How to Find a Therapist

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Looking for a Therapist?

Looking for a therapist can be a daunting task. I know because I have had to find several over the last 40 years. Finding someone compatible can take time and when you are in a crisis, time is not what one typically has.

Here, I will lay out questions that can help with the screening process for who might be a good fit… and who will definitely not be a good fit.

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How to Find a Therapist

Finding who to call can include getting names from Human Resources, your insurance book or Googling “Therapists.”

I find that if you need low-cost therapists, going to support agencies can help more than just Googling. I suggest the LGBTQ+ Center in the nearest town, even if you are not wanting to talk about those issues, they keep a long list of therapists who are low-no cost. You can also search the county’s social services site.

You can call the local college and ask them for recommendations. If it is a school that licenses therapists, that can be a jackpot, asking for newer therapists because they often charge less. It can seem not fabulous to ask for a new therapist, but they are often the ones with the newest ideas in research and are willing to work with you and your desires for therapy.

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Once You Have the List

It can be daunting to call the long list of therapists you have in front of you. Take your time. Call 3, then take a break and call 3 more the next hour or so. Be gentle on yourself even if you are desperate.

Desperate, of course, means NOT in a place to harm yourself or others.

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If you are in a suicidal or homicidal place, PLEASE CALL 911 IMMEDIATELY.

Calling for an Appointment

You will almost always get an answering machine when you call. That is normal. So plan out what you are going to say… write it down and read it if you want to… and then say what you need to the machine. Short and as succinct as possible. Therapist’s appointments end at 10 ’til the hour, so occasionally you might catch a person between then and the top of the hour, but not usually.

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“Hi, my name is Barb Herrera and I need a therapist for depression. Your name was given to me by the LGBTQ Center. I am in crisis, but not suicidal, so the sooner I can see someone the better. My phone number is: xxx-xxx-xxxx.”

If you are in crisis, it is important to say you are. Make sure to add the not suicidal part, please… if you are NOT suicidal, of course.

If you are a parent, needing therapy for a child, you can say, “Hi, my name is Barb Herrera and my 10-year old son William needs help with his ADHD and anger issues. We are having a very hard time right now, so the sooner I can see someone the better. Please help!”

I find the phrase, “Please help me,” brings out the codependent in just about everyone. I use it in the ER, in bookstores, and looking for therapists.

You might need to call 20 therapists to get 3 to call you back. That is the way it goes, sadly. Some will be kind and tell you they cannot help, but good-luck, but that is pretty rare.

Try with all your might to answer the phone when a strange number calls (or a blocked number even) because catching each other can be a terribly frustrating game of cat and mouse.

When You Speak to the Therapist

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While it sounds like you want that exact therapist when you left a message, there is a screening process you get to do to see if they are a good fit or not.

I encourage writing down exactly what you want help with:

“I am struggling with my marriage. My partner is distant and I don’t know why./My partner asked for a divorce and I’m scared/I’m having such a hard time getting anything done, my life is shit.” Etc.

If it is for someone else, your child for example, being really clear with what you need is good.

“My 15-year old daughter is using drugs and I don’t know what to do about it/My daughter is 13 and angry all the time. I need help understanding her/My 9-year old son struggles in school and cries a lot. I need help figuring out how to help him.” Etc.

So, when the therapist calls, this is when you bring out that paper and read to him or her what you need. Then ask, “Is this something you work with?” They might say yes (some say yes to anything), but they might tell you that isn’t their skill set and that’s great. Ask if they have a referral, thank them for calling and move on.

If you make an appointment with someone who says yes, WRITE DOWN THE APPOINTMENT DATE AND TIME and keep it handy. I say this because you want to keep talking to the therapists who call you back. Make an appointment with each one, just keep them straight (stars or ** next to the ones you like) so you can cancel  the others when you get a feel for the right therapist. It is rare you will not connect with one of the folks that eventually calls. If you do not, pick the least objectionable and start there.

