How Do I Know If I Need Therapy?

For some people, the decision to seek out therapy is an easy one — they’ve received a mental-health diagnosis they know they can’t handle on their own, or maybe they know they want to try out cognitive behavioural therapy.

But, you don’t need to have a specific diagnosis to benefit from therapy. “Most of us have relationships that are in need of some rehab, and most of us have some habits or behaviours that we would like to shift or change,” Toronto-based psychotherapist Dr. Bronwyn Singleton , who works with both individuals and couples, told HuffPost Canada in an interview. 

She said there are several commonalities that have driven her clients to seek out therapy. Read on to find out if therapy is something that might help you, too.

You’ve gone through a big life change

Change of any kind — even if it’s positive — can lead to emotional and physical stress , according to studies dating as far back as the 1960s. Change creates confusion, according to psychotherapist Hans Loewald , because you’re all of a sudden in a situation where you don’t know what to expect. 

It’s obviously going to rattle your sense of self to deal with a painful change, like the death of someone close to you, or finding out your long-term partner has been cheating, or receiving a life-altering medical diagnosis. 

But, sometimes even good changes can be overwhelming, Singleton said. If you’re feeling overburdened or anxious in a new job, or overwhelmed with a new baby, seeking help might be a good idea. It’s common to start doubting yourself when you’re given new responsibilities, especially with a big life change that’s made of many smaller changer to your day-to-day life or routine. A professional can help you through a situation that feels insurmountable. 

You’re repeating unhealthy behaviour or thought patterns

There are so many different kinds of destructive behaviours — drug or alcohol abuse, self-harm, starving yourself or binge-eating, choosing the wrong kinds of romantic partners, having unsafe sex, or engaging in violent confrontations. 

Everyone takes missteps, and occasionally veering into risky behaviour (even for periods of time) that doesn’t serve you is common. But, when you can’t stop the behaviour and it’s interfering with your ability to function properly in your day-to-day life, or it’s negatively affecting your relationships, it’s time to pause and seek help. 

“Therapy can help you examine your actions, better understand their motivations, and formulate a plan for change,” Singleton has written .

For some people, the stakes might not seem as big — maybe your behaviour isn’t unhealthy, but your thoughts are, and they are constant. If you’re caught in a cycle of shame, cruel self-talk, or unhealthy fantasies, there are many therapeutic practices that work to interrupt the cycle. 

Cognitive behavioural therapy, for instance, is commonly suggested for people with low self-esteem, or negative ideation. CBT invites you to identify negative thoughts — “everyone hates me” — and interrogate or “reality test” them, in Singleton’s words.

What concrete proof do you have that people hate you? What assumptions are inherent in that thought, and what are some other possible explanations for the way you feel? The more you engage in that kind of questioning, the more you’re able to dismantle that negative self-talk.

Mindfulness-based therapy is also a good approach, Singleton said. It will typically blend CBT techniques with mindfulness techniques like meditation and breathing exercises. By focusing on where you are right now, as opposed to getting lost in destructive thoughts, you can learn to “distract yourself or move on from these thoughts,” she explained.

You feel like your life is being interrupted by trauma from your past

Some people who experience trauma are affected by it in immediate and obvious ways. But post-traumatic behaviour can look really different in different people, and sometimes it’s subtler or more insidious, according to the National Institute of Health . Many people will have some combination of both instant and delayed reactions, and in some cases those delayed reactions can happen long after the fact.

A few of the many delayed reactions trauma survivors might endure include, according to the NIH : intrusive memories or flashbacks, self-blame, preoccupation with the event, depression, emotional detachment, sleep disturbances, magical thinking as a way to prevent future trauma, and hopelessness.

There’s no single way to “get over” past trauma, but if it’s intruding into your everyday life — if you can’t stop thinking about your trauma, or you’re isolating yourself because of fear it will happen again — there are ways to cope. According to the Mayo Clinic , cognitive therapy can help with thought patterns that are keeping you stuck. Exposure therapy, also common for trauma, will confront the traumatic memory itself as a way to move beyond it. A therapist can also help you come up with a system to de-escalate panic and stress if it recurs.

