One of the hardest things that a man can do in his life is learn that sometimes he needs to ask for help. It could be almost anything that leads you to realizing that you can’t handle things on your own. You may simply feel like you’re unable to deal with your issues on your own. You may feel like everything is spiraling out of control. It might be that you feel like you’re hanging on by your fingernails and your grip is slipping. You may feel overwhelmed with feelings of despair or hopelessness. It may be that you simply can’t feel at all.
And sometimes it just feels like you’re one bad day away from losing your shit completely.
Deciding to ask for help is tantamount to admitting weakness, and if there’s one thing that men are taught over and over again, it’s that Real Men Handle Their Own Shit. Even when we have example after example of fictional tough-guys and bad-asses being willing to open up, admit their fucked-upped-ness and recognize that they need help, there’s still this stigma against saying that you can’t do it alone. We’re supposed to let it all slide off of us as though it doesn’t matter. We minimize the problem because who wants to admit that they’re upset because they’re single? That they can’t “handle some people being mean to them?” Or that they can’t shake this feeling of emptiness or hopelessness or despair?
I should know. I dealt with a number of emotional and mental issues through most of my life, stemming from chronic depression. I acted out badly, treated people inappropriately at best – horribly at worst – and closed in on myself because I hated myself. I simultaneously wanted love and connection with people but didn’t think I deserved it – or could even have it. I was, frankly, all kinds of fucked up. But I didn’t want to talk about it. I thought the fact that I was letting “the blues” get to me was a sign of weakness.
It wasn’t until I had a full-on breakdown in college that culminated with passive suicide attempts that I finally started to get help. And even then, my friends had to strong-arm me into agreeing to it. I didn’t want the label of “mentally ill” attached to me. I didn’t want to admit that I needed help.
But they were right – it was what I needed. I had to learn that being willing to ask for help was, ultimately, the strongest thing I could’ve done.
Here’s some of what I had to learn when it came time to ask for help.
Find The Help You Need
Deciding that it’s time to ask for help is, in many ways, the simple part. Understanding where to go and who to talk to? That part can be surprisingly confusing. Unless you’re already familiar with the array of titles, labels and acronyms, you can drive yourself batshit just trying to figure out who does what and who you actually need to see.
After all, do you need to see a psychiatrist? A psychologist? What’s the meaningful difference between a therapist and a counselor? And why are social workers in the mix too? It’s not like you’re trying to report somebody’s kid living in a colony of rats, you’re trying to find someone to talk to…
So, a quick and dirty breakdown: Counselors and therapists are blanket terms that cover a wide variety of training and education. Therapists can be, but are not always, psychologists, but the term also can encompass social workers, life coaches and other professionals who talk with patients and provide support, guidance and help them resolve their issues. Most (but again, not all) therapists and counselors are licensed and have an advanced degree in counseling, psychotherapy or other related degrees. A psychologist has a doctorate in their discipline and are actually qualified to diagnose mental and emotional disorders and help determine appropriate treatments. Psychologists frequently work in tandem with psychiatrists, who are medical doctors and can prescribe medication. Psychiatrists may nor may not actually conduct therapy and may prescribe meds based on a psychologist’s suggestion.
Now how do you decide who you need to see? In my case, I was lucky; I was in college when by emotions decided I could go fuck myself for the last time and so I went to talk to Health Services, which included a counselor; he, in turn, was able to recommend a psychologist in town that I should see. This simplified the process for me – a good thing since I probably would’ve just used the frustration as another excuse as why I didn’t “need” to talk to anyone.
As a general rule of thumb, social workers and counselors tend to be the front-line when it comes to dealing with issues; if you’re simply needing someone to talk to who is trained to handle problems like yours, then they may be your best bet. If you’re worried that you’re dealing with an actual disorder, then you may want to try to find a psychologist.
Of course, other factors such as, y’know, money can crop up as well. And while I won’t pretend that it’s not a significant hurdle, there are options. Your job may have an Employee Assistance Program which can help you find free or low-cost sessions. Similarly, if you’re a student, your school or university’s health services can help you out – if they don’t have a counselor on staff, they can assist you in finding one. Teaching hospitals and community health centers also frequently have affordable mental health options. If you’re a member of a church, mosque or synagogue, it may be worth talking to your local clergy; they’re often trained counselors themselves or may be able to help you find the help you need.
And sometimes it helps just to cold-call and ask about rates, co-pays (if you have insurance) and if they can work with you in terms of finances. Sometimes the answer is “no”, but it never hurts to ask.
