How to Support Someone with Depression: What to Say and How to Help

                  As we continue moving through Mental Health Awareness Month, I thought it might be a good time to revisit supporting a loved one or friend who is living with mental illness. I have discussed this in past posts: What Not to Say to Someone with a Mental Illness, Being Present, and  Helpful Words to Say to Someone with Depression. Take a look at these after you read this post, if you are interested in learning more.

                  Often, it is difficult for people to know how to talk to or support someone with a mental illness. I think this comes from not understanding what mental illness is and from the stigma that surrounds mental illness. There are frequent negative impressions of mental illness in movies, television shows, and on social media. Government officials are presenting false information about mental illness and treatments for these illnesses. I think there has been improvement in the presentation of mental illness in movies, television, shows, and social media. In contrast, I think government officials are going in the opposite direction, which is dangerous. However, talking about that requires its own post.       

                  When movies or television shows present characters who commit crimes or do other negative things as having a mental illness, they are perpetuating the stigma that hurts so many of us. I think the negative image makes it difficult for people to learn how to interact with those of us who live with mental illness. Maybe if I share my thoughts on how to interact with me when I am struggling, I can provide some ideas for others. 

                  First, I would urge people not to be afraid of people living with mental illness. We are not dangerous. We are people just like everybody else. Our illness may make us seem unapproachable. We may be withdrawn or overly excited. These are part of our illness. Depression can make us seem sad. We may isolate ourselves. Don’t let this discourage you from reaching out. We welcome kindness just like everyone else.

                  I was in a cancer support group the other night. Someone shared something that I think is a great way to interact with someone with a cancer or mental illness. This person shared that when she is struggling, she has a friend who will ask, “Do you need me to talk or listen?” That is such an incredibly empathetic and powerful question. It acknowledges that the person who is struggling knows what kind of support they need. It demonstrates that the person asking the question is willing to provide the support in the manner their friend or loved one needs. 

                  Let’s consider how this might look when someone is struggling with depression. The question is asked. “Do you need me to talk or listen?” Obviously, two responses are possible. If the person, let’s say it’s me, says “I need you to talk.” Here is what that conversation might look like:

                  “What are you feeling?” (I think “what” is better than “how” because it already acknowledges that you recognize the person is feeling something.

“I am struggling. The depression is very heavy right now.” 

“I understand that you are feeling depressed. You have told me in the past that this is a very dark feeling. Is that what you are experiencing right now?” 

“Yes, I feel trapped, and the darkness feels heavy.”

“Are you considering harming yourself?”

“No, I just feel like the depression is overwhelming me.”

“I am glad you are not considering harming yourself. I can be with for a while. Would it help if I stay with you?”

“Yes. I need help distracting myself from the thoughts I am having.”

“I know you have several coping strategies for that. Maybe we could try one.”

“That might help. Can you help me get started on one? I don’t know where to begin because I feel so overwhelmed.”

“Definitely. Maybe we could start by listening to some music or writing something.”

“I would like to listen to music. Can you put something on?” 

“Definitely. We can listen together. Do you want to listen to a particular musician?”

 

At this point the conversation can continue into music. You have given the person (me) a chance to try a coping skill. You ascertained that the person did not have thoughts of harming themself. By engaging with the person in their coping skill, you are letting them know they are not alone.

What if you are communicating with the person by phone call or text? You can still engage with them. You might support the person as they put music on. You can continue the conversation as they listen to music, or you can make a commitment to call or text them in a short while to check back in and see if they are doing okay or if they need further support. I think it is important to check back in a few times. This lets the person know you are interested in how they are doing and that you are there for them and invested in how they are doing.

If a person says they need you to listen. You simply listen without judging. You are being an empathetic ear. You are providing your loved one or friend an opportunity to share what they are going through and feeling. If you are physically with the person, be sure that your body language is open and caring. Look at the person while you listen. Whether you are in person, talking on the phone, or even texting be sure that you are giving your loved one or friend your full attention. They/we need you in this moment. It is important to be an active listener. So, acknowledge what the person is saying. You might repeat back what they are saying in a way that lets the person know you are listening. This might be saying something like:

“I hear you saying that the depression feels overwhelming, is that how you are feeling?”  

