How to Know When it’s Time to Seek a Counselor or Therapist

More than 46 million American adults were living with a mental illness in 2017, but less than 20 million received mental health care that year, according to the National Institute of Mental Health. 

“People might wonder, ‘How’s a therapist supposed to guide me through something I feel so hopeless about?’” said Dr. Margaret Rutherford, counselor and author of “Perfectly Hidden Depression.” “But a therapist isn’t going to solve your problem. A therapist is going to help you get back in touch with your own strength.”

The need for counseling or therapy may be difficult to identify, because mental distress looks and feels different from person to person. Symptoms that signal it’s time to seek therapy can change as people age. It is also not required to observe or feel any of these symptoms before seeking help; help is available to anyone regardless of their personal experiences.

The Benefits of Counseling and Therapy

Romantic breakups, parenting struggles and career burnout might seem like typical stressors for the average person. But these events can lead to unhealthy coping mechanisms, like trouble eating and sleeping, emotional outbursts, social anxiety or isolation that need professional attention.

Both therapists and counselors can provide mental health care for someone in need. Licensed professional counselors can diagnose and help treat mental or emotional disorders. Licensed therapists address clinical mental health needs with holistic approaches.

Seeing a professional therapist or counselor can provide a consistent source of support on an interpersonal level. Whether the visit occurs in person or online, clients will receive emotional help, fill their knowledge gaps about mental health, and establish new patterns of behavior by learning behavioral skills that last a lifetime.

While every counseling session is tailored to the individual’s needs after evaluation, counselors can provide a range of benefits to their clients.

WHAT A PROVIDER CAN DO:

  • Offer information and resources
  • Be a companion during painful experiences
  • Normalize your experiences
  • Provide empathy and understanding
  • Give examples of healthy boundaries
  • Model positive behaviors

WHAT A PROVIDER CAN’T DO:

  • Make decisions for you
  • Tell you how to behave
  • Convince you or others to change
  • Know you better than you know yourself
  • Fix problems for you
  • Prescribe illicit drugs

“When things are spinning out of control, people come in to get a hold of their lives,” Rutherford said. “But a therapist is going to have you unpack the source of your shame and perfectionism first, before you can address the issue of control.”

Signs that a Counselor or Therapist Can Help

Anyone can see a counselor even if they haven’t experienced an identifiable trauma or developed a mental illness. However, it’s common for adults to brush off feelings of stress or not take their symptoms seriously.

Rutherford compared the process of identifying mental health concerns to that of physical health concerns.

“If one of your children came up to you with a cut on their arm, would you say, ‘Just be glad it’s not broken?’” she said. “No. You’d immediately do something about it.”

Some behavioral patterns or emotional symptoms  are a more classic indication that someone needs help, according to the National Alliance on Mental Illness. These signs look different across the lifespan.

Children [Ages 1 to 12]

Kids may develop behavioral issues as they age and begin to socialize with others. They might also face traumas or adverse experiences that result in a need for professional support.

Signs to monitor for children:

  • Difficulty discussing emotions
  • Inappropriate expressions of anger or affection
  • A desire to hurt others
  • Difficulty coping with the loss of a family member
  • Refusal to follow instructions from authorities
  • Extreme changes in appetite, energy or sleep
  • Overly concerned about abstract or adult issues

Teens [Ages 13 to 18]

Teenagers may struggle with identity formation as they navigate new aspects of sexuality and socialization in middle school and high school. Academic and social pressures can be compounded with expectations of social media and college applications, and lead to coping mechanisms that require professional attention.

Signs to monitor for teens:

  • Obsessive behaviors with social media
  • Negative self-comparison
  • Preoccupation with self-image or body image
  • Sudden extreme dieting or exercise
  • Irritability or impatience with peers and parents
  • Sudden change in academic performance
  • Withdrawal from social groups or extracurricular activities
  • Self-harm or suicidal thoughts

Young Adults [Ages 19 to 39]

Young adults transitioning into their first jobs, homes and lives away from their families may experience anxiety, homesickness or general issues coping with new independence and distance from their support systems.

