Everyone experiences periods of stress, sadness, grief and conflict, so when you’re feeling off it can be hard to know if it’s time to see a professional about the problem. And apparently, those who would benefit from some therapeutic intervention are not seeking it enough: While one in five American adults suffer from some form of mental illness, only about 46-65 percent with moderate-to-severe impairment are in treatment, according to the Substance Abuse and Mental Health Services Administration.
And while identifying and managing diagnosable mental illness is a priority in the psychiatric community, psychological help for those without a clear condition to manage can be just as important. Aside from suffering needlessly, those in distress may actually make the problem worse by avoiding professional help.
“The earlier someone gets help, the easier it is to get through the problem,” says psychologist Daniel J. Reidenberg. “There will be less time and less strain and stress involved in that.”
Psychologists attribute this low rate of treatment to the stigma and many myths attached to seeing a therapist. Among them, the concern that only “crazy” people need therapy or that accepting help is a sign of weakness or that the treatment options will be time-consuming and expensive. These are not true, says psychologist Mary Alvord, Ph.D.
“Your treatment doesn’t have to be analysis four times a week; I have some patients who come for just two session consultations or for a cognitive behavioral therapy for a year,” she says. “People feel like they’ll get stuck and that’s just not true.”
And while treatment can be very expensive and is not always covered on par with other medical treatment in most health insurance plans, there are cheaper options out there, including many university-associated treatment centers and therapists who will charge on a scale of affordability.
“There is still an unjustified stigma around mental illnesses, but we’re not even talking about mental illness,” says Reidenberg. “We’re just talking about life and how hard life can be. The benefits of pscyhotherapy [can be viewed] more like stress-relievers like exercising and eating right — just strategies that help make life easier and help to remove stressors.”
So what are some signs it might be time to set up an appointment? We asked Reidenberg, Alvord and psychogist Dorothea Lack to reveal some indicators we can all look for during times we’re feeling low. The biggest takeaway? It’s simply a question of measuring to what extent you can manage — anything that makes you feel overwhelmed or limits your ability to function is fair game for a therapist, social worker or psychologist.
Everything you feel is intense
“We all get angry and sad, but how intense and how often? Does it impair or significantly change your ability to function?” asks Alvord.
Feeling overcome with anger or sadness on a regular basis could indicate an underlying issue, but there’s another intensity to be on the lookout for: catastrophizing. When an unforeseen challenge appears, do you immediately assume the worst case scenario will take place? This intense form of anxiety, in which every worry is super-sized and treated as a realistic outcome, can be truly debilitating.
“It can be paralyzing, lead to panic attacks and even cause you to avoid things,” says Alvord. “If your life gets more constricted because you’re avoiding a lot, it is probably time to see someone.”
You’ve suffered a trauma and you can’t seem to stop thinking about it
The pain of a death in the family, a breakup or job loss can be enough to require a bit of counseling. “We tend to think these feelings are going to go away on their own,” says Alvord, adding that this isn’t always the case. Grief from a loss can impair daily functioning and even cause you to withdraw from friends. If you find you aren’t engaging in your life or those around you have noticed that you’re pulling away, you may want to speak to someone to unpack how the event still affects you. On the other hand, some people respond to loss with a more manic reaction — hyper-engagement with friends and acquaintances or an inability to sleep. These are also signs that it is time for professional help.
You have unexplained and recurrent headaches, stomach-aches or a rundown immune system
“If we’re emotionally upset, it can affect our bodies,” says Alvord. Research confirms that stress can manifest itself in the form of a wide range of physical ailments, from a chronically upset stomach to headaches, frequent colds or even a diminished sex drive. Reidenberg adds that more unusual complaints like muscle twinges that seem to come out of nowhere (read: not after a big workout) or neck pain can be signs of carried stress or emotional distress.
You’re using a substance to cope
If you find yourself drinking or using drugs in greater quantities or more often — or even more often thinking about drinking or drugs — these could be signs that you’re hoping to numb feelings that should be addressed.
That substance could even be food. As Reidenberg notes, changes in appetite can be another sign that all is not well. Both over-eating or not wanting to eat could be signs that a person is dealing with stress or struggling with the desire to take care of himself.
You’re getting bad feedback at work
Changes in work performance are common among those struggling with emotional or psychological issues. You might feel disconnected from your job, according to Reidenberg, even if it used to make you happy. Aside from changes in concentration and attention, you might get negative feedback from managers or coworkers that the quality of your work is slipping. This could be a sign that it’s time to talk to a professional.
“Adults spend most of their time at work,” says Reidenberg. “So people who notice are those who have to compensate, just like in families.”
You feel disconnected from previously beloved activities
If your clubs, friend meet-ups and family gatherings have lost their previous joyfulness, it can be a sign that something is amiss, explains Reidenberg. “If you’re disillusioned, feeling like there’s not a lot of purpose or a point or feeling a general sense of unhappiness, seeing a therapist could help you regain some clarity or start in a new direction,” he says.
Your relationships are strained
Have trouble communicating how you really feel — or even being able to identify it in the moment? If you find yourself feeling unhappy during interactions with loved ones on a regular basis, you might make a good candidate for couples or family therapy, according to Alvord.
“We can help empower people to make better choices in how they phrase things — and we teach people that it isn’t just about what you say, but about your body language and overall attitude,” Alvord says.
Your friends have told you they’re concerned
Sometimes friends can notice patterns that are hard to see from the inside, so it’s worth considering the perspectives of those around you.
“If anybody in your life has said something to you along the lines of: ‘Are you talking to anybody about this?’ or ‘Are you doing okay? I’m concerned about you’ — that’s a sign that you should probably take their advice,” says Reidenberg.