How? How does talking do anything? I went a few times before but it never meant much to me other than a private place to cry. I just talked and then life continued as the same shit so what was the point of talking?
I’ve tried plenty to come out of my depression and anxiety. I make more money, I stay fit, have some hobbies, try to have a positive mindset and give myself some slack, but I mean, it’s all pretty futile isn’t it? At this point I’m just going to remain a loser. Plus, why even try when we’ll all die and nothing will be remembered?
Even when I took meds or microdosed shrooms, I always felt worse about the fact I couldn’t feel better without something
14.
“There are only two things in life I have to do — 1: I have to die one day. 2: Whatever I decide to do, I have to live with the consequences. The rest is completely up to me.”
“I had problems with perfectionism and burnout, and eventually everything stressed me out because I had the feeling that I had to do things for my job and for my family and I felt trapped in it all the time and I completely lost myself. So this changed a lot for me.
I don’t have to be productive all day, but I can decide to be. I don’t have to do the dishes, for example. The consequence is that I’ll come into a dirty kitchen the next morning and I hate that. So instead of having do to it (and feeling overwhelmed by ‘all the work I have to do’), I decide that I want to do it. Change the wording. It doesn’t sound like much but it changed everything for me.”
—u/batsbookstea
People Asked A Stress Psychologist Just About Everything On Reddit
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iStockphoto
We’ve been asking Americans about stress in their lives.
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Jessica Pupovac/NPR
Jessica Pupovac/NPR
On Friday, the tables were turned when Dr. Lynn Bufka, a licensed psychologist with expertise in treating anxiety, stress and related problems, came to NPR to take questions on Reddit about coping with stress.
Bufka, who works at the American Psychological Association in Washington, D.C., is on Twitter: @DrBufka.
She said that the questions during the “Ask Me Anything” session were common issues that her patients ask about all the time. “We’re all going to experience stress,” she told Shots. “It’s a normal part of our day, but we have a choice in how we respond to it.”
When asked if doing the AMA was stressful for her, she responded, “No, not really.” Besides, she said, “It was fun and a little challenging — but I like to be challenged. If one person learned something helpful then that’s great.”
Here are some of the highlights from Reddit, edited for length and clarity. You can find the full set of questions and answers here.
How much can stress affect my ability to make small talk? What do you recommend I do to avoid/reduce stress most effectively?
Stress can interfere with many things we try to do. Some people can be very anxious about being evaluated socially and therefore are reluctant to make small talk because they are concerned about how other people will perceive their comments. In those situations, try to focus on the other person and draw him or her out. Once he or she is chatting, you may start to feel more comfortable too.
Lots of strategies can reduce stress — try to maintain regular sleep/eat/exercise habits as much as possible, say “no” when overwhelmed with tasks, turn off news/information for some mental downtime, spend time with people who make you feel good, participate in something with others (a sport, volunteering, religious services) or maybe find your own quiet rituals to take some slow breaths and let go of the day’s pressures. These are only a start in trying to reduce stress.
What small steps do I have to overcome when dealing with social anxiety? It has come to the point where I can barely go out and find a job, I barely socialise with people and I stay at home, that is where my comfort zone ends, which I understand is extreme. So any advice on how to deal with social anxiety?
Try to identify situations that make you a little anxious but you think you can do. Maybe making small talk with a family member, or making eye contact with the person you are buying items from, and practice those. Make yourself mini practice assignments that seem doable, track how you do and as you practice them they will become easier.
Here’s something many people find very surprising: Most people are paying more attention to themselves, not you. You might feel anxious and might be concerned that you look nervous, but the person next to you might feel the same way about himself, or she might be looking at the time and wondering if she’ll catch her bus, or they might be thinking about what to cook for dinner! …
Is it normal for family to be a very large source of stress in my life? (No abuse, just trying to live up to their expectations)
Family can be stressful for a variety of reasons, even if that same family is a source of love and support. Sometimes, it is just the busyness of lives — lots of people with different activities and different ideas and just trying to stay connected can be a challenge.
However, if it is about trying to live up to expectations, part of the challenge is helping your family understand who you are and what motivates and interests you so that they can be supportive of your aims and goals. Families, no matter how much they love us, sometimes have ideas about who we are supposed to be that don’t match up with who we really are, and navigating that is tricky. Trying to have an open conversation is a good first step.
