Mental Health Awareness Month Stigma-Breaking Roundup!
May is Mental Health Awareness Month, so over on Instagram (@betterwaycc) this month, I've been rounding up questions that I hear from friends, family, and clients, and answering them - frankly, and honestly. Below is the roundup of all of those questions and answers.
Mental illness is a diagnosed illness that affects your day-to-day life. Mental health is something that everyone has - just like physical health - that is part of their overall wellness.
The theme of Mental Health Awareness Month this year was #4MIND4BODY - the idea that our overall health increases when we prioritize our mental health in the same way that we prioritize our physical health. We can choose things in our daily life that are good for our mental health, in the same way that we choose to exercise or eat healthy foods for our physical health.
There are so many answers to this! Ultimately, paying attention to your emotional well-being and taking it as seriously as your physical well-being. If you need a break, take it. Prioritize your emotional needs with a self-care routine that energizes you and makes you excited about your life. Hang out with friends. Talk to a counselor. Set boundaries. Make time for a hobby. Even though it can feel backwards at first, you will find that taking the time to take care of yourself well leads to taking care of others better.
The short version? Therapists have made a significant investment to learn how to help and serve people effectively. Therapists are specifically trained in empirically proven treatment methods (I know, that sounds fancy, right? It just means that the methods we’ve learned are scientifically supported by research). # We go through extensive training to “check” our bias, and often do our own therapy to make sure that we are doing the emotional labor that is needed in own lives and not transferring it to yours - because life is hard sometimes, and therapy works. Our friends and family have our best interests in mind (usually), but sometimes they have an agenda just because they have a certain expectation for you and where your life is going - or should go. This causes them to give advice that serves that vision, rather than open their eyes to other possibilities outside of that scope.
I think if you’re asking this question, then probably so. But before you write me off as someone just looking for another paycheck, hear me out. Counseling is for everything - it is for your overall mental wellness journey. Counselors see people that are dealing with deep and intense grief, trauma, and mental illness - this is true. But counselors also see people that are just looking to enjoy their lives more, or to experience the next stage of personal growth. Those things don’t have anything to do with being “crazy.” They are sessions with “normal” people, like you and me. If we began to take care of our mental health in a similar way to the way that we take care of and prioritize our physical health (which, by the way, we should!!) - then this wouldn’t even be a question. Dealing with everyday stress, relationships, and decisions can take a toll on anyone. Counselors are really there to provide a sounding board to live your best life.
In most places, these words are used interchangeably. But this can vary by region! Counseling is often thought of as more advice-giving than therapy. Therapy is sometimes thought of as more clinical than counseling. In some US states and countries, one or both of these words may not be regulated at all - meaning that anyone that considers themselves a “helper” can call themselves a counselor. Because of this, it is important when deciding on a counselor/therapist, to find someone that has the credentials that will be most helpful for what you are experiencing - preferably someone who is regulated by a licensing board, for your own protection throughout the process.
You don’t really “have to” stay in counseling - unless it is court ordered or required by someone for some reason. But generally speaking, your length of treatment really just depends on your counselor, their style, your goals, and your treatment plan. If you are looking for long-term intensive work, or even a long-term maintenance relationship (someone to kind of check-in with when you need to), you should make that clear with your therapist when you initialize treatment. Similarly, if you are looking for acute support or brief therapy, you can specifically look for therapists that practice these methods. If you aren’t sure, these are great questions to ask during your initial session or consultation! While they may not be able to give you a specific time period, asking about an “average” amount of time that someone spends in therapy with them can be helpful to gauge if this therapist is a good fit for you.
(Personal note: My personal style is brief solution-focused therapy. My clients are generally with me weekly for about 8-10 weeks, and then we reevaluate frequency at that time. This can vary by treatment and personal goals.)