When you have the appointment with the therapist, please call the others and cancel. You will get a machine again, so no worries on hurting their feelings. It happens all the time. BUT, thank them for their time and that you are holding onto their number for future reference. And then do so so you don’t have to go on the search again in the future if the one you choose does not work out.

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Appointments

The first appointment can make or break the relationship, but I highly encourage having at least 3 before deciding you are not a good fit and moving to the next one.

It is also so so tempting to stay with one that is meh because the prospect of starting over is daunting and can be really challenging when you are in crisis. But, I promise, if you give the therapist 3 sessions and you are still not clicking, the idea that you will eventually is really delaying the obvious. Best get out and start over now. The sooner you do, the sooner you will find the right fit.

When I moved from San Diego after my 28-year marriage ended, I had specific needs because of the situation… needed an LGBTQ+ friendly and knowledgeable person. The first three people I had were very young and I spent those first 3 sessions teaching them about the transgender person. I stayed the 3 hoping after session 1 and 2 that they would learn on their own and come back armed with information they could use to help me. When it was clear I was going to be the educator, I ended the relationship and moved onto the next one. With the 4th, I hit the jackpot and am still with her 3 years later. I did not have to teach her one thing about the trans community or the trans experience. She is older and volunteers as a therapist at the LGBTQ+ Center in town. It took almost a year to find the right person, but it was worth it. (A year waiting for appointments to open up and the down time between therapists when I was frustrated and was too tired to move forward.)

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Lastly

Trust your instincts.

If you are able to be CLEAR about your needs… even if it is merely describing your child’s most difficult behaviors or your most intense emotions about your job… that is a fantastic way to start.

Others who have made these choices, do you have other ideas on how you choose therapists?

I’m Depressed (Again)

Due to a glitch in my insurance and the Latuda company’s lack of medication, I went about a week without it. Might have been more. I have been back on it for 4 days now, but have fallen into depression. I wasn’t sure at first, but after sleeping 20 hours a day 3 days in a row, I think that qualifies as depression.

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And the crying.

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I hate the crying.

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The welling up of tears for (seemingly) no reason. The way they fall unabated, no amount of logic stopping them. They just turn on and off at their own whim.

What am I sad about? Nothing. There is no precipitating factor here, merely biochemical.

I want out of it.

NOW.

Bipolar Diary: Just Below the Surface

Monday, 10/24/16, 1:56am

I thought I should have a title for these Bipolar posts. I came up with Bipolar Diary. Original, I know. laughing

Not Having Fun

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Today (10/23/16) has been a really difficult day. I went to bed at 5:00am, slept for 3 hours or so, then up for a few hours, then down again. And again. And again! I keep napping for 1-3 hours at a time. Where is this fatigue coming from? Am I depressed?

This happened a week or so ago, too. I don’t have the patience to go search and see how far back it was. I don’t have much patience for anything. If I hadn’t been in menopause for 8 (or whatever) years, I would think I was having PMS. I cannot keep a thought in my head, am so scattered. I am sure this post will be ghastly, but need to write anyway.

Visual Hallucinations

Most of the hallucinations have gone, but the visual ones are making me crazy.

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How I was more tolerant of the slew of visual, auditory and tactile hallucinations than I am with just the visual is beyond me, but I think much of this sleep crap is because I am overwhelmed with the visions I keep seeing. Roaches, yes… some… but mostly like things are just moving. Sliding around. The covers shifting, the pillow edging over, the carpet rising.

It’s like I am on a tilt and everything is going to fall off the edge.

Frustrating is an understatement.

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Also, I have very little attention span. I have tried to watch Grey’s Anatomy, a show my daughter recommended, but it is too much new information to retain so I end up watching Sex & the City or Friends again (on Amazon & Netflix), two shows I practically have memorized. (Monster’s Inc. is on as I am writing this; another movie I know by heart.)

