As I always say, when the going gets tough, the tough go shopping. Shrink shopping, that is.
I am often suggesting to my friends on Diabetic Connect that it might be helpful to talk with a mental health professional about what’s going on in their lives, especially if they are facing anxiety, depression, fear, or having relationship problems. And then I wonder if the people I give this advice to actually know how to find one.
So here are some ideas that I hope might be helpful:
First, you may want to consider both medication and psychotherapy. Generally, these are delivered by two different professionals.
Some patients take an anti-depressant and also work with a therapist. Others work only with a therapist.
You might want to begin with talk therapy, and see if your therapist recommends that you also consider medication. If you have health insurance, you would probably want to begin by calling your insurance provider and asking for a behavioral health referral. Some companies have a Website that you can go to and look at the names and descriptions of therapists in their plan, or you may need to call and get a few names. These individuals may be trained in counseling, social work, or clinical psychology.
From here, I would recommend calling the therapists they recommend, or the names you find on the insurance company behavioral health website, and asking to make an initial appointment. You might get a feel for the therapist on the phone, but it’s a good idea to make an appointment and meet together.
When you make your initial contact, you might want to ask if the counselor/therapist is experienced in working with individuals facing chronic conditions like diabetes. And you might want to see if they use cognitive behavioral therapy and mindfulness techniques (this is my bias, but they are also approaches that have been proven helpful to individuals with chronic conditions).
If you know anyone who is in therapy, you might also ask for a recommendation. You can then check with that person, or with your insurance provider, to see if that person is in your plan. Of course, if money is no object, so much the better. But for most of us, money is an object.
Also, here is a link to a directory of therapists:
If you don't have insurance, your community mental health department or department of social services will also have low or no cost treatment available, though you will have fewer options as to whom you see and there may be some wait time before you can get in. Don't give up.
I know this sounds a little complicated, but the starting place, for better or worse, is what you can afford, and the coverage that you have (or don't) have.
Chemistry is unpredictable. Get a feel for how the therapist works, if you feel comfortable talking with them, if they seem to be listening to you, if they have a personal style that meshes with yours, what kinds of goals they usually recommend for a patient with issues similar to yours, how they would envision you working together going forward, and how available they are in terms of scheduling flexibility.
If you go the medication route, you would work with a physician, that is, an MD. Your regular doctor may be able to prescribe an anti-depressant if you are not already being prescribed one. Ideally, working with a psychiatrist, or a psychopharmacologist, a professional who specializes in prescribing drugs for psychological issues, is recommended. But patients have success with either route, and insurance companies sometimes encourage patients to at least first talk to their regular doctor, or even insist upon it. Your insurance company/behavioral health provider may also recommend a nurse practitioner who is also qualified to prescribe medications. Make sure that anyone recommending medication is fully aware of any other medications you are currently taking, including diabetes medication.
Again, your therapist might recommend that you consider medication. If you do decide to go this route, or if you need to, I would still recommend working with a therapist to help you with day to day coping strategies going forward, in tandem with your medication.
Support groups can also be helpful. The Website, www.nami.org, lists many support groups all over the US. Local hospitals or community mental health departments, may also sponsor support groups for individuals experiencing depression, anxiety, and other difficult emotions. Supports are a great way to share experiences and receive emotional support.
A few words of caution: If you are feeling really overwhelmed by your emotions, to the point that you are having difficulty functioning in any way, then I would recommend getting medical attention immediately, through your regular doctor or through your behavioral health provider's recommendation. Don't wait.
Also, keep in mind that if you see a therapist, you will be evaluated for depression during your initial session, and medication may be recommended at that point as well.
Don’t go through this alone!
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