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Psychotherapy (also sometimes called talk therapy) can be an effective way to treat mental illness or improve your mental health. But is there a way to know if you need therapy or if therapy would even help with what you’re going through? Spoiler: Yup!
Here’s how to know if you need therapy, plus some advice for finding the right therapist for you.
If you have a diagnosed (or suspected) mental health condition like anxiety or depression, your physician might have already recommended therapy as a way to manage symptoms. But therapy can be a good option even if you don’t have a diagnosed mental health condition.
According to the National Institute of Mental Health, people seek out therapy for major life stressors (like a tough job, the loss of a loved one, or relationship issues) or symptoms that can’t be explained by some other condition (like low energy, irritability, or changes in sleep or appetite).
Some forms of therapy can also help you address things like financial stress and low self-esteem.
But at what point does stress, grief, or low energy warrant regular sessions with a licensed mental health professional?
The American Psychological Association suggests that it might be time to seek therapy if you have one or more issues causing you distress and it’s interfering with your daily life.
People with untreated mental health conditions have a higher risk of:
- having trouble keeping relationships
- finding it difficult to care for yourself or others
- having a tough time at work or school
- experiencing an increase in health issues and/or hospitalization
Remember: Going to therapy doesn’t mean you’re broken
Therapy can help you deal with whatever you’re going through to improve your well-being and healthy way of life.
If you have a broken leg, you don’t ignore it or put off a visit to the doctor for help. It’s not a bad idea to treat mental and emotional health issues similarly.
1. You’re super overwhelmed
We all know what it feels like to be overwhelmed with too many tasks at school or work — it’s stressful.
And whether there’s a clear reason you’re super overwhelmed (read: having way too much on your plate) or not, long-term stress can impact your health negatively — so it’s important to find a way to manage it.
People who are stressed have a harder time concentrating, feel more fatigued, and have short-term memory issues. But it can cause issues in the long run too, like accelerated cognitive decline.
2. You’re sleeping too much or too little
Sleep and mental health go hand-in-hand.
Sleep problems are especially common in people experiencing anxiety, depression, bipolar disorder, and ADHD. Therapy can help you better manage symptoms of mental health conditions that are interfering with your sleep.
But again, you don’t need to have a diagnosed mental health condition for poor sleep to have a negative effect on your mental health. One 2018 research review showed that sleep deprivation can lead to mood swings and leave you more emotionally vulnerable.
Some types of therapy can help you improve your sleep hygiene, give you tools to sleep better in general, and help you manage the effects of not getting enough Zzz’s.
3. You’re avoiding being social or can’t keep relationships
If you find yourself withdrawing from friends, isolating yourself, and distancing yourself from your partner(s), there might be an underlying reason. Stress, trouble sleeping, and anxiety can all play a role.
Like stress and poor sleep, there are potential consequences of social isolation. People who isolate themselves socially are more likely to develop certain health problems (like depression and chronic pain), be less active, and eat less nutritious diets.
Therapy can help you manage any mental health conditions that are getting in the way of social interaction. It can also help you deal with any social anxiety you might be having.
4. Your anxious thoughts consume you
Many people experience the feeling of worrying — it’s hard to convince your brain to quit.
But if it reaches a point where your thoughts are taking over and interfering with your day-to-day life, you might be experiencing intrusive thoughts.
People with certain mental health conditions (like PTSD and OCD) are more likely to have intrusive thoughts. But anyone can experience them.
Research shows that therapy can help people learn how to handle distressing thoughts and take back control of their life.
5. You can’t control your emotions
Reminder: Being an emotional person doesn’t necessarily mean you can’t control your emotions. But if your emotions are getting in the way of your daily life, therapy might help you gain more control over how you feel. In fact, research shows that cognitive behavioral therapy (CBT) can be an effective way to learn how to better manage your emotions.
6. You don’t care about anything
People with clinical depression often lose interest or pleasure in hobbies and activities, according to the National Institute of Mental Health. Losing interest in the things you enjoy can make it harder to find relief from stress or maintain some relationships.
Research has found that psychotherapy is an effective way to treat depression. It also found that therapy has longer-lasting effects than drugs (like SSRIs) and that most people prefer therapy to drugs.