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What I look like with tactile hallucinations. From Monsters, Inc.

It is difficult to work in this state. My mind flits from thought to thought and I keep talking over clients. I try so hard to pace my words, but they just tumble over each other.

And, as a few weeks ago, my fingers are fumbling with the keys on the keyboard… spelling homophones instead of the correct word (reed instead of read, meat instead of meet, etc.). Argh! I hate having to re-type the right word! (Write came out first. Fuck me running.)

This Is Progress?

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When I saw the Psych last week, he was happy the auditory hallucinations were gone and said I was on the right track. Today I had the first tactile sensation after several days without any; brief, but still there.

I hate the see-sawing of emotions. One day feeling great and doing well, the next (today) being total shit and missing a day of work. Isn’t there supposed to be balance sometime?

I don’t even know where to go from here, so I’ll just end.

heavy sigh

10/24/16, 2:29am

I Am a Fluorescent Tube

Tuesday, 10/18/16, 7:06pm

You know that sound they make? That incessant buzzing?

That’s what I feel like.

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And in perpetual motion.

Non-Compliant. Again.

I don’t know who I think I am fooling when I sneakily “forget” to take the Risperdal. Up for 25 hours, trying to sleep periodically and feeling like I am electrically charged, getting back up again a few minutes later.

I’m somewhat productive, writing posts for work and here, organizing my Kindle music library, pulling things out of drawers and stuffing them into garbage bags, but I feel sad all at the same time. Not that wonderful, blissful feeling of the last few weeks. My therapist, just like my Psychiatrist, reminded me that it was not all that “blissful” and my mind is playing games with me.

TAKE THE FREAKIN’ RISPERDAL.

(I did.)

Therapy

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I hadn’t been to therapy in a couple three weeks because I was working with the doctor instead. It’s almost an hour to get there and the prospect of taking that trek twice in one day was too daunting. I did it today, but probably shouldn’t have.

I barely remember anything we talked about, knowing I wouldn’t even as my lips were moving. The whirring so loud in my head and coursing through my body.

What I remember is that I need to honor my Self and take my meds every day and on time.

It’s the goal for the next few days.

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7:58pm

Bipolar Balancing Act

Tuesday, 10/18/16, 11:02am

The visit with the Psych went well.

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We talked about my meds, my sleep patterns, my lowering hallucinations… and then I asked if I was getting depressed. He was very gentle and said after where I’d been anything is going to feel depressed.

Sleep

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He said my figuring out a way to have one block of sleep will help me not relapse. I told him how I hated the Trazodone and I would rather sleep fitfully than feel like I am going to pee in the bed from being unable to wake up enough.

I have slept in this bizarre cycle of 2 hours of sleep, 4-5 hours awake… 3 hours asleep, 3 hours awake… since at least the second manic episode in 1998. Even gorked out on opiates, I still slept like a baby does (not sleeping “like a baby”; babies sleep like shit). I don’t toss and turn. When I go to bed, I go to sleep. But when I wake up again, I am UP! Even the dispatchers at work have gotten to know my strange cycle of on/off. I don’t know if I can change it without meds. Honestly don’t know if I even want to.

Hallucination Origins

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I asked where the holy hell do those terrifying hallucination sights, smells, sounds and feelings come from. Why does the brain pick a horror show to illustrate its illness. He said that scary things in the brain are easy to access. The brain chemistry goes wonky and the synapses misfire and the most accessible images/thoughts/etc. get scooped up and displayed. I said I thought that was a fucked up system.

We talked about how voices that direct behaviors (which I do not have, thank goodness) tend to mimic their inner belief systems. Those with religious histories have heavenly/satanic voices telling them what to do. Those without that, have “magical” voices. Psychosis in different cultures bends towards that culture’s belief systems and experiences. Even though I have religious belief in my past, none of my hallucinations have ever taken on a religious tone, either good or evil. Apparently, my mental illness is as atheist as I am.

