I’ve spent a lot of my time over the years writing about the importance of understanding your illness, learning all you can about possible treatments (including hearing about other people’s experiences), and becoming your own best advocate in your recovery. After all, who really knows you and your needs better than yourself?
But before you can begin advocating for yourself, you really have to understand the problem as you see it, what kinds of things happened in your life to bring you to where you are today (whether or not they are directly related to the problem), and figuring out where to go from here. Then you need to understand your treatment options, and how to get the type of treatment you want.
It’s not always easy, and sometimes it can be especially challenging to advocate for yourself when you’re in the throes of mental illness.
Learn About Your Treatment Options
Don’t go into a doctor’s office — whether it’s your primary care physician or family doctor or psychiatrist — without having some facts in hand. Doctors are human, and that means they have their own biases — which they may or may not share with you (or even be fully aware of them). Some doctors will advocate for a prescription medication, and leave it at that. They may mention other treatment options, like psychotherapy, but their interest in them may be fleeting since they don’t actually provide such treatment.
A good doctor will not simply write a prescription when their patient comes into their office complaining of mental health symptoms. A good doctor will refer that patient to a mental health professional right away — because it is a mental health professional who is the expert when it comes to proper diagnosis and treatment of mental illness. If you doctor doesn’t do this, you should raise an eyebrow — and question their judgment.
Even if you do go into see a mental health professional, such as a psychiatrist or psychologist, you should come with some knowledge about what kinds of treatments are available for your concern. I could boil down most options to, “medication and psychotherapy,” but that’s oversimplifying things. For instance, there are dozens of different kinds of psychotherapies, and just as many medications for any given disorder. While no one expects you to become an overnight expert on these things, the more you know about your options, the better informed choice you can make when the options are put to you to make a decision.
Be Patient, But Settle for Nothing but Improvement
Treatment takes time, and for some people, patience is not their greatest virtue. While many people will find some immediate relief after their first or second session of psychotherapy (it feels great to release all that built-up anxiety and stress related to our concern!), longer-term progress is a slow and usually painful road. After all, these problems generally didn’t start over the course of a few weeks — they often build up over months or even years. They will take months (and yes, sometimes years) to treat.
Most medications prescribed for mental disorders (with the exception of some of the fast-acting, anti-anxiety medications) take anywhere from 4 to 8 weeks to achieve their full effect. Four weeks seems like forever when you want relief; 8 weeks might as well be an eternity.
But if you’re in psychotherapy at the same time, you can also begin working on improving your coping skills and attack some of the core irrational beliefs that are going on that may help with your symptoms. For instance, since many forms of depression can be successfully treated in 12 to 16 weeks of psychotherapy, you can begin to feel the long-term beneficial effects of treatment sooner rather than later.
You should, by and large, always be on a gradual, upward path of improvement in treatment. Most treatment comes with temporary set-backs that can take you back a step or two during treatment. But if we were to track your weekly moods over time (you know, with something like our own great mood tracker!), we would expect to see your mood getting better from month to month.
Know When It’s Time to Change or Call it Quits
Psychotherapy and even most psychiatric medications for most mental illness isn’t meant to last forever. Most effective treatment for most disorders is time-limited — meaning you should be done with it in a set time period. That time period may vary widely among different people and different disorders — anywhere from 16 weeks to 16 months. A relationship concern could be resolved in just a handful of sessions, but someone grappling with schizophrenia or bipolar disorder may be looking at a lifetime of taking certain medications.
If you find yourself treading water in treatment and making little or no progress, it’s time to re-examine your treatment and your treatment provider. Either you’ve given up working on change in your treatment, or your therapist or doctor has stopped providing the kind of emotional and educational support that most benefits you. Those are signs it’s time for a change — a new treatment provider, or perhaps a new kind of treatment, or even both.
Since most people’s treatment isn’t meant to last forever, you should know when to call it quits too. If you notice little change week to week, and you end up talking about what went on in your life in the past week with no particular purpose, then that may be a good sign it’s time to end treatment.
Ending treatment can be just as simple as it started, with your indication to your therapist or doctor that you think it’s time to call it quits, and that you’d like to schedule your last session with them. While sometimes a therapist or doctor will be the first to make the suggestion, you don’t have to wait for them to do so. Advocating for yourself means understanding when you’ve had your fill of treatment for the current concern.
Advocating for Yourself can be Challenging – But Don’t Give Up!