After this allow the person to continue sharing. Listen actively. Check in to see if the person wants you to talk at any point.

Whether you are talking or listening it is important that refrain from judging. The last thing the person needs is judgement. They need support. They/we need to know that someone cares about them. Often, depression tells a person that they are alone or that there is no one in their lives who understands. By being present for your friend or loved one you really are making a difference. 

One thing that is important is an awareness of the person’s safety. Depression often carries with it self-harm and suicidal thoughts. As you check in with your loved one or friend, ask them if they are having thoughts about harming themselves. I know this question can be difficult to ask, but it is important. There should be no judgement in this question. The depression or other mental illness is causing the self-harm or suicidal thoughts. In most cases the person really does not want to harm themselves. 

What do you do if the person expresses thoughts about harming themselves? If the person is in immediate danger, you should call 911. If the person is not in immediate danger, you can call the 988 Lifelinefor support. In some cases, the person might have a mental health provider who can be called. It is okay to ask the person if there is someone you should call. 

Some people with mental illness have safety plans. I have one. This is a plan that outlines how to support the person and what to do when the person is having self-harm or suicidal thoughts. For more on safety plans, please check out this article I wrote: Creating a Safety Plan for Times of Suicidal Crisis. It details how to create a safety plan and why a safety plan is important. 

Being present for a loved one or friend with depression or other mental illness can be challenging, but you can be there for the person. You can learn to talk or listen. If you would like to learn more about supporting a loved one with mental illness you can read an article I wrote for NAMI Glendale here: Supporting a Loved One Living with Mental Illness: 8 tips from a peer's perspective. 

 

 

 

24 Years Sober: My Story of Depression, Alcohol, and Healing

                   “My bravest thing?” Getting sober.” – Jamie Lee Curtis, Pass It On! Billboard

                  I was driving today and saw a billboard that hit me hard. I have seen it before, but today as I read it, I felt connected to it. For this post I would like to discuss depression and alcohol. I want to start by telling my story. Then go into a discussion about the interaction of alcohol and depression.

                  Tomorrow, May 19^th is my 24^th soberversary. I became sober on this date in 2002. It seems so far away and at the same time it seems like yesterday. I was 29 and at a very dark point in my life. My depression and anxiety had me in a downward spiral. My use of alcohol as a numbing agent had intensified. I hit rock bottom. Scary chest pains landed me in an emergency room. There was no cardiac issue. I was told it was my anxiety and to seek help. I was also told that if I did not stop drinking, I would end up dead. I was not in therapy at this point. I was being given an antidepressant by a primary care provider, but it was not helping. 

                  Let me explain my use of alcohol. I was not a social drinker. When I was in high school, I learned to use alcohol to numb the pain depression was creating in my life. At night I would drink until I passed out. No one knew I was drinking. Even though I told myself that drinking alcohol numbed my depression, it did not. It only masked what I was going through. I spent the next 15 years drinking to cope with depression and anxiety in varying degrees of alcohol abuse.

                  The ER doctor scared me into quitting drinking. I stopped drinking cold turkey as some say. It was not easy. In fact, it was incredibly hard. What saved me was that within days I had my first session with Dr. K, the psychologist who has been with me for the last 24 years. He helped me through the early days of becoming sober and has supported me every time the thought of drinking has surfaced since. I am lucky to have found him. I always remember that my soberversary is also my anniversary of therapy with him. 

                  I have had other help along this journey including my sober friends Sharon and Robert. Both know the struggle and are people I can turn to when I am struggling. You may wonder how I could struggle after 24 years. That shows how powerful alcohol is. Wanting to drink alcohol is one of my defaults. When my depression is bad or when my anxiety is really high, that old urge to numb what I am feeling by drinking alcohol resurfaces. Sometimes my sober friends remind of all the good that has come from sobriety. Other times Dr. K is there with that support. I also have Dr. S, Stephanie, and Brittany now. We cannot overcome alcoholism on our own. I am grateful that I have support from amazing people.