Missing the Mania

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I told the doctor I really am missing the mania, the energy, the lack of pain. He gently reminded me of the terror I was in 2 weeks ago when I came to him… that I was about to admit myself into the hospital because I thought I was going to fall into a million pieces. I asked why can’t I live in hypomania? He chuckled and said everyone asks that, but hypomania is a staircase… going up or going down; it isn’t a landing. I said that sucked. He nodded and said he agreed, but it is what it is.

heavy sigh

There are no med changes and I see him in 2 weeks if I need to, a month if I am okay in 2 weeks.

I go to therapy for the first time in several weeks this afternoon. I have barely missed it for being so bizarre in the head. I look forward to seeing her again today, though.

More later.

11:42am

 

Bipolar Mania: Settlin’ Down

10/18/16, 2:08am

Melancholia

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artist, Valeria Fulop

I think the Mania is gone.

Hallucinations have shifted. The tactile ones are all but gone, the olfactory ones haven’t returned since starting the Risperdal and the visuals are much less… smaller… less intense. The last nasty one was when a roach crawled out of my Diet Coke can onto my face (it was not real) and I threw the can across the room. That was… 2 nights ago? 3 now? Otherwise, the shadows are pretty small… more translucent. I haven’t had an auditory hallucination in over a week.

Even though all those horrible hallucinations have all but abated, I am sad I am not filled with energy like I have been. I feel like a sloth now… it taking inordinate amounts of energy to do anything. Still not sure if I am dipping down into depression or not. I see the Psych in the morning and will run it by him.

Medications At the Moment

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Psych Meds
  • Risperdal 2 mg at bedtime
  • Wellbutrin
  • Cymbalta
  • Lamictal
  • Buspar
Meds from ER Visit & GI Doc
  • Bentyl – finished (not sure it did anything)
  • Cipro – finished in the morning; feel MUCH better in my abdomen, diarrhea gone, suspected UTI gone
  • Lomotil – haven’t picked it up from the Pharmacy yet, but didn’t need it after the Cipro
  • Probiotics bid – helps keep the yeasties at bay with the Cipro

Work & Sleep

I’ve been back to work 2 days in a row now. Luckily, we can log in and log out whenever we want/need to, so when I get tired, I just log out and take a nap. I spent 3 days barely able to function as things slowed down. I felt like my brain was stuttering and I never knew, from one minute to another, whether I would be able complete a call or need to crash asleep, so I pretty much listened to music, did some work writing and watched Netflix or Amazon.

My hair-trigger anger seems to have settled some as well, but when I get upset, it is over-the-top, but simmers down quicker than it would have a week ago.

I’ll write more after seeing the Psych and my therapist tomorrow.

In the meantime, I’m just resting.

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artist, Sera Knight-Horsell

10/18/16, 2:45am

If I Have to Have Hallucinations…

… then why can’t I also have the energy behind them?!?

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scary hallucination descriptions below

Fucking Roaches

But, nooooo, I am sleeping 18-hours a day and seeing roaches crawling everywhere. On the ceiling, on the walls, on my legs.

CRAWLING OUT OF MY DIET COKE CAN & ONTO MY FACE!!!

See the splatter of Diet Coke across the room on the wall? I’ve already cleaned it off the keyboard, the screen, the chair and the floor.

My favorite hallucination last night was when the big snake crawled across the wall. Beat the cockroach on my face by a slither.

Is This Normal?

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(As if normal were even anything to claim or aspire to….)

But now I am reading some of Dr. Google’s “Bipolar Mania” because I am still a week away from seeing the doctor and I really want some answers.

  • Why am I still having hallucinations?
  • Am I getting depressed?
  • When do hallucinations disappear after mania?
  • Does depression always follow mania?

I swear the hallucinations have actually increased as I am getting more sleep. At least the past couple of days.

STOP IT ALREADY.

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