It’s not expensive because your therapist is getting rich. It’s expensive because of the state of our healthcare system and how it perpetuates the stigma of mental health. (Boom!) The bottom line is that it’s expensive to have a private practice. In addition to typical small business expenses, therapists have a masters level (or higher) education in order to have knowledge of the range of issues their clients see them for. We are additionally required to pay for ongoing education and licensing. Therapists don’t see clients for 40 hours a week - we really just can’t effectively sustain that in a healthy way without giving super crappy service, or burning out from the emotional labor of our work. (In comparison to doctors and other health care professionals who can see people back-to-back-to-back, usually for shorter timeframes) But, in addition to seeing clients, we also have administrative, marketing, and documentation that needs to be done, none of which are paid for. Regarding insurance - many clinicians (myself included) don’t take insurance simply because we wouldn’t be able to afford to run our businesses effectively with the low contracted rates that insurance companies pay (because :ahem: they continue to perpetuate the stigma against the importance of mental health).
The cost of therapy generally changes based on the area that you live in - so if you live in a higher cost-of-living area, therapy will be more expensive. Finally - if it were up to me, therapy would be included in your 100% covered preventative care for 6-8 sessions a year. And that 100% reimbursement would be a rate that clinicians could keep the lights on with. But for now, we still have a LOT of work to do to make the idea of even taking care of our mental health more mainstream before that becomes an option.
Because good therapy works. I mean, that’s the short answer. The longer answer is to really think through why it may not have worked before. Did you connect with the therapist? Think they were competent? Believe that they cared? Respect their feedback? If not, that’s ok. And also really normal! If you can think through what it was about them that you struggled with, you can use that to find what you do/don’t want next time around. But that relationship is KEY for healing. If your counselor doesn’t make you feel safe and accepted, you’re probably not going to get very far. When seeking out a new therapist, talk openly about what you did/didn’t like about your previous experience. What about you? Did you come in with an open mind and expecting to work? Did you talk openly? Did you explore your positive and negative feelings about therapy with your therapist? Did you share when you felt stagnant? Did you take notes, or process/journal/revisit the themes of your sessions after it was over? Most therapeutic work is done OUTSIDE of the session, when you utilize the tools (or practice - or even *consider* practicing) that were discussed in session. The honest truth is that if you are open to try new things, to be challenged, and to work - progress will come over time. It may not look the way you expect it to look, or feel the way you expected it to, but sometimes part of that work is redefining what “works” and what may not.
The therapeutic relationship is the most important equation in healing. Your therapist can have all the letters in the world behind their name, but if they don’t make you feel comfortable and safe, you still won’t get anywhere. Many therapists do a free consultation, where you can get a feel for who they are, how they work, and get any questions answered. During that consultation, make sure that you feel heard, understood, and comfortable - it’s a short time, usually, but you can get a good feeling about someone in just a few minutes. Make sure you ask any questions that are important to you. There are lots of questions online about what to ask, but if their therapeutic modality doesn’t mean anything to you, don’t ask questions about it. Think about what a good match for you looks like - “how would you help me stay accountable to my goals?” or “do you assign homework, what would that look like?” are some really great, relevant questions I’ve been asked. Also, questions about whether that person is a “direct” speaker, or their conversational approach may be good information to have. If they don’t seem like a good fit, that is perfectly ok. You can tell them what you are looking for and ask them for referrals for that type of therapist - most therapists are very happy to help in that way, and would rather you find a good fit for you than to waste your time (and give you a bad feeling about therapy!)
