I've seen this question many times in the comments,
"Doc, I have many of these symptoms that you described
"but how do I know when I should see someone about it?"
That's what I'm going to answer today.
I'm Dr. Tracey Marks, a psychiatrist,
and I make mental health education videos.
Whether or not you see a doctor
is based on how much of a problem the symptoms cause you.
You can walk around with mild depression symptoms
that don't cause a lot of problems
and then go away in a few days.
Also, what's a problem for one person
may not be as much of a problem for the next person.
So there's not one answer to this, but here's my opinion
about what you should consider when determining
if your symptoms are bad enough
that you should seek treatment.
You can look at four things,
the number of symptoms that you have,
the intensity of your symptoms,
the frequency of your symptoms,
and how much the symptoms are causing problems for you.
So let's take a look at the first one.
The number of symptoms you have.
The Diagnostic and Statistical Manual of Mental Disorders
has a list of symptom criteria for every disorder.
And usually, to qualify for the diagnosis,
you need certain number of symptoms
like five out of eight for depression,
but you don't need to memorize the eight symptoms
that match depression so that you can know if you have it.
Just think about the things that are not normal for you.
Like maybe you feel sad all the time.
Maybe you feel hopeless and not motivated to do anything
or maybe you have trouble sleeping.
So let's start with those four, sadness, hopelessness,
low motivation, and sleep problems.
The next thing is to look at how intense are these symptoms.
Do you have a day when you're in a funk
and you want to cry all day, fighting back tears
or wanting to cry is more intense
than just feeling sad without crying.
Next, let's look at the frequency.
Let's say you have an off day
and you find yourself having a couple of crying spells.
Then after crying, you feel better.
And the next day it's over that one day of crying
may not be a reason to see a doctor
but if you keep waking up fighting back tears on most days
and more weeks of the month than not,
then some thing is off.
Especially if there's not a situation
that could have triggered your sadness.
Then you want to look at how your symptoms
affect your functioning
and ability to move through your life in the usual way.
Are the sleeping troubles and low motivation
getting in the way of finishing projects,
or meeting responsibilities?
Maybe it's not, and it's just a minor nuisance for you.
Or let's say you feel like you're going through
a rough patch where things aren't flowing for you
but then you get back on track by talking to a friend,
reading a self-help book,
or watching a helpful YouTube video.
In these cases, you don't need professional help.
Whether or not you seek professional help
is still a personal decision.
But another way of looking at this question is
are the problems you're having likely to go away
on their own or will they get worse until you get help?
That's a different perspective on this question.
You may be going through a tough time
that allows you to keep things moving
and it's only temporary.
But how do you know if your symptoms are an early warning
of something that will inevitably get worse?
Here are some symptoms that are not part of the ordinary ups
and downs of life and are likely to worsen
without professional help.
In the depression realm a more serious symptom
is feeling suicidal.
If you find yourself
thinking that people would be better off without you
or that you'd just rather not be around
because you can't stand the pain,
you should seek professional help immediately.
If you don't have quick access to a psychiatrist
you can see your primary care doctor.
If you have a formed plan that you're waiting to act on
you should go to the hospital for stabilization.
Another symptom that usually only gets worse
is delusional thoughts.
Some people can have a fleeting about of paranoid thinking
that's transient which means that it comes and it goes,
but often this kind of fleeting paranoia
doesn't rise to the level of being fully delusional.
If the person is challenged on it
they may back down and say, yeah
I don't really believe my neighbors are trying to spy on me,
but I just don't trust them, they make me uncomfortable.
But fully formed, irrational, delusional beliefs
are not normal.
Even if they go away for a little while,
there's still a good chance they'll come back.
You should seek a professional to help you see
or figure out why you're having these thoughts.
Delusions that happen inside of a manic
or depressive episode are usually a measure
of the intensity of those conditions.
Severe depression can lead to delusional beliefs
as can and intensely manic experience.
So in those cases, you're having other symptoms
that go along with the delusions.
And if you ignore all of the symptoms
they can continue to intensify like a hurricane
moving over warm water.
Anxiety signs that I think are not likely to resolve
without professional help are severe compulsions and rituals
that are getting in the way of your functioning.
An example of this is taking two hours to drive to the store
because you keep stopping to make sure
that you didn't run over someone with your car.
Other anxiety signs that usually worsen without help
are frequent and intense panic attacks,
and lots of avoidance associated with a phobia.
An example of this kind of avoidance
is say you start with avoiding crowded places
because people make you anxious.
But then this progresses to not leaving your home,
even for important things.
Avoidance is a big part of anxiety
and it makes whatever you fear grow into a bigger problem.
The last symptom I'll mention
that needs professional attention
is other psychotic symptoms like hallucinations.
I already mentioned delusions
which are a psychotic symptom
but hallucinations and very disorganized speech or thoughts
should be evaluated by a professional.
Drugs like psychedelics, alcohol intoxication,
and marijuana can all cause these symptoms.
And if that's why you're having the psychotic symptoms
they usually go away once you stop the substance.
But if you have these symptoms all by themselves
it's usually a sign of some other kind of psychiatric
or even medical disorder that should be evaluated.
When would you see a therapist instead of a doctor?
You would see a therapist for problems
related to changing your behavior,
or improving relationships,
or working out trauma experiences.
Examples of behaviors that a therapist could help you with
are compulsions and avoidance from phobias
like social anxiety, or spiders.
Medication may help the anxiety or depression
that these behaviors cause,
but therapy is really what you need to change your mindset
and actions.
The same with a trauma reaction.
Medication may help you sleep or ruminate less,
but working through and processing the traumatic experience
is a separate process.
Can a person live with traumatic memories
without needing to see a doctor or therapist?
Yes, many people do,
especially if they were mildly affected by the trauma.
What would that look like?
You may be reminded of a difficult childhood
and that memory causes you distress
but the distress is momentary.
It doesn't keep you from working or having relationships.
It may affect your self concept
but you still have enough esteem that you can pursue goals
and have positive expectations for yourself.
Take a look at this video where I talk about how trauma
can affect the way you remember things
and this one on recognizing the difference
between having depression and feeling depressed.
Thanks for watching.
See you next time.