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When Self-help Is Inappropriate

Mark Dombeck, Ph.D.

Some mental health issues are simply too challenging and serious to safely address on your own. Some mental illnesses (otherwise known as psychiatric disorders), including bipolar disorder, schizophrenia and related disorders, and severe forms of depression, for example, require medication in addition to psychotherapy and/or participation in a psychiatric rehabilitation program if reasonable outcomes are to occur. For instance, people with severe eating disorders need access to psychotherapy and often to medical attention too before they will get better. They are by definition unable to be objective about their conditions and may cause themselves serious harm or even inadvertently kill themselves if they try to treat themselves. Serious mental health problems really require professional medical and psychotherapy treatment; they cannot be successfully addressed with self-help means alone. Self-help has a role to play with regard to serious mental illness, but that role is a secondary one at best.

Medical interventions such as medication prescriptions and hospitalization can only occur with the assistance of a medical professional. When your therapist or counselor is also a physician, prescribing nurse or physician’s assistant, he or she can prescribe you the appropriate medication and dosage that will best support or lead to your mental health stability or recovery. When you aren’t already seeing a medical professional for your therapy, your therapist or counselor will be able to refer you to a doctor or other medical professional who can properly attend to your medication needs.

Milder problems and disorders, such as some milder forms of depression, anxiety disorders and attention deficit problems, may benefit best from professional treatment, but possibly can be handled through self-help care.

Deciding whether a given problem can be helped through self-help means or instead should be addressed through professional intervention is a vital and important part of self-help planning. If you make a mistake in this planning process and fail to get necessary medical or professional care, you may end up harming yourself inadvertently To help you make the right decision, we describe pros and cons of self-help for mental health problems in the following discussion, with the aim of increasing your understanding of when self-help methods will be appropriate for you and when they should be avoided, or assigned a secondary role.

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