By Jeremy Godwin.
Welcome to Let’s Talk About Mental Health, the weekly podcast about improving your mental health and wellbeing by Jeremy Godwin. Each episode focuses on one specific topic and is full of practical advice for improving and maintaining your mental health and wellbeing.
This is Episode 33 and this week I’m talking about support – I’ll be discussing the different types of support available, what to expect and how they can help you to improve and maintain your mental health and wellbeing. Listen to the podcast episode now in the Spotify player below or continue reading for the article/transcript version. Let’s talk!
Admitting that you might need some support to help improve your mental health can be confronting and even scary, especially if you don’t know what to expect, and a lot of people put off getting the help they need – according to the Black Dog Institute, in Australia alone it’s estimated that 54% of people with mental illness do not access any treatment and that the number of people who do access treatment is half that of people with physical disorders (1). Considering that each year between 20 and 25% of us will experience a mental health condition, and roughly 45% of us will experience one in our lifetime (2), that’s a lot of people not getting help to deal with serious health issues.
A quick overview of mental health conditions
Let’s just take a moment to cover some key information about mental health conditions before we discuss support.
There are almost 300 disorders listed in the DSM-5, which is the standard diagnostic tool used in mental health. Most can be broken up into seven major categories, which are:
- mood disorders (like depression or bipolar disorder)
- anxiety disorders
- personality disorders
- psychotic disorders (like schizophrenia)
- eating disorders
- trauma-related disorders (like PTSD)
- substance abuse disorders
As there are so many different conditions, I won’t be able to cover support options for all of them today, so I’ll be discussing ‘support’ broadly as well as focusing on depression and anxiety.
Depression and anxiety are the two most common conditions, and it’s not unusual for someone with depression to also have anxiety and vice versa (source: Talkspace). Nearly half of all people diagnosed with depression are also diagnosed with anxiety (source: ADAA).
How do you know when you might need support? It’s different for everyone, but some of the common warning signs are:
- Long-lasting sadness or irritability
- Extremely high and low moods
- Excessive fear, worry, or anxiety
- Social withdrawal
- Dramatic changes in eating or sleeping habits
(source: New Roads Treatment)
Generally, if you’re experiencing symptoms like these for two or more weeks, it’s highly recommended that you seek professional support.
Mental health support
So, what does support look and feel like? Well, before we dive in, let me just make four quick points that you need to keep in mind as I talk through this topic:
- Every single one of us is unique — so that means that you need to consider what support options might be best for you based on your circumstances, preferences and even the current severity of your condition; also, bear in mind that what works today won’t necessarily continue to work for you tomorrow because things do change, so it’s important to monitor your mental health daily and keep on top of it just like you (hopefully!) would with your physical health.
- Being diagnosed with a mental health condition is not the end of the world — in fact it’s the start of a better future, because once you know for sure what you’re dealing with then you can start to put in place ways to improve your situation over time.
- Physical, mental and spiritual health are all connected (as well as social health) — so if you’re struggling with one area of your health, it’s important to look at all areas and put in place solutions to manage your overall health.
- Everything takes time and effort — none of the options I am going to talk about today will instantly make you feel better; however, with time and perseverance, they will definitely improve your condition and your quality of life.
With that in mind, let’s get into the good stuff: support options. I’m going to start with the external options, then we’ll spend a few minutes on your internal options (which are the things you can do to support yourself at the same time as you’re getting help externally). Improving your mental health takes effort — and that involves working on your condition yourself as well as getting professional support, because you can’t do everything alone but also external support won’t be successful unless you do your part; I’ll explain more about that shortly.
The first type of external support I’m going to discuss is seeing your doctor (i.e. General Practitioner). Going to the doctor is often the first step for most of us, because it’s the most accessible way to have health issues diagnosed. If you’ve been struggling with your mental health for a prolonged period (two weeks or more), then you really need to go and see a doctor to talk about what’s been happening — the sooner, the better.
It’s important to get a proper diagnosis — it can help put things into context, but it’s also about making sure that you are treating the right thing… if you had a broken leg, you wouldn’t expect just taking paracetamol to fix it!
If you don’t feel comfortable talking to your regular doctor, then that’s a problem — and it’s probably the most common issue for many of us, in that we need to find a doctor who we have a good rapport with and to whom we can disclose anything. That might mean that you need to shop around and try a couple of different ones until you find the one that feels right to you (note: do make sure that you have your medical records transferred from your old doctor once you find one who you feel comfortable with).
