When Is It Time to See a Therapist?

I’ve talked to a good handful of people who have made great strides in overcoming personal challenges and achieving growth that some around them may have believed required therapy. Massive collections of self-help guides in your local bookstore are frequently met with eye rolls despite many of these books containing tremendous insight from some who have overcome the same challenges we are currently facing. Then, there have been others who have pushed and pushed against a wall; barely moving and feeling defeated by the end. Perhaps the self-help or support they sought didn’t meet their needs or the issue was too complex. Those people likely would have saved time and energy while achieving a significantly higher quality of life had they sought a therapist. This all leads to the question of when is it time to see a therapist?

I realize that most of these types of articles will leave the answer vague. I’ll create a little yes/no quiz to help you decide based on my professional opinion. I’m also going to include a vignette for those who still feel that they are on the fence after going through the quiz. I like to highlight that the difference between a therapist and the right therapist is tremendous. At the end of this quiz or sometime down the road you decide to seek therapy, please shop around. Here is a helpful guide I wrote on assessing your therapist: A Test to Know if You Found a Good Therapist — Minds That Matter

If you answer yes to any of the eleven questions below, I believe you should begin your process of looking for a therapist. As a general rule, the more complex the challenges are that you face, the greater the education and experience background you want your therapist to have. There are many brilliant clinicians with less formal training and some awful psychologists with lots of it. That said, it’s still a helpful guideline to consider.

Should You See a Therapist?

Scoring: If you answer yes to any of these questions, please consider reaching out to a local therapist and getting connected with support.

• Do you feel anxious, sad, isolated, angry, or stressed and have for a while? Have you tried to improve things without much change?

• Have you had thoughts of suicide and are not confident you can keep yourself safe? - If yes, please seek care immediately.

• Are the ways you handle your difficult feelings making more problems than they are solving?

• Is your health suffering as a result of behaviors that you are having a difficult time changing or even don’t want to change them?

• Do you feel stuck or out of control?

• Is everything that has happened along with what you’re feeling interfering with the relationships that are important to you?

• Do you feel like you’re surviving but haven’t “lived” for a while?

• Do you find yourself “skipping time” as much as you can through things like sleeping, watching things you aren’t very interested in, or drugs/alcohol?

• Is it difficult to be alone with your thoughts without any distractions?

• Are you uncertain as to how to move forward or do you know the path but are having difficulty walking it?

• Are the things you’re working towards only getting worse?

If you are safe and able to make consistent strides towards your goals, you likely do not need therapy. A helpful exercise for many is to take an inventory of where things are now. If they are able to identify where things are and take consistent steps towards where they want things to be, they are on a good path. If things are getting worse or if they are not getting any better despite notable efforts, therapy is likely the best path forward.

Seeing if you can course correct.

I’ll use someone battling social anxiety as an example. We’ll call her Susan. Let’s say that Susan once had rich relationships when she was in school. Due to frequent cancellations, no-shows, and/or not returning messages, the relationships have been distant and maybe even awkward. The thought of calling or sending a message to ask some of her old friends to hangout fills her with hope initially of how fixable things feel. However, as she thinks about it more, the thoughts of explaining why she has been so distant and worrying about what they will think often results in her opening twitter and closing her messaging app. That dread that arose quickly slowly fades as she tells herself that she can do it another time and will just not answer this invitation in the group chat. She is busy after all. When the feelings of loneliness creep in, she often has a few glasses of wine and puts on some comfort shows from when she first got cable in high school. Things are difficult. Over the last two years, she’s found herself doing curbside pickup for her groceries and avoiding any unnecessary human interaction. As long as she isn’t alone with her thoughts for too long, she feels like she can manage. It is getting more difficult to do so with each passing season though.

Let’s say that Susan is aware of the path she is on. She feels like she could fix things if she really wants to. She just hasn’t “really buckled down.” Not yet at least.

Here, I would say Susan is at a major crossroads. Things need to be worked on for her to live the life she deserves. If she already knows that social anxiety is her primary challenge, she can likely find some great resources online, at her local library (if she was willing to go), or at a bookstore. If she draws a line and says that she is going to initiate a conversation with one of her old friends once over the next week and does just that, I would be hesitant to say that she needs therapy. But, this progress has to be sustained. New goals have to be set and worked towards. Hiccups can happen, but if progress is halted for more than two months, it’s time for her seek professional help. Maybe she keeps saying that she will work at it. It’s been months and months, but she needs to do a few things first. It’s still time to see someone. I’ll write about goals more in the future. The best ones to set for yourself are always going to be “difficult but doable.”

Lastly, I know you have to be able to afford to work with a therapist. It’s uncomfortable to ask, but please reach out to some local clinicians if you cannot afford services. Ask if they offer sliding scale payments or even free sessions. Although I don’t advertise it, I along with many others will happily make things work regardless of someone’s financial status if they are in need. It’s always worth asking.

Written by Dr. Luke Bieber on August 22, 2025