When someone decides to call a psychologist it is usually after many months of internal debate.  Something has to tip the scales to reach out to a stranger for help.  Something inside the person has to build up to overcome two important ready-made obstacles: the financial investment and the stigma.

Studies continue to calculate the high cost of mental illnesses, such as depression and anxiety, to individuals, to families and to society.  These illnesses are not rare.  The National Institute of Mental Health reports that 9.5% of adults suffer from depression and over 18% suffer from anxiety (http://1.usa.gov/h2FyBu).  Even with some overlap of these two populations, approximately 20% of the adult population in America is dealing with a moderate to severe mental illness.  Studies also show that only 25% of these people get the help they need.  

One-in-five people are dealing with some form of mental illness.

Twenty percent of Americans report stress levels that are EXTREME (an 8, 9 or 10 on a 10-point scale) according to the APA’s Stress in America survey (http://bit.ly/14GEwNO).

A recent New York Times article calculates depression’s toll to our economy at half a trillion dollars: http://nyti.ms/1dc77Ji.

As a psychologist I am naturally interested in and can offer a partial explanation for why many people steer away from seeking professional help for psychological issues.  Seeking mental health services is not the same as going to the doctor for diabetes or a bad back.  Most people can divorce themselves from feeling responsible for their medical problems.

Many people who are depressed believe they “should not be” depressed, or “should be able” to help themselves.  

They do not hold these beliefs about their physical symptoms.  People who take on the feeling of responsibility may have this internal monologue cycling inside their head: “if I’m responsible I should fix this myself.  I should not ask for help.  I should not want help.  Actually, help is what I want and what I’ve always wanted in life, but I won’t ask for help because I never have and if I do it now and receive it (from therapy) then the void of support in my life seems all the greater and I do not want to face the tragedy of that.  

Feeling responsible allows one to feel in control.  

There is also the damaging equation where having depression or anxiety means “being crazy.”  People do not like to think of themselves as crazy so they do not go near anything they associate with crazy.  If you are reading this, you are probably saying to yourself, “I know being depressed is not the same as being crazy.”

It is not a rational thought, it is an emotional association.

People who know rationally that something is good for them very often do not choose this good thing for emotional reasons.  They may not understand their emotional reasons and remain in a pattern that they know is not healthy.  Not taking the road that leads to a better life is a way to protect oneself from the realization of another deep void in one’s life.  This is the void of having someone in your life who knows you and who wants what is good for you, even if it is not good for that person.  When this is not modeled in early life, children can grow up feeling undeserving, even afraid of assertively caring for themselves.

Psychotherapy is an investment of time, energy and money.  The financial investment of psychotherapy trips up many people in ways that other things do not.  People spend money on vacations, restaurants, new cars, gifts, or sporting events, tuition (and many other things) to reduce stress, feel better or get ahead in life.  Investing in psychotherapy is a declaration, “I am worth it.”  I once saw a middle-aged woman drive away from a school parking lot in a luxury sports car with the license plate, “My Turn.”  This car was her form of taking care of some wound inside.  It was an expensive cure and probably did n0t soothe the wound for long, but there you have it.  This anecdote – which is 100% true – offers an irresistible metaphor: you can drive around in your pain (drive away from it?) or you can confront it and put it to rest.  It is a matter of where your focus lies.  Focusing inward is to face a wound.  Focusing outward allows for distraction from that wound.  I get the call when the distractions no longer work.