Hello! We're Laura Squiers and Adam Paine, specialists in mental health.

What are the options for someone who needs therapy but can't afford it? Not even any of those low-income, heavily discounted services?

Hello Kotori,

This is always a tough one, and sadly a problem for way too many people out there.

Therapy can definitely get expensive and is sadly out of reach financially for a lot of folks, even if they are using insurance. If someone doesn't have any funds for therapy, there are still some things they can do; (just bear in mind this is all very general and not as a replacement for therapy or healthcare treatment)

1. Books, there are some great books out there related to mental health. (and sadly a lot of not so great ones.) Some that I often recommend to clients:
   1. The Feeling Good Handbook by David Burns. This is considered the book for mental health self-help. It's kinda old school, but there's a lot of great stuff in this book, it's been around for decades and is highly regarded in the mental health community.
      
   2. Miracle Morning: While not written by a mental health profession (just bear that in mind), I have recommended this book to many clients and gifted it to clients and family members as I find it's very practical and has had a very positive effect on both myself and those I've recommended it to.
   3. Here's a list of top self help books from Psychology Today (the feeling good handbook is number 2). https://www.psychologytoday.com/us/blog/the-art-self-improvement/202112/the-12-best-self-improvement-books
2. Support groups: Here's a resource for finding a support group in various topics, including free and donation based groups: https://www.verywellmind.com/find-a-support-group-meeting-near-you-69433
   1. Depression Anon:https://depressedanon.com/meetings/online-depressed-anonymous-meetings/ This is also listed on the verwellmind list I mentioned above. Offers both in-person and virtual free support groups for depression.
      
   2. Nami Support Groups: https://www.nami.org/Support-Education/Support-Groups . Nami offers free support groups related to mental health, and has a hotline for general support or how to deal with a mental health crisis.
3. Annual physical: If the person has access to other medical services, like a primary care physical, I would recommend they get their annual physical, and these are generally free under almost all insurance plans. Things like undiagnosed medical conditions, vitamin deficiencies, hormone imbalances, etc, can have a big impact on our mental health and when treated can often improve mental health symptoms.

I really hope this helps! Take care

I also just found this: https://www.psycom.net/how-to-find-affordable-therapy/

It has some other suggestions related to your question.

What are some known effects on mental health of spending hours a day on reddit? (Yes, this is a serious question)

Hello CrosseyedDixieChick,

Love this!!!😃

Most of the research our there is more specifically aimed towards social media in general and usually refers to Facebook, Twitter, Instagram, etc., and not Reddit as much. So I guess it depends on whether you consider Reddit social media or not. That being said, the research for excessive use of social media in general seems to be negative.

Here's a good article on several studies about this (reddit isn't included unfortunately): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364393/

(Hopefully reddit doesn't kick me off for posting this😁 )

To save yourself some time, skip down to the discussion and conclusion sections; the study concludes that while not all studies show negative effects of social media, many do.

​

I also found article this article specific to Reddit from the University of Utah: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379019/

This study shows some positive effects for reddit users in certain situations, but is based on a specific subreddit for depression.

​

I think Reddit, social media in general, and pretty much anything can be bad for us if we use it excessively and for the wrong reasons. I've worked with clients who are exercising excessively and it's causing serious harm in their life. (we almost always consider exercise a positive thing but even this can be bad if we do too much of it).

To determine if something is bad for a client, I always ask two questions:

1. What's the impact of the behavior? (does it prevent the person from doing their homework, going to work, paying their bills, spending time with one's kids, etc.) If it's having a negative impact in their life regarding their social, academic and/or occupational roles, it's likely bad.
2. What's the function of the behavior? (Is the person engaging in the activity because they enjoy it and feel it makes their life better or are they avoiding a situation or trying to avoid an emotion they're feeling). If the behavior is being used to avoid something (even a negative emotion), it's probably not being used in a healthy way.

(The above two questions are largely based on the criteria for addiction from the DSM-5, the official diagnostic manual for the American Psychiatric Association).

Hope that helps!

Wow. Thank you.

Edit. Hit reply too quick there. Thank you for the reply. I can’t research right now, need to got off reddit and get some things done (har har).

I very appreciate your response and will come back to later.

No problem! Have a great day! Hope you are also getting to do some things non-screen related today!