The Drugs Help…
Sometimes your issues are purely emotional or cognitive and you just need to talk things out with someone who understands and can help you make sense of things. Other times you may be best served by talking to somebody who understands how your thought-patterns work and can teach you how to break those patterns and reframe those negative thoughts and emotions. Still others may help guide you through surface issues by asking a series of leading questions and helping you drill down to your underlying problems.
Other times, your problem may be in your head… literally. The more we understand how the brain works, the more we realize how little we actually know. One of the things science has discovered how delicate the brain’s neurochemistry can be. It’s weird to think that a simple chemical imbalance – one that, in all honesty, we barely understand in the first place – can completely fuck you up. It’s like finding out that one microgram too little of citric acid turns a delicious Diet Dr. Pepper into sentient sludge hellbent on world domination. Many mental disorders, such as depression, are problems with your mental wiring and can be treated with medication.
Of course, a lot of us have an instinctive NOPE when it comes to psych meds, often with good reason. In my case, when I started talking with my psychologist, one of the first things she did was recommend I go on Zoloft. I nearly lost my shit right then and there. Having grown up in an era when “Prozac” was a punch-line, the idea that I needed to take anti-depressants was antithetical to me. It was hard enough to just ask for help and see a doctor; to my mind, going on drugs was a sign that I couldn’t hack it. There was (and still is) a stigma to taking medications for your issues, a brown translucent bottle of “you’re broken” sitting in your medicine cabinet of judgement.
Other people see medication as a “short-cut” or a “bandage” for people who don’t want to do the work and just want Dr. FeelGood to give them something to make them all better.
But here’s the thing: if I hadn’t gone on Zoloft, I probably wouldn’t be writing this column right now. Once the medicine kicked in… well it wasn’t like a whole new world but holy shit, I was feeling better. It was like a strangely heavy fog had lifted that just sucked the self-worth out of me. The only way I can think to describe it is that it was akin to recovering from mono. You go from feeling like ten pounds of ass in a five pound sack to… not feeling quite so bad. Then maybe a little bit better. And a little bit better after that. Of course, you’re still (emotionally) weak as a starved kitten, but when you’re feeling like the most worthless individual ever, even a little relief from the unrelenting misery is like a revelation.
Going on antidepressants didn’t “cure” me, but they did make things easier. They took the edge off and that meant that I had the energy, and the desire, to deal with my other issues. Once I could function like a human being again, not only were my shrink and I able to get to the roots of my problems, but I was able to learn how to cope.
And it’s a good thing too because…
They Also Have Some Significant Downsides
Like I said earlier: the brain is a crazy sack of chemicals and wiring and even the slightest tinkering with the mix can produce some unexpected results. When it comes to psychopharmaceuticals, there’s a lot of dicking around when it comes to trying to make things work the way they’re supposed to. Not all of the drugs work the same way – MAOIs and SSRIs are both forms of antidepressants, for example, but they work on entirely different parts of the brain. Hell, two different people on the exact same drug with the exact same dosage will get wildly different results. There’s no way to accurately predict how the drugs will interact with your particular issue, so there’s a great deal of trial and error in terms of pills prescribed, dosages and so-on.
Even medical experts aren’t 100% sure of how antidepressants actually work, just that they do.
As a result, being prescribed medication often feels less of a solution and more the beginning of an especially obnoxious science experiment by a mad scientist using your brain as a guinea pig.
To make things more frustrating, it can take time for the medication to start working. You often have to wait for the meds to build up in your system before it will have any significant effect. There’s nothing quite like spending weeks and months throwing money at a prescription only to find out that you need to be switch to another drug and start the entire process over again.
In my case, I was supremely lucky; we got my dosage right more or less on the first try. Good thing too, because if I had to deal with more side-effects, I would’ve lost (what was left of) my goddamned monkey mind.
Remember when I said that brain chemistry is delicate? Tinkering with it to fix one problem can often lead to new and different problems. If you’ve ever seen commercials for anti-depressants or other psychopharmeceuticals on TV, then you may well have noticed the surprisingly long list of potential side-effects that sound less like results of medication and more like witches’ curses on the townspeople of Salem. Hell, some are just fucking ironic – Zoloft, an antidepressant, has been linked to suicidal thoughts. You know, just in case you wanted to add “do I want to kill myself, or is it my drugs?” to your list of anxieities.
