How Do I Know if I Need Therapy?

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Seeking therapy doesn’t mean you have a mental illness or mood disorder. Therapists can help people get through difficult times and everyday life stressors.Getty Images; Canva
In 2020, more than 1 in 5 Americans sought mental health treatment and 1 in 10 sought counseling or therapy, according to the Centers for Disease Control and Prevention (CDC) National Health Interview.

Maybe you’ve struggled with your mental and emotional health and have considered therapy. Here’s what you should know to help decide if therapy might be a good step for you.

First of all: You certainly don’t need a doctor’s referral to seek therapy to help with your emotional or mental health. (“Therapy” can refer to a broad range of treatments for many types of mental and physical illnesses; throughout the rest of this article, we’ll use the word therapy to describe talk therapy for emotional or mental health.)

And “you don’t need to have a mental health condition in order to engage in therapy,” says Christine Crawford, MD, an associate medical director at the National Alliance on Mental Illness (NAMI). “Therapy is for everyone.”

Talking to a therapist about your emotional health is considered preventive care for your mental health, she explains.

“It’s about learning strategies and tools you can use to navigate life and protect our mental health, so we’re not inundated or overwhelmed,” says Dr. Crawford, who is an adult and child psychiatrist and an assistant professor of psychiatry at the Boston University School of Medicine.

Here’s how to decide if therapy might be a good option for you.

What Types of Conditions Does Therapy Help With?

For starters, therapy is often a key component of treatment for diagnosed mental health issues, according to Lynn Bufka, PhD, a licensed clinical psychologist and the associate chief of practice transformation at the American Psychological Association (APA), where she works on healthcare policy issues and improving mental health care delivery.

Talk therapy can help people with clinical mood or other mental health disorders (like anxiety, depression, bipolar disorder, and others) manage their diagnoses and learn how to live with them, she says.

“Through therapy, I’ve seen people’s lives change dramatically,” Dr. Bufka says.

Research shows that talk therapy (sometimes called “psychotherapy” in scientific literature) is beneficial for treating several mental health conditions, including depression, anxiety, panic disorders, eating disorders, substance abuse, and personality disorders.

Research suggests the advantages of therapy continue even after sessions have stopped, with patients feeling better about themselves, reducing their psychiatric symptoms, and developing long-term coping skills and tools to manage life’s challenges (this study followed individuals for at least nine months or more after therapy had ended).

The Mayo Clinic says therapy can help with the following conditions:

Therapy Can Help People Without Mental Health Diagnoses, Too

Therapy is for everyone, not just people with a mental health diagnosis.

According to a 2018 survey conducted by Barna Group, a California-based private research company, 28 percent of people who started therapy did so following a trauma, such as the loss of a loved one, job loss, sickness, an accident, or a divorce.

Another 19 percent began their therapy journey in light of a life transition, including marriage, moving, starting a new job, or having a baby.

Therapy is a deliberate step to take control of your mental health and take care of yourself, Crawford says. For many, talking to a mental health professional offers a unique opportunity to have a space to reflect on your thoughts and feelings, where you have someone to listen and guide you. “It’s a safe space to work on yourself,” she says.

The APA says therapy might be helpful for any of these life stressors:

  • Coming to terms with an ongoing chronic illness, or with death and bereavement in the family
  • Struggling with financial issues, job loss, or problems in the workplace
  • Managing relationship stress, including trying to make a marriage work, caring for young children or aging parents, and managing friendships
  • Recovering from physical or sexual abuse
  • Witnessing violence or a traumatic event
  • Coping with sexual problems, whether they’re due to a physical or psychological cause
Mental Health America says therapy can help you change behaviors that are holding you back, learn to manage unhealthy emotional reactions (like road rage or passive-aggressive behavior), build relationship skills, feel more resilient in the face of challenges, or heal from past pains that are affecting you.

So, How Do I Decide if I Need Therapy Right Now?

We all face hurdles at some point in our lives. Sometimes making extra time for self-care and talking with a supportive friend or family member might help us through these difficult times. Other times, those solutions aren’t enough.

“A lot of people think you need evidence of long-term impaired functioning to need therapy — the reality is it needs to be for just two weeks that you’re not doing well at work, school or socially, or you’re not doing well with basic things like eating or sleeping,” Crawford says. Or people think what they’re struggling with isn’t severe enough to warrant therapy. But for many people, seeking out help for your emotional or mental health early, before a problem is significantly impairing their life, will prevent a lot of suffering, she says.

If you notice yourself preoccupied with strong emotions or mental distress at work, at school, in your social life, or in a way that it's interfering with your day-to-day functioning (sleeping, eating, and so on) for two weeks or longer, therapy might help, she says.

Ultimately, the decision to start therapy is often a very personal one. The APA suggests asking yourself these questions:

  • Is the problem distressing? Do I spend a lot of time thinking about this issue each day or week? Is it causing me to hide or withdraw socially? Is it affecting my quality of life?
  • Is the problem interfering with some aspect of my life? Does it take up more than an hour of my thoughts each day? Is it interfering with my productivity at work or school? Am I rearranging my lifestyle because of it?

A “yes” to any one of these questions is a sign therapy might help.

Pay attention to what your friends and loved ones are telling you when you open up to them too, says Bufka. If they’ve noticed you’re struggling or they admit these are emotions or concerns they don’t feel qualified to help with, listen.

“If you’re struggling to do it all on your own or if your friends say ‘I can’t handle this,’ that’s often a clear sign,” she says.

The National Institute of Mental Health (NIMH) recommends seeking therapy if you’re experiencing any of these symptoms for at least two weeks.

  • Feeling down, with symptoms of depression, apathy, or negativity?“You may not even want to get out of bed to tend to your daily tasks,” Crawford says. Your symptoms could be subtle too, though. The NIMH notes you may still be able to carry on with your daily duties while feeling low or out of sorts.
  • Difficulty falling asleep or staying asleep because of stress or conflict in your life. Bear in mind, most adults need at least seven or more hours of sleep each night.
  • Sleeping much more than usual, or excess fatigue. On the other hand, you could be logging more hours of sleep or napping during the day, while still feeling lethargic.
  • Appetite changes, like not eating enough and skipping meals, or turning to comfort food and binge eating to self-soothe. If you’re noticing drastic changes on the scale that aren’t the result of an intentional effort to lose or gain weight, consider if it’s due to an unhealthy emotional coping strategy.
  • Loss of interest in things you usually find enjoyable?This could include withdrawing from friends and family, or not bothering to engage in hobbies and extracurricular activities like your book club or sports team, Crawford says.
  • Thoughts of death or self-harm?If you’re encountering suicidal thoughts, turning to alcohol or drugs to numb your emotions, or you’re thinking of hurting yourself, you should seek out help from a mental health professional.

If you are actively in crisis and need immediate support, call 911. If you or someone you know is feeling hopeless or having suicidal thoughts, you can talk confidentially to a trained counselor by calling the toll-free, 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Starting on July 16, 2022, everyone across the country will be able to connect to the Lifeline by calling 988.

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