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This is an article that every mental health blogger has written. The thing is, those articles are written by therapists or therapy clients – people who have found a solution and are sticking with it. What these articles are really telling you the signs that it’s time to do something about your mental health. And I don’t think “You’re Human” qualifies as a reason to seek professional treatment.

Every single day I find new ways for people with mental health issues to help themselves. New tools, books, tricks, apps, articles – this very blog has a “self-help” section. I’m mildly suspicious of each new self-help tool that I come across, checking to see if this is just a cash grab, or something that’s well-intentioned but poorly executed. After all, how many people have gone in for a free “personality test” and suddenly found themselves getting a hard sell for Scientology?

Really, though, what I’ve found is that most of these are pretty good. The best ones incorporate the same kind of scientific research that informs therapists’ practices and combines them with the technological capabilities of a smartphone platform. And they work! However, there is a point where the best self-help tools are not going to be enough, and you’re going to have to talk to a professional. Think of it like fixing a car – maybe you can use Youtube to replace a tail light or change your oil, but there’s a point where you just need to take it into a mechanic.

1. You’ve already done everything you can think of

I’m shooting myself in the foot here, because these are my favorite types of clients. They might have low level depression or anxiety, or maybe their stress level shot up for whatever reason, and all they need are some tips for how to address their emotions and their all set. Therapists offices are full of people who just need to learn how to slow down their breathing. There’s an app for that.

It’s when I hear about all of the things that people have tried that I start to have to turn my therapist brain on. These are the people who have tried all the good habits, like exercise, meditation, talking to friends, and then they turned to the bad habits, like drinking to cope, and nothing is getting them to where they want to be. It’s not helping, or it’s not helping enough.

Therapists can have a few jobs in this case. They can help figure out why your current methods aren’t working. You might be unintentionally making the problem worse. A lot of times, people with PTSD will notice that their symptoms get triggered by certain situations, like crowds or loud noises, so they’ll try to avoid them. Counterintuitively, what these people are actually doing is negatively reinforcing the fear response, which actually makes it more likely. Or people with insomnia will often start sleeping later and later, unintentionally wreaking even more hell on their Circadian Rhythm.

2. You know what to do, you just can’t seem to do it

It’s an open secret among therapists that you could spend your copay on a gym membership and probably get about the same benefit.You could spend 25 minutes per day getting intense cardio exercise, and in addition to the benefits to your heart, lungs and muscles, this is a pretty solid treatment for depression. The research tends to agree with us. The trick is getting people with depression to actually exercise.

A lot of people know what they need to do to pull themselves out of what their dealing with. The most obvious example is smoking – I know this is killing me, I hate that I’m doing it, I just can’t get myself to stop. There’s a lot that therapists can offer in this case. Therapists are experts at human behavior – what people do and why they do it. We know what’s happening in your brain and your mind that’s keeping you stuck where you are, and we know how to jiggle you out of it.

If it seems like I’m being overly broad here, it’s because this is one area where the treatment is really tailored to the individual. This is where therapy has a strong advantage over the machines (i.e. apps), because we can get the right information to know what exactly will help you do what you need to do, and then we can help you do it.

3. You don’t know what’s going on

Self-help is good for well-defined problems. You’re afraid of snakes. You need to practice good habits. You have trouble falling asleep. There’s an app for that.

I like to remind people over and over that the human brain is the most complicated object in the known universe. That means that nothing is ever really simple. Take depression and anxiety, two conditions that tend to go hand-in-hand. Should you practice some relaxation skills for that anxiety, or will that just bring your depression even further down? Should you try to get out more, or will that just make you more anxious?

Or even more likely, what’s going wrong with you doesn’t fit easily into one of our diagnostic boxes. Maybe you have every reason in the world to be depressed – your dog died, you just got fired, the new Teen Titans show looks godawful – but instead you just don’t feel anything. Is something wrong with you?

I could go on listing hypotheticals, but the list is really endless. Humans are weird, complicated, poorly constructed organisms, so there’s a lot of weird, complicated things that can happen.

4. You’re not the only one affected

Self-help is best when the problem is relatively contained. If the issue is something that causes you some distress or keeps you from achieving some personal goals, then it’s fair for you to try to handle it yourself first. However, when things start to affect other people in your life, that’s when you need to get some professional attention.

In some cases, this may be what we call “a failure to fulfill role obligations.” This means that you can’t act in a way that you’re supposed to. Most people have multiple roles – worker, student, family member, friend, etc. If your issues are affecting your ability to really act in any of those roles, then you owe it to the other people who are being impacted by this to pay it the attention it deserves. When your boss is on the edge of firing you because you came into work drunk, telling him you bought a book about alcohol isn’t going to cut it.

Remember, too, that just because you are able to keep it together enough to function in your roles doesn’t mean that you aren’t affecting the people around you. Emotions are contagious, and some people are more susceptible than others. We also know that people are not very good at judging how well they are hiding problems, so it’s best to err on the side of more help.

5. It’s an emergency

Think about it like a medical appointment. You have a runny nose, coughing, sneezing, headache – fine, don’t go to the doctor. You have a broken arm – go to the doctor. There are mental health equivalents of broken arms. Here are just some of the things that apps are not equipped to handle:

Suicidal thoughts

Homicidal thoughts

Self-injury

Risky behaviors like unprotected sex or criminal acts

Illicit drug use

Body mass index under 17

Daily alcohol use

Hallucinations

Disorientation

Grief/bereavement

Binge/purge eating

There’s no app for that.

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