Having trouble coping? Time to go shrink-shopping!

Dr Gary
By Dr GaryCA Latest Reply 2011-02-13 18:30:33 -0600
Started 2011-02-11 22:02:18 -0600

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!

6 replies

realsis77 2011-02-13 14:18:47 -0600 Report

Good advice! I know my antidepressant helps me a lot. I used to have panic attacks but I haven't had one in years since I've been on my antidepressant. It does make a big difference. I've also had years of thearpy and that helped me tremendously. I think its good for everyone to do thearpy. I had to learn to erase old negative thought patterns and replace them with positive ones. It took awhile but it really did help and you never forget what you learn! I had some childhood issues to work through in my 20s and it has really helped me! I'm in my 40s now but I still use the tools I've learned back then! I do recomend it for everyone.its always good to learn new healthy ways to cope. Although sometimes its hard it will give you valuable life skills if you stick with it!

Dr Gary
Dr GaryCA 2011-02-13 18:30:33 -0600 Report

Hey! Nice to hear from you! You said it much better than I did. Getting some help from a therapist as you pass through the various challenges and transitions of life. The 20's are a reallly good time to get help in unpacking childhood baggage and learning some new coping skills, along with getting some help at other times. We are works in progress, and sometimes we need a helping hand to keeps us moving forward and not backward. Antidepressants can also be a great help in keep our emotions stabilized. I am glad that you have taken advantage of the help that's out there. Thanks for sharing your perspective!

bobby 58
bobby 58 2011-02-12 20:12:12 -0600 Report

Very interesting but is there a time when it's to late to get help? Some people Iv'e talked to say I'm weak to be thinking of talking to someone but they also tell me diabetes is nothing to worry about.

Dr Gary
Dr GaryCA 2011-02-13 18:22:01 -0600 Report

It's never too late to reach out for some help from an objective voice, someone who can llisten and give some perspective. There are people out there who don't understand the value of getting counseling and who have a bias against it. It's a shame because they may need it themselves someday and may talk themselves out of something that might really help. Thanks for checking in!

RAYT721 2011-02-11 22:14:50 -0600 Report

Great advice!!! When people feel out of sorts there are people and agencies that can help but those resources won't come to those in need.. When you need help, you need to search and shop for the help and answers. Sometimes it is hard to say "I need help" or people will just put it off. Don't.

It's important to reach out and touch someone and you'll be touched in return. (did that sound dirty?)

Dr Gary
Dr GaryCA 2011-02-12 09:05:30 -0600 Report

Thank you! I think that it takes a lot of bravery to admit that you need help, and then to actually reach out for it, and finally to accept it. And no, that kind of reaching out is not dirty (LOL)!

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