The Doc has a question...

[Dr.Bobby]

Hi all!

In my travels 'round this place, perhaps the most alarming for me are the ones where people talk about their "Issues" with such desperation. But in their desperation, therein lies the answer: Get help. Tell someone and get help.

My question is why this needs to be said, why is it that people who are so desperate need to be told the obvious, that they should tell someone and find the help they're looking for.

I'd value the opinions of those who've been there and can relate to the need for help, yet the inability to take the steps to get it. And Part Two: what do you think caregivers like myself could do differently IRL to make that process easier.

Thanks!

[Sequin]

Originally Posted by Dr.Bobby

My question is why this needs to be said, why is it that people who are so desperate need to be told the obvious, that they should tell someone and find the help they're looking for.

All I can do is theorize, and I will limit my answer to the context of this online website since you prefaced your statement by mentioning how this was something you wanted to ask based on your experiences here.

I may be oversimplifying a bit, but it seems to me that a large part of therapy revolves around finding answers people already have the ability to find on their own. Notice I said "ability" but not necessarily "initiative." Hence, the "how does that make you feel?" questions and the "what do you think about that?" inquiries I'm sure you have used yourself in your practice at times. A diagnosis has to take into account what the patient says, how they say it, how they act when they say it, etc... which means they are going to be exploring their thoughts together with another human being in a social, non-threatening environment. The professional will have a better sense of the variables to take into account, but the patient has the actual mind being explored. Could the patient do this on their own? Certainly some could, but we are social animals and for a lot of people this might have a lot more to do with a need to feel an attachment to another being so that they know someone out there cares. To be isolated from that would probably harm them more than aid them. I'm only bringing this up because it leads to my addressing your question:

It would seem if people who needed help had full initiative and use of reason, your job would become a lot less needed (no offense intended by that, just an observation). Many more would not only seek help outright, but (going in line with that thinking) I would also suggest they probably could ask themselves the questions you would ask and find no need for therapy all together. They could research the variables on their own, right?

(Now, keep in mind, I am not advocating that people should ever self-diagnosis themselves as that is never a good idea - especially when dealing with an irrational urge/feeling/emotion - but what I was getting at is that your question seems to imply that those urges/feelings/emotions are not important in the equation because it seems to imply people who are here asking for help/advice are always operating at full capacity for reason/logic and should be capable of doing the obvious thing - where-as I believe this might have more to do with a need for something outside of the advice, itself, for a lot of people - a "reading between the lines" mentality, if you will)

One possibility for not acting on the logical choice of seeking help is that some persons who post these issues are acting on a need to feel a connection/affirmation. By forcing others to "state the obvious" to them, they are able to see someone else feel for them or (in some cases) comfort them. That need for an external force affirming their existence as well as the existence of their problem might just give them the necessary strength they need to do what they already know they should.

What I am trying to get at is that you cannot simply look at someone seeking advice in the context of what they say in their post. There is a reason they came here instead of seeking help on their own. They might know the answer to their question, but that doesn't eliminate another basic need they have as a human being. And yes, that connection can come from a complete stranger.

It is also possible that some of them don't feel ready to seek help, but they want to get something off their chest so that somebody, somewhere knows what they are going through. They do not necessarily want some stranger online to "fix" them, but rather to assure them that they exist and that someone cares. This reaffirms that their suspicions might be true but also gives them a needed boost of self-confidence to move forward. They might not even be aware of the fact they are doing this. But that's what makes the mind interesting, isn't it?

Of course, there are many who post here who actually do want to know what do do. They should not be forgotten, either.

But yes, some do ask questions which seem to have an obvious answer. But it's not always about the answer they get. Sometimes it's about the feeling they are seeking out. Emotions are irrational and (when put to the extreme) uncontrollable. They cause people to do irrational things that cannot be easily analyzed.

Of course, I'm sure a few of them are simply trolling for attention as well. But that comes with the territory.

I am rambling a bit, so I will end my thoughts here. I doubt any of that was helpful, but I suppose you could say I felt an irrational urge to contribute something while I was here.

Again, just theorizing. I hope you don't mind, because you do seem to be a lot more invested in your job (if you are telling the truth about your job, that is) than my own therapist.

And I do hope you get an answer from someone with the experience necessary to satisfy your curiosity. Good luck with that.

