How Do I Know if I Need Therapy?

Lena Weib

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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