After a recent presentation I gave on anxiety and depression, an audience member approached me and said, “My 25-year-old son has many of the symptoms you described, and he has for the past year.” This woman went on to explain her son’s struggles, including his chronic sadness, lack of motivation, isolation, and self-medicating with alcohol.
She concluded by saying, “It’s obvious he needs help, and I know he would benefit from professional counseling, but he won’t go. I’ve tried to talk him into going to therapy, but he insists he can get better on his own. I’m worried. What can I do?”
In my role as a mental health professional and founder of a large treatment clinic addressing numerous issues, I hear pleas like this every week. And each story ends with similar words: “I’m worried. What can I do?”
Chances are that you, too, have someone in your life you’re concerned about—a family member, friend, coworker, or neighbor—who is struggling with a mental health issue. This may involve depression, anxiety, eating disorders, trauma recovery, or other challenges. The fact is, there are millions of people struggling with serious troubles who don’t seek help.
- The National Institute of Mental Health (NIMH) reports that one in five U.S. adults is currently living with a mental illness. Yet more than half of these individuals are not getting help.
- 30 percent of Americans struggle with Social Anxiety Disorder and/or Generalized Anxiety Disorder, yet only one out of four of those individuals utilize mental health services to address their problems.
- According to NIMH, 21 million adults (age 18 and above) and 3.7 million adolescents (age 12 and 17) had endured a “major depressive episode” in 2021. However, 39 percent of the adults and 60 percent of young people received no treatment of any kind.
It isn’t only people with clinically diagnosed problems who could benefit from therapy. Many dealing with the more typical challenges of life—a marriage that’s hit a rough patch, raising a troubled teen, job burnout—would likely find counseling a source of support and solutions.
Perhaps you have already broached the idea of seeking therapy with the struggling person you care about, and the suggestion sparked resistance. Maybe you’re working up the courage to recommend therapy. As you consider ways to encourage your friend to pursue therapy, start by being aware of the most common reasons people resist therapy:
“If people find out I’m in therapy, they’ll think I’m really screwed up.” At the heart of this belief is the stigma attached to needing professional help. Thankfully, our society has come a long way in recent decades toward overcoming negative connotations about seeing a mental health provider. But there still exists a negative perception among some people and groups.
“I can take care of my issues by myself.” Many struggling people try to “muscle through” their problems on their own. Some people mistakenly believe that distress will “go away” if they keep pressing on. Trying to be strong and steadfast is a worthy pursuit—but usually not enough to achieve lasting health.
“Therapy costs too much.” It’s true that therapy is an expense many people have not planned for or budgeted for. Thankfully, options exist to help. Many therapists offer a “sliding-scale” fee based on a client’s income and other factors. Health insurance plans often cover the cost of a certain number of counseling sessions. Many employers offer a health savings account or flexible spending account, which can be used for mental health services. Remote online counseling is often a lower-cost option compared to in-person counseling.
“I don’t have the time.” In our modern era, the phrase “I’m too busy” has become the go-to excuse to avoid anything we would prefer not to do. Since therapy typically consists of one or two hours per week, most people could find time to talk with a counselor if they really want to. Consider that the average person in America spends 2.5 hours watching TV and more than two hours on social media each day.
“I’d feel weird talking about my problems with a stranger.” A skilled therapist won’t feel like a stranger for long. Most therapists are adept at helping clients feel comfortable and developing a strong connection. Plus, a seasoned therapist has heard a wide variety of personal problems and failures—whatever you have to share won’t shock your therapist.
“I’ll just take medication.” There are times when medication is appropriate and helpful, but I believe its best used for the short term. Use of medications can sometimes stabilize an individual enduring an acute crisis. But when used as the only treatment over the long term, the individual often will not explore the root causes that created the crisis in first place (such as diet, unaddressed trauma, toxins in the body, life circumstances, emotional upheaval, sleep habits, addictions, and more). For many people, drugs generate undesirable side effects, such as drowsiness, nervousness, and insomnia.
“My friends are my therapists.” I am a strong believer in the power of connection with others to promote our wellness. Still, when dealing with serious problems, we need someone who brings training, experience, and objectivity. A therapeutic relationship is more than a friendship: Not only does it provide support, but it challenges you to grow and gain new insights.
“How can I be sure it will remain confidential?” Psychotherapy is confidential, and the content discussed in therapy sessions is protected by law. As long as you do not present a danger to anyone, what you choose to talk about with your therapist will not leave the therapy room.
What You Can Do to Help
To help the person you care about move toward professional help, consider these steps:Gently encourage without being pushy. Know that nagging will get you nowhere. When we see someone we love struggling with problems, we want to help—and that desire to help can sometimes cause us to push and prod. Doing so will only leave you and your friend frustrated.
Seek to understand the reason for resistance. You might have heard one or more of the reasons discussed above. It might be that your friend has never been to therapy and is apprehensive about “spilling my guts to a total stranger.” It could be that the person wants to avoid the pain involved in confronting a problem. Understanding why the person is resistant may help you know how best to approach it.
Explain your concerns calmly and compassionately. Since nagging isn’t the answer, you’ll have a better chance of success if you caringly share what you observe about your friend’s struggles and your belief that therapy will help. Pick the right time and place, then explain your point of view with abundant empathy.
Focus on what your friend could gain from therapy. Spell out exactly why talking to a therapist could improve the person’s life. For example, if your friend has severe depression that has adversely affected many aspects of life, you could say, “A therapist can create a treatment plan that will get you out of the dark place you’ve been in. That will help you regain your energy and optimism at home, at work, and everywhere else. You can feel like your true self again.”
Lead by example. If you have benefitted from therapy yourself, share your experiences, saying something like, “I went to therapy awhile back and found it helpful. When I felt depressed and disoriented going through my divorce, my therapist helped me understand my feelings and come to terms with what was happening. It wasn’t a magic fix, but it helped me cope.” If you don’t have any personal experience, you could talk about how a family member or another friend benefitted from therapy, keeping names and identifying details confidential.
Offer practical support. Your friend may be open to therapy, but there might be barriers getting in the way. Here are some ways you could offer practical support to a friend who is thinking of starting therapy:- “If you’d like, I would be happy to help you get referrals for local therapists.”
- “If you’re hesitant to go to the therapist’s office, I could drive you there and wait until you’re done. Would that make it feel more comfortable?”
- “Would you like me to help you find out if your insurance covers the cost of therapy?”
Please note that if you are concerned about someone dealing with an active addiction, you can expect lots of defensiveness and deception. Because of the complexity of that issue, I encourage you to see my book “When a Loved One Is Addicted.” 
