Do I Need Help?

For starters, no one enters therapy unless they think they have a problem, so the short answer is, “Yes.” However, very few people come into my office saying, “I think I have schizophrenia/narcissism/borderline/etc.” The vast majority of new clients come in complaining of some combination of four things (in this order):

  • Anxiety
  • Depression
  • Emotion Dysregulation (i.e., the inability to control emotions such as anger)
  • Emotional Trauma

From those four complaints, and the information we gather in speaking with the client, we create a picture of the diagnosis. That diagnosis can be anything from a mild depressive or anxiety disorder to a full-blown personality disorder. Look at it this way–you go into the doctor’s office complaining of a cough. It could be a mild cold or it could be stage 4 lung cancer, or anything in between. You don’t know what the problem is, but you know something isn’t right.

It is very common for clients to seek help at the prompting of friends or family. 

It is usually those people who see the client’s behavior and know it is disruptive, dysfunctional, or in some other way outside the norm. Sometimes it can be helpful to the therapist to talk to those people, as they can give the therapist insight into the client’s behavior that the client may not be away of or view as significant. Of course, the therapist must keep in mind that these friends and family may be upset with the client or even have some ulterior motive, so their reports may be biased. As a therapist, it is our job to 

separate the wheat from the chaff.

As a last note, I would urge people not to rely on self-diagnosis, diagnosis-by-friend-or-family or, worst of all, diagnosis-by-Google search. These “diagnoses” are very rarely correct and can often cause more harm than good. Depression is more than just sadness, bipolar is more than just mood swings, and narcissism is more than just a sense of entitlement. Seek the advice and help of a professional.