TOOLBOX: Psychological Counseling, YES please.

Image from Psychology Today

I wish I had known when I was in crisis in 1997 or so that seeking psychological counseling and even care from a psychiatrist is really just not that big of a deal.  I was all wracked with guilt and shame at concept of not being able to cope well enough with my life,  of needing help.  I saw it as an admission of failure and inadequacy of the mind, of weakness.  I have a friend I am leaning on to seek counseling right now and I'm pretty sure she is viewing the prospect in the same light.  So I thought, maybe others might need to know what I was telling her.  Now, not every person who seeks counseling is in crisis and not every person is in the grips of major depression or anxiety, but I am going mainly from my own experience, and I was a mess.



How far have you let things go before asking for help or having someone intervene on your behalf and point you to finding professional assistance?  Why are you or they concerned?  Do you just want to check that you are not letting a bad situation damage your emotional health?  Are you functioning, or maybe not so much, barely keeping your head above your emotional water?  Have you been beaten down by physical or mental abuse?  Do you cry every day?  Have you been sleeping too much or not enough?  How about eating too much or not enough?  Have you lost interest in the things that you used to enjoy?  Have you lost hope that things could get better or that you deserve for them to get better?  Do you feel like you don't deserve to live or use up resources?  Do you just think it would be better for everyone if you got hit by a bus or had some kind of fatal accident?  Does the critic in your head constantly harangue you with how you should have behaved, what you should have said, how you should look but don't, how you're without value or purpose?  Are you starting to believe this about yourself?  Any, some, or all of these experiences, especially if they have affected your lifestyle and lasted more than a few weeks, can be symptoms of depression.  Feelings of constant worry, like if you don't worry about something bad things will happen, nausea, tremor, a spacey out-of-body feeling, a constantly racing heart and feeling of dread—these can be symptoms of anxiety disorder, again, if they change your lifestyle and last for more than a few weeks.

I have a personal soapbox issue with those who make judgements of the character of folks with mental illness as if they know what they're talking about.  The only thing that can make the above suffering worse is the feeling that it is all your fault, that if you were only strong enough, resilient enough, something enough as other people, you could be OK.   People get tired of hearing what is bothering you and annoyed that all their helpful advice has not fixed the problem or that you were unable to act upon it.  Why don't you just stop feeling this way, choose to feel better and get on with life, right?  DUH, don't they realize that no one chooses to feel this way or get so stuck?

This is all very difficult to understand or imagine if one has not been through anything like that, not because of any lack of empathy, but simply because the brain has not ever been stimulated in a way that results in the prolonged chemical imbalances that cause depression and anxiety disorders.  It's like childbirth, if you haven't done it, you don't get it.  Even if you know you don't get it, you don't really get exactly how much you don't get it.  For those of us who have been there, we can report that it is an excruciatingly painful experience, despite the lack (often, but not always) of physical pain.  When the situation is ongoing, when the feelings do not subside in a wave of exhaustion, the suffering after weeks is just as acute as it was in the first instants.  Daily survival becomes a war of attrition, a forced march, and, in the case of anxiety, conducted as if with a gun to the head.

Yet seeking help for this problem that we're told is our personal failing is also stigmatized.  "Psychotherapy is bunk.  It's for the weak-minded.  If you had enough willpower/faith/you-name-it you could handle this like everyone else handles bad spots in their life."  These are statements made by people who just simply haven't been there and don't get how much they don't get it.

So, OK, down from my soapbox.  What are we supposed to do?  What do you do when you just aren't getting better on your own?

GET HELP.

Help is not for the weak.  It takes strength to admit you need help and to ask for it.  In my case, my boyfriend (future husband) got me to have lunch with him at Burger King and told me he thought I needed medication.  I was angry and insulted and afraid.  After a long talk I accepted that going to an appointment didn't mean that I had to do anything I didn't want to.  If it didn't help, fine, but if it did that would be good.  What was there to lose?  I eventually agreed.  That was the first time.  The second time I needed medical intervention I knew it.  I was two months post-partum and couldn't stop crying.  When we were in the office, my husband had to do all the talking.  I was not able to be present enough in the moment to even deal with answering the doctor's questions.  Hopefully you're not there.  Though, if you are, I can tell you that you can get better.  Don't be satisfied until you ARE better.

I found it comforting and helpful to be able to talk with someone who had dealt with mental illness in the past and personally seen that progress can be made, even to the point of successful remission.  I learned that for things to get better it takes time, effort, and tools.  You could, in theory, change a tire without a tire iron or jack, but it would be exceedingly difficult and why undertake such an expenditure of effort when you are broken down in front of the hardware store?  This isn't some reality show where there is a prize for completing a task with the most suffering!  There's no medal for suffering unnecessary pain.  Use the tools that are available to you.  One of these is counseling.  I was more willing to do that than to take medication, though in the end I did both.  The brain is a bunch of neurons talking to each other with electricity and chemicals.  You can change your brain by changing your thoughts, or you can change your thoughts and therefore your brain chemistry using chemical means.

So here I am, your friend whose been there, or somewhere nearby, and I've dragged you to a favorite restaurant to tell you I am concerned about you and here's what I've got to say on the subject of seeing a psychologist or psychiatrist.

IT IS NO BIG DEAL.  (Really!)

Stop overthinking it and just do it.  

If you are having thoughts of harming yourself or others, call 911 or go to the nearest Emergency Room.

Otherwise, click on the Psychology Today link on my Resources tab.  Find a provider.  Perhaps you can find someone who is within your health insurance network.  If not, it is still worth seeing someone for just one appointment in order to have help making a plan and to ask that provider whom they would suggest you contact.  Make an appointment.

Keep the appointment.  DO NOT WAIT TO FEEL BETTER FIRST!  This will not happen.  Feeling better follows action, not the other way around.  It sucks, but that's the way it is.  Go whether you want to or not, whether you feel up to it or not.

Next Post:  What is it actually like to see a counselor? To see a psychiatrist?  I'll describe my typical appointments, my first appointments, and tell you again that it's NO BIG DEAL!