How do I know if a therapist can help me?

Factual Questions
1

I don’t know anything about mental health professionals and I don’t really know when they should be called on. I figured I would ask on here to find out maybe what I should do.

Here is my background situation:

I have always been a pretty well balanced guy. I grew up pretty poor and made friends with the wrong kids (nerds) very early on in my life. Unfortunately I grew up in a small town, so I graduated HS with the same kids that I started kindergarten with. The problem with this is that once kids form an opinion of you they tend to keep it forever unless there is some drastic change that makes them think differently. So I grew up as an outcast etc… I won’t go into that story because you have all probably heard the same one from a million different people on this board at one time or another.

Flash forward to when I turned 18. I had my first sexual experience at this age. It was with the girl I was in love with my whole life and it was worth the wait. I went in the USAF and moved out of my home town. When I got thru basic and hit my first duty station I was lacking the skillset that I needed to go out and meet people. I was, and am, extremely uncomfortable around people I don’t know. I met a girl there who I dated for a year and a half. We were best friends as well, so I pretty much hung out exclusively with her. Then she cheated on me while I was TDY in the desert and I had to dump her.

So I had about 4 months after I broke up with her to break out of my shell, make some friends, and have a 20 year olds life before I was going to go to Korea. I managed to meet some nice people and I partied, had sex, and did all the things young guys do. Didn’t make any really good friends though.

Got to Korea and made some really good friends. I also met my wife there. She was a GI and was slated to go to England and I was going to Colorado. So, like so many others, we got married so we could stay together. We had a good relationship for the most part. The problem was that she was a socialite and I was a home body.

Skip forward to FeB this year and my current problem:

We split up after 4 years. There was no infidelity, we were just incompatible. My daughter lives with her and I live alone in an apt downtown. We are still friends for the most part and I see my daughter all the time. The ex started dating someone a few months after I moved out. That hurt as it does most people, but I am not in love with her anymore so I am fine with it.

The problem is that I have no friends and have been alone, and I mean totally alone, for 8 months now. All of “our friends” became “her friends” after the divorce. You see, I work mid shift, full time as a network engineer. I work alone, and I mean totally alone, at work. There are only 3 people in the building on my shift.

I am a full time college student in my senior year of a BSEE. I go to school full time at night the whole week. The school I go to caters to working adults and the majority, like 80%, are over the age of 40 and/or married with kids. There is no resource for friends at school. I have been going to school non stop my entire life and it contributed to the failure of my marriage. I CANNOT slow down and take a class or 2 a quarter. I can’t take school anymore. I wouldn’t even finish if it weren’t for the massive amount of student loans I have accumulated. I am on track to graduate next September. If I had to go one more quarter past that I would seriously lose my mind.

The little bit of time that I do have, I need to make time for my daughter. I have her over night once every weekend and I try to get her for a few hours a few times a week. I can’t sacrifice this time with her to go hang out or make friends or whatever.

I was able to handle this living situation for the first 6 months or so after my divorce. I have always been a loner and, though it was hard, I was able to go back to being alone and survive.

The problem is I can’t handle it anymore. I really feel like I am going crazy. I NEVER go out because I am not really a clubber and don’t like to go to the clubs alone anyway. I haven’t had as much as a hug from anyone but my daughter in over 8 months. I work mids so on the weekend night that I don’t have my girl I can’t sleep at night. I try to watch movies and sometimes I will grab a 6 pack and that worked ok for 6 months or so.

I am suffering from MAJOR loneliness right now. I seriously don’t know if I can handle it much longer. My life growing up is starting to affect me again. I am starting to have major self-esteem issues from this and this is further pushing me away from society. I know in my head that I am a pretty good looking guy, but I always feel real ugly now. I have a mild case of adult acne, which I am already trying to treat with prescription drugs, and when I get one zit on my face, I become a total recluse until I can get rid of it. My teeth aren’t perfectly straight and it is buggin me now. My nose is big, etc… you have heard it all before. I find myself telling people I know, how shitty my life is on a pretty regular basis now.

I am in a desperate need of affection from someone other than my daughter. It’s getting to be winter time and thats the most depressing time of the year. I have been trying online personals and I went out with a pretty girl on Friday. She seems interested in me still, but for some reason I am finding myself obsessed with whether or not she, or anyone else I meet, is really gonna like me. I didn’t sleep more than 3-4 hours in the 2 days after we met. I haven’t heard from her since Friday, which is only a day, but I am feeling rejected for some reason. It’s sucking the life out of me.

So, to wrap this up, I think I may need help with this because I know in my head that I am overreacting to this situation. I know that this girl is just a person and I am not a total loser, but I can’t stop thinking about how shitty my life is right now. It’s on my mind constantly. I can’t shake it and it is bringing me down in a big way.