[PSY]

Getting help may seem obvious to you, but guess what? That's not always the case. Teens who have been invalidated their entire lives may not see "getting help" as an option. They may feel helpless, like there is nothing they can do except for talk about their problems (and then stay with those problems and not expect anything to change). Sometimes, teens know they need help, but they don't know where to start or whom to talk to... so you have to be specific, and tell them to talk to a counselor at their school. I've met teens who didn't even realize their schools HAD counselors! Again, it may seem obvious to you, but that's not always the case for people who come to TeenHelp. Sometimes, the obvious actually isn't all that obvious, and they begin to entertain an idea that they've never entertained before.

As for what you can do differently... well, aren't you already involved in pro bono work of some kind, such as getting "plugged in" to the community and discovering where services are needed? If not, get on that. Work with non-profit organizations in your area that target teens in particular, and let them know that there IS hope and there ARE ways to get help, whether it's by calling the phone number for the non-profit organization or talking to a trusted adult. Get in touch with nearby schools and see if you can get involved in some way. If you're a psychological professional like you claim to be, then surely you've already discovered several options over the decades?

[Loving Linux Penguin]

Frankly, reaching out for help, for many is a very SCARY experience. I mean...sharing things that are private to you, and asking someone else to talk about it (which can involve a display of emotion) may put one in a vulnerable state...and it's scary to be vulnerable, isn't it? So, as I see it, people tend to reach out to their friends and/or this website (and I'm sure many consider people here to be their friends as well) because they feel more comfortable talking to someone their own age. Case in point: I talk to my friends about 'boy problems', needlephobia, and my sexuality. However, talking to adults about those things is a lot more uncomfortable. I will DO it, when I need to, but there's a sort of sense that said adults don't understand as much or don't relate the same way. Granted, in nearly all cases, they probably indeed CAN relate quite well, but when you're in that position, you tend to think that talking to your peers is a much easier and more comfortable way to go about things. Hope I'm of some help

[Dr.Bobby]

Thanks for the replies [Edited]

Let me rephrase the question: Why do you suppose people who are desperate for help overlook the easy answer of finding a professional, or telling some adult who can help them IRL? What else are they looking for, what could we/I say to them here that would make that acceptable? What are they looking for?

[PSY]

[Edited]

Originally Posted by Dr.Bobby

Let me rephrase the question: Why do you suppose people who are desperate for help overlook the easy answer of finding a professional, or telling some adult who can help them IRL? What else are they looking for, what could we/I say to them here that would make that acceptable? What are they looking for?

In some cases, they may say they want help, but they're only willing to go so far. For example, they may want help in the sense of receiving empathy/encouragement/support from others, but they're not ready to actually do the hard work of therapy. Some people are willing to share their long-held secrets of being abused by parents, but they're not willing to call CPS/DCFS. They're not ready to take action, and many times, it's because they anticipate a poor outcome (nothing will change, or things will get worse). They need reassurance, and while you can't convince them to tell an adult, you can empower them and eventually lead them to feel strong enough to take a risk and get help by talking to an adult they know in real life.

[OMFG!You'reActuallySmart!]

Originally Posted by Dr.Bobby

My question is why this needs to be said, why is it that people who are so desperate need to be told the obvious, that they should tell someone and find the help they're looking for.

One reason stems from the name of this website: HELP. I consider it to be absolutely useless to tell someone to go see a doctor because frankly that's not the kind of help people are probably expecting. It's common-sense, not help of any sort as people are already aware of psychologists and psychiatrists. The only productive thing I see out of such responses is increasing one's post count.

Although you're asking specifically in reference to depression, I think your questions can be applied to many other mental illnesses. There are a plethora of possible answers, ranging from believing it is shameful to ask for help, cultural pressures that look down on those with mental illnesses, etc... . It's similar to when someone is badly injured with the bone sticking out of their leg and a stranger will ask the common question, "are you okay?" The question is to be interpreted non-literally, as asking what can a non-medically trained person do to help the situation. I think this is similar to such questions on this forum, where the meaning behind the question isn't as literal as you're interpreting it.

Originally Posted by Dr.Bobby

Let me rephrase the question: Why do you suppose people who are desperate for help overlook the easy answer of finding a professional, or telling some adult who can help them IRL? What else are they looking for, what could we/I say to them here that would make that acceptable? What are they looking for?

Some of your questions are self-explanatory, either that or I'm being dense and not understanding. When people come onto a help site, more often than not they're looking for help and support. That's the only universal answer because each person comes with their own unique baggage and problems. There's no common sentences you can post that would help them out, it's a case-by-case basis. There are cultural differences to consider, which your questions seem oblivious to despite the fact they are already recognized by the APA. Frankly, I find it pathetically lazy for you to even ask such a question as it implies you want to spend as little of your energy as possible trying to formulate your own answers. I can certainly understand a doctor trying to ask the younger generation for their experience to improve their ability to generate better solutions but that's not what you're doing.

