Do I Need Therapy for My Depression or Anxiety?

Conversations about mental health are more widespread and socially acceptable than ever — and they should be, as factors like the pandemic take a major toll on the mental health of us all. You may be noticing signs of depression or anxiety in yourself for the first time — or realizing that depression and anxiety have been part of your life for a while. But what should you do about it? Is this something you should just try to manage on your own with lifestyle changes, you may wonder, or is this something you should be seeking professional support for? Here’s my advice on whether your depression or anxiety is something that you should be treated with therapy.

You don’t need to “need” therapy for it to be worthwhile


One important first step is to really examine your current impressions of therapy: what it is, who it’s for, and what it means to go to therapy. Many of us may have the idea that therapy is for neurotic or “crazy” people, or for egotistical people who like to hear themselves talk. Maybe you feel like therapy is for people who have something wrong with them that needs to be fixed, or that it’s an esoteric practice like phrenology where an old man asks you to explain your dreams.

In reality, therapy is and can be a lot of things, but it’s none of the ones listed above. In the simplest terms, therapy is about having a professional on your side to help navigate complex internal experiences and support you in growing and becoming a healthier person. This can look like a lot of things, from a therapist who specializes in Dialectical Behavior Therapy who helps you work on regulating emotions and having more stable personal relationships, to an Internal Family Systems practitioner who helps you make sense of how your early experiences and family of origin are showing up in your current life. 

While therapy can mean a lot of things, the main takeaway is that you don’t have to have a problem “bad enough” — or even have a specific diagnosis at all — to benefit from it. It might be useful to shift from thinking “is my depression or anxiety bad enough for therapy?” to “could therapy be helpful or useful to me in any way?”

Take stock of how your depression and anxiety are impacting you


To decide whether you want to make managing your depression and anxiety symptoms a goal in therapy, think about how they’re currently showing up in your life. How much of your daily life is materially impacted by depression or anxiety? How many decisions on a daily or weekly basis are informed by them? 

It can be hard to answer these questions off the top of your head; for many of us, we’ve been depressed and/or anxious for a long time, maybe always; we may not be consciously aware of how it’s manifesting in our lives each day. Remember also that depression and anxiety both have complex sets of symptoms that may not present the way we first think of them. Depression may not look like just being sad; it may show up for you as being fatigued, irritable, exhausted and fatigued, unable to sleep, or feeling “brain fog.” Anxiety may look like “feeling worried,” but it could also look like a racing heart, insomnia, racing thoughts, hyperventilation, or trouble focusing. 

Do you cancel on friends or turn down invites because you just can’t get up the motivation to leave the house? Are you late for work because you just couldn’t bring yourself to wake up or get out of bed even though you go to sleep on time? Do you have to take a sleeping pill to fall asleep at all because otherwise racing thoughts will keep you up all night? These are all ways that depression and anxiety are materially impacting your life — and the more things like this there are, the more likely therapy can help. You may feel overwhelmed by the prospect of trying to manage all these factors — they have a tendency to snowball — but a therapist can support you by giving you strategies, tools, and treatment to make all these things easier.

Take an assessment to help see your depression and anxiety symptoms more objectively


It may not feel productive to evaluate how your depression or anxiety is impacting your life — after all, it’s hard to see our own experiences objectively from the inside of it. If you’ve been dealing with depression or anxiety for a long time, it’s likely that many of its signs and symptoms just feel normal to you. 

For this reason, many professionals use objective assessment tools or scales to try to “measure” how intensely depression or anxiety is impacting someone’s life. Trying some of these free online tools can help you get a more accurate sense of how your depression or anxiety is manifesting right now, and you can use that information to assess whether you want to seek counseling or therapy. Here’s an online self-assessment for depression, and a worksheet that helps you locate your anxiety on a scale. It’s helpful to take both even if you don’t think of yourself as having both depression and anxiety; the two experiences often overlap and coexist.

When in doubt, it won’t hurt to make an initial appointment


Trying therapy doesn’t need to be a big deal, and it’s certainly not an irrevocable decision. If you’re wondering whether the best approach to managing your anxiety and depression is pursuing therapy, the easiest way to find out might be to ask a therapist. You don’t necessarily need to sign on for a full course of treatment to talk to a professional; many will do an initial conversation over the phone or answer questions to determine whether it’s the right fit for a first appointment — you can describe what you’re experiencing and let the potential therapist honestly explain what they’d do to support you and if they think they can help.

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