                  Now, I would like to share information about depression and alcohol. There are many aspects to consider. I hope this discussion can help others find sobriety and with that healing from depression. Some of what I will share can also be applied to alcohol and anxiety, but there are differences. Maybe I can address that in a future post.

The Connection Between Alcohol and Depression

                  Alcohol can contribute to the symptoms of depression. At the same time people with depression turn to alcohol to cope. This can create a two-way cycle that is difficult to break. Alcohol appears to reduce emotional discomfort. However, repeated or heavy alcohol use can lead to depression-related symptoms including:

·      Increasingly lower mood

·      Increase in anxiety or irritability

·      Disruptions in sleep quality

·      Reduction in motivation and concentration

·      A worsening of feelings of hopelessness

·      Increase in impulsivity

·      An increase in suicidal thinking

 

You might recognize these as common symptoms of depression. The problem with

drinking alcohol is a person often drinks to escape these symptoms. I know I did. However, drinking actually worsens these symptoms.

                  Some people with depression might drink to do one or more of the following:

·      Numb emotional pain

·      Escape stress

·      Escape loneliness

·      Find help sleeping

·      Discover social comfort

 

Using alcohol in this way can be a form of self-medicating. That is what I believed I 

was doing. I told myself that the alcohol was helping. For me this started in my teen years when my brain was not formed enough to see how illogical this was. One of the main problems with using alcohol to self-medicate is that it actually worsens the symptoms the person is trying to make feel better. Once the effects of the alcohol wear off, the depression symptoms return. Sometimes they return worse than before the alcohol.

                  There are some risk factors that make the combination of alcohol and depression worse. One is a family history depression or substance abuse disorders. Another is trauma or chronic stress. A third is social isolation. Chromic medical illness is another. Other mental health conditions like anxiety or PTSD can also be risk factors.

What Are Signs that Drinking Alcohol and Depression Might Be Connected

                  When a person drinks more when they are feeling sad, empty, or stressed it can be a sign that the person is using alcohol to cope with depression. Another indication might be if the person drinks when they feel depressed or anxious or the person feels depressed or anxious after drinking. Losing interest in activities they once were interested in while drinking. Another sign might be worsening sleep or energy levels when drinking. The person may have difficulty lessening the amount they drink even if there are emotional consequences. Another important sign that alcohol use and depression may be connected is experiencing problems relationships, work, or health that are tied to drinking and mood.

                  It may be difficult for a person to get themselves out of this cycle. The person may not see it. They may see it and not know how to get out of the cycle of drinking to help with mood. The person may not have the resources to get help. Finding a way to stop the use of alcohol to cope with depression is difficult. It requires a lot of work. This work does not end. I have been sober for 24 years now and there are still times when my depression pushes me to the point of wanting to numb myself with alcohol. Over the years I have developed coping skills to help me fight back when the urge to drink arises. 

Ways to Treat the Use of Alcohol to Cope with Depression

                  It is important to treat both the alcoholism and the depression together. Psychotherapy, especially Cognitive Behavioral Therapy is an important form of treatment for depression combined with drinking alcohol. Support groups, such as Alcoholics Anonymous, are an important part of treatment. Medication may be necessary for the depression. Treatment programs for alcohol use disorder are an important part of the overall treatment. Other things that can help include getting adequate sleep, increasing exercise, and becoming involved in social supports. 