Again, I was lucky (if you want to call it that): all of the side-effects I encountered were of a sexual nature. The SSRI family of antidepressants are known for causing all sorts of sexual dysfunction. In my case, it killed my libido deader than disco. And if I had even vague ideas about wanting to get off… well, let’s just say that was never going to happen. At all. No matter how much I tried. Like a bad fitting pair of boots, the gods themselves couldn’t get me off.
For many people – especially people dealing with heavier medications than I was dealing with – the side effects mean that the treatment can be worse than the disease. The problem is that it can be very difficult to stand up for yourself when you’re dealing with a medical professional, especially when you’re dealing with mental health. You have to be willing to advocate for yourself, especially when it comes to medication and the way it affects you.
(Remember: Dr. NerdLove is not a real doctor. You want to talk to an actual health professional about your meds, not just listen to a loudmouth on the internet with a blog.)
But then, that’s why…
You Have To Find The Right Therapist
Your relationship with your therapist will, by necessity, be an incredibly intimate one. You’ve gone to someone to ask for help with emotional issues, which means you’re going to be getting pretty damn deep territory, plumbing depths of your psyche that we often don’t let our families into.
In many ways, therapy is like dating: you need chemistry to make it work. It doesn’t do any good to ask for help when you feel like you aren’t connecting with your therapist or don’t feel comfortable opening up to them. You need a therapist who you feel gets you and understands what you’re going through.
Unfortunately, therapists, counselors and psychologists are human. No matter how much training and education they have had, they’re still prone to the same quirks, frailties and flaws that the rest of us are. You may find a counselor who is closed-minded, judgmental or who simply doesn’t understand. You may find someone who’s determined to slot you into an easily-defined box no matter how complicated your problems really are. You may find some who let their prejudices blind them to the real problem or who simply don’t listen. Still others want to provide quick, easy answers and may push solutions (or even medication) that you don’t want or won’t work for you.
Many people, when faced with a therapist who they don’t click with, often just quit getting treatment. It’s unfortunate, because we often don’t realize that you don’t have to stay with the same therapist if you don’t feel like it’s working. In fact, it can be important to “date around” as it were when you’re looking for help. It’s a good idea to talk to a number of counselors or therapists before booking an appointment and finding the one you feel is a good fit for you. Likewise, it’s also important to realize that if you don’t feel that your current counselor is helping you, you can break up with them and find someone else… even if you’ve had multiple sessions with them. It’s easy to get caught up in the sunk-cost fallacy and assume that you’ve invested this much time so you have to stick it out.
Of course, you don’t just want to find someone who tells you what you want to hear and won’t push you when you need to be pushed. Getting help and talking to a therapist can be uncomfortable at times. That’s part of the process; you’re trying to unpack and resolve uncomfortable issues after all. But at the same time, you want to find someone who listens to your concerns, who doesn’t pressure you or dismisses your legitimate questions or unease with types of treatments.
But more than anything, you have to realize:
It Takes Time
One of the most frustrating parts of getting help is that any form of therapy takes time. It was hard enough getting up the courage to ask for help; you want to be better now, not at however far down the line it’s going to be. But that’s the nature of therapy: you’re trying to unravel issues that go back years and tend to have any number of complicating issues. Our problems, especially emotional troubles, rarely have a direct relation of cause and effect; often you have to dig through layer upon layer of contributing factors and untold little psychological burrs and irritants that’ve been wrapped in folds of emotional confusion like an especially neurotic pearl. Even medication isn’t a “shortcut” – it takes time to get any significant help from them.
In my case, alleviating my depression meant that we could start the tricky business of digging into my other issues: my stunning lack of self-esteem, a desperate need for approval from others, resenting the ease others had at fitting in, the fact that I was in a toxic, emotionally abusive relationship… none of these were going to be solved over night. And, to be perfectly honest, some of those problems dogged me for years after I left college. But if I hadn’t let go of the toxic bullshit that made me afraid to ask for help, I wouldn’t have learned the tools that it took to make me who I am today.
One of the things that can often set you back is that there’s often self-imposed pressure to be “better”. You want to be “fixed” and it’s very easy to convince yourself that you’re further along than you really are. As hard as it can be, you need to be willing to settle in for the long haul. It takes time to build up the trust and rapport with your therapist that lets you open up in the ways you need to.
Realizing that it’s time to ask for help can be hard. Getting those answers and working through them can take even longer and processing them can be even harder. But asking for help often reveals a strength that you never knew you had. We all need a hand sometimes, and learning how to get that helping hand is worth it.