7. You feel hopeless
If you think you have depression, it’s important to seek care as soon as you can. If left untreated, depression can lead to suicidal thoughts and ideation and self-harm. According to the National Institute of Mental Health, suicide was the second leading cause of death among people ages 10 to 34 from 2011 to 2020.
Help is available
If you or someone you know is feeling suicidal, call the National Suicide Prevention Lifeline at 800-273-8255 or text “HOME” to 741741 to reach the Crisis Text Line.
- Ask someone to stay with you until help arrives.
- Remove any weapons or substances that may cause harm.
- Only call 911 if you think someone is in immediate danger and you are unable to reach them. Calling 911 should be used with caution.
8. You’re having problems at work
Having a hard time at work can cause mental health problems or make existing mental health problems worse. In fact, a 2010 research review found that mental health problems are often a reason employees take sick leave, drop out of work, or leave a job.
If you notice that it’s harder to concentrate on your work, receive unusual feedback about your performance, or feel burnt out, therapy might be a solid step to take. It can help you address work stress, anxiety, depression, and other factors impacting your mental health and make heading to the office (or your WFH setup) much less miserable.
9. You’re eating more or less than usual
Change in appetite is common in some mental health conditions, including depression and anxiety. While some people lose their appetite, others find themselves overeating. Managing symptoms of depression and anxiety with therapy can help regulate your appetite.
It’s also possible that your eating habit changes are a sign of something more. According to the National Institute of Mental Health, if you’ve had severe disturbances in your eating behavior and your thoughts and emotions around food or your body, you could have an eating disorder like anorexia nervosa or bulimia.
Therapy is often the first line of defense for treating eating disorders and can be an effective way to recover.
10. You’ve experienced a recent trauma
Traumatic events can trigger post-traumatic stress disorder (PTSD), which can include symptoms like flashbacks, emotional numbness, sleep troubles, and irritation.
Some peeps might think that PTSD only occurs in people who’ve served in the military, but it can happen to anyone. Examples of traumatic events include accidents, natural disasters, and physical or sexual assault.
Research found that trauma-focused cognitive behavioral therapy can effectively treat acute and chronic PTSD.
11. You’re grieving
Grief can be difficult to live with and can cause an explosion of emotions. If it’s getting to the point where you’re not feeling any better after a long time, or it’s interfering with your daily life, it may be time to seek help. Therapy can help you talk through and process grief, so you can learn to live with what you’ve lost.
12. You’re using substances as a way to cope
Whether you have a diagnosed mental health condition (like depression) or are experiencing a lot of stress, it’s possible you’ve turned to substance use as a way to cope with what you’re going through.
And while it might feel good in the moment, substance use is likely to make you feel worse.
Therapy can help you address any mental health conditions, stress, or deeper-rooted substance use concerns.
13. You’re engaging in secretive behavior
Keeping to yourself isn’t always a bad thing, but regularly hiding your actions or thoughts from others isn’t healthy.
“Having a sense of self that is separate from the other people in our lives is normal, and even healthy,” says Heather Z. Lyons, PhD, a psychologist based in Maryland. “Sometimes, though, the parts of self that we keep to ourselves grow larger and larger. This can signal that a sense of shame or unproductive ways of coping are developing,” she says.
Lyons says that therapy can offer a judgment-free space to discuss any behaviors or thoughts that might feel more shameful.
14. You’re ready for a big change or transition
If you feel like you’re about to undergo a major change, it might be time to seek support.
“Transitions are a normal part of life,” Lyons says. “However, transitions also require the development of new skills and perspectives. Therapy can help support those changes.”
Understandably, sometimes we have a tough time summoning the courage to make the changes we need, she says. But, “therapy can help us identify the potential benefits to transitions,” so we can “gain the motivation we need to follow through.”
There are many benefits to seeing a therapist so you can work through anything that is negatively impacting your mental health.
Therapy is 100 percent confidential. Confidentiality is only broken if there’s a serious danger to yourself or others. You can talk about things that perhaps you’re too scared to talk about with anyone else. There’s no judgment.