Urgent Need for Help

                  There are times when the need for help may be urgent and require immediate professional involvement. These include:

·      Thoughts of self-harm or suicide

·      Drinking to the point of blackouts or dangerous withdrawals

·      Impairment in day-to-day functioning

·      Unsafe mixing of alcohol and medication

 

 

Please know that help is available. Receiving help is important. Back to my personal

experience. I experienced all four of the above points. I needed help. The ER visit and the words of the ER doctor were the start. Dr. K and therapy were a major part of my ability to stop drinking to cope with depression. Getting on the right medication for depression helped in the short term. Although, as I have mentioned many times on the is blog, I am treatment-resistant, meaning medications do not work for me. So, now I receive alternative treatments for depression (TMS and esketamine). Learning to live without alcohol requires developing coping skills. It is important to replace drinking with a coping skill that will ease the depression. There are many coping skills available. Both of my sober friends go to AA meetings. I have Dr. Klein’s support and use journaling and art to cope. I also use self-hypnosis and music, including meditation music created to reduce anxiety or improve mood. 

                  Important Note

                  If you are in crisis or do not have resources for help, I urge you to call the 988 Lifeline. Help is available. 

                  As I take a moment to reflect on my 24^th soberversary, I am proud of myself. I know it has not been easy. Depression lied to me and told me alcohol would help me feel better. That lie led to addiction. Even 24 years after that last drink, there are times when the urge to drink rises up. I know I can lean on Dr. K, my mental health team, and/or my sober friends. Depression and alcohol do not mix. I wish I had known that when I was a teenager. I wish I had received help earlier. However, the important thing is I got help. If you need help or know someone who does, reach out to the 988 Lifeline, a mental health provider, your primary care provider, an Alcoholics Anonymous group, or a trusted loved one. While it is not easy, it is possible to stop using alcohol to cope with depression. Take it from me life is better when we are not using alcohol to self-medicate depression.

                  Back to that Pass It On! Billboard. Getting sober is brave!

 

 

 

 

Depression Doesn’t Change Who You Are: Challenging Mental Health Stigma

I am the same person I was before you found out I have a mental health disorder.

– Unknown

 

                  The above quote popped up in my Facebook memories today. I posted it seven years ago. Just like when I first posted it, this quote struck me as meaningful today for a few reasons. One, I think it fits well with Mental Health Awareness Month. Another reason is that it points out that stigma still exists in our world. The third reason is more personal. Sometimes when I am struggling, I feel alone. At times it seems that my mental health isolates me. It shouldn’t because I am the same person whether I am struggling with my mental health, or I am doing well. Today, I would like to delve into the message of this quote and its relevance in our world.

                  It is Mental Health Awareness Month. It is a month where many of us put forth extra effort to make others aware of what it is like to live with mental illness and what resources are available. We try to provide an understanding of mental illness and how it affects people. There are efforts to inform people, to raise money, and to join in community. It is an important month for everyone, not just those of us affected by mental illness. This month provides a chance for everyone to learn about mental illness.

The theme NAMI (National Alliance on Mental Illness) is using for Mental Health Awareness Month is “Turning Silence into Connection” as its theme for this year. I think this is a powerful statement. For me it also connects to the above quote. The other day I had an experience where someone asked how I was doing. I was really struggling. So, I said that I was “struggling with my mental health”. This was someone I am close to. Still, I was meant by silence. I am not trying to find fault with this person. The response was genuine. The person did not know how to respond to my comment or the fact that I was struggling. This shows the need for more awareness. We need to spread education about what it is like to live with mental illness. We need people to learn that it is not something to be afraid of or to shun because you do not understand. For my part, I could have told this person what I needed. Instead, I met the silence given toward me with silence of my own. To say the least, it made the conversation awkward until one of us changed the subject. Gone was my chance to feel supported. We did not allow silence to turn into connection. I do not want to use the word “fault”, but I think we both could have handle the situation differently. I could have asked if I could share what I was feeling and what I needed. The other person could have asked me what I was feeling and what I needed. Better conversations grow from awareness efforts. That is why educating people about living with mental illness and supporting someone with a mental illness is so important. 