I am wondering if a therapist or shrink may be able to help me shake myself out of this. I have a full year before I can make any drastic changes to my life because of school, so I have to get thru it. I seriously feel like I am losing my grip and I am not sure that I can handle it alone anymore.

Any advice? Should I see the help of a professional? (BTW, I am not suicidal or anything like that, just ultra depressed)

2

My feeling is if you think it will help you, even just a little, you should go for it.

I remember a college stress questionnaire I took (several times, as it was part of the class I taught). It listed about 70 of the biggest stressors people in college can experience, and assigned point values to each. The greater the stressor, the more points it had. You gave yourself those points if you’d experienced that stressor in the last 6 months-year. Divorce, the beginning of a new relationship, academic and financial pressures, changes in living arrangements, sleeping and eating patterns were all on that list, and I wager that you’ve experienced them all.

Give counseling a try. This is very likely to be the most stressful time you’ll experience in your lifetime, and if it were me, I’d find what I could to make it easier to bear.

Does your university health center or student services center offer any type of counseling? Some do, for free, and you can go talk to someone trained (maybe a professional, maybe a volunteer student) about what’s on your mind.

Good luck to you. Hope things get better for you soon.

3

You’re having problems coping with your situation. It sounds like the kind of business that drives a man out of his gourd.
Get professional help.
See if your employer offers an Employee Assistance Program (EAP) that will get you 3-5 initial appointments with a counselor for free.
From there, you can receive professional advice on what kind of professional would best serve you. Perhaps you just need a clinical social worker to see you, or perhaps you need a bonda fide psychologist and psychiatrist team working together to keep your head screwed on. Some depression pretty much requires medication to break out of, in addition to “talking therapy”.
I’ve been in similarly unpleasant places to where you are. I sincerely hope that you can overcome your problems.

4

Stinkpalm:

Generally speaking, we need significant others in our surroundings to help us deal with stress and other emotional difficulites. Without a support network, all of life’s troubles become even harder to bear.

You sound really unhappy with your studies. Being a single father, and facing all those issues and responsibilities in apparent isolation, also has to be a serious drag.

I think you should definately see a therapist and try to get a handle on precisely what it is about your past/present that is leading you to lose your sense of self-esteem. A good therapist can help you reflect over, and hopefully solve, a number of the problems you’ve metioned. You have a right to lead a good life, and your daughter needs a father who is happy, healthy, and emotionally available to her.

For what its worth, recent studies have found that people who were “picked on” as children are much more likely to suffer from depression, lack of self-esteem, sleeping disorders, and many other problems as adults.

5

Another vote for giving a therapist a try. It can’t hurt, and sometimes it helps just to have someone to vent to who acknowledges all the stress you’re experiencing. But in the meantime, isn’t there other stuff you can do to be around people? Can you take your daughter to the park to play with other kids, and maybe meet some of their parents (and maybe even a nice single mom or two) in the process?

6

I’ve always been very skeptical about mental health…My mother has been in therapy my whole life and I’ve seen no improvement in her quality of life…

But then I found myself in a crisis situation myself earlier this year and became involved in the therapy process myself…My skepticism has since been decreased dramiatically…

I think therapy provides guidance and tools you need to figure out your situation and what you’re going to do with who you are…It isn’t the therapists responsibility to “fix” you, it’s yours…

Starting with an EAP program as someone suggested is a good start…Remember you get out of it what you put into it …
Investigate different theories and courses of therapy…Don’t tolerate a bad therapist either…

Recognizing it is time for change is a big step…Best of luck to you…

7

If you can, go for a therapist who is also an MD, and can prescribe medication. Talk therapy can be very helpful, but anti-depressants can work wonders in addition.

A good, well-recommended therapist will detect pretty quickly whether your problems can be helped by therapy and what kind. So it’s definitely worth trying.

OTOH, finding the right therapist can be trying. It’s not like finding the right doctor, because you need someone you can talk to honestly and openly, who you connect with, etc. It’s more like a teacher or professor – some of them connect with you, some don’t. So sometimes you need to try a few therapists before you find one that connects. If that’s the case, don’t let it discourage you!

8

Ok, so this sounds like something that some one could help me with then. So my next question is how much do they cost? I am guessing that mental health is not covered by standard insurance plans with my employer. I pay a ton of child support, I took all the debt in the marriage as well so my funds are limited.

I am guessing that I have the same doubts most people typically have when it comes to seeing a therapist. I feel like I know what the problem is. I don’t know what someone else could tell me that I don’t already know. I am aware of the problem, have a pretty good idea of how I should be dealing with it, but my brain just decides to deal with it differently. I don’t THINK that I need to be medicated to cope, but do people ever think they do? I don’t feel like a nutjob.