[Edited]

[Silvia]

I think that posting your worries in a site like this is actually reaching out for help. It is a first step and a good way to talk about intimate things, things difficult to share, as we all know. The "anonymity" which the Internet gives you makes yourself more comfortable than just talk to someone in flesh and bone. Besides, you know that here for instance, you are going to find people that feels or at some point has felt like you do and feeling you are not alone undergoing that stuff and that you can learn from their experience, justifies enough coming here first...

[Kate*]

As obvious as it may be, professional help is very scary. I can use myself as an example; I struggled with depression, suicidal thoughts, and mild self harm. I was a minor for the first 5 years of that struggle and my mom did not understand, didn't listen and told me to suck it up and get over it. She's a single mom so I figured out I wasn't getting any help even if I wanted it and I learned not to bring it up with her again because it would just make me feel worse. Once I was an adult I had handled it so long it was easier to just keep going without help. I still lived at home with no transportation so my mom would have to know about any help I received and it just wasn't worth it.

Depression, or at least the form that seems to afflict me, will do everything it can to "stay alive" by convincing me NOT to get help period. It takes past situations that have happened to me and things people have said and uses them to convince me of some pretty horrible things and then I don't go to anyone, professional or otherwise because I'm afraid I will be judged, yelled at, criticized etc. if not by the professional, by my family members who don't have the most accepting view of mental illness.

Enter TeenHelp: You can vent to people who understand you and are going through the same things, people who know first hand what may work or not work. You also have the opportunity to share your experiences in hopes that others can learn from you without having to have a professional degree (this obviously has serious drawbacks, but bare with me). There's also something to be said for the lack of face-to-face interaction. For me, that's intimidating enough when discussing the weather let alone what goes on in my disordered mind! Annonymity allows people to open up in ways they normally can't and to express things in more healthy ways (posting a thread as opposed to harming oneself) There might also be lack of people to talk to in real life so we find support here. And finally, there's something to be said for the fact that no one are professionals because while that has clear negatives, the idea of "professional" or even "adult" is intimidating serious issue or otherwise. That's why some people start by telling their friends first and then progress to more capable individuals later. Of course there's the added bonus of no one has to know or consent for you, so you can "get help" without some of the serious obstacles. As for what you can do, I answered that in your other thread.

[Whisperer]

I find it embarrassing. I feel like it's my fault when I have a bad day where I feel suicidal. People get upset when I tell them when I've cut so I don't want to make them upset so I keep it inside. Whenever I tell my therapist something like that he automatically has to tell me parents if it's serious which makes me not want to tell him because then my parents will hound me about it constantly. Also when I'm feeling depressed and I want to be left alone I'm not going to tell my parents I'm depressed because then they sit with me and check on me and everything to make sure I don't cut, which makes it worse because I get so irritated with them. Also even after seeing my therapist a year I don't feel comfortable always saying everything. There are some things that may haunt me the rest of my life but I don't want everyone to know everything about me, if that makes sense at all.

Recently I realized how bad I was at telling my therapist things were bothering me. So, I made a list. I listed everything I should talk to him about vaguely so I would understand it but if someone were to see the list they wouldn't. I put it in my drawer until the day I was going to see him then I was going to bring it to show him and go through each step. But when the day came, I wasn't in the mood to talk. I didn't want to bring up all the bad memories when I was already in an okay mood. I don't want him to know my deepest darkest secrets. And even though he has promised he doesn't, I'm terrified he will judge me.

[i_like_black]

Getting help from professional sources is scary, especially considering the amount of things that can potentially go wrong, especially if you're legally a minor.

I know that for me, when I first got referred to "professionals" at 13, it triggered an avalanche of other issues within the family - for which the majority of the family has not, to date, forgiven me for. My parent's marriage was already on shaky ground, my younger brother was doing chemotherapy for leukaemia, and my behaviour was outside of what they could understand or predict.
The professionals insisted that my family attend therapy with me - even though I had told them that nobody would want to come. They thought they knew better. They threatened my mother with legal action if she didn't attend. That appointment was a complete fiasco, there was lots of yelling and shouting within my family, me and my siblings got told off for making jokes - it's one of the ways we react to stressful situations, we try and make light of it - and my mother said to the therapist(s) in front of all of us that her marriage was pretty much finished.

