A Somewhat Comprehensive Guide to Seeking Care
Perhaps you should see a counselor. I’ve given this advice to a handful of people the last few years, and for good reason. From a mental health standpoint, it’s one of the single best decisions I’ve made in my life.
I understand taking the step in scheduling an appointment with a counselor is easier said than done. It’s also far easier than you think it is difficult. What’s holding you back, more than likely, is stigma and pride. I know because I’ve been there. When I went to the doctor for the first time shortly after my dad died, my doctor recommended I speak with a counselor. It was obvious I was experiencing grief and depression. She wrote down the name of someone, including the phone number. I didn’t have to do any digging on my part. She had done all the heavy lifting for me. All I had to do was pick up the phone and call.
I lied and said I would, and never did. Ten years before, I had met with a counselor and thought it was mostly useless — mainly, I realize in hindsight, because that particular counselor wasn’t right for me; so, I did what most do, and scoffed at the idea my doctor presented before me now all this time later. I don’t need to talk to someone about my feelings. I’m fine. I can handle this on my own.
It would take me another five years to call the number my doctor had given me that day. All the while, I had slowly been dying on the inside by not addressing the lingering depression, coupled with anxiety, within me. I was fortunate in that the name of the counselor my doctor had given me those years before when my dad died ended up being a counselor that was right for me.
On my first visit, I choked back tears telling Peter, my counselor, a dream I had shortly after my dad died, in which I was a small child again, just a boy. In the dream, my dad came into my room, which was pitch black, as I was having a terrible nightmare. He sat down beside me on the bed, waking me from my sleep, and said, “Everything is going to be okay.”
Then everything went bright white, my dad disappeared, and I woke from my dream — no longer a boy, but a man, laying in bed, present day.
I found myself sobbing as I re-told this dream to Peter. I had never told anyone about the dream until then.
“How does it make you feel to tell someone that?” he said to me.
“Like a weight has been lifted off my chest,” I said. “Like I can breathe again.”
I tell this story because I hope it will encourage at least one of you reading this to consider counseling. Before I scheduled my first appointment with Peter back in 2015, I felt that I was on the verge of destroying not only myself, but my marriage, my role as a father, and my career. I was deeply depressed, though I didn’t fully know it, and was constantly overwhelmed with severe anxiety.
I’m not going to say I would be dead or lying in a gutter somewhere had I not started seeing a counselor, but I do think where I am today — mentally and even physically — can be partially attributed to me taking the initial step I had put off for too long: talking to someone.
With that said, I wanted to offer some additional words of encouragement for why you should consider talking to a counselor, some advice on what to expect, and other reasons of benefit I have witnessed from my own perspective.
How to find a counselor
If you’ve never searched for a counselor before, and you have no idea what you’re doing, here are the steps I recommend.
Talk to your regular doctor
Talk to your regular doctor who you are an established patient with already. Your doctor can provide a recommendation, and they almost always have a list close at hand to assist you. Bonus being, as their patient, they know you, and may recommend a counselor based on their experiences with you and your personality type.
Search for a provider on your health insurance company’s website
Search for a provider on your health insurance’s website. To ensure it’s not a hassle in your day, I recommend picking someone within 10-15 miles of your home or work. If you live in rural Virginia, you may need to extend this to 30 or 45 miles, but the closer often the better. What you don’t want to do is create barriers to getting the care you need. For example, it’s easier to ask your manager at work permission to be gone two hours during a workday every two weeks than it is to have to take a half or full-day of paid time off (PTO) because you’re driving an hour to and an hour from your appointment (plus factoring in the length of your appointment, which is usually 45 minutes to an hour). Also, you’ll burn through your PTO in less than six months quickly this way, which will add other stresses into your life. For example, when you need to take time off for being ill or having to stay home with your kids — not to mention, vacation and holiday time off. So, word of advice: find a counselor that’s right for you nearby, if at all possible.
Call your health insurance company’s Customer Service line
Frustrated with your health insurance’s provider search engine? Call your health insurance company’s Customer Service line, and ask them to help you. That’s part of what they do. The phone number can be found on your member ID card or on their website’s contact us page.
Finding a counselor that’s right for you
Once you nail down how to find a provider, it’s important that you find a counselor that’s right for you.
Give your new counselor a chance
Regardless of who you go see, give the individual at least two chances (i.e. two visits) before you blow them off as a lame-o, kook, or new age mystic. That’s more often a stereotype in American film culture than it is reality. If you want to see a Christian counselor, they exist. If you read about cognitive behavioral therapy (CBT), and that sounds like something up your alley, they exist, too. The list goes on. The first visit is more intake than it is therapy. You don’t know the counselor and they don’t know you, and for them to help you, they need to get a better understanding of why you’re there, and also, your personality type so they know how to approach your individualized counseling sessions.
