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How do I Know if I Need Therapy?

I see this so often online, so I'm sure you do too. I'm doom-scrolling through my cat videos and the latest TikTok dances. And there it is in yet another comment section. People on social media are having a disagreement and one person says to the other person, "Ugh. Go get some help. You need therapy."

As an actual therapist, I cringe when I see this. Foremost, therapy and concerned statements about someone's mental health shouldn't be used as insults or a punishment. Secondly, I don't believe therapy is the solution to everything or that everyone "needs" therapy. Lastly, whether someone "needs" therapy is up to that person and the qualified therapist they may ask to help them figure it out. Concerned friends and family giving supportive feedback is one thing. But truly, no one should assess and comment on someone's mental health without that person's consent.

How do you decide if you should seek out a therapist to determine if therapy might be helpful to you? Let's review some of my tried-and-true advice I've been giving for almost a decade.

The Formula of Three

I was taught this in my master's program years ago and still use it because it's still so good. My most concise answer to the above question is: "It's a good idea to consider therapy whenever anything happening with your thoughts, emotions, or behavior is affecting your ability to work, play, or love." "Thoughts, emotions, and behavior" are the three components of human psychology that therapists address. And "work, play, and love" are broad categories of daily life that encompass our social and mental wellbeing.

Is there something about my thoughts, feelings, or behavior that affects my ability to work? Please note that work includes any meaningful activity - not just work work. This includes volunteering, childrearing, or caring for loved ones (and more). For example, sometimes people "call off" a lot because they feel unmotivated or anxious. For someone else, thoughts about their own self-worth might keep them from asking for the raise they need and deserve. For another person, they may take on work tasks that aren't theirs due to a chronic sense of overwhelming responsibility for other people. Another person might consistently turn projects in late because they dissociate or lose focus. So on and so forth.

Although I would never say, "Everyone needs a therapist," I do think that anyone at any time is totally valid in going to therapy for support with a self check-in.

Is there something about my thoughts, feelings, or behavior that affects my ability to play? And by play, I mean - can you easily have fun? For example, someone might feel so low and just weighed down emotionally that they cancel important plans. Someone else might feel so emotionally exhausted that they stop working on a hobby that they usually love. Another person might feel numb or bored while reading or watching media that they usually find entertaining. Someone else might feel so anxious and overwhelmed about trying a new activity that they can't take the next step. Etc.

Is there something about my thoughts, feelings, or behavior that affects my ability to love? By love, I mean having the ability to maintain a variety of different relationships and connections. I also mean the ability to feel satisifedf and healthy with the connections they do have. Someone might have trouble finding the lasting romantic relationship they desire because they struggle to be vulnerable enough. Someone else might have frequent conflict with their child and need help co-regulating emotions with their child when this happens. Another person might struggle with being so invested in others that they forget about their own needs. The list goes on.

Bottom line: you do not need to have any clear idea as to why work/play/love are not going well in order to ask for a therapist's help. It's the therapist's job to help you sort that out.

Chronic Mental Health Challenges

Someone who has a chronic mental health challenge may wish to always stay connected to a therapist (or another supportive program) throughout their life. We wouldn't expect someone with a chronic medical condition to just "tough it out" and suffer just for the heck of it. We need to acknowledge that, for some folks, ongoing therapy in some capacity is what they need to suffer less and to enjoy life more.

As a Preventative Measure

No one actually needs to wait until work/play/love are affected when they have experienced something difficult in their life and want to take preventative action. I have had so many clients over the years start therapy immediately after a significant death, a bad accident or some other trauma "just in case." A lot of these clients don't end up needing me for very long and that's amazing for them.

To Empower Yourself

Sometimes (a lot of times) the problem isn't you. Its your environment or the people around you. Lots of folks come to therapy who mainly experience problems with work/play/love because of barriers around them that prevent them from enjoying life. A therapist can help with problem-solving, coping through adversity, and/or finding the strength to leave behind toxic people and situations not meant for you.

To Touch-Base With Yourself

Although I would never say, "Everyone needs a therapist," I do think that anyone at any time is totally valid in going to therapy for support with a self check-in. I have had lots of clients who were successful in therapy and return monthly for a check-in. This is kind of like getting a routine cleaning at a dentist or a wellness check-up with a doctor.

You are not a burden. You are not bothering a therapist by reaching out.

To Amp up your Personal Growth

Some therapists really focus on pathology (illnesses and problems that underly challenges with thoughts, feelings, and behavior) and healing. Some of us also love to use our knowledge and access to research about psychology to help you advance your thoughts, feelings, and behavior to the next level. A therapist could help you discover why you do what you do or think how you think. You could work on strategies for better controlling your emotions so that you can "rise" to a big occasion. I LOVE working on growth with clients.

It's true that people make those, "You need therapy" comments for no other reason than to be hurtful. However, it's also absolutely OK to ask yourself if you think you could benefit from therapy. Also "I want to try therapy" is a full sentence. It's a good enough reason all by itself. It does not make you weak. You are not taking up resources other people need (you are also a people with needs). You are not a burden. You are not bothering a therapist by reaching out. You are not too sick or not sick enough. You are your own greatest expert. If you want to give therapy a try, that is the only justification you need.


Amanda Woolston, MSS, LCSW, CT is a co-owner, lead therapist, and practice director of Therapy Center for Transformative Growth in Parkesburg, Chester County, Pennsylvania. There, she works with folks with a variety of needs which include adoption, foster care, stress, co-dependency, trauma, grief and loss, and personal growth. Amanda has taught psychology, social work, and sociology for several years and loves spreading education on these topics.


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