Is it possible to be totally stress-free in society nowadays?
I’m not sure we want to be totally stress free. Sometimes stress makes us work harder, get more prepared for tasks we are facing, or perform better. Stress sometimes results from good things — like getting married or bringing a new pet into the home!
However, we want to be aware of those situations in which we feel overwhelmed by demands. That is when we want to try and reduce our stress, by doing things like changing the demands (when possible), or changing how we think about situations. Sometimes the situations are stressful and sometimes we make them more stressful because we pile on expectations or mental demands or perfectionism even beyond whatever the situation is.
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When thinking about how to find a therapist, it’s important to consider local resources, apps, organizations, and reliable online therapy options. Here’s everything you need to know.
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If you’re considering therapy — whether it’s to restore a relationship, recover from trauma, adjust to a new life phase, or improve your mental health — finding the right therapist is the first hurdle to cross.
Researchers have found that the bond between you and your therapist is likely to have a big impact on your growth. That’s why it’s important to do your research, ask questions, and pay attention to your own responses in your search for the therapist that’s right for you.
Here are some tried-and-true methods for finding a therapist to help you reach your therapeutic goals.
1. Consult your provider directory
If you plan to pay for therapy through your insurance plan, your first step might be to look through your plan’s provider network.
It’s also a good idea to find out whether your plan limits the number of sessions you can attend each year and whether using an out-of-network therapist will affect your out-of-pocket costs.
Looking for ways to support your mental health and well-being? Try Healthline’s FindCare tool to connect with mental health professionals nearby or virtually so you can get the care you need.
2. Ask someone you trust
A referral from a friend, colleague, or doctor you trust is another way to find a therapist who might be a good fit for you.
While a referral is a good place to start, it’s important to recognize that you may have different needs and goals with your therapy than the person giving you the recommendation.
So, a good match for one of you might not be as beneficial to the other.
3. Use a reliable online database
A number of mental health organizations maintain up-to-date, searchable databases of licensed therapists.
Your search could start as simply as typing in your ZIP code to generate a list of counselors in your area. You may also be able to search for specialists, like marriage and family counselors or therapists who focus on drug and alcohol use.
Some of the most commonly used online search tools include:
- American Psychological Association
- American Association of Marriage and Family Therapists
- Association of LGBTQ+ Psychiatrists
4. Explore local resources
Your community may also have resources to help you. If you’re a student, your school might provide access to a counseling center.
If you’re employed, your human resources team might offer a list of therapists available through a workplace wellness or employee assistance program.
If you need counseling related to domestic or sexual abuse, you might be able to find group or individual therapy through a local advocacy organization.
If you want your faith to inform your treatment, you might consider reaching out to your church, synagogue, mosque, or another worship center for a list of licensed therapists affiliated with your faith.
6. Think about your goals ahead of time
What do you want to accomplish in therapy? Studies have found that when you and your therapist both work together toward the same goals, your outlook will be better.
If you think some type of medication may help with your symptoms, you’ll want to find a psychiatrist or practitioner who can prescribe medications.
If you’ve heard that cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR) therapy have been effective for others with your condition, you’ll want to look for a therapist with certifications or specialized training in those treatment approaches.
If you want to be part of a supportive network of people who understand your experiences, you may want to consider looking for a therapist who’s involved with support groups or group therapy sessions.
Your goals may change as you work with a therapist. It’s OK to talk with your therapist about changing the direction of your treatment plan as your needs evolve.
7. Try an online therapy app
Talkspace and BetterHelp both offer tools to help you explore the kind of therapy you want. They can also match you with a licensed, accredited therapist you can work with online or via phone.
Some people find a digital therapy platform to be more convenient and more affordable than in-person therapy. Weekly sessions range from $35 to $80 for online therapy.
At least one study found that people with depression felt that their symptoms improved after online sessions. It’s worth noting, however, that two of the researchers involved with this study were consultants or employees of the digital therapy provider used.
8. Ask questions about the things that matter to you
When you meet your therapist, whether it’s online, on the phone, or in person, it’s not uncommon to completely forget every question you wanted to ask.
To make sure you have the information you need to make a good decision, keep paper and a pen, or a notes app, handy for a few days before your meeting. Jot down questions as they come to you.
The American Psychological Association suggests a few questions for you to consider asking your therapist during your first session:
- Are you a licensed psychologist in this state?
- How many years have you been in practice?
