Is It Time to Go Back to Therapy for Mental Illness?

If you've quit therapy for mental illness in the past, have you ever asked yourself if it's time to go back to therapy? I've asked that question of myself recently. I've had so much therapy it would make your shrunken head spin, but I've been out of therapy for about 10 years now. I'm a believer in therapy for everyone, I just thought I was no longer benefitting from it at that time. But are there signs that mean it's time to go back to therapy for mental illness?

Going to Therapy for Mental Illness

It's clear that most who get therapy alongside their medical treatment for many mental illnesses do better than those that get either treatment alone.¹ (In some cases, such as in the case of borderline personality disorder, therapy is actually the preferred treatment.²) The science on this has actually been in for decades. This is why I'm a strong believer in people with any mental illness getting psychotherapy whenever possible. I can certainly attest to the fact that I wouldn't have made it through various parts of my treatment without the aid of psychotherapy.

Among other things, psychotherapy can offer you:

• Education about your illness (known as psychoeducation)
• Coping skills to use
• An understanding of your own psychology
• A way to work through past events that may be weighing you down
• A place to feel supported and heard

But it's like anything else, though, these benefits may cease over time. Eventually, you may learn what you need to know about yourself and your illness and not need the support you once did. After all, the goal of therapy is for you to leave therapy and use the tools you have learned there on your own.

When Is It Time to Go Back to Therapy for Mental Illness?

And while I have felt fine without the support of a therapist for a very long time, it has occurred to me that sometimes I would like the support of a professional to help work through things with. It would be nice to converse with a psychology professional -- rather than just a medical professional (my psychiatrist) -- about certain aspects of my own psychology. Plus, it would be nice to have an hour to discuss things rather than 25 minutes (even less is available for those undergoing a "med check" appointment in the United States). Additionally, while a psychiatrist works for you, it seems so frequently that they care so little about you as a person, having a psychotherapist there for support, would be a boon.

Other reasons you might consider going back to therapy include:

• Undergoing a trauma
• Finding old issues coming up and negatively affecting you
• Relationship issues
• Issues at work or at home
• A change in circumstance -- such as anything from having a baby to losing a job
• A change to your mental illness

Another very valid reason for going back to therapy for mental illness is just because you want to. It's always okay to seek out more help for any reason.

Barriers to Therapy for Mental Illness

That said, there are barriers to getting psychotherapy. As far as I can tell, the biggest barrier is cost. Some people will have a certain number of appointments covered partially or fully per year, many people will have none -- and psychologists are expensive. The option, there, is to see a counselor with a different qualification (not a certified psychologist with the accompanying education) but I never recommend this. My feeling is the serious business of handling a serious mental illness like bipolar disorder needs to be dealt with by a person serious enough to get their full qualification. Additionally, I always recommend seeing someone who is an expert in your illness and has a lot of experience with your illness. The last thing you want is someone giving you therapy from a textbook because that person doesn't have the experience to do better. (Because believe me, while psychologists are all trained in mental illness, that doesn't mean they all know how to deal with them effectively. That really does require practice.)

Some options to one-on-one therapy for mental illness include:

• Group therapy -- sometimes cognitive behavioral therapy or dialectical behavior therapy is given this way and it can be very effective. (Make sure a psychologist is running the group.)
• Books -- if you absolutely can't afford psychotherapy, I understand. There are books (including workbooks) that can help with various issues and teach you about your illness or teach various therapies. 
• Support groups -- you can't expect to get any kind of therapy from support groups but you can expect support and that's a great thing.

Going Back to Mental Illness Therapy

For me, I'm not sure what I'll do. I'm still on the fence. Therapy is a commitment and I'm not sure I'm prepared to make it right now.

If you are, though, good for you. Working on your mental health with a therapist can be very beneficial and those benefits can last forever.

Sources

1. Mintz, D. MD, "Combining Drug Therapy and Psychotherapy for Depression." Psychiatric Times, October 2006.
2. Choi-Kain, L., "What Works in the Treatment of Borderline Personality Disorder." Current Neuroscience Behavioral Reports, February 2017.