Maybe one way I can turn this silence into connection is to find a time when I am feeling better to explain what I need when I say I am struggling with my mental health. I can share resources from organizations like NAMI. I can share this blog. What I am doing right now is a way to spread awareness. After I post this, I will add posts to my social media accounts to let people know what I posted on my blog and that my blog exists. I do this for every blog post. Will I get the number of reads necessary to make a huge difference? Probably not, but I might just reach the one person who needs to hear that they are not alone in their struggle with mental health. One of my blog posts might encourage someone to seek treatment. The effort is what matters during Mental Health Awareness Month. If we stay silent, we cannot help anyone. If speak about mental illness, we connect and when we connect healing happens.

I guess I just combined my first and third reasons. Mental illness is a lonely illness. When there was silence between the person I shared my struggle with and myself, I not only felt alone, I felt isolated. I think mental illness is a lonely illness. The lack of understanding leads us to isolate. Combined with the mental illness we are already living with, isolation pulls our mood down further, increases our anxiety, or exacerbates other symptoms of mental illness. This is why we need to raise awareness. Knowing we are not alone can help us find the strength to battle our illness.

Stigma is a huge issue when it comes to mental illness. Stigma is defined as negative attitudes, stereotypes, and prejudice directed a people with mental health conditions. It usually results in discrimination and shame. Sure, awareness has helped reduce stigma, but stigma is still there. Just look at our government. Robert Kennedy, Jr, the U.S. Secretary of Health and Human Services, has said, “We will no longer treat psychiatric medications as the default.” He is trying to limit the prescription of psychiatric medications. This angers me. He has no medical or psychiatric training/education. He is pushing for a reduction in the use of psychiatric medications. He has suggested links to violence with some psychiatric medications. This is stigma. He is basing his comments and decisions on stereotypes and prejudice, not medical and psychiatric research.

Conversations about psychiatric medications should be between the patient and their mental health team. Decisions about medication should be between a psychiatrist and their patient. Kennedy’s policies demonstrate the stigma that surrounds mental health. He is minimizing the struggles and pains we go through. People who take psychiatric medications need them. With his policies he is increasing the stigma we face. I should stop here before I get any more political. I leave it at this: Stigma allows policies like this to be put in place. Stigma allows a non-psychiatric professional to think he understands mental illness. This is a reason why we need mental health awareness.

Stigma surfaces everywhere. It is in our pop culture. It is present in the television shows and movies we watch. It is present in our schools and workplaces. Stigma pushes us to hide our mental illness. It also leaves many loved ones and friends unable to understand those in their lives who live with mental illness. We see stigma in jokes people make and insults that are used. How many times have you heard someone use a mental illness as an insult or to describe a behavior that is consider negative? It happens more than any of us think because stigma has engrained in our lives. Awareness is how we fight back.

Awareness can mean different things. It can be as simple as wearing a green ribbon or putting a green ribbon on your car. It can be as challenging as asking a loved one who has a mental illness to explain what they live with. There is so much in between. Raising awareness can be checking out organizations like NAMI. It can be creating lessons for schools to use with students. Going to your local NAMI chapters events  NAMI Walks is a great way to get involved and learn about mental illness. It is also a fun event. My local NAMI chapters, united through NAMI Greater Los Angeles County, have their NAMI Walks this Saturday, May 16^th. You can attend mental health workshops. Reading mental health blogs or social media content is another way to raise awareness. Hey, look at you! You are raising awareness by reading this post!

The bottom line is that we need to work to make the world a better place for people living with mental illness. We are the same people we were before our diagnosis. Just as my cancer diagnosis did not change who I am, my depression and anxiety diagnoses do not change who I am. People with mental illness are capable of great things. Do a Google search and you will find many successful people who have lived with or are living with mental illness. Read through past posts on my blog. I have written about so many aspects of mental illness. You are bound to learn something. There is a search option on the right side of the post. Search for something related to mental illness, you will find a post that might interest you or even help you or a loved one.

Let me end by saying, we can live with mental illness. It may not be easy. We may face stigma, but we can live positive, productive lives. I hope this post encourages people to learn about mental illness. Even if you have a mental illness, there are things you can learn. I am constantly learning about mental illness, and I have lived with it for almost 40 years. This month and moving forward let’s challenge ourselves to make NAMI’s Mental Health Awareness Month’s theme, “Turning Silence into Connection” a reality and reduce the stigma surrounding mental illness. In doing so, we will make so many people’s lives easier.

