To start, let’s consider the World Health Organization’s “Optimal Mix of Services” pyramid. It’s a helpful visual to understand the approach to any health condition, not just mental health:
So, there are different levels of “care” that require different responses. The same pyramid could translate to physical health conditions. When folks have stomach issues like heartburn, most will turn to some sort of over the counter medication like antacids; they don’t rush to the emergency room. When the antacids don’t help, that’s typically when someone goes to their primary care provider.
Self-care for mental health
One of my colleagues who is a psychiatrist told me “What person doesn't feel better after going for a walk on a sunny day?” People should not be required to come to a psychotherapist to learn how to go for a walk to help their mood, informal supports can help with this (in the clinical world, we call behaviors like walks to help change our mood as "behavioral activation.”). There are many things that we can do to take care of ourselves, for instance like talking to a friend after a stressful argument with a partner, or pumping ourselves up with positive phrases before an upcoming work presentation. We have everyday resources (that we sometimes forget about) that can help with day-to-day stressors, and I don't think I need to go into self-care here because there are articles upon articles about informal ways to take care of yourself.
Seeking formal care for mental health
The big question should be, “When do I need to see somebody for this?” In the world of behavioral healthcare, we would respond asking about three main things. Frequency is considered how often something is happening- “is this happening on a daily basis or weekly basis?” Duration considers how long something's been happening – “has it been a few days, or has this been going on for 2 weeks?” Magnitude is considered how severe or intense something is- “is this just butterflies with a worry, or are you hyperventilating?” These questions help to figure out if something requires more than self-care/informal care.
How do I decide to seek care? Luckily, there are informal screeners that can help inform patient decisions about whether or not to consider reaching out to a professional. These screeners are not diagnostic tests to self-diagnose; rather they are intended to give a snapshot of what may be happening for someone. Mental health symptomatology has yet to come into the daily health lexicon, so these screeners help the general population. I don’t think we have knowledge of mental health syndromes down yet to the extent that we have understanding of the symptoms of a cold (Just think, running nose, sneezing, feeling tired, congestion- most people would think “cold symptoms”).
Connected to formal care for mental health
So let’s say you see your primary care provider (PCP). Your symptoms go beyond self-care or general lifestyle changes that can be managed with the PCP, and they recommend mental health treatment.
What’s next? You’ll meet with a more specialized provider. When you get connected, the provider will see if what you have is considered an “adjustment disorder,” or a group of symptoms that can occur after someone goes through a stressful life event, such as moving to a different city, a life change, or relationship problems. The reactions to these events can be “bigger” than someone’s resources to cope with the stress. I see most Employee Assistance Program referrals typically falling under the category of adjustment related stress. The current worries related to the coronavirus pandemic would most likely fall in this category (FYI, check out this simple exercise offered by Martin Seligman, director of Penn’s Positive Psychology Center, to help manage during this time).
How long will this take? Mental health care can take some time, and maybe this is where folks tend to think of it as different from caring for our general health. Luckily, there are evidence-based treatments like Cognitive Behavioral Therapy (CBT) that can be completed over 5-20 sessions. Your provider will work with you to find the right treatment. Behavior change takes longer than reducing the symptoms of a cold- regardless, your body can heal itself!
For chronic conditions, like persistent depressive episodes or psychosis, care can be seen as symptom management. This is just like caring for chronic illnesses for diabetes- it requires medication management, some lifestyle changes, and regular contact with a health care provider. Refer back to the pyramid here – this is where self-care requires ongoing provider care.
I like to tell people that seeking treatment for mental health is not a commitment they can never back out of or something that they have no say in. Mental health providers really mean to focus on empowerment, so the client can have improved capacity to care for themselves. Sometimes issues resolve with some brief support. Sometimes issues are managed enough to allow people to sustain a lifestyle they are comfortable with.
Seek support if you need it. If you’re unsure, a little prevention like reaching out to your primary care doctor can go a long way. Of course, if you are in crisis, please reach out for immediate support, like National Suicide Prevention Lifeline 1-800-273-8255.
Moving forward with caring for mental health starts with the mindset shift – just do it!
Disclaimer: Information in this article is for general use, and it is not intended to diagnose problems or provide treatment for its readers.