Watch: Residential schools and the trauma they inflict on Indigenous people. Story continues below. 

You have big decisions to make

If you’re having a lot of trouble deciding whether or not to get a divorce, or have a baby, or stop drinking, it might be a choice that’s too big to make on your own.  In situations like these, “your family and friends may be too invested to provide honest counsel,” Singleton wrote .

A good therapist won’t make the choice for you — that’s not their job. What they will do is work with you so that you can figure out the right answer for yourself. A therapist provides you with support, a neutral space to talk, and tools to figure out what it is you really want.

They might help you by breaking down “all-or-nothing” thinking — there’s no “right” or “wrong” decision about whether to have a child, for instance. There are two choices that could both be right, and your job is to figure out which one you’re more suited to. So many of our choices are weighted by expectations from our families and friends, or our partners, or society at large — a therapist can help you better understand what will actually work for you.

Your relationship feels unhealthy, or has just ended

It can be easy to forget or minimize when you’re not living through it, but heartbreak can feel like a death. That’s normal, Singleton said: “Relationships provide us with identity and meaning.” A therapist can help you either strengthen or leave a bad relationship, and can help with coping techniques if it ends.

A therapist can also help you examine the specific issues in your relationship. Do you unconsciously seek out partners with the same unhealthy qualities? Have you experienced the same kinds of issues in different relationships? If you feel like you’re repeating the same mistakes, that’s a sign that you could use some help.

Couples’ therapy can also be a good way to maintain a happy relationship. You don’t need to be in crisis to seek out a therapist who can help you ensure you’re communicating effectively, showing your partner you care in a way that will resonate with them, and handling conflict in healthy ways.

Your physical health is interfering with your mental health 

In situations where your physical well-being is tied to your mental state — for things like insomnia, weight loss, menopause and so on — therapy can help. “Therapists aren’t medical doctors, but we often help clients manage challenging illness, temporary or chronic medical conditions, and various physical symptoms or conditions,” Singleton wrote .

If a physical condition is negatively affecting your mental state — if you’re living with chronic pain, for example, and it’s taking a toll on your mood — a therapist might be able to help you with coping mechanisms. If you’re suffering from insomnia, there may be some emotional reasons that a therapist can help you deal with.

You’re worried you might have a mental illness

If this is something you’re worried about, or if you read a list of symptoms of a specific illness and you feel like it applies to you, make sure you see a doctor or contact a crisis line as soon as possible. There’s no reason you or the people in your life should have to suffer unnecessarily. 

You want to make sure you maintain mental wellness

If you don’t feel that you’re suffering or struggling, you may not feel you need any help. But most people do have challenges to contend with, and not everyone has healthy strategies in place to deal with stress or heartbreak or grief when they pop up, unwelcome and unexpected. “Therapy is a significant investment in yourself,” in Singleton’s words. 

If it’s something you’re thinking about, the best approach is to talk to a therapist first. Most of them offer free exploratory calls — Singleton said she actually insists on it. That can give  people the chance to both explain why they’re seeking therapy and voice any misgivings they might have about the process.

Are you in a crisis? If you need help, contact Crisis Services Canada at their website or by calling 1-833-456-4566 . If you know someone who may be having thoughts of suicide, read this guide from the Centre for Addiction and Mental Health (CAMH) to learn how to talk about suicide with the person you’re worried about.

Taking care of your mental health is critical — but there’s still a stigma about seeking therapy to manage your own wellbeing. In our series, “This Could Help ,” we’ll explore how to get started with therapy and fit it in to your life and your budget. We’ll answer the questions you’ve been wondering, and show you the ways therapy can benefit you and the people you love. Whether you’re struggling or just want to make sure you’re on the right track, support is available, and it really can help.