You will usually expect the doctor to spend a fair amount of time exploring what symptoms you’ve been experiencing, what internal and external factors have been affecting you, and also looking at your physical symptoms to ensure that they are making a sound diagnosis. This might take a few visits. You may also be asked to complete some questionnaires, such as the K-10 (which is the Kessler Psychological Distress Scale), in order to better understand your current state. The biggest challenge when talking to a doctor is to be completely open and honest, but it’s the single most important thing you can do because that will allow them to get a clear picture of your situation. If you ugly-cry, don’t worry; they’ve seen much worse. Your doctor may choose to prescribe you medication or refer you to see someone for therapy (or both), so let’s explore those next.
Medication. With so many different conditions there are a huge number of medications that might be considered, so I’m not going to go into specifics here. What I will say though is that there are a few main things to be aware of:
- There are different types of medications for each condition, and not all types will be effective — for example, I had to trial three different types of antidepressants before we found one that worked for me based on my biology, so it can be a bit of trial and error (which, of course, takes time).
- Even when you do find the right one, all medications take time to work — so if you’re expecting that you and your doctor can just quickly find the right treatment for you and that it will cure you overnight, I’m sorry to say but that just will not happen in most cases. Between trying different meds and then stabilising my treatment once we found the right one, it took more than six months to begin to see positive effects. Be patient and work with your doctor (and that means seeing them regularly, especially in the early stages of treatment).
- All medications can have side-effects, which will depend on a number of factors. I developed a skin condition, completely lost my libido, found it almost impossible to get a full night’s sleep, and was constantly overheated and dripping with sweat. It’s up to you to decide if the side effects outweigh the benefits of the treatment.
- If you do decide to discontinue your treatment for whatever reason, never just stop taking your meds. I mean it — NEVER. The effects can be horrendous and even life-threatening; your brain chemistry is delicate, so any changes need to be carefully managed with your doctor (and monitored by them). When I decided I was ready to come off my meds a few years back, it took nearly two years in total — first to wean me off my anti-anxiety meds, then to wean me off the anti-depressants which were at the highest possible dosage. It was a very difficult process and the withdrawal symptoms were still awful, but I did it safely with the support of my doctor — which is the right thing to do.
OK, so that’s what to expect for medication. Now let’s talk about the other main type of treatment, therapy. Your doctor might refer you to a counsellor, psychologist or psychiatrist, or you might find one yourself; you can do an online search or do a ring-around to find someone, or you can use an app to connect with professionals in your area.
Finding a professional that you like and who you feel comfortable with is really hard, and this week I’ve partnered with an app called Avalo (www.avalo.app) for an unpaid cross-promotion. This is the first time I’ve ever done any kind of promotion on LTAMH, and I’m doing so because the app is brilliant as a way of finding a professional to talk to and it’s free — which is my favourite price for anything!
Normally when you try to find a mental health professional, you pick someone based on where they’re located and hope for the best — which is very hit and miss, and I don’t know about you but I’ve had some shitty experiences with seeing therapists who I just didn’t feel comfortable with or click with at all. Using an app like Avalo you can talk directly with mental health professionals (as well as other people dealing with mental health challenges), so it provides a much less confronting way of finding someone than going and auditioning professionals by phone or face to face, and it’s completely anonymous and confidential. You can find professionals in your area (although it’s mainly North America at this stage but it’s growing), and they have a strong focus on being troll-free and stigma-free. Avalo is available for iOS and Android or you can find out more at www.avalo.app. Please note – Avalo is not a therapy platform, so if you find a professional you’d like to work with you need to book with them directly to start the therapeutic relationship (however you can obviously chat to them beforehand through the app, which can help you decide if they feel like a good fit for you and that’s why I’m talking about them because that initial hurdle is often the hardest bit).
Once you’ve found a professional you want to talk to, what can you expect? Well, it depends on the type of professional. You might work with a counsellor, who use a person-centric approach to help you explore your emotions and identify solutions; you might work with a psychologist, who use a variety of approaches to reduce distress and problems with their patients as well as conducting research; you might work with a psychiatrist, who will have a medical degree and tend to treat disorders (and may also prescribe medication); or you might work with a social worker, who runs community programs or group sessions (such as support groups).
The main thing to be aware of is that you should always check to confirm the qualifications of the person you want to work with — each country has their own rules and guidelines, and often professionals will be required to register with an industry body (such as the ACA or Australian Counselling Association here in Australia) who are responsible for accreditation and ensuring that their members behave professionally and ethically at all times. I do not recommend that you work with someone who does not have the appropriate training and qualifications — dealing with mental health issues is really delicate stuff, and the last thing you want is to wind up in a worse situation because the person who is supposed to be helping you actually has no idea what they’re doing, so do your research.