Signs to monitor for young adults:

  • Sudden extreme dieting or exercise
  • Involuntary change in sleep cycle
  • Difficulty coping with major life transitions
  • Self-harm or suicidal thoughts
  • Withdrawal from social groups or extracurricular activities
  • A change in substance use like alcohol, tobacco or illicit drugs
  • Anxious feelings that make it difficult to complete daily tasks

Middle-Age Adults [Ages 40 to 65]

Adults in midlife may have difficulty coping with changing financial circumstances, parenting challenges, changes in career and the loss of their parents. These major life events often overlap, causing drastic lifestyle changes after years of established routine.

Signs to monitor for middle-aged adults:

  • Sudden withdrawal from social groups
  • A change in substance use like alcohol, tobacco or illicit drugs
  • Restlessness or unusual sleep patterns
  • Self-harm or suicidal thoughts
  • Anxious feelings that impede obligations or tasks
  • Losing interest in hobbiesor career
  • Excessive exercising or dieting
  • Negative self-comparison to others

Older Adults [Ages 65+]

Older adults have the highest suicide rate of any age group, and often experience some rate of cognitive decline as they age. Coping with the death of peers and loved ones and the loss of independence and mobility can be sources of depression.

Signs to monitor for older adults:

  • Lack of sleep or restlessness
  • Difficulty coping with the death of friends or family members
  • Consistent worrying or anxiety
  • Lack of desire to do any physical activity
  • Sudden withdrawal from social groups
  • Irritability, aggression or impatience with others
  • Development of a chronic illness or disability
  • Persistent feelings of sadness, depression or thoughts of suicide

Symptoms may be masked by perfectionism, overachievement, denial or extroversion.

“People with perfectionism have a hard time seeing their problems because their lives look so good to others,” Rutherford said.

Across all age groups, a mere desire to seek help from a professional or trusted confidante is enough reason to look for a counselor.

How to Encourage Someone to Seek Professional Help

Friends and loved ones will often see the signs before a person recognizes a need in their own life. In fact, almost 1 in 5 people who have seen a counselor said they found a provider through a recommendation from a friend or family member. Thoughtful, compassionate encouragement can help a person pursue professional care in a safe way.

“No matter your age, watching someone else struggle is difficult,” Rutherford said. “Talk to them about how it impacts you as a starting point.”

While children and teens may be subject to their parents’ and guardians’ decisions about pursuing mental health care, adults may struggle with the stigma related to seeing a counselor or asking for help, especially when faced with losing independence as they age. To address stigma with compassion, Rutherford identified several ways to support someone who needs help.

Talking to Someone about Counseling

Create a safe space. Speaking openly and compassionately in a private, neutral space may help avoid feelings of embarrassment or ambush. Laying out your own feelings and inviting the other person to also be vulnerable can evoke solidarity, safety and understanding.

Identify patterns that you’ve observed. Point out behaviors from your own perspective. Try saying, “It makes me sad to see that you’re spending more time alone,” or, “I’ve noticed that our phone calls are getting shorter.”

Ask for help from others. If you’re not the only one who sees the need for help, you can ask other friends and family members to independently speak with the person. That can help illustrate that your concerns aren’t an isolated event.

Offer to help find a therapist. Instead of threatening them with a forced visit, look for available counselors in your area. “I’ve looked around and found a few people who might be able to help,” can be a neutral place to start.

See a counselor on your own. Rutherford recommended seeing a counselor on your own first, before encouraging someone else. Modeling a positive investment in one’s own well-being can set an example for others and serve as an opportunity to invite them along with you.

How to Find a Counselor or Therapist

Search online for a counselor in your area at any of the following sites:

If you are interested in a career in mental health counseling, learn more about how to become a mental health counselor.