Finding a Mental Health Professional

If you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or crisis hotline such as 1-800-273-8255 (TALK) immediately.

If you or someone you care about is having a hard time with mood swings, feelings, emotions, situations or memories, you may have decided it’s time to seek professional help. If sadness, guilt, feelings of worthlessness, anxiety, racing thoughts, problems with sleeping or eating or any other symptoms have started to interfere with your work, social or personal life, or if you experience a sudden change in mood that makes you feel “not yourself,” a visit to a professional may help you.

You may be unsure about talking to a health care professional about your thoughts and feelings, and this brochure can help you through that process. You are not alone. Many people worry about seeing a doctor to talk about mental health issues. Some think they will be labeled “crazy” or that they will be judged. You may have been told by others that you needed to “snap out of it,” “control yourself,” “pull yourself up,” have more faith, or that your symptoms are your fault. This is not true, and you are not “crazy”. Seeking help is the best thing you can do for yourself, and the best way to start feeling better.

As you search for a health care professional, keep in mind that you have a right to expect certain things, no matter who you are, what challenges you are facing or how much money you have. These include:

  • Privacy, confidentiality and respect
  • Sensitivity to your needs and cultural background
  • An understandable explanation of what is the matter and all of your treatment options
  • Freedom to express yourself
  • Freedom to find another professional if you are not satisfied with your treatment or don’t think it’s working as well as it should

Your relationship with your doctor should be a partnership. The two of you will work together to find a treatment plan that will help you feel better. You should never feel intimidated by your doctor or feel that you are wasting his or her time. A good doctor, despite time limitations, will make an effort to listen to you and understand you.

How do I decide which type of professional is right for me?

To get a better idea of your own needs, it might be helpful to answer some questions and/or make a list of your symptoms and issues.

What are the main things I’m looking for help with? (Example: I need help working through issues with my family, I’m having trouble sleeping, I can’t stop getting angry all the time, there are problems in my marriage or relationship.)

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Am I looking for talk therapy? If so, what kind of therapist do I need someone who will listen to me, someone who will help me set goals, someone who will help me learn coping skills?

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Do I have any concerns or questions about taking medication?

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What has my health history been like? Include recurring physical problems such as headaches or stomachaches, and habits such as drinking, illegal drug use, prescription drug abuse, or self-abuse (cutting). Also include any treatment you’ve had with a psychologist, therapist, social worker or psychiatrist in the past and how it helped you.

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What options do I have to pay for treatment? (You may need to call your insurance company or Medicare/Medicaid provider to find out what is covered. If you will be paying out-of-pocket, you may want to make a budget and see how much money you can afford to spend per week or per month.)

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What kinds of professionals do I have to choose from?

Primary care doctor or family doctor (MD or DO) Your family doctor should give you thorough physical examination to find out if you have any other illnesses that might be contributing to your symptoms. Your family doctor may talk to you about troubling issues or prescribe medication for you, or he or she may refer you to a psychiatrist or psychologist. Primary care physicians are trained to treat a variety of illnesses, and can effectively treat mild to moderate depression that responds well to treatment.

Psychiatrist (MD or DO) A psychiatrist is a medical doctor who specializes in treating illnesses of the brain. If your primary care doctor is not comfortable making a diagnosis, is unsure of your diagnosis, or believes you may need a combination of treatments, he or she may refer you to a psychiatrist. Some psychiatrists offer talk therapy and medication, while others see patients to prescribe and adjust medications only.

Psychologist (PhD, PsyD, EdD, MS) A psychologist has intensive training in illnesses of the brain and can help you feel better by teaching you coping skills and helping you change the way you approach things. Your appointment with a psychologist will usually be about 50 minutes long, and you will have a chance to talk about what is happening in your life and what you can do to get through it. In most U.S. states, a psychologist cannot prescribe medication.

Social worker (DSW, MSW, LCSW, LICSW, CCSW) or Counselor/Therapist (MA, MS, MFCC, MFT, LPC, LCPC) Social workers, counselors and therapists are highly trained professionals who work with thought- and action-related coping skills. Their methods are similar to psychologists’ methods.

