Anxiety- Finding a therapist

[LittleBrownDog]

I have had mild anxiety off and on for years- I was always reluctant to admit it, because my mom had it and I always thought she was "weak" and should just deal with it : I did not want to admit that I was having the same problems and was also, in my mind, weak.

Now that I have a baby, the anxiety seems to be getting worse and I want to deal with it before she is old enough to see it. I have also started to recognize that some things that I have going on that I thought were physical illness are probably also signs of anxiety.

So I've decided to see a therapist, but I have no idea where to begin. I've had friends who have gone to therapy and they just never seem to help at all. I know it's a matter of finding the right therapist, and that you have to also be willing to help yourself.

How do you find the right person? For anxiety, should I be looking for a mental health therapist, a family therapist, a pyschiatrist, a psychologist, something else altogether? I don't even know where to start.

I read Emilie's thread on anxiety and it was very helpful- I am going to start to try to pay better attention to my diet and exercise... I also read that around 4 months post partum your hormones undergo a major shift and that that can also contribute to anxiety- does anyone have any info on that?

Thanks in advance!

[rowantree]

if you havea good family physician you could start by asking her (or him).
good luck!

[LilithParker]

Definitely ask your family doctor for a referral. Personally, I've had bad luck with counselors and family therapists... they're okay with helping work out interpersonal relationship issues, but when it comes to fixing the stuff in your head, not so much. A psychiatrist will probably try to put you on meds (the right medication can make a world of difference, but if you're concerned about, say, contaminating breastmilk, you might want to stay away from that), but will offer better therapy than a counselor. IMHO, your best bet is to find a good psychotherapist. They can't prescribe medication, so the only thing they do is talk with you and help you change your thought processes.

If you do want to go on meds, find a psychiatrist. Make sure s/he tells you about any side effects and withdrawal effects first, and ask about other medications so you know what your options are. I'm not up on anxiety meds, but there should be a few different types that essentially do the same thing, but have different tableting agents (the stuff they mix the medication into so it can form a pill) that produce different reactions in certain people. The psychiatrist should also provide "regular" therapy (talking about problems, recognizing triggers, developing coping skills).

Good luck!

[jmreinke]

When I was feeling similar things as you, I spoke to my midwife and she put me on Zoloft for PPD. I'm not saying that meds is what is right for you. What I am saying is that starting with your Dr. or OB/GYN/MW might be a good place to start. That person may also be able to recommend some names for you.

You may also be limited by your ins. and who is covered in your area. You can get great therapy for a MSW, or PhD psychologist, or any other type of psychotherapist. You can call your ins. co. and they can give you a few names, and then you can call an interview them. As a "consumer" of therapy, you can shop around until you find someone you are comfortable with.

But, as pp have said, I would start with your dr. and go from there.

[bunny's mama]

i'll first of all out myself here as a psychotherapist.

i think it's great that you are in the mindset to 'shop around' for the right match in a therapist. many potential clients don't feel that empowered, just go with a therapist from the phone book or on their list of approved therapists from insurance, etc. and then stay when they don't feel comfortable.

IMO, in 10+ years of doing therapy, i've found that the "magic" of therapy rests largely in the relationship between therapist and client. by magic, i mean that i'm continually amazed at how the journey unfolds for my clients. there are formal "techniques" that i use (not many, really), but in the end, the healing happens (IMO) mostly thru our establishing a genuine relationship, then my listening, validating and giving what the great humanistic psychologist carl rogers called 'unconditional positive regard." so if the connection is not there, i think it definitely can effect the effectiveness of the therapy.

as far as different types of therapists, there are generally 3 different types. the main differences being type and length of education:
1) psychiatrists: these are folks with medical degrees (MD) from medical schools. they usually do a psych rotation during their schooling which is what all MDs do, but then they choose psych as their specialization and do a specialized residency in psych. in most cases, these residencies are working on psych wards with more seriously mentally ill folks. they are the only therapists that are authorized to prescribe meds. and most are not very skilled at doing therapy. most insurance companies also will not cover psychiatrists to do weekly therapy with you. the most you'll usually get is a check-in appointment about once a month. if you feel you need meds, i'd reccommend you go to a psychiatrist for meds and then to one of the following 2 for therapy.

2) psychologists: these folks have doctoral degrees (PhD or PsyD) and also go thru a internship process after their grad program and then take exams and become licensed. they are qualified to do therapy and a generally a good choice if you have some more serious mental health issues such as depression, anxiety, etc.

3) master's level psychotherapists: these are folks who get a master's degree in a range of areas (social work, counseling, marriage & family therapy) and then do internship hours & take exams to get licensed (the number of hours and testing required vary from license to license and state to state). these folks are qualified to do therapy, and are generally a good choice if you are having relational issues (parenting, couples issues, recovering from abuse, identity issues, sexuality, etc.) but many are also skilled at treating less serious depression and anxiety (especially as a result of abuse or other relational issues whereby there is an identifiable problem that brought on the anxiety or depression)

i'd suggest you get a list of therapists and draw up a short list of questiosn to ask, including what their specialty areas are, their experience in treating anxiety, etc. whatever else you want to ask. and pay attention to the responses you get to asking hte questions and how you feel about the therapist AS A PERSON. do you feel listened to? cared for? i've had clients tell me they asked a potential therapist if they could ask a few questions and they were denied! shipes! that tells you something right there, doesn't it?

also, please DO NOT SEE AN UNLICENSED THERAPIST!!! in california (where i practice) its perfectly legal for anyone to call him or herself a therapist or a counselor and hang out a shingle. this is what many folks are doing htese days and calling themselves "life coaches." most of these folks have tried and failed int he licensign process and have now gone another route, but IMO there's a reason they are not licensed and they should not be practicing anything remotely like therapy, but its a "buyer beware" world out there, so just be aware. ask about when someone was licensed and you can also check license status online in most states (i can give you the link for Cal. if you're here, otherwise try a google search)

good luck, i wish you the best.

[boomingranny]

I found the best help I got for my anxiety was doing CBT and biofeedback training. CBT = cognitive behavioral therapy and biofeedback teaches you to work with your biological responses to stress. I learned a lot of ways to calm myself down both mentally and physically. It was very useful and pragmatic. It worked better than other traditional therapy I had encountered.

[bunny's mama]

i think that CBT, biofeedback, and meds can be really useful for helping with anxiety, however if you know the root cause of your anxiety (like for instance if you have been sexually abused or raped, or if you were physically abused as a child or in a domestic violence situation as an adult) talk therapy in conjunction with biofeedback and/or meds is really the most effective.

in my experience, CBT is not as effective if your anxiety is a result of trauma.

[Greensleeves]

Bunny's mama,
Thanks for your input, I'm not the OP but I was just wondering how to go about finding a counselor/therapist, and your post has some good info.