Not long after that - within a matter of weeks - I was removed and my parents separated, and I felt far, far worse than before I'd received any "help". My family (with the exception of my father and grandparents, whom I was living with) refused to talk to me and I then had the added stress of travelling across the city to attend school, where my marks were slipping as a result of everything else.

Every time somebody from the realm of "professionalism" found out about my self harm, they informed my family - those that I was living with - regardless of the fact that it was superficial and I was at no real risk. They pushed me to talk about things that I wasn't ready to talk about, which did more damage than good, and they didn't offer anything constructive to help me deal with the mood swings I was experiencing.

A lot of younger people have similar experiences with their first foray into the mental health system - it's a nightmare. If you self harm, or if you're suicidal, there's a massive fear that your family will find out, and it's hardly ever a good thing when they do, because most families judge harshly for that sort of behaviour and thinking. If you're under 16, the professionals legally have to let your parent or guardian know. And I know that for most people, self harm in particular is a very private issue and they don't want it shared with anyone.

Whereas, if they come to TeenHelp, they are suddenly surrounded by people within the same age group, many of whom can relate to what they're going through - no adult can truly comprehend the fears of a teenage mind, which has a lot of hormones and the like complicating matters. Other teenagers understand almost perfectly. On TeenHelp they have access to places to talk about what's going on without being judged. They have anonymity, so there is no fear of people finding them out and blowing their cover. They have a support network that will pretty much always be there for them if they need it.

And most of all, they get people who will open gateways to things like professional help - who will suggest things like teachers, aunties, uncles, school counselors, and GPs - people who aren't generally as scary to think of as those people with the labels "psychologist" or "psychiatrist".

So there are two main reasons that people don't go for the professional help that you see as "obvious" - one is fear, which is perfectly logical, the other is ignorance - people can't know about these things if they aren't informed. You can't just expect someone to know that help is available, and even if they know it's there, you can't expect them to know how to access it, and you can't expect it to be an easy or logical option for them.

Being a teenager is hard at the best of times. Being a teenager with mental health issues is damn near impossible at times. Please don't belittle these young people by saying, essentially, "Oh seeing a therapist is so obvious, why don't you do that?"
But on the other hand, good on you for trying to understand the whys and wherefores of people not going to professionals.

[oldaccount]

Well, for me, personally, I've been trying to get help for three years. Now I don't want to entrust my mental issues to a therapist or psychiatrist or someone who works in a behavioral health center because nothing seems to help me.

[Firesong3]

Hi Doc! I'm one of those people you are referring to. I posted on here a little over a month ago wondering if I should get help.

The thing is, it took me a whole year to actually decide I needed professional help for my depression. When I first felt myself relapsing, I denied that I had a problem. As it worsened, I blamed it on other things- a broken heart, too much pressure from uni, a poor diet, my period, lack of sleep. I even moved house thinking that a change of location would make me feel better! I distracted myself from it as much as possible- dived into books, ignored my steadily worsening marks, played games, surfed the net excessively, and decided that anything that took even a little bit of effort was a bit too much for me just at that moment- that I would feel better in that far-off world called "tomorrow" because I was just having an "off-day" or an "off-week."

Even after I posted on here, I was reluctant to seek help- despite the fact that I was now quite clearly suffering from depression and getting closer to harming myself everyday- because I thought that it would mean I had to tell somebody, and in my mind that was the worst thing ever. The dissapointment in my parents eyes- however lovingly they might act- would be too much to bear. My entire life since I was young was about proving I could go it alone, and having already achieved that dream there was no way I would relinquish that independance and give my family- or anybody- the satisfaction of knowing that I needed them. (and even to this day, despite knowing that I have enough resources to achieve financial independance, my parents still insist, to the point of anger, on paying for most of my basic needs. It's how they feel needed.) But, being too depressed and exhausted to even look for a job, I had no money and due to my past experiences with therapy, I thought that the only options were expensive therapists (i.e. $150 AUD per hour) and expensive medications. I simply couldn't afford it alone.

So, feeling completely trapped, crying for no reason every night and at the brink of serious self-harm, I typed "I want to die" into Google. There I found a number of a 24 hour hotline that you could call for any reason at all- even if you were just lonely. So, still in denial, I decided that I could call them- for loneliness if nothing else. I called, and sobbed into the phone about depression... they told me that there were cheaper options out there, and we had a really great discussion. And that is how- for $20 AUD a month- I finally decided that I could get the help I needed, and what's more, I could keep it a secret from every single person I knew. And that is how I am being treated. It took a year and one phone call to a stranger for me to figure out this simple thing.