- How much experience do you have working with people who are dealing with [the issue you’d like to resolve]?
- What do you consider to be your specialty or area of expertise?
- What kinds of treatments have you found effective in resolving [the issue you’d like to resolve]?
- What insurance do you accept?
- Will I need to pay you directly and then seek reimbursement from my insurance company, or do you bill the insurance company?
- Are you part of my insurance network?
- Do you accept Medicare or Medicaid?
The Anxiety and Depression Association of America adds questions like these:
- If I need medication, can you prescribe it or recommend someone who does?
- Do you provide access to telehealth services?
- How soon can I expect to start feeling better?
- What do we do if our treatment plan isn’t working?
Note: If you’ve ever been abused by someone in authority or affected by historic trauma or racism, you may want to ask questions that help you find out whether a potential therapist is culturally informed and sensitive to your experiences.
Pay attention to red flags
Regardless of whether you see a therapist in-person or virtually for the first time, you’ll want to pay attention to any factors that make you feel uncomfortable. Therapy is meant to be a welcoming and accepting space for any and all feelings that come up.
Some red flags to potentially look out for include:
- Does the room make you feel physically uncomfortable? Does it feel private and secure?
- Are you experiencing overwhelming feelings of anxiety or panic? Some anxiety or nervousness is understandable, but you’ll want to communicate to your therapist if you’re experiencing symptoms of an anxiety or panic attack.
- Do you feel comfortable telling your therapist anything? Are they making you feel judged or uneasy in any way?
- Is your therapist completely present with you throughout your session?
9. Pay close attention to your own responses
No matter how many professional accreditations your therapist has, your own feelings of trust and comfort should be your top priority. Will therapy be uncomfortable from time to time? Possibly. After all, you’ll likely be discussing difficult, personal topics.
But if you feel uncomfortable with your therapist for any other reason, it’s all right to look for someone else.
You don’t need a reason to switch therapists. It’s enough that you don’t feel comfortable.
Here are a few things to notice as you talk with your therapist:
- Does the therapist interrupt you, or do they listen carefully to what you’re saying?
- Does the therapist respect your time by being prompt to appointments?
- Does the therapist brush off or invalidate your concerns?
- Do you feel seen, heard, and respected during your session?
What if it’s not a good match?
In the event that you meet with a therapist for the first time and decide that they’re not a good match for you, know that that’s completely fine. It’s totally normal and happens to many people who are looking for the right therapist for them. It can take some time to find someone that you feel completely comfortable with.
At the end of your first session, your therapist may want to schedule another appointment. If you know that you do not want to meet with them again, you can let them know that while you appreciate their time, you don’t think that it’s a good match at this time.
If you feel uncomfortable communicating this to them face-to-face, you can also text, call, or even email them to let them know you’re no longer interested in seeing them.
Regardless of how you choose to tell them, it’s important that you do inform them, instead of not showing up to your next appointment without an explanation. Many therapists have cancellation policies, so make sure you cancel at least 24 hours before your appointment to avoid a fee.
Therapist vs. psychiatrist
Therapists and psychiatrists aim to treat mental health conditions and improve emotional well-being. But there are key differences between the two professions.
Therapists
Therapists are licensed mental health professionals, including psychologists, social workers, and counselors. They aim to help people manage their emotions, build healthier relationships, and understand themselves better.
Therapists use talk therapy and behavior modification techniques to help people make positive life changes. During therapy, they can assess, diagnose, and treat mental health conditions.
Therapy typically suits people who want to learn more about themselves and make long-lasting changes in their lives. It may also help people with mild mental health conditions.
Most therapists have a master’s degree and may have a doctorate. All licensed therapists have to have at least a master’s degree.
Generally, therapists can’t prescribe medications. But in some states, psychologists with specialist pharmacology training can prescribe certain medications.
Psychiatrists
Psychiatrists are medical doctors who specialize in diagnosing and treating mental health conditions. Because they hold medical degrees, psychiatrists can prescribe medication.
Psychiatrists may use a combination of talk therapy and medication to treat mental health conditions.
Working with both a therapist and a psychiatrist may be the better option for people who experience more severe symptoms and may benefit from a combination of therapy and medication to help treat their symptoms.
