How to Start Seeing a Therapist

therapist
A picture of a man in a white doctor’s coat. Credit to flickr.com user Tyler Byber. Used with permission under a Creative Commons license.

A version of this post first appeared on the International Bipolar Foundation Website, found here.

Seeing a therapist can be enormously helpful in sorting out issues you may have in your life. You can also develop coping skills in therapy to deal with serious problems, or just the less-serious issues of everyday life.

But how do you start searching for a therapist? Read on to find the solution.

Facts to Keep in Mind During Your Search

There are a few things to keep in mind before you start your search for a therapist:

  • You need to find someone you feel comfortable talking to. No therapist worth his or her salt will be offended if you decide that your relationship with him or her isn’t working out. Don’t stick around if you need to move on.
  • Secondly, if you want medication, you’ll need to see a licensed psychiatrist or nurse practitioner who is allowed to prescribe for you. You may encounter a combination therapist-psychiatrist, but those are a rare and dying breed. More likely, you’ll hire a treatment team to take care of all your needs. You don’t need to factor this into your search for a therapist, but if you need meds, you’ll have to find someone other than your therapist who can prescribe for you.
  • Third, you will find that there are all sorts of acronyms following the names of various therapists. There are Marriage and Family Therapists (MFTs), Licensed Mental Health Counselors (LMHCs), Licensed Clinical Social Workers (LCSWs), and Doctors of Psychology (Psy.Ds.), among others. Don’t be put off by the variety in titles. Rest assured that your level of care will be similar despite the different acronyms. Just make sure your therapist is licensed. Look up the meanings of some of these acronyms. It may help you narrow your search.

Step 1: Figure out What You Want and Need in a Therapist

Do you want a female therapist? Maybe someone Christian? Someone with experience with elder care? Sometimes therapists will list their specialties on their office websites, but it’s not difficult to ask before you see them a question like whether they have experience with patients with bipolar disorder or generalized anxiety.

Next, figure out what you need, not just want, which can be more difficult to pin down. Do you need someone who approaches you with tough love, or someone who indulges you a little? Do you need assignments out of the office? Do you need a shoulder to cry on?

Make separate lists of your needs and wants, and reflect on them at your first appointment, to see if the therapist you’ve chosen is meeting most of your needs and some of your wants.

Step 2: Figure Out How Much Care You Can Afford

Some mental health counselors take insurance, but many will require payment out-of-pocket. Fortunately, most therapists charge on a sliding scale, which means they will consider your ability to pay in determining the price. Determine how much you can afford to pay per month, and how many sessions you think you need. Your budget will determine what therapists you’ll think about using. Keep in mind that mental health is crucial for your day-to-day functioning, and a therapist should be able to help. If you can’t afford a therapist, then that will add strife, not help.

Step 3: Start Searching

There are several ways to find a therapist once you’re ready to search. First, ask for recommendations from your family and friends, provided they’re supportive of your mental health journey.  Next, ask for a referral from your doctor, if you have one, and your insurance company–they’ll send lists. Searching online is also an option. GoodTherapy.org allows you to search by location.

Step 4: Prepare for the First Appointment

Once you’ve done the research, it’s time to make appointments. If you can, try to vet more than one therapist to cover the bases of your wants and needs. Prepare for the first appointment(s) by writing down a few questions to consider when meeting with your therapist:

  • Do I feel comfortable with this therapist? Can I make a relationship with him or her?
  • Does he or she ask me enough questions?
  • Has my therapist asked me what my goals are?
  • Does my therapist meet my wants and needs?

And so on. Finding a therapist takes time and dedication, but the results are worth it. If you can establish a relationship with your therapist, then you can address the problems which are plaguing you.

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National Prevention Week: How I Prevent Oncoming Bipolar Mood Episodes

The week of May 12-18 is National Prevention Week, so I’d like to talk about how I try to prevent oncoming bipolar mood episodes. Because I was diagnosed at twenty-two and started medication and therapy, I have a decade’s worth of experience in managing my bipolar disorder. Read on for a roadmap discussing how to tackle the prevention of mania and depression head on.

Fight Self-Stigma

Self-stigma is when you have absorbed the negative, inaccurate messages about your mental illness around you. This affects your perception of your mental illness and your need to treat it, which in turn affects your behaviors and actions in terms of seeking treatment. In order to face taking medication every day for the rest of your life, you need to fight stigma, especially self-stigma. The way I fought it was to recognize that I needed to be my best self for my newborn son, which entailed taking medications and going to therapy. I needed to treat my disorder so I could properly mother my son. It wasn’t just about me.

If you have a reason outside of yourself, awesome, but if you don’t, you still deserve treatment. You are better than your disease. You are a human being, a precious individual. Caring for yourself, especially in the pit of depression, is one of the hardest issues you’ll ever face. But you deserve proper care, even if it’s mostly self-care for a while.

Medication

I can’t recommend medication enough. In combination with therapy, medications saved my life. When I was first diagnosed, Depakote toned down my psychotic mania, and two years later, lithium lifted me from the black sucking hole of suicidal depression. Now I’m on Risperidone and Wellbutrin, and the combination has enabled me to be stable for over six years. Taking my medication daily has prevented the dizzying spin of mania and the pit of depression. Part of this is my fighting self-stigma, as I said above.

Therapy

Another tactic that has helped me remain stable for the past half-decade is attending counseling sessions with my therapist. Therapy has helped me learn coping mechanisms to handle my day-to-day life, including emergencies. I’ve been able to treat my manic and depressive episodes, and learn how to flourish. I am thriving, and I wouldn’t have thrived so successfully without those weekly appointments with my therapist.

Sleep

Proper sleep is crucial for managing your bipolar disorder. Sleep disturbances trigger bipolar mood episodes, especially mania, and too much sleep triggers the crash of depression–usually following mania. Problems with sleep are a common symptom of bipolar disorder; in a future post, I’ll be looking at how common insomnia is for this specific mental illness.

To ensure I sleep as well as I can, I practice what’s called good sleep hygiene. I don’t drink water or caffeinated beverages right before bed. I wind down before bed, taking a bath every night. I wake up every morning at 8:30am, if not earlier. I try to go to bed at the same time. I wake up frequently in the middle of the night with a racing mind, but I try to calm myself by praying or meditating. Generally, that works, and I’m able to get back to sleep within fifteen to thirty minutes; I recognize that I am lucky in that manner. Try to practice good sleep hygiene, and you, too, might be able to prevent oncoming bipolar mood episodes.

jessi RM
A picture of a smiling woman next to a frowning woman, in black and white. Credit to fliclr.com user Jessi RM. Used with permission under a Creative Commons license.

Final Thoughts

Fighting self-stigma, getting proper treatment for your disease (including medication and therapy), and sleeping properly are some of the best ways to prevent oncoming bipolar mood episodes. If you’re looking for a post on how to manage the most common bipolar triggers, click here.

You can do this.

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