However, I think that if I was a teenager, and experiencing this awful relapse again, it would be an entirely different kettle of fish. Living with my parents would certainly make it incredibly difficult to get any kind of treatment without them discovering it- although I have managed it for a few weeks- and most teenagers are still emotionally and financially dependant on their parents. I can completely understand why they would feel not only reluctant, but unable to get the help they need. And their parents may not be as understanding as mine were, when I did have depression as a teenager. They are so trapped, and teenhelp provides an outlet for maybe just a little of that awful feeling.

[Gemma.]

Anonomity - it means i can tell things to people without them pre judging me by looks or intelligence etc. Also, like others have said, i'm not great at face to face stuff so this is just better

As for the, posting on here even though the person knows there is a simple answer - i think that many people's issues on here are so complicated and have taken so long to get to that point that it makes sense that it will take just as long to unwind. So, something like 'counselling' looks and sounds just too easy. It probably won't work

For me as well, i post in a way to find out from other people whether i deserve help. Or in fact, i'm the one who deserves to suffer. Posting is my way of asking if i deserve help.

It's good to have verification from those who have been through things, that actually something like counselling is the correct thing to say. Often teachers who may have no experience will suggest counselling. In my mind, this made no sense as i felt they were taking a stab in the dark and were hoping i could burden someone else.

I think everyone has covered this already, but i kind of wanted to add my thoughts too

[LiveLongAndProsper]

I first found this site when I was home alone one evening with no one to talk to feeling suicidal. It's somewhere I can turn to when I need immediate help. For years, I would feel suicidal at just the times when I had no support, so it helps. I've seen three counselors, almost got kept in at the hospital (my mum fought them to let me go home) and made next to no progress. Professional help hasn't been so great and it's been th that has kept me going. I'm scared to try harder at finding better professionals because of how rubbish they've been already, but at least here I have a support network who have kept me alive over the last year.

[lauri]

What we need from professionals is compassion that would really keep the number of suicides down. If therapist just had simple compassion and if they truley cared that would help too.

Like all therapist if they truley care and have compassion should call and check up on there patients and let them email them.

Thats the help people are looking for and with out it thats why there is bad therapist. Thats why when Im a therapist things will change I will have compassion, love and truley carring for my patients.

[Muse]

Something I commonly hear is that kids don't want to talk to someone who is only listening to get their paycheck. We want to be loved and respected and genuinely cared for. I think being anonymous helps the effectiveness of TH immensely as well... As does not needing insurance, money, parental permission, and the shield of online compared to face to face.

All you can really do is care and respect. I don't like to be referred to as desperate (nor does anyone)... Adults can be very intimidating in light of feeling belittled. Whether you are a certified doctor of psychology or not is none of my concern... I'm just appreciative of the work you do and the concern you have for teens.

[LiveLongAndProsper]

Originally Posted by Evanesco

I first found this site when I was home alone one evening with no one to talk to feeling suicidal. It's somewhere I can turn to when I need immediate help. For years, I would feel suicidal at just the times when I had no support, so it helps. I've seen three counselors, almost got kept in at the hospital (my mum fought them to let me go home) and made next to no progress. Professional help hasn't been so great and it's been th that has kept me going. I'm scared to try harder at finding better professionals because of how rubbish they've been already, but at least here I have a support network who have kept me alive over the last year.

I just realised that I didn't quite get my point across last night. (I typed that when I was half asleep).

Basically, when I came to TH a lot of people kept telling me to get professional help, and that was the one piece of advice that I didn't take for ages, because I had already had bad experiences with the system. Other people offering a listening ear, telling me they cared about me and giving more practical advice (like self harm alternatives, ways to boost self esteem) helped much more.

[Cather]

Getting help is a terrifying thing. I tried getting it a few months after everything started. Back when I was 13 I told a teacher about how my sister had been trying to kill me. He made a joke about it and did nothing.

After that I was done. I completely put myself out there only to have my pain laughed at. You have no idea how many times I've been told "everyone fights, it's just sibling rivalry" or that I'm being over dramatic, etc.

No one believed me, and my parents just sat back and watched, too afraid to help, ignoring the fact that anything was going on.

I may have permanent back damage, but despite all of the abuse, I never bruised visibly enough for there to be proof.

So, getting help never ended up being an option. After awhile, I convinced myself that I was too strong for help--that seeing a professional was a sign of weakness. Or, I said I'd wait until I was 18 so that my parents wouldn't find out.

But now that I'm in a position to talk to someone, I don't want to. I don't want therapy. I don't want to have to relive everything that took so long to be put behind me.

That's my reasoning.