Your relationship(s) is (are) strained and not improving.
Some signs your relationship is strained are:
  • You're barely speaking.
  • You avoid contact – calls, emails, texts, etc.
  • You argue all the time – about anything, even unimportant things.
  • You argue about the same things over and over with no resolution or change.
  • Affection is being withheld.
  • Sex has changed or stopped.
  • Secrets are being kept.
  • You have been or are thinking about being unfaithful.
  • You or your partner is using porn.
  • You think everything would be ok if your partner would just change or stop ________.
  • You remember when your relationship was good or long for it to be better.
  • Your children are asking if you are going to divorce.

If anything you have read in this post makes you upset or angry, chances are you need therapy. Your anger response is a way of not dealing with what is going on in your life.

If you know someone who would be angry if you sent them this post, then chances are they need help. The Bible says – never tire of doing good [Gal 6.9; 2 Th 3.13]. Never tire of being persistent! Someone will eventually be glad you did.

For more information on mental health read the Mental Health Passport or assess your mental health with the Mental Health Meter at CMHA.

Larry G. Pardy CD RSW BSc. HBSW MDiv.
Copyright © L3C 2016