One of the things that the different forms of therapeutic treatment have in common is that you will probably find yourself doing a lot of talking, about your past and present, in order to identify solutions for your challenges. That can be exhausting and confronting, and it puts you in a vulnerable and uncomfortable position… but it is worth it. Unless you work through what has happened and why, and have a professional guide you towards possible solutions, you will quite likely remain stuck in the situation you’re in — and as I said in last week’s episode about Letting Go, being stuck will make you miserable. Therapeutic treatments like counselling or working with a psychologist are often combined with medication as the main forms of treatment for many mental health conditions like depression and anxiety.
There are a couple of things to consider when seeking treatment:
- Depending on your country, you’ll need to do a little research to find out what the guidelines are if you’re using public or private services that are aligned to state-based or country-based healthcare services or insurance… for example, here in Australia there are some different ways you can see a registered psychologist for a small number of sessions and have it either paid for or partially subsidised by the government, but the rules and guidelines are quite strict and don’t cover some services including seeing a counsellor; in the UK you have different rules under the NHS; in the US there will usually be rules that are specific to your insurance provider; in other countries it’s different again — usually a good starting point is either doing a little bit of research on the Internet or talking to your doctor.
- Unfortunately, one thing most countries have in common is that mental health care is frequently grossly underfunded and you will often find that the ownership for finding support (and paying for it) falls back on you — so, my advice is to look at the options that fit for you based on the severity of your specific situation (e.g. You might find it more cost effective to see a counsellor for a larger number of sessions rather than a psychiatrist for a small number of sessions if the cost works out the same, depending on their rates, your situation and your condition)… you need to make the decision that’s right for you based on the severity of your condition.
Whatever you choose to do, deal with issues while they’re still small, because things can deteriorate rapidly if you let them go. Early intervention is essential!
I know it’s often really hard to take that first step. It took several months for me to talk about it with my doctor, even though I was going regularly due to all the physical symptoms I was having as a side effect of my situation; he was asking me a lot about my mental health and I kept on pretending everything was fine until I just couldn’t pretend any longer. When I did finally tell him what was going on, he was so kind that I burst into tears because it was such a relief to finally admit it… so, rip that band-aid off and talk to someone.
There are lots of other support options out there which relate in some shape or form to the ones I’ve discussed, such as treatment centres (e.g. Rehab for alcohol addiction), mental health facilities (which tend to deal with more severe cases and might be either in-patient or out-patient programs, or a combination of both); and community support programs (like support groups for alcoholics, narcotics, gambling, and so on). Note that some support services, especially some free ones, are aligned to religious organisations and so their methodology and agenda might be underscored by very specific spiritual and religious beliefs; it’s worthwhile taking the time to understand who you’re dealing with first (even by just reading the ‘About Us’ section of their website) to understand their approach so you can make an informed decision and select a service aligned with your own values and beliefs. For example, most Alcoholics Anonymous/Narcotics Anonymous groups tend to be religious and have a strong focus on surrendering to a higher power; if you aren’t religious, you may find that really difficult to deal with or it may not be even remotely appropriate for you — so choose a support program or support mechanism that aligns with your own values and beliefs.
There are also phone support lines you can call or online services (e.g. In Australia there is Mental Health Online, which provides free online treatment services – find it at https://www.mentalhealthonline.org.au). Many of these support services are crisis-focused, however there are also services for situations like financial counselling or grief counselling and so you may find it helpful to have a chat to someone if these are issues you’re struggling with, rather than going through the process of finding a therapist or counsellor to work with face-to-face (which can take longer). As I said before, it’s about finding what works for you.
You can also get support from friends and family, however I really do challenge you to not rely solely on this form of support. Why? Well, because people who care about you may find it hard to be objective and also they’re probably not qualified to provide support (and if they are qualified, then they’ll know that it’s a conflict of interest for them to treat you because they won’t realistically be able to remain impartial).
And then, of course, remember that if you’re in an emergency situation where your life or someone else’s is in danger, call emergency services.
You can find a list of resources for most English-speaking countries at letstalkaboutmentalhealth.com.au/resources.
I mentioned earlier that support is about both external and internal support… so, what does that look and feel like? Well, there are a lot of things you can choose to do to complement the external support that you’re receiving, such as:
- Daily activities like gratitude practice, mindfulness, meditation, journalling, even tuning in to your favourite weekly mental health podcast — I talk about these types of proactive activities a lot and there’s mounting evidence that these sorts of practices can improve your mental health over the long-term.
- Use websites and apps that work for you — apps like Headspace and Calm provide you with tools and resources to try different things so you can see what works for you.
