For many teens and adults who are facing sadness or are feeling down about a recent event or disappointing experience, or who may not be feeling as optimistic about life as they used to, or who are perhaps feeling heartache over an ended relationship or friendship or even undergoing grief from loss, the practice of self-care can be very beneficial and there are a wide variety of actions through this practice that can be taken to help them get through that low point in an otherwise healthy mindset.
But for those feeling moderate to severe depression, which is a diagnosable and treatable mental health condition, many self-care activities or suggestions are not enough to surmount the overwhelming symptoms they may be experiencing. For most people facing this level of uphill battle, professional mental health services may be necessary. They were for me.
When someone has some type of accidental fall and they are feeling or showing signs of a broken arm, would you tell them to go outside and get some sunshine, go for a brisk walk, pick up a new hobby, spend money to spoil themselves, or listen and sing along to their favorite song to feel better? No, of course not, you would take them to a medical professional, perhaps with persuasion if they are initially reluctant.
Yet in mental health we do exactly the opposite of what we should do. We avoid and downplay, we pretend like it’s not happening, we keep it a secret, we allow ourselves to be silenced due to shame and guilt, and we refuse to get help in the unrealistic belief that it will magically go away on it’s own. But it won’t because mental health conditions don’t work like that. You can’t grow out of it because it’s not a life phase, you cannot just “get over it” because it’s not a perspective or chosen state of mind.
While the causes of moderate to severe depression are still being researched and debated and the question of whether or not it is a chemical imbalance or something else entirely remains unanswered, we do know that it’s more than feeling like you’re in a funk. There are both psychological and physical health consequences to having untreated moderate to severe depression, especially in the long-term.
More than likely there are many contributing factors beyond a chemical imbalance or malfunctioning neurons, including such factors as untreated trauma and life challenges related to finances, family, social pressures, internally and externally induced stress and anxiety, unhealthy coping mechanisms like substance use, or the symptoms of another untreated or undiagnosed mental health condition like PTSD and/or a co-occurring substance use disorder.
For cases of moderate to severe depression, I urge people to reach out to a professional mental health services provider, whether that’s directly to a counselor or indirectly through a conversation with a primary care medical provider who can connect someone to mental health services.
As a former certified peer specialist and as someone with lived experience with bipolar disorder which has interrupted and interfered with my life for the past 23 years, I want to tell you that there is no shame in seeking help. We seek medical assistance for physical ailments, so it makes sense to seek assistance for mental ailments as well.
As someone who has gone through multiple counselors and therapists, and a psychiatrist, I know that not every person you reach out to can be helpful or even competent. To be honest, some doctors, counselors and therapists are not effective at their jobs, some should even have their licenses revoked. If you don’t like your mental health provider, leave them and get another one! With the rise of telehealth and online providers we are no longer bound by our physical locations when it comes to seeking help.
There are many different kinds of counselors and therapists with a wide range of specialties who are trained in different types of therapy or treatment modalities. Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Eye-Movement Desensitization and Reprocessing, Psychotherapy (talk therapy), and support groups, are just some of the most common types of therapy but there are so many other types that are specific to certain situations or specific needs or goals.
Just because someone is young does not mean they are immune to developing mental health conditions, in fact quite the opposite is true. Youth are at the greatest risk because most symptoms of mental health conditions develop at the onset of puberty or well into the 20’s. Youth within the age range of 10 to 24 years should be regularly evaluated for the signs and symptoms of mental health conditions. The earlier it can be diagnosed the more we can prevent years of unnecessary suffering.
My mental health struggles started when I was 14 years old, suicidality started at age 16, hospitalization happened at age 19, and another suicidal episode happened at age 22. My hospitalization at age 19 occurred just a few months after I had dropped out of college and had started working a full-time job. I was encouraged by a coworker to self-admit into a local hospital’s inpatient behavioral health ward after an uncharacteristic emotional outburst at work and my disclosure that I was having suicidal thoughts.
A lot had led up to that moment. My previous career goal had recently been crushed, I had hated college and withdrew my enrollment, I was battling with self-acceptance, struggling with a then undiagnosed and consequently untreated mental health condition, and unaddressed childhood trauma.