Other types of mental health professionals
What they areWhat they can doQualificationsTherapista mental health professional who can provide a safe space for people who want to talk through life issues, changes, or symptoms of a mental health condition– perform talk therapy
– diagnose and treat mental health conditions– a master’s or doctorate degree
– may specialize in a particular area, like marriage and family therapy or trauma processingPsychiatrista person in the mental health field who focuses more on biological factors (genetics, social sciences, neurology, for instance) – diagnose and treat mental health conditions
– prescribe medications
– order medical tests
– perform a comprehensive mental health exam – one of two medical degrees: doctor of medicine (MD) or doctor of osteopathic medicine (DO)
– in the U.S., board certified by the American Board of Psychiatry and Neurology
– 4-year residency Psychologista mental health professional who uses talk therapy and psychological evaluations to help patients – perform talk therapy
– help clients with issues not related to specific mental health conditions, like stress, grief, or big life changes
– administer exams and assessments to help diagnose a condition– a doctorate degree
– a 1-year full-time supervised internship during graduate school
-a 1-year full-time supervised post-doctoral fellowship after graduate school
– a national examSocial workera professional who works with different types of people and communities to help guide them to living a healthier, happier life– work in settings like hospitals, mental health facilities, schools, and halfway houses
– coach individuals or groups by discussing issues like communication, empathy, organizational techniques, and self-care skills– a master’s degree in social work (MSW)
– 2 years of supervised clinical experience after graduate school
– a license in the state they practice inLicensed professional counselorsomeone who may specialize in a certain type of therapy approach (cognitive behavioral therapy, CBT, or interpersonal therapy, for example) and may work alongside a person’s medical doctors to provide a more holistic approach to therapy– perform talk therapy
– treat mental health conditions and issues like anxiety, depression, phobias, bipolar disorder, and others
– in some states, they can provide a diagnosis – licensing varies by state, but many have a master’s degree in counseling and 2–3 years of supervised experience
Frequently asked questions
How much does therapy cost?
The cost of therapy can depend on the type of therapy, the therapist’s experience, and whether you’re talking with a therapist in person or through teletherapy.
Therapists may charge between $100 and $200 per session for in-person appointments. But in bigger cities, therapy can cost more. Some therapists may offer sliding scale rates. If you have insurance, you may pay a portion of the fee depending on your coverage.
Teletherapy is generally less costly. The price per session starts at around $50. Some platforms offer unlimited therapy with a weekly or monthly subscription.
What types of therapy are there?
There are many different types of therapy, and the type you choose will depend on your needs and preferences. Some common types include:
- Cognitive behavioral therapy (CBT): CBT helps you identify and change negative thinking patterns and behaviors.
- Dialectical behavioral therapy (DBT): DBT combines elements of CBT with structured skill-building in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
- Psychodynamic therapy: This type of therapy focuses on your unconscious thoughts and emotions.
- Interpersonal therapy: The focus of interpersonal therapy is on your relationships with other people.
- Family therapy: This type of therapy helps families resolve conflict and improve communication.
- Group therapy: In this type of therapy, you meet with a group of people who share similar experiences.
- Art therapy: This type of therapy uses art to express emotions and help process trauma.
- Eye movement desensitization and reprocessing (EMDR) therapy: EMDR is an interactive form of psychotherapy used to relieve psychological and trauma-based stress.
What are the benefits of therapy?
Therapy has several benefits, including improving mental health, resolving personal issues, and increasing self-awareness. Therapy can also help people learn new coping skills and manage stress.
Some people see therapy as a way to prevent mental health issues or as a way to address underlying causes of mental health conditions. Others use therapy to work through traumas or difficult life events.
Therapy is an effective treatment for many mental health conditions, including anxiety, depression, PTSD, and eating disorders.
The bottom line
Whether you’re coping with grief, trauma, or relationship issues, or want treatment for a mental health condition, finding a helpful therapist can make a big difference in your journey.
To find a therapist who’s a good fit, start by considering practical matters like licensure, insurance coverage, location, and specialties.
You may find that friends, colleagues, and healthcare professionals are a good source of referrals. You may also find options by using search tools provided by organizations that address your specific concerns.
When you’ve narrowed down your choices, you may find it helpful to think about your goals and questions. This way you can be sure you and your therapist are well matched and aligned on your treatment plan.
Ultimately, finding the right therapist is a personal matter. Human connection is at the heart of effective therapy, and you can build that sense of connection whether you talk with your therapist in person, on the phone, or online.