Psychiatric nurse (APRN, PMHN) Psychiatric nurses work with individuals and families to assess needs and develop treatment plans. They may monitor treatment, assist with crisis intervention or offer counseling.

Most professionals use a combination of approaches, and alter their approach to best help the person they are treating. They may also hold group or family therapy sessions. Some people find it helpful to get feedback from a group; others are more comfortable talking one-on-one.

No one type of professional is better than another. The most important thing is your ability to work with the person, talk honestly and openly, and make progress. Choose the one that is the best fit for you in terms of your needs, your comfort level, and your finances.

Sometimes people see more than one professional. For example, a person might get medication from a family doctor, and then see a social worker for talk therapy.

Where can I look for a professional?

  • Your family doctor can give you a referral.
  • Your workplace employee assistance program. (If you are worried about confidentiality, first find out if this service is confidential.)
  • Your insurance network. If you have insurance, your insurance company may have a list of professionals that are “in the network” and rules for seeing those who are not.
  • Friends, family, community centers or places of worship. Sometimes a friend or relative’s doctor will recommend someone, since some people don’t feel comfortable seeing the same person a close friend or relative is seeing.
  • Professional associations.  
  • Your city or state mental health department. (Check the community, government or Blue Pages section of your phone book.)
  • Local hospitals, or universities that have teaching hospitals.
  • A local doctor referral service.
  • Recommendations from people at your DBSA support group.
  • DBSA’s online referral program.  

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What should I tell the professional?

Many people find it difficult to “open up” to a new doctor, especially if they are talking about feelings and emotions. Take another look at the list “What are the main things I’m looking for help with?” Bring it with you to your first appointment. It can be a good way to start talking about the main things that are causing problems in your life, or the things you want to improve. The following list can also be helpful. 

Check if “yes”:

  • Has anyone in my biological family been diagnosed with depression, bipolar disorder or another mental illness?
  • Has anyone in my family had to “go away for a while” or had a “nervous breakdown”?
  • Has anyone in my family abused alcohol or drugs (illegal or prescription)?
  • Has there been trouble with chronic pain, headaches or stomach problems in my family?
  • Have there been other medical illnesses in my family?

If you answered “yes” to any of the above, describe:

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Have any major changes taken place in my life lately? (Include changes to your life situation such as a new job or a new home, and physical changes such as trouble sleeping, loss of appetite or other illnesses.) 

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What medications am I taking (for all illnesses)? What medications have I taken in the past? How did they work?

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How much have I been drinking? What about drug use?

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Have I had thoughts of death, suicide or self-harm, now or ever?

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If you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or crisis hotline such as 1-800-273-8255 (TALK) immediately.

What are my main concerns or fears about treatment? (Example: I get uncomfortable talking about my feelings; I usually don’t stick with things I start; I don’t have the time for weekly appointments.)

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Do I have any special needs for extra privacy and confidentiality?

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Remember that seeking help is no reason to be ashamed. You would not be ashamed if you asked for help with symptoms of diabetes, asthma or any other health problem. Your doctor should not judge you or your actions. If, after a few appointments, you feel your doctor is judging you, it may be helpful to talk to him/her about it, or look for another doctor that you feel is more accepting.

After you have found some health care professionals that look like they fit your needs, call the office of one and make an appointment. Most of the time you will only need to give your name and phone number to the person who sets the appointment you will be able to explain your reasons for seeking help during the appointment. If you have concerns about privacy, bring them up during the call.   If you need help right away, let the person know. You don’t need to go into detail, just say you are in a crisis situation. If the first doctor you call can’t see you soon enough, call other doctors until you can find one who is able to help you quickly.

What should I expect at my first appointment?

