You and Your Mental Health: How Do I Know If I Need Help?

I am often asked the question: How do I know I need to see a therapist?

First, I suspect I am preaching to the choir by emphasizing that living with a chronic condition can have an impact on your mental health.

But if you do need some convincing, here are examples of situations my clients with chronic conditions have described to me:

  • Running out of your medication due to a pharmacy or mail glitch
  • Problems with insurance coverage
  • A canceled doctor’s appointment when you need attention right away
  • Uncertainty, like financial concerns
  • An unhelpful medical professional

And let’s not forget the impact of living with any kind of chronic condition during a global pandemic.

Now I am well aware of the amazing resilience of individuals living with chronic conditions. You don’t live successfully with a chronic condition without learning to manage it day to day.

But still… my clients talk to me about days when situations like the ones I listed, especially if they have been hit with one or more of them in a short period of time, can leave them feeling like they are reaching the limit of their ability to cope on their own. That’s why they gave me a call. And keep in mind that repeatedly experiencing stressful events can, over time, wear down your resilience.


Life Can Wear Your Coping Ability.  That’s a Good Sign It’s Time To Reach Out For Help 

Here are the three mental health conditions I often see among individuals living with chronic conditions, as well as their family members:

  • Depression
  • Anxiety
  • Post-Traumatic Stress Disorder (PTSD)

So I would like to provide my own personal perspective on this question.

How do I know I need help? The following are some of the key signs that it is time to reach out to a mental health professional:

I feel overwhelmed by a situation I am dealing with. Life throws a lot of curveballs our way. But if you are facing situations or events that seem to have tapped out your coping skills, then it’s time to learn some new ways to cope. Mental health professionals are trained to teach their clients coping skills.

My symptoms seem to be coming out of nowhere. Life events can push our coping skills to the limit. But changes in the way you are feeling emotionally may also come out of nowhere, and just seem to hang around, for months or years. This is sign that you may have a biochemical imbalance. A mental health professional can evaluate your symptoms and talk to you about a treatment plan, which may include the possibility of medication. Keep in mind, you are the ultimate decision-maker regarding your mental health treatment.

The way I feel is having a negative impact on my relationships. Your emotional state can affect your relationship with your partner or your children, you may find yourself shutting down, for example, or blowing up in anger. Individual therapy can help, but so can couples or family counseling.

I’m having trouble doing my job. Your mental health can affect your ability to work in a few ways. Having trouble focusing. Difficulty interacting with your boss or co-workers. Inability to motivate yourself. As a therapist, I often find that having trouble earning a living is at the top of the list in terms of what makes someone reach out for help.

My eating and sleeping have changed. Nutrition and rest are the cornerstones of your self-care, critical to both your physical and emotional wellness. Changes in diet and sleeping are not only a potential symptom of emotional distress, but also lack of adequate food, or eating the wrong kinds of food (as well as alcohol), and lack of rest, can worsen anxiety and depression.

I have thoughts that bother me and won’t go away. Especially anxious thoughts, or scary thoughts, also referred to by therapists as intrusive thoughts. They constantly pop up, often about scary, or bad, things that could happen to you, or that you might do to someone else, however irrational, causing you to feel suddenly fearful about a scene you imagine, or worried about the future, or ashamed. A mental health professional can help you to train your mind to let go of these thoughts.

I’m not interested in the activities I used to enjoy. This is another important red flag. The things we do by ourselves and with others that give us pleasure help to keep us grounded, and happier.  If you just aren’t feeling it these days, this is a sign you may have something going on with your mental health.

I don’t feel like taking care of myself. If you’re living with HIV, you are already an expert on the importance of paying daily attention to your health. Treatment regimen burnout is a dangerous place to be.

I am thinking about suicide. Our minds can go to very dark places when we experience the sense of helplessness and hopelessness that can accompany mental illness. If you are having thoughts of suicide, or if you have a friend of loved one who is talking about suicide, the time is now to get connected with mental health resources!

To quote the sign in the New York City subway system, if you see something, say something. And that means monitoring your own emotional wellness and keeping an eye on the people in your life. The absolute bravest action you can take is to admit that you can’t do it on your own and then take that important and life-affirming step of reaching out for help. The absolute bravest! It also takes bravery to take a loved one aside and express your concerns about their mental health. But taking that step can make all the difference in their life.

You and your mental health.  If you think you may need help, don’t wait.  Reach out!


Dr. Gary McClain, MS, PhD, is a psychotherapist, patient advocate, blogger, and author, specializing in helping clients deal with the emotional impact of chronic and life-threatening illnesses, as well as their families and professional caregivers. His website is His email is He welcomes your questions and comments.