 

 

 

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You Are Not Alone: Understanding and Healing from Postpartum Depression

                  Usually, I try to write about aspects of mental illness I either have experience with or have knowledge about. Since today is Mother’s Day, I thought it might be a good time to discuss postpartum depression. 

According to PostpartumDepression.org about 1in 8 women experience symptoms of postpartum depression after giving birth. The rate could be as high as 1 in 5 women in some US states. When looking at the numbers this could mean that approximately 460.000 women in the US experience postpartum depression. PostpartumDepression.org notes that these numbers only pertain to live births. Women who experience a miscarriage or stillbirth can also develop depression. So, if we include all these women, the number of women experiencing postpartum depression increases. Also of note, is that new fathers and same-sex partners can experience depression. The likelihood of a father or same-sex partner experiencing depression increases if the mother experiences postpartum depression. PostpartumDepression.org explores the statistics on postpartum depression more thoroughly, if you are interested.

Postpartum depression (PPD) is “a form of major depression and a mental health disorder that affects women after childbirth. Each person with postpartum depression may experience different symptoms. There are several symptoms that may be present. These include: 

·      Mood swings

·      Trouble sleeping or oversleeping

·      Changes in appetite

·      Anger and irritability

·      Feelings of worthlessness

·      Moderate to major depression

·      Fatigue

·      Excessive crying

·      Inability to bond with the new baby

·      Anxiety, worry, and/or fear

·      Loss of interest in activities once enjoyed

·      Withdrawing from friends and family

 

Symptoms usually develop in the first few weeks after birth and may last up to six months to a year. It is possible for symptoms to develop before birth. While symptoms generally last only up to six months after childbirth, if left untreated, PPD can become a chronic depressive disorder. Because PPD has many forms and symptoms it is difficult to isolate a specific cause. It is important to understand that postpartum depression is not caused by anything the mother does. Some possible causes of postpartum depression include:

·      Changes in hormone levels

·      Sleep deprivation

·      Physical Body Changes

·      Postpartum stress and worry

·      Birth trauma

·      Life stressors

 

Risk factors for postpartum depression are varied. It is possible to have genetic or medical risk factors. There are environmental risk factors, which might include low social support. Mental or emotional risk factors include recent stress or abusive relationships. Unplanned pregnancy and substance abuse can also be risk factors. 

From a mental and emotional standpoint, it is important to pay attention to certain things. Be aware of stressful events in your life. A woman should get support if she has experienced a stressful event such as the loss of a job or the death or a loved one. Fears or worry over finances can be add to risk. The lack of a support system can be another risk factor.

                  When pregnant and after childbirth women need to find time for self-care. They should find time to socialize or be with others. The social support of a partner, friends, and family members is an important factor in reducing risk. It is important that a woman receives support if she is in is in a physically or emotionally abusive relationship.

                  How is postpartum depression treated? According to PostpartumDepression.org, psychotherapy is the standard treatment for postpartum depression. This is known as “talk therapy”. In some cases, antidepressants are prescribed. Many antidepressants are safe during breastfeeding. However, this is something to be discussed with your doctor and beyond the scope of this blog post. Support groups can also help those suffering from postpartum depression. If postpartum depression becomes severe or if postpartum psychosis develops, inpatient treatment may be necessary. 

                  Postpartum psychosis is a mental health emergency. According to the Cleveland Clinic, postpartum psychosis affects the mother’s sense of reality. It causes hallucinations, delusions, paranoia, and other behavior changes. If the case is severe, there is a risk that the mother may try to harm herself or her newborn. Treatment is important. Postpartum psychosis is treatable. Earlier treatment leads to better outcomes. If a mother is experiencing any of the above signs it is important to seek help immediately. This can include calling 911 if the woman or baby is in danger. Another important thing to remember is that with treatment the mother can recover. 

