When to see a therapist/counselor? Part 1

Once I had a question from a family member—when do you know to see a therapist? I think I was still in a Christmas ham stupor to give much of a comprehensive answer. We often think it is the garden variety of anxiety and depression, mixed in with ill effects from traumatic events. These are in the wheelhouse of many therapists. However, there are other areas where therapists can help, such as coming up with more options, developing resiliency, reducing stress, or developing more skills.

Here are some areas to consider seeing your therapist about:

Pervasive negative thoughts

As humans, we have a negativity bias. The theory is that it has enabled us to persist in being by being aware of situations, animals, vegetation, or other humans that may cause us harm. However, too much of a good thing – can become a bad thing. Layered on top of our negativity bias are lived experiences that have caused the way we see the world more negatively. Or even more pervasive, that we view ourselves more negatively. These thoughts can get worse by becoming more hardwired into our brains. They are often reinforced by confirmation bias, which means that our brain pays attention to things that confirm the biases we have. I recall reading a quote that states, “We don’t see the world as it is, we see it as we are.” In this case – negative.

This does not mean that we should or would be a much better human if we were more pollyannish. However, it does say we may see some good things that occur in the world and ourselves. This in turn can create a happier and less stressed life.

Suicide ideation

Without saying – this is serious. I like to think of it as the equivalent of pulling the fire alarm handle or opening the exit door on the plane. Something is or has gone terribly wrong. As mentioned earlier, pervasive negative thoughts can be corrosive and are kindling for this personal fire hazard. According to Mental Health of America, 4.58% or 11.4 million adults experience serious thoughts of suicidality in 2022. This was a 664,000 person spike over 2021. These thoughts can stem from major depression, schizophrenia, or one of the personality disorders such as borderline personality disorder. Often people can think of irrational thoughts such as “my family/spouse will be better off if I were not here”, or “If I were no longer here, I would not feel as much pain.” One of the biggest errors we as a society can make is to think that they will not do it. They are so – fill in the blank (smart, pretty, handsome, sweet, etc). However, we do not know what that person is dealing with behind closed doors or if they are overcompensating to feel better. A couple of high profile examples of dying by suicide are Robin Williams and Anthony Bourdain. Both were beloved by their legion of fans. We thought their lives of being an all time great comedian/actor and an uber successful travel/cultural show host and best selling author, were magical. They unfortunately, did not. Take home message from my clinical experience in treating some of these: You can not tell who has these thoughts, nor do you know if the thoughts may one day become action. Treat these seriously. Encourage them—and even take them — to get help, check in on them, and alert a few others close to that person. Also let them know they can call you or another close friend or family member when they are having dark thoughts, or either of you can call 988 for help.

Work issues

Work is one of the top stressors we have. Data shows that 94% of people endure some level of chronic stress, while 68% experience moderate, high, or unsustainably high levels of stress. Therefore, most will experience it at some point. Whether it’s a boss who doesn’t like you, rumors of layoffs, or being fired. Especially if you have some bigger financial commitments such as the purchase of a bigger home or private school tuition amongst others. The stress of performing so that you can get that raise or promotion can become very consuming. Issues dealing with another employee due to conflict or bullying, can be very triggering, especially if you have negative experiences from childhood. The “couch” (although hardly anyone lays on the couch for sessions) or better said in a therapeutic session is a good place to learn some new skills on how to better process, handle, or cope with the situation.

But wait there’s more! Stay tuned for our next installment of When to See a Therapist?