How to Tell If Someone You Love Needs Therapy

By Sherry Amatenstein LCSW

According to a report issued by Mental Health America (MHA), over 40 million Americans are dealing with a mental health issue. Yet 56 percent of those struggling do not seek help for a variety of reasons – i.e.: the cost of treatment; shame; the difficulty of pulling oneself out of the emotional gridlock that typically accompanies foggy thinking.

So if you are concerned that a loved one is undergoing mental health issues – whether longtime anxiety, depression, or situational distress triggered by a specific event, don’t dismiss your fears offhand, thinking, “Aw, he (or she) will probably snap out if it.” The reality is that psychotherapy and possibly psychotropic meds are frequently required to help someone deal with serious issues.

Look for these signs

* Isolation, apathy about activities that used to be of passionate interest

In recent weeks or months the inner light has left your loved one’s eyes. He or wants to sleep or, like Garbo, just be left alone. When pressed for why he or she has abruptly ended a decades-long three-times-a week gym habit or haunting flea markets for antiques and bargains, the answer is a yawn or a shrug.

* Expressing feelings of hopelessness, depression, anxiety

When someone is in the middle of an emotional desert, he or she sees no way out; it feels like life will never hold anything but bleakness and fear. Answering your loved one’s statements with comments like, “Oh, it’ll get better, you’ll see”, won’t accomplish much beyond making him or her feel even more alone and misunderstood.

* Recent trauma

A terrible setback or big lifestyle change – the illness or death of someone close, a romantic break-up, job loss, even retirement – can cause someone to spiral downward. He or she likely can benefit from therapy, which offers an opportunity to process the experience and learn skills to better handle difficult emotions.

* Exhibiting new, disturbing behaviors

When someone suddenly starts drinking and/or using drugs, posting angry or uber-depressed screeds on Facebook, or having angry outbursts at work or with family, professional help is a sound idea.

* Giving away possessions, talking about ending it all

The name for this kind of behavior is ‘suicidal ideation’ and yes, it’s a cry for help. If he or she is not merely expressing ideation but talking about doing it imminently and has decided on the method – i.e.: downing a bottle of Ambien; jumping from a 26th floor window of a high rise, it is not just a cry but a scream. Help must be sought immediately.

You can’t force someone to seek treatment. Again, the only time you must take action of this nature is if your loved one seems in immediate danger of hurting him or herself. This person might need to be hospitalized until the crisis has passed. The National Suicide Prevention Lifeline – 800-273-TALK – has trained counselors at the ready who can advise you.

When the situation is serious, not dire, here is how to proceed.

How to have ‘the talk’ about seeking help

* Come from place of compassion

Sometimes when one is worried and stressed, it’s possible to come off angry and impatient with your loved one rather than concerned and caring. You also don’t want to lay on a guilt trip. (“Look what you’re doing to me!”) What you do want is to be gentle and supportive with your friend or family member who is super-vulnerable, perhaps defensive, and likely not thinking clearly. Share all the traits you think are wonderful about your loved one, and why he or she has so much to offer the world. Stress that sessions with the therapist are confidential, offering an opportunity to be completely honest without fear of hurting anyone’s feelings.

* Listen to their objections

Everyone wants to feel heard and taken seriously. So ask what the objections and fears are, and listen to the answers. Empathize with their emotions. If you’ve been in therapy, talk about what your misgivings were initially and how you ultimately found the experience helpful – perhaps life changing. Show some research and stories about potential benefits of therapy.

* Do all the research

Even if someone is not totally resistant to the idea of seeking help, the prospect of finding a therapist can feel overwhelming. So do some research before your talk. (The Psychology Today website offers listings of mental health care healers) Have a list of therapists in hand that accept your loved one’s insurance, along with a few low cost outpatient mental health care clinics if finances are a concern. FYI: a psychiatrist prescribes medicine. A therapist (social worker, psychologist, psychoanalyst) helps patients accrue insight, understand and better control their destructive feelings and make better decisions. Offer to go to the first session.

The good news for your loved one is that mental health problems are “normal” and most of the time can be greatly alleviated with professional help.

Sherry Amatenstein, LCSW is a NYC-based therapist, speaker and author of four books, including How Does That Make You Feel?: Confessions from Both Sides of the Therapy Couch and The Complete Marriage Counselor: Relationship-Saving Advice from America’s Top 50-Plus Couples Therapists. Her website is www.marriedfaq.com.