Is it Time for Therapy?

Warning signs a loved one might need counseling

/ Author:  / Reviewed by: Robert Carlson, M.D

How do you know when someone you love, or you yourself, could use the help of a therapist? Often, people exhibit some warning signs that they are dealing with overwhelming feelings or circumstances.

These warning signs can be an indication of an immediate mental health need due to a specific event, or potentially because of an undiagnosed condition such as depression, bipolar disorder, or anxiety.

According to the 2010 release of the US Mental Health report from the Substance Abuse and Mental Health Services Administration (SAMSHA), over the course of a year, 19 percent of the population experienced some sort of anxiety disorder, 2.8 percent experienced a form of Bipolar Disorder, and 6.8 percent experienced Major Depressive Disorder.

Unfortunately, it is not always easy to tell when therapy might be helpful or even necessary. Over 32 million Americans suffering from a mental illness do not receive treatment.

While approaching someone about therapy is not always easy, it can be better to take action than to risk letting a loved one suffer in silence. If you recognize these signs, it could indicate that a therapist’s help may be beneficial.

Watch for these 5 warning signs:

1. Cries for Help – Pay attention to a person’s attempt to let you know about their distress.

Usually, a cry for help is very subtle and can sometimes be hard to identify. It is important to recognize if these seemingly insignificant events are occurring for the first time, occurring repeatedly, or if multiple cries for help are happening all at once.

Some examples might be bizarre or vague text messages and social networking posts, conversations revolving around death, meaninglessness or violence, or leaving personal items, like a diary, lying around the house.

2. Deterioration of Work and Relationships – Often, a person experiencing serious emotional or personal difficulties will struggle to keep up with work and relationships.

Notice if they run late frequently because of excessive sleepiness or fatigue, or skip work entirely. It is also common for people to withdraw from relationships by turning down invitations, staying home alone more often, and avoiding social situations like happy hours or parties.

Over time, these events can cause a person to lose their job, lose their social circle, or hurt close friendships.

3. Drastic Changes in Behavior – Notice any serious changes in behavior that could lead to violence or accidents. Pay attention to new interest in violent behavior, fighting, or “dare-devil” like activities.

Identify excessive anxiety or anger, or severe mood swings that seem out of the ordinary, like unexplainable shifts from extreme energy and happiness to fatigue and depressed mood.

Also pay attention to changes in personality that last over longer periods of time, like a nice person acting cruelly, or a typically upbeat and engaged person feeling sad and apathetic. While these shifts may seem small, behavior that is very out of the ordinary is important to note.

4. Physical Changes – Look for any distinct changes in physical appearance or health. Dramatic weight loss or gain could be a sign of a serious issue, like an eating disorder, drug abuse, or depression. 

Also note changes in physical health, for example, the rapid onset of illness, chronic fatigue, fainting, or change in sexual desire.

It’s also important to recognize that problems with physical health can actually be the cause of mental health issues like anxiety and depression. It can be important to consult a doctor when you have mental health concerns.

5. Self-Harm Behaviors – Pay attention to any self-harm behaviors, such as cutting, burning, hair-pulling or head-banging.

It is common for people to try to disguise the injuries from these behaviors. Notice if someone is consistently using long sleeves, scarves, hats, or other ways of covering up the cuts and bruises of self-harm. Self-harm is a dangerous sign of distress.

Attempting suicide is the most grave of the self-harm behaviors and should be taken very seriously.


If these warning signs seem familiar, please contact a mental health professional. If you do, you are not alone, according to SAMSHA, about 27.9 million people receive mental health services during a year.

Today, many different types of therapy exist to help people with all sorts of mental health issues.

Common types of therapy used today include cognitive behavioral, mindfulness, and marriage and family therapy. All deal with a range of issues and can be helpful to a variety of people.

Cognitive behavioral therapy, or CBT, is a frequently used approach due to its focus on thoughts and behaviors. This approach is goal-oriented and helps clients pinpoint undesirable thoughts and behaviors in order to change them.

Mindfulness therapy is a growing field in the United States, and is often used to reduce stress and anxiety. This approach stems from Buddhist techniques of meditation and awareness.

Marriage and family therapy focuses largely on work with couples and families, even though therapy can be done with individuals as well. The goal of marriage and family therapy is to understand and create healthy relationships.

Finding the right therapist is an important piece of the puzzle, not all therapists are the same. Ask your doctor, social worker or religious leader for a referral to an appropriate therapist, or you can call 1-800-Therapist to find a professional in your area.

In the case of suicide or emergency the National Suicide Prevention Hotline can be reached at (800) 273-TALK; or you can call 911.

Review Date: 
July 31, 2012