Recent years have pushed mental health to the forefront of public consciousness, especially as the COVID-19 pandemic raged across the world. As shutdowns and social isolation orders abounded in the first year of the pandemic, global rates of depression and anxiety spiked by 25%. Fortunately, this rise in poor mental health has been accompanied by a decline in associated stigma. The math checks out: more of us are now managing mental health symptoms, so we encounter the topic more often in our day-to-day lives. Many more people now understand that there is no shame in seeking mental health support to improve your quality of life. Demand for mental health treatment is climbing among U.S. adults as a result. Maybe you or someone you love is also considering seeking mental health support to get back on track. The following Q&A kicks off a series that will cover some common questions asked by those who find themselves in this position.
Q: What are some reasons that people might want to seek therapy?
A: The decision to seek therapy is a highly personal one. For some, the journey is prompted by a particular relationship or event, especially when there are problems that the individual has been unable to resolve over time. Relationship issues with a partner, family member, friend, or colleague can prompt someone to seek therapy to improve communication and address interpersonal challenges. Life transitions like divorce, loss of a loved one, career changes, or relocation can also be overwhelming and require extra support. Traumatic events can lead individuals to therapy as well, whether it is acute trauma from a single incident (e.g., natural disaster, accident, victim of crime) chronic trauma over a prolonged period (e.g., intimate partner violence, childhood abuse).
Often, it’s the symptoms themselves that drive people to consider therapy, particularly if they overpower their ability to cope effectively. For example, they may find themselves feeling persistently sad, anxious, angry, or filled with other intense emotions that interfere with their daily functioning or school/work performance. Others may have chronic physical symptoms without clear medical explanation, like headaches, stomachaches, or insomnia. Many find themselves relying on unhealthy coping mechanisms such as substance abuse, self-harm, or excessive avoidance. Some have a sense of being stuck in life, whether it’s related to personal growth, career, or decision-making.
Q: How does an individual first come to the realization they want therapy?
A: The path to realizing one could benefit from therapy generally involves getting fed up with the obstacles presented by symptoms and deciding to address them. In this process, the person goes through the five stages of change:
- Stage One: Precontemplation – The person is not seriously interested in getting help because they do not believe there is a problem.
- Stage Two: Contemplation – The person is considering changing their behavior but still having trouble believing that the long-term benefits will be greater than the short-term costs.
- Stage Three: Preparation/Determination – The person has committed to changing (e.g., “I’ve got to change”) and is starting gathering information about how to change their behavior.
- Stage Four: Action/Willpower – The person is actively taking steps to change their behavior using many different strategies.
- Stage Five: Maintenance – The person has changed their behavior and is successfully avoiding temptations to return to previous behavior.
To summarize, the individual goes from believing there is no problem, to acknowledging its existence, to committing/preparing to change, enacting the change, and finally maintaining the change. The decision to go to therapy involves the same steps.
It’s important to note that the stages of change are not linear; it is normal and natural for person to progress and regress before progressing again. Problems arise when people get stuck in a stage. People may get stuck in the contemplation stage, some spending their whole lives weighing the pros and cons of changing their behavior without ever deciding whether they should get help. Others try to skip the preparation/determination stage without doing enough information-gathering, then slip and regress out of the action/willpower stage as a result. Suffice to say, any decision to make a significant change is a tricky process that is unique to each individual.
Q: What are some signs that someone needs help?
A: There are many signs that someone you care about may need extra support in the form of therapy. They may talk about having persistent issues at work, such as finding it hard to concentrate, declining in productivity, or having intense, difficult-to-manage emotions. In other cases, you may notice changes in their sleep habits, physical health, appetite, weight, or substance use. Some people may simply describe feeling “off,” which still can merit therapy if the feeling lasts for longer than two weeks. Others may have persistent relationship issues, such as feeling short-tempered with their partner or repeatedly rehashing the same problems. A sudden lack of contact can also be a sign that someone needs help, as mental health issues can encourage individuals to self-isolate.
Q: How do you approach the subject of therapy with someone who could benefit from it? And what if they don’t want to?
A: When we notice someone we care about is in distress, it is natural to want to help. Friends, family members, or healthcare professionals may suggest therapy if they notice signs of distress or if they believe it could be helpful for the individual’s well-being. But as a sensitive topic, it is important to approach it nonjudgmentally. Psychology Today suggests several guidelines for conversations on this topic to increase the likelihood of a good outcome. For example, select a time and place where the person will likely feel safe and receptive. Make sure both your words and your tone come from a position of care and concern rather than anger or judgment. Do some research and preparation ahead of time to address any common fears or concerns about therapy, like that it’s too costly, time-consuming, useless, weird, or scary. If you’re willing to do so, you even can offer to help them with the logistics of finding a good therapist. They may be particularly grateful for such a favor, as their symptoms may make this process more intimidating and difficult to get through.
However, it’s important to realize that people are within their rights to reject the idea of therapy, no matter how well-crafted and caring your suggestion is. It’s best to respect that right. Therapy is ineffective if the individual isn’t truly invested in making changes anyways, so there’s no use in forcing the matter. For you, you can use their decision to decide how you want your relationship to move forward. If you can tolerate their decision not to attend therapy and you want to preserve the relationship, you can simply let them know you are always there for them if they change their mind. If the relationship is too damaging to you, though, you may decide that you need to draw new boundaries or end the relationship.
Conclusion
All in all, the decision to seek therapy is a courageous one, and there is no specific set of criteria that must be met. If someone is unsure whether therapy is right for them, a mental health professional can help assess their situation and provide guidance. If you are looking for such guidance, you can contact OnePatient directly or use the Psychology Today Therapy Directory to search for available therapists. Psychology Today is also a resource for answers to many common questions about what one can expect from therapy and how to find a therapist. And throughout the decision-making process, it pays to remember that seeking therapy doesn’t mean someone is “broken” or incapable; it is a step toward personal growth and well-being.
To schedule an appointment with OnePatient, contact info@onepatient.org.