In your first session, you will probably do most of the talking. You should tell the professional why you are there and what you would like to get from treatment. The professional will tell you how he or she can help, and the two of you will work together to set goals and develop a treatment plan. After the professional gets to know more about you and your situation, he or she may be able to give you an idea of how long treatment will take and when you can expect to feel better. Most treatment today is goal-oriented and it does not necessarily go on indefinitely.  

What should I find out from the professional?

This will depend on your personal needs and concerns, but here are some questions you may want to ask:

  • What type of training and experience have you had?
  • What’s your treatment philosophy/method?
  • How long do appointments usually last and how often will they be?
  • How do you handle billing? Do you offer a sliding scale?
  • How can I reach you in an emergency? 

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How will I know if I’m making progress?

If you and the professional you’re seeing make a list of short- and long-term goals at the beginning of treatment, you’ll be able to check the list and see if you’re closer to reaching any of those goals. It’s helpful to keep a journal or a DBSA Personal Calendar to track your progress how you feel each day and how you deal with difficult situations. You and your professional should also set a time when you will look back and review your progress. Improvement won’t happen overnight, and the problems you’re having may not completely disappear, but you should be able to see some change, even if it’s just a better understanding of your own thoughts and feelings. Many people who keep journals or Personal Calendars are surprised when they look back to see that they have made a lot of progress. Another helpful tool to track your progress is the “How is my treatment plan working?” worksheet.

It is also helpful to learn everything you can about mood disorders (and any other illnesses you have) and their treatments. Check your local library for other books and reference materials. You can also ask your pharmacist for information if you are taking medication, or find information at www.nlm.nih.gov/medlineplus/.

What if I’m not making progress? 

As hard as professionals try, sometimes they may give you an incorrect diagnosis or lack the time to pay attention to your unique needs. If, after honestly looking at your goals and your feelings before and after treatment, you believe that you are not getting better, you have a right to seek a second opinion (as you would with any illness), and to have the best treatment possible. You do not have to stay with your current professional. But if you are taking medication, never stop taking it without the supervision of a medical professional, to avoid harmful effects.

Look for additional referrals and start again, using the knowledge you’ve gained from your time in treatment. Don’t let one unsuccessful experience make you unwilling to try treatment again. And don’t blame yourself. Sometimes the match of professional and patient personalities doesn’t work out, or a patient might make more progress using a different method of treatment. Keep trying and don’t give up hope. There is a way for you to feel better.

Let your doctor know you won’t be returning for further treatment, and ask that copies of your records be forwarded to the next professional you see. Be courteous and remember to cancel any appointments with enough advance notice.

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How can a DBSA support group help me?

If you think you might have depression or bipolar disorder, a DBSA support group is a helpful, reliable, knowledgeable group of people who know what you are going through and can help answer the question, “What next?” and other questions you have.

DBSA group participants are people with mood disorders and their families who share experiences, discuss coping skills and offer hope to one another in a safe and confidential place. DBSA support groups provide the caring and assistance that is important to lasting recovery, and are a valuable addition to therapy and/or medication. People who attend say that the groups:

  • Provide a safe and welcoming place for mutual acceptance, understanding and self-discovery.
  • Give them the opportunity to reach out to others and benefit from the experience of those who have “been there.”
  • Motivate them to follow their treatment plans.
  • Help them to understand that mood disorders do not define who they are.
  • Help them rediscover their strengths and humor.

People who had been attending DBSA groups for more than a year were also less likely to have been hospitalized for their mood disorder during that year, according to a DBSA survey.

How can I deal with financial and insurance issues?

There is no easy answer to this question. Unfortunately, mental illnesses sometimes are not insured at the same level as other illnesses. Sometimes mental health coverage is not offered at all, or a person is unable to get health insurance. Here are some things you can do to try to reduce the cost of your treatment.

