The test that matters
Everyone has bad weeks. The better question is whether the way you feel is interfering with your life. Look at three areas: work or school, relationships, and the basic upkeep of eating, washing, sleeping and paying bills. When one of those has been slipping for more than a couple of weeks, or when holding all three together takes everything you have, you have passed the point at which waiting is a plan.
Signs people talk themselves out of
- You need alcohol, cannabis or anything else to get through an ordinary evening or to fall asleep.
- You have had panic attacks, which are sudden waves of pounding heart, short breath and dread that peak within minutes.
- You have stopped doing things you used to enjoy, and stopped answering people you like.
- You are irritable or angry out of proportion, which is a common face of depression.
- You avoid more and more places, tasks or conversations because of worry.
- Two or more people who know you well have asked whether you are all right.
Nobody requires a crisis before you ask, and most people who start therapy are functioning adults.
Where to start
Your primary care doctor is a perfectly good first stop. They can screen for depression and anxiety with a short questionnaire, check for physical causes that mimic both, such as thyroid disease, anemia and poor sleep, and either begin treatment or refer you. If you would rather go straight to a therapist, you do not need a referral under most plans. Students can use campus counseling, and many employers offer a few free confidential sessions through an employee assistance program. Treatment is effective. Talk therapy, medication, or the two together help most people who stay with them, often within a few months.
When it cannot wait
Thoughts of suicide or of harming yourself are a reason to reach out today, not at the next available appointment. Call or text 988, the Suicide and Crisis Lifeline, at any hour to talk with a trained counselor. If you or someone else is in immediate danger, call 911 or go to the nearest emergency room. If the person you are worried about is a friend, ask them directly whether they are thinking about suicide. Asking does not plant the idea, and it usually comes as a relief.
Tip Before the first appointment, write down what you have been feeling, for how long, and what it is costing you. People routinely minimize in the room, and the note keeps you honest.