                  Postpartum depression is treatable. It is important that the woman seek treatment. Her loved ones and friends should take this seriously and understand that the depression is real and what the woman is experiencing is real. The OB/GYN can provide resources and referrals. A psychologist, psychiatrist, therapist, or primary care provider can also be contacted for support. Women can recover from postpartum depression. I mentioned earlier that the father or same-sex partner can experience postpartum depression. They need to seek treatment, too. 

                  On this Mother’s Day I would like to encourage all mothers to ensure that they give themselves grace. Find time for self-care. Remember that your health, including your mental health is important. To all the mothers, fathers, same sex partners who are or who suffered from postpartum depression, to all the mothers who have experienced depression whether diagnosed or not, and to all the mothers who have had moments of struggle, you are seen, you are heard, and you will be okay. 

 

 

 

How Therapy Helped Me Survive Depression: Why Mental Health Treatment Matters

                  Therapy has been a part of my life for over three decades. That may seem like it has been ineffective. The opposite is true. Therapy is a lifeline and a changing force for me. I process my emotions and struggles in therapy. I work on life issues that arise. I receive support when my depression pushes me into wanting to harm myself. I know my psychologist will guide me into feeling better. Therapy is not a magic potion. It is workspace. Being in therapy requires a commitment. Sometimes it takes time develop that commitment, but it is worth the time it takes. 

                  Let’s look at why people go to therapy, how therapy can help, and what a therapy session might be like. Keep in mind that there are different types of therapy. Different people find certain types of therapy more effective than others. In a way it is similar to different medications working better for different people. We have a right to find the type of therapy and the therapist that works best for us. 

                  First, we should define therapy. Therapy is a structured form of treatment for mental illness. In therapy a trained mental health professional helps a person understand, manage, and improve their thoughts, emotions, behaviors, and overall well-being. The goal of therapy is larger than just a temporary fix, although there are often times when the focus of a therapy session needs to be on the short-term, especially if the person is experiencing a crisis. One of the overarching goals of therapy is improve the quality of a person’s life over time. Embedded in this is learning how to live with depression or other mental illness and how to utilize forms of treatment and coping strategies.

Reasons Why a Person Might Go to Therapy

                  There are many reasons a person may choose to go to therapy. Therapy is an important part of most treatment plans for depression and other mental illnesses. For me it has been vital. I would not be where I am today, able to write this blog, or able to live my life, without therapy. 

                  Therapy can help a person learn about their mental illness and how it affects them. This is an important reason for going to therapy. Living with a mental illness is difficult. There is a lot we need to learn about our illness. Understanding our illness and how it affects us allows us to manage our illness more effectively. A good therapist will guide us through gaining this understanding.

                  Dealing with emotional distress is another reason to go to therapy. The therapist will help a person cope with the distress. There are many types of emotional distress. It might be suicidal thoughts, panic attacks, anxiety, persistent sadness, hopelessness, or emptiness. In therapy a person will receive support coping with depression, anxiety, mania, anger, or trauma. 

                  Therapy can address grief. A person might go to therapy to address low-self-esteem or feelings of worthlessness. A therapist might also address anger, mood swings, or emotional numbness. Therapy is an important part of dealing with thoughts of self-harm or suicide.  Substance abuse can be addressed in therapy. 

                  A person does not need a diagnosis to benefit from therapy. Sometimes people just need a little help. Therapy can provide support when a person is struggling.

                  If a person has a mental health condition, therapy, in some form, is often a part of the treatment plan.  These diagnoses would include major depressive disorder, anxiety disorders obsessive-compulsive disorder, post-traumatic stress disorder, bipolar disorder, schizophrenia, and other mental diagnoses. Therapy helps people learn to manage these disorders. 

A Look at a Therapy Session

                  In the first appointment the therapist will spend some time getting to know the person and their needs. First, the therapist will ask about the person’s needs and concerns. The first session is used to begin to establish trust. The therapist will likely take a history. They will ask about current symptoms, emotions, and struggles. The therapist will ask about past therapy experiences. A good therapist with explain how the therapy will work and explain their treatment approach. A plan for session frequency and goals for therapy will be established. 