Hopefully you are right, that this is the most stressful and trying time of my life and that it can only get better.

9

Unfortunately, insurance doesn’t cover mental illness as it does medical issues…Investigate therapists who offer sliding scale payment…

A lot of the time psychiatrists don’t offer therapy…Only medication management…They can recommend good therapists though…And I’d rather pay a therapist 's rather than a pyschiatrist’s hourly rate…

10

It sounds like your situation would be difficult for anyone to endure. When I read your post and considered all of your circumstances, I was not at all surprised that you were feeling depressed. You have a tremendous amount of stress in your life, obviously. The point I am trying to make, is that your reaction to all of this adversity is imho, understandable / normal. I am not a doctor or therapist but I am encouraged and optimistic about the possibilities for your future happiness. The reasons are:

  1. You are aware of the problem and you seem eager to pursue a solution.
  2. You are a devoted father, unselfish, hard-working, educated, and persistent.
  3. Sounds like your situation will be temporary. Your graduation will probably lead to a more favorable working situation. This will mean better hours and more money. In a short time you will have several options that will present new social and economic opportunities.

Good luck with therapy and I hope you meet an interesting person that will help you discover your capacity to connect, love, and laugh. I am confident that good things will begin to happen for you very soon.
pv

11

Finding a good therapist is more important than he/she having an M.D., clinical social workers and pyschologists will usually have access to an M.D. that they can refer you to for medication managment if it’s indicated in your case. I would also check to see what resources are available at your school. Colleges often have counseling services that are low-cost or free (read included in your tuition).

12

I am a therapist, just out of college but still a therapist, and the biggest problem a lot of people face is thinking that their problems are not important enough to bother someone else about. It is a good idea to see someone if the problem seems to be causing a disturbance in your normal life patterns, which it seems they are. It cannot hurt to look into a therapist, even if it is just for them to give you some ideas into where to go from here. Therapists will have links to resources that may be able to help you make it through this stressful time.

Many insurance companies and HMOs do cover the cost of mental health services, but it is limited to a small number of sessions per year, and is not always advertised as strongly as physical services. Also, if you can find a therapist and do a screening (which may cost you out of pocket), they may be able to go to your insurance company and lobby for coverage. Your primary MD may also be able to do a referral if you present your issues to him or her, and this may get you an opportunity to at least consult with someone. Also as others have stated, many colleges offer counseling services for students free of charge, or a small fee. This may be through the health center or other organizations on campus. I don’t know exactly what kind of company you work for, but some employers will offer mental health services as part of a benifits package, but again you would probably have to ask directly.
Remember chosing a therapist is an important thing, and if one isn’t giving you the services that you were hoping for, ask for a referral to someone else.

13

I am a therapist, just out of college but still a therapist, and the biggest problem a lot of people face is thinking that their problems are not important enough to bother someone else about. It is a good idea to see someone if the problem seems to be causing a disturbance in your normal life patterns, which it seems they are. It cannot hurt to look into a therapist, even if it is just for them to give you some ideas into where to go from here. Therapists will have links to resources that may be able to help you make it through this stressful time.

Many insurance companies and HMOs do cover the cost of mental health services, but it is limited to a small number of sessions per year, and is not always advertised as strongly as physical services. Also, if you can find a therapist and do a screening (which may cost you out of pocket), they may be able to go to your insurance company and lobby for coverage. Your primary MD may also be able to do a referral if you present your issues to him or her, and this may get you an opportunity to at least consult with someone. Also as others have stated, many colleges offer counseling services for students free of charge, or a small fee. This may be through the health center or other organizations on campus. I don’t know exactly what kind of company you work for, but some employers will offer mental health services as part of a benifits package, but again you would probably have to ask directly.
Remember chosing a therapist is an important thing, and if one isn’t giving you the services that you were hoping for, ask for a referral to someone else.

14

I am a therapist, just out of college but still a therapist, and the biggest problem a lot of people face is thinking that their problems are not important enough to bother someone else about. It is a good idea to see someone if the problem seems to be causing a disturbance in your normal life patterns, which it seems they are. It cannot hurt to look into a therapist, even if it is just for them to give you some ideas into where to go from here. Therapists will have links to resources that may be able to help you make it through this stressful time.