If you’ve been coping on your own for some time, it can be a huge relief to get everything off of your chest with someone who can provide evidence-backed tools to help you. It’s comforting to know there’s someone listening: a therapist who wants to help.
Healthy coping mechanisms
Being able to cope and deal with things in a healthy and constructive manner is important for having a happy and successful life. We all face challenges and therapy can help you learn how to deal with them in a positive way.
Overcoming past trauma is not an easy thing to do, but it’s something you can safely do with a licensed therapist or psychiatrist.
Therapy can help you keep your relationships on track and understand the importance of them. It will also help you look at whether you’re in healthy relationships and learn how to establish boundaries. Therapy can also help you develop insight, change negative thinking patterns, and feel less alone.
What if therapy didn’t work before?
If you’re hesitant to try again, you’re not alone. Not everyone enjoys therapy or finds it beneficial, but this is often because you haven’t found the right therapist or form of therapy.
It’s so important to have a good connection and established trust with your therapist, as well as an informed understanding of what type of therapy will be the most beneficial for the issues you’re facing.
If you’re ready to give it another go, you don’t have to attend multiple sessions. Instead, you can ask for consultations to get a feel for the therapist before committing to anything.
Remember that there are plenty of therapists out there, and you don’t have to settle. The match between the therapist and client is extremely important, and it’s OK to shop around until you find a therapist that works for you.
Looking for the perfect therapist can be tricky, especially with so many out there. But these steps might help simplify your search:
Step 1: Figure out what you want out of therapy
For instance, if you have a diagnosed mental health condition, look for a therapist or psychiatrist who specializes in that condition. If you’re going through issues with your partner, consider couples therapy.
If you’re a Person of Color, part of the LGBTQIA+ community, or have a disability, you might feel that it’s important to match with someone who’s either a member of your community or who specializes in issues relevant to your experience.
Pro tip: We’ve compiled a big list of directories that can help connect you with a therapist that’s right for you.
Step 2: Decide what type of therapist you want to see
What if you’re going to therapy to become less overwhelmed … but deciding what type of therapy is making you even *more* overwhelmed? We got you.
There are lots of options out there. According to the American Psychiatric Association, these are the different approaches therapists take:
- Cognitive behavioral therapy (CBT). CBT aims to identify and change negative thinking patterns so you can live a healthier, more fulfilling life. It’s often recommended for those with depression, anxiety, eating disorders, and trauma-related disorders.
- Dialectical behavioral therapy (DBT). A form of CBT that helps peeps learn how to regulate emotions. It’s typically used to treat people with suicidal thoughts, borderline personality disorder, and PTSD. You’ll participate in individual and group sessions to learn how to change negative behaviors.
- Interpersonal therapy (IPT). Most often used to treat depression, IPT is usually a short-term therapy that helps folks address interpersonal issues (like grief, relationship problems, and life changes).
- Psychodynamic therapy and psychoanalysis. These types of therapy focus on improving self-awareness to change unconscious thoughts or feelings that are negatively impacting your life. They also focus on childhood experiences that might still influence you today.
- Supportive therapy. This type helps you develop resources to address issues related to a mental health condition. It can be used to build self-esteem, reduce anxiety, and develop healthy coping mechanisms.
Psychiatry is also an important part of many treatment plans — especially for certain mental health conditions like bipolar disorder. A psychiatrist can prescribe medication and work closely with you to assess how you’re feeling. Some psychiatrists might offer talk therapy services too.
Step 3: Pick between online and in-person
These days, there’s no right way to do therapy. Deciding whether online or in-person therapy works best for you will help narrow down your options. Are there therapists within walking, driving, or transiting distance from where you live? Are you comfortable video chatting?
Keep in mind that some therapists might offer a combo of both if that sounds like your thing.
Step 4: Figure out whether you have insurance coverage
If you have insurance that covers mental health services, you’ll want to research therapists that specifically accept insurance and accept your insurance in particular. (Unless you want to pay out of pocket.)
You should also check with your insurance provider to see if there’s a cap on how many visits they’ll cover each month or year. If you don’t have insurance, ask your therapist about sliding scale options or other types of financial assistance.
Places like the Open Path Psychotherapy Collective have compiled a list of therapists who charge sliding scale rates (aka therapists whose rates are dependent on your income).
