One of the questions I always ask my clients,  in some variation or another, is, “What prompted you to seek help now?” Put another way, this question gets at another significant question, “What stopped you from seeking help before?” The Mental Health Commission of Canada has reported that greater than 60% of Canadians experiencing mental health concerns have not sought treatment. But, why?

From my clients’ responses, I have learned 5 common reasons why people don’t seek help sooner. Surprisingly, the cost isn’t one of them.

1. Not recognizing the symptoms. We’ve all heard the phrase, “The first step to changing is admitting you have a problem.” But what if you genuinely do not see the signs? What if your symptoms are actually a “lack of symptoms” (what are referred to as ‘negative symptoms.’)? Or, what if your symptoms are seemingly mild and difficult to attribute to any one thing?  

This is the case for a number of my clients. Particularly those experiencing symptoms of depression. In some cases, these clients do not fit the typical image we often see of a “depressed person.” They don’t stay in bed all day, they don’t cry continuously, they don’t have thoughts of suicide. No. They hit the snooze button a few too many times, get to work and lack the motivation to get their work done, they’re quick to snap at their partner, they don’t feel up for social events, or rather, they don’t feel much of anything.

Depression, like anxiety, and many other mental health concerns present in a variety of different ways for different people. And what we often don’t realize is that mental health issues fall onto a continuum from say, ‘mild,’ to ‘severe.’ And, while your symptoms may be “mild,” this doesn’t always mean the overall impact on your quality of life isn’t significant. What it does mean is that recognizing the symptoms can be a bit more complicated than going through a WebMD checklist.

2. Thinking, “I should be able to deal with this on my own.” I would argue that this is the natural tendency of the vast majority of people in this world. Or, at least the western world. We live in a society that emphasizes, praises, and rewards, independence. Some of us learn this value at an early age or from our closest family members. So, now, to expect that we would go against everything we have been taught to value and embody and ask for “help,” . . . come on.

It makes sense that our first reaction is not to call up a stranger and bare our souls. And for some that have, to a professional or personal connection, it isn’t always well received. Many of my clients have made previous attempts to seek help from others and were met with dismissive or outright judgemental responses only affirming that, “They should be able to deal with this on their own.” Let’s face it. . . asking for help is a vulnerable and emotionally risky process that takes courage and trust.

3. Trusting others is risky. I’ve already touched on this third point. However, I think it is worth emphasizing. Trust is something that develops over time and consistency. Not something that happens immediately. Again, seeking help from a professional (unless you have worked with them before and established a relationship of trust) is an emotional risk. If your trust has been broken by people close to you in the past, why would a stranger be any different? Well, the reality is sometimes they are different and sometimes they are not.

Even professionals have been known to violate trust. While it is my assumption that most professionals take their responsibilities to build and maintain their clients trust very seriously, it is the truth that this is not always the case. Asking for help and sharing your concerns is a vulnerable process that requires a willingness to take a risk (usually multiple) and develop trust over time.

4. Holding negative personal beliefs and judgments about mental health. This point could also be referred to as the “stigma,” of mental health. Whether we believe that mental health only impacts the “weak,” or the “insane,” or, that, “if you can’t see it, it doesn’t exist,” or that, “it isn’t significant enough for anyone to care,” we all likely have some preconceived beliefs or judgments that hold us back from asking for help when we need it.

We all want to feel “normal,” whatever that means. The reality is that we all will experience some level of mental health concerns at some point in our lifetime, if not several times throughout our lifetime. Experiencing mental health issues is “normal.” Mental health is fluid and fluctuates depending on a number of factors including age, hormones, life experiences, stress, physical health, among many others. Nobody is immune to mental health concerns and, if it is impacting your life in any undesirable way, it is arguably worth asking for help.

5. Feeling lost or hopeless. Chances are you have intentionally or unintentionally attempted to resolve the issue. Whether through previous counselling or therapy, or situational problem solving, or talking to friends and family, or some other method, all of my clients have made some attempt to resolve the issue with varying degrees of success. While these attempts may have helped to some extent, they often do not hit the mark entirely (if they did, it would no longer be an issue). This can leave us feeling like nothing and no one can help.

The truth is that not all treatments are appropriate for all conditions and all people and not all therapists or counsellors are the right fit for every person. But, there are very good and effective treatments available for almost all mental health conditions and there are some very good professionals who could be just the right fit. Overcoming life’s challenges requires hope and persistence, and in some cases, a bit of trial and error.

To summarize, whether you aren’t quite sure your concern is a “real problem,” or you’re worried that by asking for help you will be judged, or you feel like you “should be able to deal with the issue on your own,” or you’ve tried “everything,” and “nothing works,” or you have a hard time trusting people because you’ve been burned before, there is good help out there for you.

As someone who has dedicated my entire adult life to studying, practicing and perfecting my ability to help others improve their mental health, let me just say that it is a privilege each and every time someone allows me to be a part of their journey. And, I think my colleagues would agree.