In which ways can those that have never experienced much depression best support the chronically depressed?

A few of my family members have been battling depression for decades. I personally don't experience depression that often myself, so I sometimes have a hard time empathizing. I care about them very much and hate to see them suffer, but my usual tactics of trying to offer advice, cheer them up, do things for them and hear them out doesn't feel like it actually helps them progress all that much and usually brings us both frustration.

Hello kittyraincloud,

It's always so hard to watch people we care about suffer. And I think it's especially hard to watch someone deal with depression. The first thing I suggest to clients who want to support someone dealing with mental health issues is to ask what the person they want to help would find helpful. I think we all do what we think we would want in their situation, but that might not be the right thing for them. Some of the things you're already doing might actually be helping. but we only know if our efforts are helpful if we ask. And if they aren't, then we ask what we could do differently.

It's also important for us not to personalize someone else's issue or feel it's our responsibility to "fix" it. While offering the right kind of support is often welcomed (right being what the person asks for and not what we assume is helpful), it's still something they have to work through, we can't do the work for them.

How do you feel about Jungian thoughts that depression and anxiety are a mere failure to confronts ones shadow?

Hello Jumpinjax89,

Such a cool and specific question. I'll do my best to answer this!

It's certainly an interesting idea. And I think it can be compared to Freud's views on sexuality and psychosocial development. At the time of Jung and Freud, mental health/psychology were very new fields, so they wasn't a lot of research (other than their own) or other authorities to consult or compare their ideas/findings to. I think they did their best to try and make the field of psychology accessible by using ideas and concepts people could relate to and understand. It's hard for us to imagine in 2022, but 100 years ago the idea of "mental health" was almost entirely unheard of in mainstream society and many people did not recognize it as a credible field (and there are sadly still many people who think this today despite all the research showing otherwise!).

Since our understanding of the brain was even more limited in the time of Jung than it is now, he and his contemporaries couldn't account for depression's causes with things such as "chemical imbalances", or consider other causes or treatments that we've only started to discover recently with more modern technology. They were limited by their time and the information and technology available to them.

Literally considering depression a "shadow to confront", and many of the ideas of Jung, Freud and other founders of psychology are typically considered outdated by modern psychology. But these ideas were still important for the development and public acceptance of psychology becoming a legitimate scientific field.

All this being said, I do think using the framing of depression as a "shadow to be confronted" could still be useful in the right context in therapy. Anything that helps someone identify an emotion or helps motivate them towards change can be a useful tool.

1. What’s your opinion on mindfulness/meditation as appropriated cultural practices from buddhism and hinduism?

2. What do you do with clients who are not improving after demonstrated effort and active participation in therapy?

Hello Hocuspokerface,

Good morning. Great questions!

1. As popular as meditation/mindfulness is theses days, I suppose there's always the possibility of it being used in an uninformed/inappropriate way that could be considered appropriation. Any time we practice something that has long-standing traditional roots in a culture other than our own, we should ask ourselves this thoughtful question you've posted. We need to understand what we're doing and why it's helpful, and ask ourselves if we're being respectful of the practice and the people it originates from. I think a lot of the mediation services offered these days miss these points; things like meditation apps often don't do the practice justice, and turn a tradition which has spanned thousands of years into a fast-food mindfulness equivalent.; which is why a lot of people who try mindfulness using said apps don't fully understand the practice, and without that understanding, a lot of people aren't fully invested in it and give up quickly, or think it isn't effective. I think though gaining an understanding of meditation either through books or someone who is trained and has experience in mindfulness is always the best way to understand and be respectful of this practice.
   
2. Another great question. When this happens with one of my clients, I usually address it with them, we review the work we've been doing and explore possibilities of why they may be stuck. I typically ask them to get a medical rule-out by getting a standard annual physical if they haven't recently; as underlying medical conditions can contribute to mental health issues. I might also encourage them to speak with a psychiatrist or their primary care physician about medication options to support their mental health. Medication isn't a silver bullet fo mental health, and isn't for everyone. But I've seen it help clients feel better to the point where therapy becomes effective again. Then the client and I can focus more on long-term behavioral change, which is typically the most effective way for them to feeling better long-term.

Hope that's helpful!

(awesome username BTW)