Detail image for Health & Wellness Guide, December 2022 story.

Our mental health can require expert assistance. The question is, how do we know when it’s gotten to that point?

Written by Lennie Omalza | Illustration by Branden Barker

The tricky thing about tending to your mental health is that it isn’t always obvious when it needs some attention. Unlike a broken bone or nagging cough, the signs of declining mental health can be harder to recognize. But as Ellen Buddeke, DSW, LCSW, with Norton Behavioral Medicine says, mental health is no different than physical health.  

“It really is the same,” she says. “We have to take care of it; we have to learn about it; we have to maintain it; we have to know how we’re doing. It’s the same — it’s health in general.” 

Just as we can care for a common cold at home, we can (and should!) address our mental health needs on our own, too. But as serious physical ailments require professional attention, there are times when our mental health requires expert assistance as well. The question is, how do we know when it’s gotten to that point? 

Ellen says it comes down to how well you’re functioning. If you’re struggling at work, or if you’re a student and your grades are starting to fall, it could be a sign that your mental health is slipping. “If your social relationships are suffering, if you can’t get out of bed, you notice changes in your appetite [or] weight,” she adds, “those kinds of things are telltale signs that your mental health might be taking a turn.” 

She adds that people with declining mental health might intellectualize, or view situations from a more practical lens rather than an emotional one. “If you talk to somebody and ask, ‘how do you feel about that?’ and they give you a bunch of logical, rational responses,” she explains, “they’re not really expressing their emotions, and that could be a hidden sign that maybe something else is going on.” 

Once you’ve determined that it’s time to enlist the help of a pro, Ellen says it’s important to determine which type of help you need. Contrary to what mainstream media might have us believe, caring for your mental health isn’t necessarily about lying down on a comfy couch while a therapist sits across from you, scribbling notes.  

“There’s a real difference between what we call supportive counseling and actual therapy,” Ellen explains. “With supportive counseling you probably go every other week. You talk your problems out, [then] you leave — but you’re not doing any actual work.”  

“If your social relationships are suffering, if you can’t get out of bed, you notice changes in your appetite [or] weight … those kinds of things are telltale signs that your mental health might be taking a turn.”

Therapy, she adds, is more like a class. The therapist provides homework, as well as clear instructions as to how and when to complete the homework. At their next session, the therapist and patient will go over the work together, the same way a teacher might review homework with a student. 

Which type of mental health assistance you should seek — whether it’s supportive counseling or therapy — depends on your needs, and those needs can fluctuate as time goes on. It’s up to you and your counselor/therapist to determine how you are progressing during your sessions and what your next steps should be.  

The tricky part about getting started is that mental health professionals do not typically label their services as supportive counseling vs. therapy. “Unfortunately, a lot of laypeople aren’t privy to the different types of therapies that are out there — especially for trauma,” Ellen says. She adds that many therapists will say they can do trauma work, but they may not be certified in specific trauma modalities.  

She also advises against companies that market 24/7 availability. “That’s actually a poor boundary,” she explains. “That’s not appropriate therapy, [or an appropriate way to manage a] patient relationship.” 

Ellen recommends resources such as the Centers for Disease Control and Prevention ( or the Mayo Clinic ( to help determine what type of therapy might be best for you and your needs. “It would just be a matter of doing that research,” she says. “What’s the best therapy for depression? You’ll find out that it’s cognitive behavioral therapy, you would go and look for a therapist that specializes in cognitive behavioral therapy. It’s really that nuanced if you want to get the right level of care.” 

If you think you need help and aren’t sure where to start or how to get going with the research process, Ellen suggests leaning on friends and family — ask them to help you find the help you need, and gather support sooner rather than later. “For someone who’s new to mental health and doesn’t really know how to work the system,” she says, “it’s really best to rely on whomever you have supporting you that can help you.” 

She adds that finding the right fit for your therapy needs can take a lot of time, energy, and effort — but it’s all worthwhile if it means you’re getting the best possible care for your mental health.