Step 5: Research your options
After you’ve narrowed down options that jibe with your financial and personal needs, you know the drill: It’s time to research.
Pretty much everything has a rating and reviews online these days, and therapists are no exception. Word of mouth is still a pretty good tool for finding the one, though! So, don’t hesitate to ask your BFF.
While visiting the same therapist as someone you know isn’t always recommended, advice from loved ones can be a useful way to find practices or apps that you’ll like.
Step 6: Ask for a consultation without commitment
Why not try before you buy? Consider asking for a consultation, which will let you connect with a professional before committing to any ongoing seshes. That way, you can see who truly connect with.
You can also look for teletherapy services that offer free trials. When it comes to therapy, you definitely want to go to someone you feel comfortable around, and this can take a little trial and error.
The rise of teletherapy is helping to break down some barriers to mental health care access. If you’re considering taking care of your mental health digitally, we scoped out the best online therapy services out there so you don’t have to.
How we chose
If it seems like there are jillions of therapy apps out there — well, there really are a lot. We narrowed them down by prioritizing:
- Company reputation. Do users love it? What about watchdogs? We dug up the deets so you have a better idea of what to expect in terms of things like privacy and accessibility.
- Industry and ethical standards. Does the company live up to its claims? We tried to find out.
- Medical accuracy and integrity. Is it HIPAA certified? Are the therapists licensed and vetted? Do they offer medical services? We singled out services that deliver.
- Vetted. We put all of these services through a thorough vetting process that checks for unsupported health claims and shady business practices. Only services that passed that process are included below.
1. Best for text-based therapy: Talkspace
- Price: $69–$129/weekly, billed monthly
- Insurance coverage: accepts some insurance, some may pay in full
- Platforms: video, audio, and texting
- Pros: daily responses, HIPAA complaint
- Cons: no medical advisory board, you don’t get as many therapist options
Talkspace is a big name in the online therapy biz. It’s especially helpful for those who feel best when their therapist is just a text away. After you sign up, you fill out an assessment and choose from multiple subscriptions of varying prices based on your needs. Then, you’ll get your pick from a few therapists.
If you have an employee assistance program (EAP) with behavioral health benefits, you might qualify for coverage.
Don’t always have time for a full therapy sesh? Users like that you can always text through your probs. Especially for those who are video shy or newer to therapy, this can also be a more comfy foray into a more intimate conversation. You don’t get your pick from as many therapists as other apps, though, which some reviewers don’t love.
2. Best for relationship concerns: ReGain
- Price: $60–$90/weekly for both partners
- Insurance coverage: no
- Platforms: chat, messaging, phone, video
- Pros: professionals specialize in relationships, 1-week free trial, your partner can participate at no additional fee
- Cons: doesn’t support 3-way sessions, doesn’t work for court-ordered counseling
Issues with your partner in particular? From psychologists to marriage and family counselors, all therapists on ReGain are specifically trained in dealing with relationship issues.
You and your partner will share an account and go to live seshes with the therapist together. Need some alone time with the pro? No problem — you can schedule a private and confidential individual session.
However, the app doesn’t support three-way live sessions yet, so you’ll need to be in the same room as your partner to talk with the therapist. Naturally, lots of reviewers don’t love this, since long-distance relationships, etc., are a thing.
Another downside is that most services on ReGain aren’t covered by health insurance. Big, pro though: There’s a 1-week free trial.
3. Best for online psychiatry: MDLive
- Price: $284 for first visit, $108 for each follow up
- Insurance coverage: yes, if your insurance covers mental health services
- Platforms: phone, video
- Pros: 24/7 unlimited access to a doc, savings of 85% on prescriptions, HIPAA compliant
- Cons: no subscription plans, higher cost to see a psych than other services, doesn’t offer email or chat
MD Live offers teletherapy and telemedicine services. You can set up your first session within a couple of days. Each session is highly secured with an encryption method to ensure your privacy. This is a great option for those who need prescription medication in combo with psychiatric services.
The major con for many is that the platform doesn’t offer messaging, email, or chat services. Also, if you can’t find coverage through insurance, it’s pretty dang pricey. Reviewers also don’t like that there’s no monthly subscription plan option.