- Natural therapies — treatments like St John’s Wort, Vitamin D, and Valerian may have a positive effect on some conditions (sources: Harvard Health and Psychology Today), however if you’re taking other medications then it’s important to talk to your doctor and make sure that you’re not going to have issues.
- Healthy lifestyle — prevention is better than cure, which is why a healthy lifestyle (and healthy coping mechanisms) is so important, but it also helps to address symptoms on an immediate basis; get outdoors, get some sunshine (Vitamin D!) and fresh air, get out into nature especially if you live in an urban environment… sometimes this can be just the tonic you need.
- Look after your overall health — your health isn’t just about the state of your body; your health is made up of your physical health, mental health, spiritual health and social health, so look at ways to improve all areas of your life. Spiritual health is not the same as religion; you can be spiritual but not religious… it’s about whatever feels right for you. In short, it’s about developing your sense of belonging; of being part of something bigger than just yourself, which I talk about a lot in LTAMH. Social health is about your connection with family, friends, acquaintances and your community. You’re not an island and we human beings need to feel connected with others in order to be satisfied. ‘Connection’ can involve lots of things like joining community groups and community centres, volunteering, local interest groups (e.g. A book club or a sports club). Find what works for you; this is something I discussed in Episode 15: Loneliness, so you might find that one helpful to revisit at letstalkaboutmentalhealth.com.au/episodes.
- Learn — do research about topics that fascinate you, read books, learn a new language, challenge yourself to learn new skills. Why? Learning keeps your mind elastic and helps you to build your knowledge and skills, making you feel more engaged in the broader world.
- Have fun — do things that make you smile, and if you can then grab a friend or relative to join you and double the fun; life should never be 100% serious, because that’s boring!
- Try new things — get a new hairdo, start a new fashion trend, play a sport, write, paint, invent stuff… do things that challenge you and that tap into your passions and creativity.
- Travel — well, maybe wait to travel until the world’s not dealing with a pandemic… but, you can explore places you want to visit in the future online; if you like culture, some of the world’s biggest museums and galleries (such as the British Museum) have adapted to COVID-19 and are offering online immersive tours through their collections, so you can travel from the comfort of your couch!
- Practice self-care — I talked about self-care in a lot of detail back in Episode 6, so check that out and find options that work for you (whatever you choose to do, just do it regularly!)
The main message I want you to take away from today’s episode is that there are so many different options available to support you in improving your mental health, so don’t go it alone or just ignore it — but also, don’t abdicate all responsibility to someone else and expect them to ‘fix’ you… it’s YOUR health, and you have the biggest role to play in improving your mental health and wellbeing.
Summary and close-out
Because when it comes to support, what it all boils down to is this: there is no ‘one size fits all’ approach to mental health support, and what you choose to do will depend on a range of factors including your personality and personal preferences. No single option will be the magic pill that cures your condition overnight, but when you combine multiple forms of support (both external and internal support activities) then you’ll start to see improvements over time. Like everything with mental health it takes constant effort and perseverance, but the truth of the matter is that there are many kind people out there who will help you on your path to recovery and who will support you as you try different things to find out what works for you. You are not alone, and once you find the support systems that work for you then you will start to see improvements over the long term — because it can get better, and it will get better.
That’s nearly it for this week. Each week I like to share a quote about this week’s topic and encourage you to take a few moments to reflect on it and consider what it means to you. This week’s quote is by Misty Copeland, and it is:
“Anything is possible when you have the right people there to support you.”Misty Copeland
That’s it for this week’s episode. Next week I’ll be talking about addiction – I’ll be discussing the impact of addiction on you and those you care about, and how you can identify if it’s time to do something about it.
I hope you’ll join me for that episode, which will be released on Monday morning in Australia & New Zealand, Sunday evening in the UK & Ireland, and Sunday afternoon in the US & Canada. You can find past episodes and additional content at the website which is letstalkaboutmentalhealth.com.au.
You can find Let’s Talk About Mental Health on Instagram, Facebook and Pinterest – I’ve recently changed the account name to better reflect the focus on mental health and make it easier for new people to identify what LTAMH is all about, so the new username is now @ltamentalhealth on all social media platforms (Instagram, Facebook and Pinterest).
If you enjoyed this episode, please take a moment to leave a five-star review on your podcast platform of choice and tell someone you know about the show (because word of mouth really helps new people to discover the program).
Thank you very much for joining me today – look after yourself and make a conscious effort to share positivity and kindness in the world, because you get back what you put out. Take care and talk to you next time.
Let’s Talk About Mental Health.
Because the more we talk about it, the easier it gets.
Let’s Talk About Mental Health. © 2020 Jeremy Godwin.