When we’re not at our best dealing with a mental health concern, advocating for ourselves can often be far down the list of things we need to accomplish. For instance, a person who is dealing with clinical depression often has neither the energy nor motivation to do much self-advocacy.
That’s fine, especially in the early days of treatment. But if you can enlist the help of a trusted friend or family member to fill this role when you need it, that’s something to consider.
As treatment progresses and you start to feel better, you can do more advocating for yourself and your needs. You can also learn from your past treatment experiences to better know and request your future treatment episodes be tailored to that self-knowledge.
9 comments
All great stuff but don’t limit their options to just psychiatrists and/or psychologists! LCSWs, LMFTS, and LCPCs are all fully qualified to provide these services (Minus the meds of course). Often times these professionals have more availability and affordability. 🙂
Not all self-advocacy is limited to working with your mental health professionals. Sometimes advocacy is lobbying to change policies or filing a human rights compliant.
Absolutely! This is also part of what Community Counselors are trained to do.
Ending treatment can be just as simple as it started, with your indication to your therapist or doctor that you think it’s time to call it quits, and that you’d like to schedule your last session with them. While sometimes a therapist or doctor will be the first to make the suggestion, you don’t have to wait for them to do so. Advocating for yourself means understanding when you’ve had your fill of treatment for the current concern.Thanks for your simple solution to ending treatment,how good would it be if it were as simple and as right as that.We have been telling them exactly that, for nearly ten years, all from a speed psychosis, drug experiment, that cleared up in a week, that followed with eight or more years of forced insanity, depression, lethargy, and insecurity in a pill and an injection every fourteen days, until we made a stand against ten mil of flupenthixol in a needle every fourteen days that was making the victim sleep their life away, and depressed and tired and alienated all the time,we were told we could have pills by one doctor and told no by another, so they turned up with the gorillas and a needle and that then led to incarceration and that then led to them electrocuting the victim to death, not in reality but literally,anyway that was our attempt at getting away, and how they treat the people that try to get away, and guess what it doesn’t matter who you write to, to try and stop it, the response anyone will get, is, the only person who can change or stop it is the abusing doctor who reckons he or she is helping, and who just simply wont say they’re not, and if you think about it imagine if they went around disagreeing with their mates or let their victims get well off their poison, get the picture, either way that might happen for private people not already prisoners of mental health but once your a prisoner, its a lot harder than just saying you’ve had enough and your life is coming together or whatever, no, sorry, your a prisoner for life, so if you can tell me how to get away from them when the story is exactly how i have told you you might have an escape route, but i doubt it, either way thanks for some hope for some,and like you say its meant to be temporary like the troubled mind of the young, if they followed that wed be right too, but you know and i know its forever, that’s how they work it, we cant cure you, but we can manage your illness that only we can see for the rest of your life,and we will, full stop. Thats how it is in the real world of psychiatry and the real world of the victim.
Pretty good post, Doc, as I see it. One quibble:
“someone grappling with schizophrenia or bipolar disorder may be looking at a lifetime of taking certain medications.”
But maybe not. Depending on how much insight the treatment specialist has into the causes of these disorders in the lives of the sufferers.
Hello Dr. John Grohol, I really like this website. I ain’t gunna lie, I had to look up the words Participatory Medicine, after reading what it means, I’m totally aboard. I just got back from seeing my Psychiatrist and after 25 year of therapy, I’m close to a major breakthrough. Just a little Bi Polar humor. I’m 48 years old and I had Thyroid Cancer in 2005. I started with general anxiety at 23 years old but after Thyroid Cancer at 43, I’m now considered Bi Polar. A little history, my mother was Bi Polar, ECT in the 70’s and never recovered. My grandmother was “weak in the mind” as the Cajun people would say. I would like to see articles about the correlation between hypothyroidism, mental illness, and genetics. Did we all have hormonal imbalances, did we all have mental illness, or is it all the same? Desiree Cart Dugas
As an advocate for OCD awareness, I find this post interesting. If someone is in the throes of severe OCD, a trusted friend or relative to help them advocate is a huge plus.
And what you say about “doing your homework” and not staying with a treatment provider if no progress is being made is absolutely true. In the case of OCD, which many health care providers still do not know how to properly treat, it is imperative that the sufferer deal with a therapist who specializes in treating OCD and uses Exposure Reponse Prevention Therapy.
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