Depressed Or Anxious? What’s Stopping You From Getting Help?

4 min readYou know something’s off. Maybe you’ve been feeling anxious for weeks, or you can’t shake a low mood. You’ve thought about getting help...but somehow, you haven’t.That gap between wanting support and actually getting it is incredibly common. And it’s not just about logistics. For the one in five adult Americans who struggle with symptoms of depression and/or anxiety—like low energy, brain fog, or fear of judgment—even small steps can feel overwhelming.“Recognizing that you could benefit from therapy or mental health care is a really important first step.”And then there’s the stigma. While open conversations on social media have helped reduce negative societal impressions of mental struggles, many still hold the internalized belief that needing help makes us weak.With advice from Victoria Jonas, PhD, a mental health expert at NYU Langone Health, the below questions will help you pinpoint what might be holding you back from seeking care—and how to take action.If the mental health care system feels confusing, that’s because it kind of is. Therapists, psychiatrists, psychologists, primary care physicians—where do you even go to get help?Jonas says a good starting point can be as simple as reaching out to your primary care physician (PCP). Both talk therapy and medication are helpful for treating anxiety and depression, and these approaches can enhance one another when done in combination. Your PCP can refer you to the right mental health professional—especially since rules about who can prescribe medications can vary by state.If you prefer to find a provider yourself but the task seems daunting, Jonas recommends taking small steps and giving yourself grace at every stop in the road. “Maybe one week, all you do is lie in bed and peruse therapists,” she says. “The next week, maybe you jot down a couple phone numbers and give them a call or send an e-mail.”If you don’t feel up to an in-person appointment just yet, Jonas suggests starting with a teletherapy session you can attend from the comfort of home.“Recognizing that you could benefit from therapy or mental health care is a really important first step,” Jonas says. You don’t have to meet a diagnostic threshold to ask for help. If the way you’re feeling is causing distress, that’s reason enough to talk with a provider.If you’re experiencing thoughts of harming yourself or someone else, seek help immediately. “Tell any doctor you’re seeing what you’re going through,” Jonas says. If you’re in the U.S., you can also call or text 988 (Suicide & Crisis Lifeline), call 911, or go to the nearest emergency department.The idea of adding yet another expense to your plate can be a major roadblock, so first check with your insurance, as many plans offer mental health care coverage. Finding a provider in-network will typically be the most cost-effective option available.If you’re uninsured, underinsured, or have found a therapist who doesn’t take insurance, Jonas says that many offer sliding-scale rates. NYU Langone’s Family Health Centers, for example, offer a discount program for eligible patients and ask applicants to provide proof of income and family size. Most therapists are used to discussing cost, so don’t hesitate to ask whether a reduced rate is available.Another tactic Jonas recommends is reaching out to providers who are in training. “Oftentimes you can find folks who offer a reduced rate because they’re under supervision,” she says. Other options include group therapy, employee assistance programs, and certain online telehealth providers.The prospect of discussing yourself with a provider can be overwhelming, and the first visit often causes the most angst. Jonas says it’s usually very basic. “An initial appointment will just be your therapist introducing themselves and maybe sharing a little bit about their approach and practice,” she says. They’ll also likely cover “housekeeping stuff” like billing, no-show fees, and patient-provider confidentiality.Beyond that, a provider will want to know a little more about you, why you’re there, what goals you may have, and how you’ll know whether therapy is helping.“I like to ask people the ‘magic wand’ question: If you could wave a wand over your life, what would change? What would be different?” Jonas says. “And then we can use that as a guide for our conversation around what things can we really change or make different.”“Finding a therapist can be a lot like dating,” Jonas says. “You may be able to narrow down what you’re looking for and know what it is you want, but there’s still an element of trial and error when it comes to finding a good fit.”She advises to keep trying even if the first few attempts haven’t worked out. “There’s lots of different types of therapy and lots of therapist jargon out there,” Jonas says. “I would recommend asking your provider to explain to you in plain terms what their approach is. Don’t be afraid to ask questions of your therapist.”It’s also important to be clear with a new provider what you did or didn’t like about your previous therapist. Any good mental health professional will take that information and work with you so that therapy can ultimately be helpful.Part of finding the right therapist is feeling confident that they’ll provide culturally responsive and identity-affirming care. During an introductory call or email—or at your first session—ask about their experience working with people who share your background. “Everyone deserves to access care from someone who they feel connected to, whether that be someone who shares their background or other qualities,” Jonas says.But Jonas cautions that it may not be possible to find a therapist who shares every aspect of your identity, as even people with common ground can experience similar concerns differently. “My job is to distill [a patient’s] symptoms and help them through that, as opposed to understanding every nuance of their experience,” she explains.Ultimately, the right fit is someone who respects who you are and makes you feel heard.You don’t need to overcome every concern—or feel completely ready—to ask for help. Take one small step by contacting NYU Langone Psychiatry Associates, where staff can connect you with a specialist.