4. Best for LGBTQ: Pride Counseling
- Price: $60–$90 a week
- Insurance coverage: generally not covered
- Platforms: chat, messaging, phone, video
- Pros: the app and site are user-friendly, LGBTQ friendly
- Cons: not available to minors, your counselor can’t provide a diagnosis or medication
If you’re part of the LGBTQ community and are looking for a therapist who truly gets you, Pride Counseling is worth a shot. All counselors are informed about LGBTQ issues and specialize in areas like anxiety, stress, depression, trauma, and family conflicts.
It’s a bummer that these services aren’t generally covered by health insurance, because users seem to love it. In addition to the chat feature, you have the option of rereading your messages with your counselor later, which is an unexpected perk for many reviewers.
Another downside is that counselors can’t provide a letter of support for hormone replacement therapy for clients.
5. Easiest to use: BetterHelp
- Price: $60–$90/week, billed monthly
- Insurance coverage: doesn’t accept insurance, but does offer financial assistance for those who qualify
- Platforms: audio, chat, messaging, video
- Pros: huge network, convenience and ease of use, HIPAA compliant
- Cons: shares data with social media companies, clinician vetting process could be better
BetterHelp is one of the most popular online therapy players maybe because of its huge provider network, decent pricing, and financial assistance plans for those who need it. When you sign up, you’ll take a questionnaire designed to match you with your perfect clinician. If you still feel like they’re not a good fit, you can choose from thousands of others.
The service offers all types of counseling, from individuals to couples’. Users say the app is intuitive and user-friendly and makes it easy to switch between therapists or cancel last min without penalty. They also love that you can talk with your therapist even outside of your sesh through the messaging feature.
Keep in mind that Jezebel reported in 2020 that BetterHelp shares personal data with social media companies. While def not a new thing in the world of anything app-related, it’s not ideal — even if it is legal.
What are the signs you need therapy?
Since therapy is truly for everyone, if you think you might benefit from it — it’s probably for you. But in general, some signs to look for include:
- feeling overwhelmed
- sleeping a lot or a little
- avoiding social sitches
- feeling hopeless, anxious, or out of control
- having problems at work or school
- eating more or less than usual
- grieving or have experienced trauma
- using substances to cope
- engaging in secretive behavior
- ready for a big change or transition
Is therapy really necessary?
Sometimes it’s necessary for court-ordered purposes — other times, it’s up to you to decide whether it’s a necessary step in your life. It’s worth noting that in a 2016 research review, scientists concluded that those who did a self-guided CBT program benefitted just as much as those who saw a therapist for CBT.
Ultimately, what works best for you might depend on your unique needs. Other things like mindfulness, meditation, and healthy lifestyle changes might also help you out. But if you think you’re more likely to commit to a therapist than self-help, go with the pro.
Should I go to therapy if I don’t need it?
You don’t need any specific reason or circumstance to go to therapy, so by all means, try it!
Who knows — if you’re thinking about therapy, maybe there’s a reason you really do need it that you haven’t uncovered yet. If you go in with an open mind, there’s most likely something you can gain from the experience.
Can I treat myself without therapy?
If you’re committed to self-help, there’s some evidence to suggest that you can improve your circumstances on your own — at least, that is, with help of a CBT program.
In a 2016 research review, scientists determined that they found no difference in outcomes between those who did a self-guided CBT program and those who saw a therapist for CBT. Either way, you’ll have to put in the work. Scientists noted that roughly the same amount of people dropped out of therapy as they did the self-help program.
If you’re having a hard time getting through day-to-day life, though, it’s a good idea to turn to a therapist. At the very least, reach out to people you trust and go from there. Let’s be real, many serious issues in life are easier to get through with a little help from our friends (or our therapist)!
Therapy can be beneficial for anyone, regardless of whether you have a diagnosed mental health condition or not. It can especially help people experiencing grief, trauma, relationship issues, confidence issues, and emotional instability.
It’s important to remember that therapy isn’t a one-size-fits-all solution. It can include some trial and error.
A good connection with a therapist is as important as seeking out the appropriate therapy for you. And you shouldn’t let one negative experience with a therapist put a stop to your search for help.