In early July I experienced my first panic attack, when I was jolted awake in the middle of the night. Weirdly, my mind wasn't racing, but my heart was. Then they started appearing in the middle of the day, seemingly out of nowhere. The first time, I was pulling a handful of wet towels from the washing machine when I felt the world tunnel away from me. I dropped the towels, sat on the floor, and pressed my back hard against the wall. Suddenly, I was less afraid of catching Covid-19 and more afraid of what this pandemic was doing to my mental health.
In fact, a national survey from October by the American Psychological Association found that "stress from Covid-19—along with stress related to health care, the economy, racism, and the presidential election—is seriously threatening the mental health of our country." Not to mention the grief surrounding the over 400,000 deaths from Covid (at the time of this writing) in the United States, and it's no wonder that mental health experts around the world are predicting a second epidemic, one centered on mental health.
So if you do want help, I wondered, where do you begin looking if you don't already have a therapist? My own panic attacks have subsided, but I still dream of maskless people coming too close to me. Happily divorced, I live alone with my sister, and I struggle with not being able to see and hug my four grown children and two grandchildren. I worry about my 82-year-old mother who lives alone. Plus, there's still that deadly virus.
Debbie Augenthaler, a psychotherapist in private practice in New York, suggests that a good place to start is with your medical doctor, or to ask friends or family for a recommendation. "The website Psychology Today is a great resource that allows you to search for a therapist by location and area of expertise."
纽约私人诊所的心理治疗师黛比·奥古塔勒（Debbie Augenthaler）建议，可以从自己的医生那里，或者向朋友或家人寻求推荐。 “今日心理网站是一个不错的资源，可以允许通过地理位置和专业领域来寻找治疗师。”
With therapy sessions taking place virtually these days, location might be less important. Stacy Shelby, a depth psychologist in Squamish, British Columbia, says, "I have been on video for six years because I have clients throughout North America, and I have found video to be equally effective as in-person."
The first time I sought help with my mental health was before Google, when seemingly overnight I fell into a deep well of depression and anxiety. Every cell and fiber of my being was filled with a sense of impending doom. On the outside, I appeared every bit the role of wife and mother, but inside me felt like an apocalyptic wasteland.
I thought my body might be trying to tell me something, but after a thorough check-up showed that I was physically healthy, my doctor finally asked me, "Do you want me to recommend someone for you to talk to?"
What I really wanted was a pill that would magically pull me out of the swirling void of blackness, but I was afraid to ask for one. I didn't want to appear weaker than I already felt in front of my doctor. It may sound ridiculous, but depression can warp your thoughts in unhealthy ways. Instead, I took the piece of paper my doctor handed me, on which she'd written the name and number of someone who practiced in a strip of low-lying offices nearby.
After four sessions, I sat across from the counselor and listened as she pronounced the reason for the darkness that surrounded me—I was projecting ahead to my empty nest. At the time, my four children were just 11, 9, and two 6-year-old twin boys. My fledglings were far from flying the coop.
If I had shared more fully my perseverating thoughts of annihilation, or perhaps if she had asked different questions, I might have felt heard. As it was, I walked out of her office and never went back.
Augenthaler says, "You should feel comfortable and you should feel heard, and if you ever get the feeling 'You don't get me,' that's not the right therapist for you."
Anne Nayor, a licensed clinical social worker in St. Thomas, said it best, "Therapists are not gods, they're just people, and they make mistakes."
圣托马斯（St. Thomas）的持证临床社会工作者安妮·纳约尔（Anne Nayor）说的最好：“治疗师不是神，他们只是人，而且会犯错误。”
I stayed away from therapy for 10 years, until my 24-year marriage was threatened by my husband's betrayal. He promised the affair had ended, but then refused to discuss or acknowledge it, and I couldn't move on without talking about it. The licensed counselor I found through my brother advised me to make my home a more relaxing place for my husband, and when he was more comfortable he'd be more open to talking about the affair.
This advice felt wrong, but I didn't know how to contradict the person with the education and training. Instead, I lit the suggested gaslights and stayed in my marriage while my husband happily carried on his affair.
Janice Seward, a doctor of clinical psychology said, "Therapy has an inherent power differential, and we're much more likely to give over things like our gut feeling when we are in a relationship where someone has the perception of power. It's important to continue to trust your gut even if someone has a PhD after their name. If you have a feeling that something's not right, probably something isn't."
After a year of making my husband comfortable, my marriage finally imploded. This time I found the right analyst, through a referral from a friend.
John Gyra, a clinical psychologist, helped me unravel the truth of my marriage and heal. I also discovered why my previous therapists had been so unhelpful—I needed someone with the training and education to recognize the emotional abuse in my marriage. With his help and guidance, I grew the strength I needed to stand firm during my three-year settlement negotiations. He pushed me to feel the anger that I suppressed under my feelings of being victimized and to learn to work with those powerful feelings. He helped me find the words to have conversations with my kids about their father.
Finally, I felt seen and heard. Seward agrees with the other professionals I interviewed. "There's been research about what's actually therapeutic and curative, and it's the relationship between the therapist and client."
She advises you to reach out for help sooner rather than waiting for a crisis to hit. Know that what you're feeling might be normal, given the stressors of these times, but it might also be outside the bounds of what you can cope with on your own.
Seward also says, "Thirty years ago there were three flavors of therapy; now there are five hundred." If you work with someone who is licensed or registered, there will be a licensing board, whose primary purpose is to ensure safety for clients. It also sets a minimum standard that a therapist must meet.
There are also many “on-demand” online providers such as BetterHelp, TalkSpace, and if you're in Canada, Online-Therapy.com. There's been a paradigm shift since I last saw Dr. Gyra, almost 15-years ago. It's made getting help much more accessible and affordable.
Ask your medical doctor, friends, and family for recommendations. If you're employed, contact your HR or employee assistance department. Don't hesitate to talk to several therapists until you find one that you feel comfortable with. Most will offer an initial 10- or 15-minute phone conversation for free. Peruse therapist websites, read their bios, and look at their pictures to see if one resonates with you, or specializes in the issues you think you're experiencing.
If you're working within the parameters of your insurance, make sure you know what your provider covers and is willing to pay for. Ensure that you and your practitioner are in agreement about the fee structure and payment. Many insurers have relaxed their restrictions and are waiving co-pays because of the pandemic.
Ask what a treatment plan would look like, and how and when the two of you would evaluate its efficacy. Can they work with you on a bi-weekly basis as opposed to weekly, if you need that financial flexibility? Ask what their fees are, and how and when are they paid. You can expect to pay anywhere from $50 to $300, and many therapists use sliding scales.
询问治疗计划是什么样的，以及你们两个人如何以及何时评估其疗效。如果您需要财务上的灵活性，他们可以每两周一次而不是每周一次与您合作吗？询问他们的费用是多少，以及如何以及何时付款。您可以期望从$ 50到$ 300之间支付费用，并且许多治疗师的收费标准都是可变动的。
Finally, know that it takes courage to ask for help and that you have it within you. We all do. One of the first things Augenthaler tells her clients is, "I want you to know that this takes a lot of courage, and I appreciate the fact that you're here."
Seward ends with, "Look at your favorite stories. There's always a sidekick, there's always a helper, there's always an ally—go find your ally." Whether that is a clinical social worker, a psychotherapist, psychologist, psychiatrist, individual, couples, or group therapy. Find the flavor that works for you.
You don't have to silently suffer alone. Your mental health is intrinsically tied to your physical health. This past year has brought so many, layered losses to so many. Don't be afraid of asking for help; it's out there waiting for you.