Great question! It’s really important to understand that therapy is a long game. It is not like a pill that you can take every so often when you’re stressed out. Look, medications treat symptoms. Therapy? That’s for the deep-rooted stuff. The long-term quality of life stuff. Sometimes you may leave therapy feeling like you haven’t gotten anywhere, or feeling impatient with progress. That’s normal. It doesn’t mean it isn’t “working” and it doesn’t mean that your therapist sucks (although, we will talk about how to know if your therapist isn’t right for you later this month 😉). But the truth is that therapy takes time. And the best way to get through those blocks is to let your therapist know about them! “Have you noticed changes in me since I started with you?” Or “I am just feeling stagnant in this process - can you help me understand our plan and goals again?” - these are great ways to confront that need directly. And understand, of course, that sometimes it feels worse before it feels better. And that’s normal, too. That’s why no one will ever try to tell you that going to therapy is easy. My advice here is to always turn this question on yourself before giving up - are you doing everything that you can to keep the process moving? Are you sharing everything that is going on? Are you showing up? Are you doing homework? Are you being authentic with your therapist? If not, course correct. Bring 100% of yourself to each session and come ready to work.
Self-care is relevant to everyone, and although it seems “trendy” right now, I think we have just gotten better at naming it. But definitely not better at doing it. Self-care is the foundational piece of your mental wellness. It is - and should be - part of a daily routine in which you do the things that bring you joy. This will look different for everyone - so just because Rebecca *enjoys* exercising every day and considers that self-care, doesn’t mean that you have to. (Note: the difference is the enjoyment of it! You should still exercise and take care of your physical body, but let’s not call it self-care if you hate every minute of it.) Self-care is NOT avoidance (I see you, wine and Netflix binges). The key to figuring out what is self-care for you is trying new things and being aware of how you feel mentally and emotionally when you have finished them.
Mindfulness, like self-care, seems like the newest trendy trick in therapy. It often brings about imagery of meditation or yoga, but if that’s intimidating for you (you are not alone there, promise), there’s another way to think about it. Mindfulness is just awareness. It’s taking the time to be present in your life. It is actively engaging with those around you, using your senses to be hyper-aware of what is currently going on around you. Being mindful allows you to stay out of the past, and stop worrying about the future for the current time. It can take some practice, as we are trained to be driven by our goals for the future, and to dissect and overthink the moments of the past. But if we are mindful, those things fade away so that we can experience what is right in front of us.
There are lots of ways you can help those that you love that have diagnosed mental illness. Be a friend to them. It can help to learn as much as you can about their diagnosis so you can decipher common actions of those also diagnosed with it. Notice changes in behavior and always direct them back to their treatment. Using “I” statements can help with this - “I’ve noticed you haven’t been feeling well a lot lately,” or “I can tell something is different - is everything ok?” - framing it this way comes across more helpful and less accusatory. Set boundaries. Remember, you are not in charge of their mental health - they are. If they choose not to attend appointments/take meds/etc., it is not your fault.
“I’m so ADHD right now.” “I’m feeling depressed about ____.” “She’s so bipolar.” “My anxiety is out of control.” Look, it’s easy to use these diagnoses as excuses for disorganization, sadness, moodiness, and stress. But if you haven’t been diagnosed with these illnesses, it can be very frustrating for those who have to hear these kinds of flippant comments. Diagnosed mental illnesses impact people’s lives in very real, and sometimes very serious, ways. And our words, while working on #breakingthestigma - are sooooo important. We can’t help people understand the way that anxiety and panic attacks impact people’s lives if we let them continue to believe that they are experiencing an anxiety disorder every time they are stressed out or something goes unexpectedly. So how can you help? Choose your words carefully. Make sure that you aren’t unintentionally mocking others that are struggling with real issues. Call out those that are, gently. “Are you actually ADHD? My cousin struggles with that diagnosis, it’s really been a battle for him.” Those comments can help people to really connect with the words they use. If that doesn’t work, try for a more direct approach. “You know, I’m working to help break the stigma regarding mental illness - did you know that using those words the way you just did can be really harmful to that cause?”
What about you? Do you have other questions about mental health or counseling that I didn't address? I'd love to help you find the answers you're looking for! You can always email me at firstname.lastname@example.org and I'm happy to help continue to #breakthestigma of mental health!
Brooke Williams, MA, LPC, is a licensed professional counselor serving South Carolina. She provides relationship and identity counseling online for busy moms and professionals. You can read more about her here.