By Wendy Kilmer
A broken bone, a fever, digestive distress or even a yearly checkup easily warrant a visit to a professional without too much thought. We’re looking for and usually leave with diagnosis, treatment, prevention and improved physical wellness. But do we use the services of a professional as readily for mental wellness? If not, why not?
Scene posed those questions and a few more to two local mental health professionals to offer some baseline information about caring for the mental and emotional health of ourselves and our loved ones.
Brenna Camp is a Licensed Clinical Social Worker. She founded Recourage Counseling in 2017 and has nearly 20 years of counseling experience, having practiced in Little Rock, Memphis and Abilene. She has worked as a therapist in adoption settings, behavioral health hospitals, and private practice and has taught courses in social work. Her practice areas include trauma, depression, anxiety, addictions and co-addictions, bipolar and grief.
Dr. Olusegun Bello is a board certified psychiatrist. He was born in Leeds, United Kingdom, but grew up in Nigeria. He is the medical director for Oceans Behavioral Hospital and also maintains private practice at Eden Springs Behavioral Services, founded in 2017. He attended his medical degree at the University of Lagos and traveled to England to begin working in the mental health field, then spent 10 years working in New York City. He has completed a fellowship program at Columbia University in public psychiatry and holds a master’s degree in public health with a concentration in health policy management.
When should I seek the help of a mental health professional?
Camp identifies two common scenarios that precipitate someone seeking professional help for their mental health: major life transitions or consistently “stuffing feelings down” over time.
“Sometimes circumstances bring it on — becoming pregnant, having a baby, major illness, caring for aging parents, life transitions,” she said. “Other times I have people say, ‘I’ve struggled with this all my life,’ and they’ve just never sought help.”
In both situations, symptoms are usually present that indicate a need for help from a mental health professional.
“Some symptoms are not necessarily dangerous in themselves but are red flags to something coming down the road,” Bello said. “It’s important to have insight to recognize when you’re getting there.”
A loss of interest in normal activities can indicate that it might be time to visit with a professional.
“In layman’s terms, I’d describe it as a place inside us that we wall off,” Camp said. “It keeps the bad out, but you’re also not feeling the good.”
After pushing down feelings over and over, people often wake up and realize they are overwhelmed, she said. Or, perhaps, feel so depressed it’s hard to get of bed.
Persistent Worry, Unhappiness
Patients sometimes describe anxiety as a heaviness on their chest or an impending sense of doom.
Help may be needed when a person can’t seem to enjoy themselves, even when doing things that are normally pleasurable – they can’t seem to lift their mood; or they face feelings of hopelessness, guilt, and that they are the cause of everything bad, Bello said.
“Almost always, sleep issues go along with anxiety and depression,” Camp said. “Sometimes that’s a first sign for people. There may be one first thing that people recognize, but usually it’s a slow gradual build up.”
Either sleeping more than usual or less than usual could indicate a problem, Bello said.
Changes in Daily Function
Mental health isn’t black and white; most people have traits that fall in somewhere in the spectrum of mental illness. Camp said the defining thing that makes it diagnosable is interference with daily functioning, and Bello agreed.
“Any change from normal patterns should be a red flag,” Bello said. That could include eating habits, weight, school performance and social behavior.
“One of the sad things to me is when it’s been interfering under the surface and people don’t get help until things get to where not working anymore,” Camp said. “Once they finally do, they start looking back and seeing ‘this has really interfered a long time, but I didn’t know how depressed or anxious I was.’ Failed relationships over and over, family conflict over and over, living in those types of situations where they get used to it and don’t realize there could be something better.”
What common barriers keep people from seeking help?
Lack of Awareness
Not surprisingly, it’s often hard for people with mental illness to recognize symptoms in their own life.
“People suffering from mental illness often lack insight and can’t accurately assess themselves,” Bello said.
For example, abuse isn’t always identified as such. Victims of abuse may not perceive they’ve been abused. The same can be true with trauma, Camp said.
“Some terminology we use is ‘big T’ Trauma and ‘little t’ trauma,” she said. “It’s easy to recognize ‘big T’ Trauma – war, car accidents, shootings, situations where you almost die. We don’t recognize as easily ‘little t’ trauma. Smaller things repeated over time have the same impact — being in an emotionally or verbally abusive relationship, even just being put down all the time.”
“Many women, but also men, say to me ‘I should be able to handle this’ or ‘I should be over this,’ when they haven’t fully walked through it; they just feel like time should have taken care of it,” Camp said.