                  Later appointments will vary depending on the type of therapy being provided. Many therapy sessions are centered around discussions between the therapist and the person receiving therapy. Usually, a focus is established to guide the session. This might look like the person expressing a need and the therapist guiding a discussion and providing support. Often, the therapist and person will talk through emotions, experiences, or challenges. Together they work on coping strategies and problem-solving skills. The therapist may assist the person in working through unhealthy thought patterns and behaviors. Work on interpersonal relationships might be a part of therapy. Sessions vary depending on the person’s need. Those needs can change over time. 

                  Therapy is a two-way process. It requires work from both the person receiving therapy and the therapist. Both need to be active participants. In this process the therapist provides guidance and expertise, while the person should do their best to be open and share what they are experiencing and what they need. When a person is struggling with depression or other mental illness this can be difficul. In these moments being present and doing the best you can is important. It is important for the therapist to create a safe, structured environment where discussions can take place. The therapist can provide support and guide the person. It is the therapist’s role to identify patterns in thoughts, emotions, and behaviors. They then provide coping skills, emotional regulation techniques, and communication strategies. The therapist can help the person practice these strategies. 

                  The person in therapy shares what they are going through. This would include experiences, symptoms, thoughts, and concerns. It is important for the person to be honest. No one needs to hide anything from a therapist. In therapy there is no judgment. A key to successful therapy is for the person to practice the coping skills, emotional regulation techniques, and communication strategies that are being taught. A person in therapy needs to consistently attend sessions, be willing to engage in sessions even if it takes some time to develop this ability, and be patient with the process. Healing takes time. It does not happen overnight.

                  As I mentioned it can time for the therapy to really feel like it is working. Both the therapist and the person receiving therapy need to build trust. Therapy is most effective when both sides have worked to build a trust and communication. It is important to remember that the person receiving therapy can say something to therapist if something feels uncomfortable or if they are not ready to discuss a certain topic. There is no one size fits all approach to therapy. This is why both sides need to work at develop the therapeutic relationship. The therapist may need to change certain approaches or provide different strategies.

                  Healing takes time and it takes work. Mental illnesses are rarely improved without effort. Mental illnesses are complex, but with effort the therapy experience can be healing. 

The Rights of a Person Receiving Therapy.

                  Just as a person in a physical health situation has rights, so does a person receiving mental health care. If something does not feel right in the therapy session, it is okay to make your thoughts known. It is also okay to look for the right therapist. Sometimes the fit is just not there. A person might not find the first therapist they see to be the right one. So, a person might need to try a few therapists to find the one they click with. That is okay. 

                  If you have health insurance, you can ask for a list of therapists covered under your plan. One way to find a therapist is to look through therapist directories. You can do this online. Psychology Today Therapist Finder is one source you can use. Another source is SAMHSA Treatment Locator. You can also ask a trusted healthcare provider. Often, a primary care provider can help you get started. 

                  It is okay to interview a therapist before committing. Ask them about their experience with your condition. You can ask about their approaches with your condition. It is okay to ask any questions you might have. 

                  It is also important consider things like insurance coverage, cost, language and cultural competence, and gender or identity preference. You might also need to consider in-person versus telehealth options. These are all important considerations. You want to make sure that the therapist is right for you in every area.

Final Thoughts

                  Therapy is important when you live with mental illness. I have been in therapy for decades. For me, therapy is an integral part of my treatment. It is my lifeline. Over the years my therapist and I have developed a relationship that allows trust on both ends. I know that I can trust him with anything I am experiencing. I think he knows that I would reach out to him if I had thoughts of harming myself. In fact, there have been times when I have reached out to him when my depression has pushed me to the point of wanting to hurt myself. The fact that he has been there has saved my life. I know this may sound like I am overexaggerating, but having a therapist and a mental health team you can rely on is so important. It can be lifesaving.