There’s no doubt that mental health matters but not everyone knows how go about seeking help or even how prevalent these issues are for patients. Soon you’ll have more confidence in picking the mental health option working best for your situation.
The fact of the matter is that no basic lab or blood tests exist for mental issues. Mental health conditions are primarily diagnosed upon having an exam or long-term study of your health. Even though we don’t know all the answers about why our lovely brains can get depressed or schizophrenic, we do know that such diseases happen a lot. According to data crunched by the CDC and National Institute of Mental Health, about one in five adults in the US experienced some kind of documented mental illness. In the last 12 months from the most recent tally in 2020, 19% of all recorded mental illnesses were anxiety-related and the next 8% were depression-related. I’d argue these numbers are probably under-reported because of the stigma in our culture that it’s shameful to have this kind of disorder. Spoiler alert—it’s not shameful by any stretch of the imagination to deal with those obstacles. Some patients might believe that the only way to deal with such problems is to have medication or do some cognitive behavior therapy. However, there are way more choices than you think and a number of professionals you can seek. Not all shrinks are created equal. Knowing what options are out there is a huge part of taking the first steps in bettering your mind.
There are a variety of warning signs that can be a trigger for seeking mental health assistance, but since this podcast isn’t a medical advice column, I’m going to link the general list of concerns as noted by the National Association of Mental Illness. That link plus anything else I cite in this episode and beyond will be found on my Substack at rushinagalla.substack.com. Let’s say you’re somewhere between being on the fence and being 100% sure that finding mental help is the next step. Where do you begin? The simplest way to go about this journey is to look at the actual professionals in your area that offer specific kinds of psychiatric care. The process of finding a mental health provider is similar to how you’d seek a primary care physician but you should have a clear aim for a solution that makes the most sense. In the mental health world, patients can get official assessments, counseling, therapy, medications, or a combination depending on the provider. But then you ask, what if I don’t know what I need? In that case, a great first step is to check out counselors in your area. These people could be licensed professional counselors that have a master’s in counseling or psychology and do first-line work that other mental clinicians may not be available for. More than anything else, the counseling option gives you a sounding board to help with both reactive and preventative mental healthcare if you’re not sure about specific options. On top of that, counselors exist to help with various walks of life—someone could assist with marital counseling and substance abuse. Even other counselors who dealt with mental health challenges themselves can jump in to comfort you. The only significant downside to first-line counseling work is that such professionals might not be able to give an official assessment of your mental well-being. If you’re leaning towards getting a concrete opinion and maybe some initial therapy, clinical psychologists are the next level up. These are people who usually have a PhD in psychology while seeing patients to make a diagnosis and provide therapy. If you happen to be in school, certain academic institutions have their own psychologists that connect with you and other staff as well. These psychotherapists may also offer cognitive behavior therapy, which is the practice of singling out negative behaviors and in turn replacing those issues with positive habits. This avenue makes sense for exploring non-medication treatment and getting an opinion without going as far as seeing a psychiatrist. This approach also makes sense when you or your contacts feel that you have a possible mental disorder requiring the kind of attention a counselor wouldn’t be able to provide. The next degree of care available to you would be the realm of prescribers such as psychiatrists. These mental healthcare workers are medical doctors who do traditional clinic work for making a diagnosis and offering medication-related treatment. Not all psychiatrists or mental health nurse practitioners may do cognitive therapy but some may instead complement treatment plans with counseling. In a situation where a mental condition is rather severe and therapy hasn’t worked in the past, then it might be proper to see a psychiatrist. Getting prescriber-focused assistance would be something to try once the choices along the counselor and psychologist spectrum get exhausted. You would likely need a referral (unless you have a PPO health plan) to see a psychiatrist outside of a hospital setting, but visiting your general doctor is another good first step to get an opinion about your condition before getting put through to another doctor or therapist. A great website to help you find local therapists is www.psychologytoday.com/us/therapists. For psychiatrists, you can visit locator.apa.org. Online platforms like betterhelp.com or teladoc.com are great places to start with as well.
No matter who you see or what app you use, you should feel comfortable asking questions just like with any provider, because you need to find out if you can trust your provider’s judgement even if you disagree with the diagnosis. The actual weight of getting a mental health diagnosis varies between patients because, again, there are no traditional lab tests with mathematical or chemical evidence showing that you have depression or any similar disorder. Some patients feel a mix of comfort and fear in being able to put a name to the face of their issues. Because mental health treatment is created based on your provider’s experience, training, and diagnosis criteria more so than with testing, there is nothing wrong with getting a second opinion—just avoid trying to visit every single therapist and psychiatrist in town.
Because mental health appointments like talk therapy, psychiatric emergencies, and cognitive behavior work differ from a traditional medical visit, I want to leave a quick note on the insurance side of things before moving on—mental health coverage is not always clear-cut and not every plan is willing to pay for such treatment. The best way to demystify this is to contact your insurance company to ask what the specific deductibles, copays, and coinsurance look like for a given scenario once you decide on pursuing a counselor, psychologist, or psychiatrist.
If a medical problem comes up fast, whether it’s related to mental health or not, you should know about the first places to go. The next pod’s theme covers the differences between urgent care and the emergency room as well as which one you should pick for a given situation. Subscribe and stay tuned to Friendly Neighborhood Patient to get ahead on healthcare. I’ll catch you at the next episode.