Change counselors if you need, but don’t give up on counseling
Okay, so, you’ve given it a go, twice, and you’re still not feeling it. Or, maybe you are. If you are, great. If not, change counselors, but don’t give up on counseling. Not every counselor is right for you. If you have to, change practices. Counselors are used to new patients never coming back, so they won’t take it personally. If anything, I can almost guarantee you they would be grateful you chose to look elsewhere instead of giving up.
Go to your counseling session at least somewhat prepared
This isn’t a prerequisite, but from my own experience, I’d recommend it. Before your counseling visit, and even during the week leading up to your session, jot down notes in a small notepad or on your phone about topics or feelings you’d like to talk about. Then, bring your notes in with you. They can be fairly general in nature. And, they will help you navigate what I call your tier one (major) issues on your visit, instead of going in only to leave realizing you talked about minor issues (tier two and three), which although important, are not as dominant in your life as some of your more major issues.
Here’s an example: I could talk about work-related anxiety and stress at pretty much every counseling session. And while it may help, and I have indeed done this on a few occasions, what would be more beneficial is if I came prepared to talk about how I’ve had anxious feelings all my life, some of which involve a traumatic event in my life that has left a scar I continue to carry with me.
Your counselor will help you work through these emotions, many of which have underlying causes, so don’t take it upon yourself to be so detailed in the notes you write. With that said, if writing helps you work through your feelings, go for it. I do. I just don’t take a mountain of papers to my appointments. I keep it simple: bullet points.
Make your mental health a priority
I would say treat your mental health just as important as you would your physical health, but the plain truth is they often go hand in hand. I know that when I was severely depressed, my physical health suffered just as much: I didn’t exercise or shoot basketball, or if I did (ex. running), I did it in an unhealthy and obsessive way. I didn’t participate in hobbies I enjoy, like writing. I didn’t eat very healthy. I isolated myself socially, etc.
So, with that I say, addressing your mental health is a proactive step in addressing your physical health. Here’s some wisdom one of my former managers at work once said to me: if you went to the doctor and they diagnosed you with heart disease or diabetes, would you ignore their advice? Of course not, I responded. How is your mental health any different, she replied.
Even though it seems obvious, I’d never thought of it that way. Have you? Treat your mental health as a priority, because it rightfully deserves it.
Embrace your courage and shut down the stigma
Talking to someone doesn’t make you weak. On the contrary. Talking to someone is courageous and makes you stronger. In severe cases, it may mean life or death. Stigma is defined as a mark of disgrace associated with a particular circumstance, quality, or person. We attach a lot of stigma to addressing mental and behavioral health in America. Other cultures do, too, but as a western nation, we lag far behind other western civilizations, and it’s a national disgrace in my opinion that equates to thousands upon thousands of people needlessly suffering or dying each year due to suicide, eating disorders, and other mental health issues that could be treated if only individuals didn’t feel like they were walking around with cooties of the mind.
My parents’ generation and their parents’ generation historically view mental health more as an incurable malady or something to passively accept, be ashamed of, or hide, and less as the treatable condition it often is, like heart disease or high cholesterol.
Even though it’s an uphill battle, the millennial generation is changing the conversation that our predecessors, Generation X, got the ball rolling on. According to the National Alliance on Mental Illness (NAMI), “millennials are more likely to talk about mental health than their parents or grandparents. As more people speak out, the stigma surrounding mental illness is beginning to lessen.”
Embracing your courage and lessening the stigma is a good first step. And while I don’t believe you can cure depression or anxiety, you can treat it and learn to manage it. Passively accepting it (“It’s just who I am”) or outright disregarding it (“I don’t have [x]”) is not helpful. Change this statement to, “Yes, I may have [x], but it doesn’t define me. I am not anxiety. I am not depression. I am [insert your name here].”
That’s a healthier statement; and if you’re a parent, it’s a healthier perspective when raising your children. Otherwise, they will be far more likely to define themselves by their perceived weaknesses, and less by their empowering strengths.
Don’t half ass therapy or play games with your counselor
Counseling or therapy, or whatever you want to call it, involves your active participation. You’ll get as much out of it, oftentimes, as you put in. Don’t expect your counselor to pull out of you all your deepest, darkest secrets. It is not a guessing game to play with your counselor, nor do they want to play that game with you. You don’t have to show all your cards on your first, second, or third visit, but neither should you hide the hand you are holding and the reasons you came in.
Protecting yourself is natural. It can also worsen the situation if you go in for a visit and expect them to do all the talking and asking of questions. Protecting yourself is not helping yourself. Open up, be honest. What you hide, they can’t see. And if they can’t see it and they don’t hear it, they don’t know about it. And if they don’t know about it, they can’t provide guidance. And that’s why you came — remember? So be an active participant. There’s a section within Mark Manson’s essay “Do You Need Therapy?” titled “Be Pro-Active. Take Responsibility for Your Progress.” Read it.