Many insurance companies and HMOs do cover the cost of mental health services, but it is limited to a small number of sessions per year, and is not always advertised as strongly as physical services. Also, if you can find a therapist and do a screening (which may cost you out of pocket), they may be able to go to your insurance company and lobby for coverage. Your primary MD may also be able to do a referral if you present your issues to him or her, and this may get you an opportunity to at least consult with someone. Also as others have stated, many colleges offer counseling services for students free of charge, or a small fee. This may be through the health center or other organizations on campus. I don’t know exactly what kind of company you work for, but some employers will offer mental health services as part of a benifits package, but again you would probably have to ask directly.
Remember chosing a therapist is an important thing, and if one isn’t giving you the services that you were hoping for, ask for a referral to someone else.

15

Stinkpalm, People do better in romantic relationships, and in the breakup of romantic relationships, if they have friends outside the couple. It’s not the same as having a girlfriend, but it’s still important and might help you feel less lonely in some ways.

There may be some community activities that would help you not to feel totally alone and might give you some practice socializing with people in a non-dating mode. I’m wondering if there is a single parents’ group, for example, or something you and your daughter can do with other parents and children her age.

If your insurance does not cover therapy, or only covers a little, and you are willing to try medication, you might want to ask the therapist to communicate with your GP. Many GPs are willing to prescribe and monitor milder psychiatric medications, and are covered by your insurance.

I cannot provide you with a diagnosis, but based on your posts, I will raise the question of whether you may have some social anxiety as well as feeling depressed and lonely. There are some antidepressants that also help decrease social anxiety. A prescriber can tell you what, if anything, might be a good match for you.

A good self-help resource for some of the kinds of self-critical, worried thinking you’re describing is Feeling Good: The New Mood Therapy by Burns. You might also like The Relaxation and Stress Reduction Workbook by Davis, Eschelman (sic?), and McKay.

16

I would probably guess that you are right, I do have social anxiety. Not extreme, since I can go out and talk to people I don’t know and enjoy myself ion public, but I am really nervous around people I don’t know.

My concern right now is that I don’t want my desperation to show thru to other people. I don’t want to get all clingy to the first few friends I make. I worry so much about what others think of me now that I can’t focus on what I like about myself.

I am wondering if this is normal in divorce, or at least somewhat common. Normally it seems that I hear about the woman being the one who crumbles, but in this case its the man. My ex is doing very well socially and I am not.

Thanks for all of your words of wisdom folks. I guess I will try to look into my options and see what I can afford to try and not afford.

Can anyone who has been in therapy give me an idea of what to expect? I picture a couch and me just pouring myself out to a guy with a clipboard. But what else happens? Is there anything to expect?

17

The couch thing is pretty outdated…Most just have normal offices with comfy chairs…Most take notes but usually ask if
it is okay…The first time you go, you would pour out all the info you feel they need to know and then they’ll ask you what you feel you should concentrate on …As with anything scary, once you walk into the office the first time, the worst is over…

18

Stink:

First off, cash in that idea that “men do well after divorce, but women crumble.” In my experience its exactly the opposite, but to completely correct, it varies from relationship to relationship.

I can tell you how I usually work, if you like, but techniques vary from country to country, and from school to school.

I generally begin with what we call a “deep interview.” This consists of 2 in 3 sessions in which I ask my potential patient a lot of questions about his/her background: childhood, upbringing, siblings, parents, recurrent dreams, etc. (During the interview I take notes, by the way, but during regular sessions I don’t, because I don’t want to interupt the “flow” of session.) Where I work (in Sweden) we charge the equivalent of 50 dollars for the interview, regardless of how how many sessions it takes.

I then present the interview material to a few collegues; we discuss it and try to establish a preliminary diagnosis, along with a few recommendations for treatment. The interview also provides patient and therapist with an opportunity to “get to know” each other a little, and decide if they want to work together.

After this process is over, the patient and I make up a “contract:” an agreement between us that the covers basic elements of therapeutic work: price (around 35 - 55 dollars a session), location, time (generally once a week, sometimes 2 or 3 times a week), and so forth.

I’ve been trained in an old-fashioned, psychoanalytically-oriented tradition of psychotherapy. Session are non-directed: my patients are invited to discuss openly whatever it might be that they have in their hearts. I’m there primarily to listen, to ask an occassional question, and to suggest interpretations of actions or events that might escape the notice of the patient. Basically, I see the therapeutic space as a place wherein a person can reflect freely over his/her life, and come into contact with split-off, forgotten, or neglected sides of his/her personality, in a safe, private atmosphere. I often tell my new patients that therapy represents a space in which they can rediscover themselves.

My sessions last 50 minutes, but many of the therapists I know have gone over to 45 minute sessions.

I do have a couch, by the way, but most of my patients don’t avail themselves of it.

Having written all the above, I honestly don’t know what your therapy will be like. If you decide to try cognitive therapy, for example, you might have a completely different experience. Actually, it’s probably wiser to go into this sort of thing with no expectations, and discover it for yourself.

Think of it as an adventure!