Life was hell for me at the time and I had already been suicidal for 3 years prior to that intervention. I was scared and confused but knew that if I didn’t accept external help that I would take my own life because I saw my life and my pain as one synonymous struggle. In my overwhelmed mind I convinced myself that ending my life would end my pain. It’s not that I wanted to die, I just didn’t want to hurt anymore and I was so exhausted from the emotional rollercoaster of thinking of ways to end my life/pain. Once I arrived at the hospital and filled out the paperwork, I was admitted for a mandatory 72-hour hold and while it didn’t magically fix everything, the experience really was a positive turning point for me.
As someone who has been involved in behavioral health personally and professionally for years, I know that not everyone supports inpatient behavioral health ward stays, primarily due to the cost, and that concern is absolutely valid, especially for those without health insurance. Thankfully, today many other crisis resources and services are available, some of them cost-free and often times a mental health crisis can be addressed without a hospital stay through such options as mental health and substance use crisis hotlines or lifelines and affiliated mobile response teams. All things I wish had been available to me when I was a teenager and young adult.
I have been in and out of therapy for decades, I have been hospitalized for suicidal behavior, have had one abandoned suicide attempt, I have received multiple diagnoses from a psychiatrist and physicians, and have been prescribed nearly a dozen different antidepressants and mood stabilizers throughout that time.
BUT I have also had a long career working full-time with only a few interruptions due to my mental health condition, I also live financially independent. My point in telling you this is that recovery and a life beyond a mental health condition is possible. My life has been interrupted but not brought to an end. Depression as a symptom of my bipolar disorder is a hiccup in the grander scheme of my life, and while it comes back from time to time, it’s just an interval. You too can get through depression if you take care of yourself and get professional treatment when you need it.
Above all else, know that there is hope and help, never be ashamed to seek help for mental health issues, doing so is literally no different than seeking help for physical health issues. There are many crisis lifelines and helplines available that didn’t exist all those years ago when I needed help. They are free, confidential, and the crisis counselors staffed for these lines have extensive training to respond to any mental health crisis.
The Suicide & Crisis Lifeline of 988 is accessible to anyone in the U.S. for call or text. They can provide assistance during a mental health crisis, such as when someone is having suicidal thoughts.
The Crisis Text Line, if you are in the U.S. or in Canada, can be reached by texting the word HELLO to the telephone number 741741 or if you live in the U.K. the telephone number is 85258 or if you live in Ireland the number is 50808. They can provide assistance with any kind of mental or emotional distress, including thoughts of suicide.
The Military/Veterans Crisis Line in the U.S. can also be reached by calling the Suicide & Crisis Lifeline at 988 and then pressing the extension number 1 when prompted, or if you send a text to 988 just let them know in your message that you are a current member of the military or are a veteran. You can also text the alternate number 838255.
For members of the LGBTQ+ there is The Trevor Project. You can call their lifeline at 1-866-488-7386 or you may text their lifeline at 678678. They have other online resources such as a private social network and online chat options, all can be accessed at their website hyperlinked above.
All of the above listed crisis and helplines will connect you with trained adult crisis counselors, and are available 24 / 7 / 365 and have various language options available. They can also provide you with resources and connect you with local mental health services where you live. You can contact them about your own struggle or you can contact them on behalf of a family member or friend who may be struggling.
For situations specifically involving substance use in the United States, the National Helpline at 1-800-662-4357 can provide recovery treatment referral options and other helpful information. For situations resulting from a human-caused or natural disaster, the U.S. government established the Disaster Distress Helpline at 1-800-985-5990 to call and 66746 to text in order to receive crisis counseling and support for those impacted emotionally by such disasters.
The Teen Line is an option for teenagers wanting to speak with someone their own age. They can be reached by phone call at 1-800-852-8336 during the hours of 6 PM – 10 PM PST (9 PM – 1 AM EST) every night, they can also be reached by texting the word TEEN to 839863 between the hours of 6 PM – 9 PM PST (9 PM – 12 AM EST). Phone calls and texts are confidential, except in emergency situations. The line is operated by high school teens volunteering their time to support their fellow teens and it is a crisis line accredited by the American Association of Suicidology, a well-known organization in the behavioral health industry. The line is operated by professionally-trained teenage volunteers based in Los Angeles, California. Despite their headquarters in California more than 70% of their incoming phone calls and texts actually come from outside the state and those they support are spread across the United States.