As a matter of fact, if what you read here isn’t giving you the extra push to consider counseling, read the entire essay. It’s good stuff, even if parts of it may offend you. Or read, “11 Intriguing Reasons To Give Talk Therapy A Try.”
Talk to your manager at work (optional)
This is entirely optional for a couple of reasons. As mentioned above, there is stigma surrounding mental health, and that stigma unfortunately carries over into the workplace. If you have an understanding manager at work, then, I can tell you, your manager probably already knows something is up. Mental health can often affect your performance at work.
As someone who once tried to quit their job because of severe depression, I can tell you this from a personal perspective. And, I can tell you it was my manager and director that kept me from spiraling even further into depression by ensuring I didn’t also find myself on the unemployment line. Moving past depression, I also have severe anxiety — much less than I used to, but still, it’s there, and I manage it daily. Anxiety can play hell on your productivity and ability to focus.
And, as someone who manages a team of individuals, I know when something is up even if my staff don’t tell me. I don’t ask any of my reports to tell me what’s going on in their lives. Some do, some don’t. It’s their personal choice to say nothing or to be as general or as specific as they want, if they want. One’s health is personal; and at work, choosing to keep your personal life separate from your work life is okay if you so choose.
With that said, if you have an understanding manager, I think it’s okay to say, “I’ve been very stressed or depressed, etc. and I need to do this for me and my family. It will help me at work, too.”
If you don’t feel as if you have an understanding manager, or that they will treat you a particular way if you open up to them (again: stigma), it’s perfectly okay to say, “I have a medical appointment,” and the medical appointment can be recurring, too. If you’ve been in your job long enough and are employed by a company with 50 or more employees, there are legal protections in place to allow you to get the help you need without consequences such as termination. Learn more at “Can I use FMLA for Mental Health?”
On that note: this is entirely up to your discretion. I’m not going to sit here and say, “If you don’t have an understanding employer or manager, you should find another job that values you and your mental health,” because not everyone is in a situation where they can just up and find another job. Life’s not always so easy.
Me, I am fortunate to have an understanding director. He knows the work I put in and the value I bring to my job day in and day out. And, I’m fortunate to have had other managers in my career that were the same way. From a manager’s standpoint, my own, who has staff that report to him, I can also say there are more understanding managers out there than there are managers that are not.
Chances are, if you made it this far in the essay, you are giving your mental health serious consideration and will take the next step to talk to someone, if you aren’t already. But, if you were like me years ago, still scoffing at the idea of talking to someone about how you feel or processing a traumatic event or experience in your life, such as the death of a loved one, abuse (mental or emotional, verbal, or physical), addiction, anxiety or depression, etc., then here’s my final push.
Five reasons to consider seeing a counselor:
1. Counselors are trained professionals who listen and serve as guides in your mental health
Counselors are trained professionals and can help you navigate through dark days or process emotions and feelings from the past that are still with you present day that have negative, long lasting consequences, and ones you often pass down generations if you don’t address it.
2. Friends are great to talk to, but counselors are a neutral party
Counselors are a neutral party. Neutral is good. Sure, you can talk to a friend or family member, and that can be helpful. Counselors, however, won’t say things like, “Suck it up,” “Just try to be happy,” or “Oh, it’s your anxiety,” etc. Sometimes you need a friend that says, “Suck it up.” Other times, you need someone to approach the situation from a different angle, so that you better understand why you feel a certain way, and actual steps on how to improve how you feel.
3. Talking to someone shows great strength
Talking to someone isn’t for wusses. It’s an act of courage that makes you a stronger person, mentally and often physically, too. Talking to someone can help reinstall that old forgotten floppy disk of meaning and happiness back into your life — meaning and happiness you may feel has been lost a long time.
4. It could save your life
It could also save your job, your relationships, your marriage.
5. Because I said so.
Look, I just wrote a 3,000 word essay that you just spent roughly fifteen minutes reading. I know you didn’t read this for nothing. I sure as hell didn’t write it for nothing. I wrote it because counseling changed my life for the better. Maybe it will change yours. Now, put these words into action. Make peace with your life. It’s in your hands now.
Share your experience in the comments below.
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Written by Jeffrey Pillow, author of the coming-of-age memoir in progress When the Lights Go Out at 10:16, which you can read on this blog as it’s being written. When the Lights Go Out at 10:16 is a story of growing up in small town America in the 1980’s in a teeny tiny town known as Phenix, in Charlotte County, Virginia. It is a story of life and friendship in the face of terminal cancer. Want to read more blog posts? Visit the blog archive. You can also subscribe to this blog to receive updates of new posts by email.