  • Talk to your health care provider(s) and try to work out lower fees or a payment plan.
  • Use community or state-provided services, many of which offer a sliding payment scale.
  • Space out your allowable psychotherapy visits over time and work on developing skills you can use between visits.
  • If you are taking medication, ask your doctor to contact the pharmaceutical company that makes your medication and see if you are eligible to receive free medication. Ask if your doctor has any free samples of your medication to give you.
  • Ask your doctor to contact your insurance company and ask if they will allow more treatment for you.
  • If you are having a hard time getting insurance because you’ve had treatment for mental illness, your state may have a risk pool, which offers insurance for hard-to-insure individuals. There is often a waiting list, and this insurance is often costly, but it is an option to consider. For more information, visit www.healthinsurance.org/riskpoolinfo.html
  • Get help before there is a crisis. A brief appointment to talk about how you’re feeling or adjust your medication can prevent more costly interventions later.

There is hope.

Right now you might be dealing with symptoms that seem unbearable, and it can be difficult to have patience as you search for a professional and go through treatment. The most important thing you can do is believe that there is hope. Treatment does work, and most people can return to stable, productive lives. Even if you don’t feel 100% better right away, its important to stick with treatment and remember that you are not alone.

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How is my treatment plan working?

This worksheet can help you check your progress and find out which issues need to be discussed at future appointments. You may want to make copies and use one each week.

WEEK OF _________________________________

NEXT APPOINTMENT _________________________________

On a scale of one to ten, how do you feel? (circle the number)

1    2    3    4    5    6    7    8    9    10

1=sad, tired, anxious, tense, irritable, withdrawn 
10=happy, rested, relaxed, energized, involved in life

Check any words that describe how you felt this week:

_ Trouble concentrating

_ Sad/Crying

_ Joyful/Pleased

_ Overeating/Not eating

_ Slept too much/Trouble sleeping

_ Irritable/Angry/Worried/Anxious

_ Calm

_ Don’t care/Pessimistic

_ Lazy/No energy

_ Interested/Involved in life

_ Aches and pains

_ Guilty/Hopeless/Worthless/Overwhelmed

_ Difficult to concentrate or make decisions

_ Wanted to be alone

_ Happy/Content

_ Thoughts of death or suicide

_ Working well/Clear thinking

_ Alcohol/Substance use

_ Active

_ Other: _________________________________

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Have my family, co-workers or friends said anything about my mood? If so, what?

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What difficulties did I have sticking with my treatment plan? (medication, talk therapy, support groups, etc.)

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Did my medication make me feel bad in any way? How? 

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I experienced the following side effects this week:

_ Nausea

_ Sexual difficulties

_ Constipation

_ Dizziness

_ Weight gain/loss (___ lbs.)

_ Shortness of breath

_ Shaking

_ Dry mouth

_ Other:

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In what ways am I feeling better than last week?

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Do I think I could be doing better? _ Yes _ No

If yes, in what ways?

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Questions to ask my doctor:

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Goals for my next appointment: 

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Symptom Checklist 

This checklist can help you prepare for a first-time discussion with your professional, or evaluate your progress from day to day or week to week. However, it is not meant to help you diagnose yourself. Only a health care professional can diagnose you.

Symptoms of depression

  • Prolonged sadness or unexplained crying spells
  • Significant changes in appetite and sleep patterns
  • Irritability, anger, agitation
  • Worry, anxiety
  • Pessimism, indifference
  • Loss of energy, persistent exhaustion
  • Unexplained aches and pains
  • Feelings of guilt, worthlessness and/or hopelessness
  • Inability to concentrate; indecisiveness
  • Inability to take pleasure in former interests; social withdrawal
  • Excessive consumption of alcohol or use of chemical substances
  • Recurring thoughts of death or suicide

Symptoms of mania

  • Increased physical and mental activity and energy
  • Exaggerated optimism and self-confidence
  • Grandiose thoughts, inflated sense of self-importance
  • Excessive irritability
  • Aggressive behavior
  • Decreased need for sleep without feeling tired
  • Racing speech, racing thoughts
  • Impulsiveness, poor judgment
  • Reckless behavior such as spending sprees, impulsive business decisions, erratic driving and sexual indiscretions
  • In severe cases, delusions and hallucinations

If you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or crisis hotline such as 1-800-273-8255 (TALK) immediately.