Fear is a barrier for some when it comes to seeking professional mental health help, Camp said.
“There is a discomfort of having to talk to someone who is, at first, a stranger. Some people say, ‘I didn’t know if I’d like you or trust you or feel comfortable with you,” she said. “You might not find the right fit the first try. But look at profiles, therapists’ bios, websites or visit psychologytoday.com to find out more about professionals in your area. It’s a good way to look for someone you feel like you could connect with.”
Many people simply procrastinate what they know they need, just as with physical health. Counseling and therapy take time out of the day and can be hard when juggling home responsibilities and work schedules.
The cost of professional counseling and therapy is sometimes perceived as prohibitive but may be a misconception. In many cases, insurance will cover some or all of the cost of mental health treatment.
Still, Bello said, financial concerns can be a true barrier.
“Access to healthcare is major issue,” Bello said “Psychiatry is still seen as secondary when it comes to health care. Insurance will cover it to some degree but not as much as other medical care.”
Embarrassment still plays a role for many in the decision to seek professional help, although it varies by culture and generation.
“I think we are doing better at reducing the stigma around mental illness,” Bello said. “But we can do even more. Many people can freely talk about diabetes or hypertension but are not comfortable talking about mental health issues, especially certain ones. No one frowns on you as much if you say ‘depressed’ but if you say ‘schizophrenic,’ people want to take a step back. There’s also a notion that mentally ill people are more violent, but that’s not what research tells us. Most people with mental illness just want help and have been mistreated and judged rather than listened to.”
Camp has observed that the Millenial generation has a higher comfort level with counseling and therapy than previous generations. For many of them, therapy is a natural part of life and self-care.
Lack of Control
Good news: you have more control than you think. Most of the time, you can and should decide what you want your therapy to look like.
“A lot of people think –and some therapists have contributed to this – that you have to delve into your past and dig up things that went wrong in your past,” Camp said “But a good therapist won’t go there unless you go there. You have permission to just address whatever Is going on right now. If you don’t want to, you don’t have to go dig up anything.”
Also, counseling can be short term; it doesn’t have to be a part of your life forever.
“One fear people have, particularly about in-patient treatment, is ‘if they say I’m not well, they’ll keep me there forever.’ We don’t keep people there forever,” Bello said.
What should I do in my daily life to maintain my mental and emotional health?
Care for yourself.
The practical aspect looks different for everyone. Perhaps it’s time alone; maybe it’s time with friends.
Camp describes it as “having time to listen to what’s going on inside of you and not ignore it, not push it away, not stuff it down. It’s easy to get into the rut of going to work, coming home, and put off self-care and soul care and life experiences.”
Both Camp and Bello also emphasized regular exercise and eating well as basic elements of self-care.
“It’s become a bit of a buzz word, but mindfulness is also important,” Camp said. “Disconnecting from technology, social media and phones and spending time with people who love us and encourage us and allow us to be ourselves.”
Be in community.
Isolation is a key reason people seek help, Bello said.
“Having a support group is something we sometimes take for granted,” he said. “Find people who you call family, and if you don’t have that, create your own community – any group of people with like-minded interests and goals.”
But also, be picky about your close relationships.
“It’s important for people not to become stuck in unhealthy relationships,” Camp said. “But once you’ve found that trusted community, listen to your family and friends if they notice things about you.”
Stay the course.
“If you have a mental illness, follow up with a doctor and take your medicine as prescribed, Bello said. “Definitely go through with your regular check-ups and follow up appointments.”
Be wise about substances.
“Don’t put yourself in a situation where you lose control over your decisions,” Bello said. “Avoid drugs. Use alcohol only in moderation. Situations where you aren’t in control and don’t know what’s going to happen are setting yourself up for failure.”
What’s the best way to reach out to friends and family who might need to see a mental health professional?
“If your friends and family members are already coming to you with their problems, you might say something like: ‘I’m here for you, and I will continue to be. But I feel like there are some things someone else could offer insight about. Someone who is trained and has listened to these things over and over can spot things and help give a name to what you’re experiencing,’” Camp suggests.
It can be tough, Bello said, but try to normalize the behavior and be supportive: “I’ve noticed a change in your behavior. Is anything going on?” Use open ended questions and try to express yourself without being judgmental, he advises.
“You won’t lose by just trying to listen,” Bello said.