In general, most people have good days and not so good days. Experiencing ups and downs in life is pretty normal. Sometimes, however, the difficult times become more frequent and begin to stick around.

We might find ourselves feeling low or anxious more than usual. Or we might notice conflict showing up in our relationships more often and more intensely. Perhaps the stress at our jobs has spiked, or school work become overwhelming. Or perhaps it is a loved one that we notice is struggling with difficult emotions or circumstances.

We can usually ride out a short season of extra stress or challenging days. Generally, people are resilient and have the strengths and resources to handle difficult times. Often a caring friend and family member will lend a listening ear and give whatever support they can. But occasionally, things begin to feel like they are too much and overwhelm our usual coping strategies and social supports.

During these times, we may find ourselves struggling along on our own, trying our best to cope with challenging situations, hoping they will improve with time, but feeling more and more overdrawn. Sometimes we try to tough it out ourselves because we don’t want to appear weak or vulnerable. Sometimes a sense of stigma attached to getting professional help stops us from reaching out.

Whether it is our own needs or concerns about a loved one, there are indicators that would suggest that getting support would be helpful.

Signs it is Time to Get Help

In general, when the difficulties overwhelm our usual resources, supports and abilities to cope, it is important to seek extra support. While it is difficult to cover every situation, there are some common clear signs that it is time to seek help:

1 Having big feelings that are hard to settle:
If we find ourselves losing our cool often, crying or yelling frequently, having emotional meltdowns or shutting down emotionally more often than before, it might be because something is getting in the way of our being able to manage emotions well. Whether related to triggers from the past, or feeling overwhelmed by our current circumstances, emotional dysregulation is something we can get help to handle.

2 Persistent thoughts that interfere with focus or sleep:
We all have times when stress or worries come up, but if they grow to the point that we are having trouble focusing at school or at work, engaging with friends and loved ones, or are preoccupying our thoughts or keep us from sleeping well, we could probably benefit from some help.

3 Increasing conflict in relationships or withdrawing from relationships:
How we connect with others is an important indicator of our wellbeing. If we or a family member are experiencing heightened conflict, relationship help might be useful. Similarly, if we or a family member are avoiding contact and spending significantly more time alone, it would be important to check in about what is going on. And if any kind of violence, intimidation or control is happening in our relationships, this is a clear sign that help is needed.

4 Low moods and energy that lasts for a few weeks:
We can all have days when we feel tired, but if we have an increase in low moods, lack of energy and no motivation to do things, it is important to pay attention. Feeling down more days than not for several weeks is a signal to get this checked out.

5 Heightened moods and energy or changes to our sense of reality:

Where to Get Help

The good news is that there are a number of great resources to help us when we need it.

1. Family Doctor, GP, Walk-in Clinic or Community Health Centre:

A family doctor or general practitioner is often the best first place to go for care. They can assess whether there might be a physical health component to our symptoms and provide general care for a range of emotional and mental health concerns. They will usually be able to refer to specialized care, whether that is to psychotherapists or psychiatrists or other community resources. Psychologists are also trained to assess emotional and cognitive health and to provide treatment.

2. Crisis Services and Helplines, or the local Hospital Emergency

In a situation where help is needed urgently, most communities have crisis lines and some may have a mobile crisis service that provides 24-hour support. When the distress overwhelms our ability to cope, or when there are safety concerns, the local hospital emergency department has physicians, social workers, mental health nurses and psychiatrists who can be called in as needed for urgent support or an emergency mental health assessment.

3. Family Services Agencies and other local therapy providers.

Family Services agencies such as Shalem Mental Health Network are available in most major urban centres, along with other agencies that provide therapy, both in person or online. Some specialize in working with children and youth. Hospitals often provide outpatient therapy for specific needs. Other therapists are in private practice, and may have particular specializations to offer. While therapists generally do not diagnose, they work closely with people to strengthen resources, develop coping strategies, address relationship issues, and manage challenging life situations.

4. Spiritual Care Providers

Pastoral or Spiritual Care is a valuable resource during challenging times. Meeting with someone to receiving support, wise counsel, spiritual care and prayer is another source of support and comfort to help us cope with difficulties. Spiritual care providers can also recommend other local emotional and mental health resources to broaden our circles of support.

5. Support Groups and Community Services

Connecting with others who are dealing with similar circumstances is often very helpful, and allows us to get specific forms of care for our unique needs. Examples include support groups like AA or Al-Anon, Grief share, Divorce Care, Parent and Tot drop-in groups, youth drop-in centres, and the many on-line groups and networks that exist. Particularly when we are marginalized and isolated, these types of groups provide resources and community, and remind us that we are not alone. 

In conclusion, while we all experience ups and downs, it is important to recognize that sometimes, we need help. Just scraping by is not a healthy long-term plan, particularly when we could be benefitting from some of the many resources available. And when things are feeling overwhelming and urgent, it is helpful to know what services to reach for, whether for ourselves or those close to us.

Susan Winter Fledderus is a Clinical Therapist with Shalem Mental Health Network

Resources

Help for when you need help:

• • Medical Health Care: If you don’t have a family doctor, you can get help from a walk-in clinic, or for Ontario residents, from a Community Health Centre, or by calling Health Connect Ontario by dialing 811 to talk to a registered nurse 24/7.
  • Mental Health Care: General Practitioners are able to provide some mental health care and refer to specialists if needed. This Ontario government website lists mental health resources. ConnexOntario is a directory of community mental health and addictions services in Ontario. The Canadian Mental Health Association has branches across the country. Psychologists cannot prescribe medication, but can assess emotional and cognitive functioning and provide treatment.
  • Crisis services: This Canadian Government listing gives links to crisis resources in each province and territory. Canada’s national Suicide Crisis Helpline number is 988. Most communities have access to a crisis service, whether some form of phone crisis line, text service or rapid response team. Googling crisis services in your location should provide the information you need. Your local hospital emergency department can provide urgent mental health care.
  • Community Counselling Agencies and Psychotherapists: In Ontario, a network of Family Services Agencies, including Shalem Mental Health Network provide community based services, usually on a sliding fee scale. This is a listing of registered psychotherapist in Ontario that can be searched by location. A directory such as the one at Psychology Today lists psychotherapists in key cities across Canada, many of whom will also provide online services within their province.
  • Online Supports: There are some great resources for specific concerns, including:
    • Anxiety Canada, which provides information, resources, tools, apps and support for dealing with anxiety.
    • This Government of Canada listing provides links to a range of services for those dealing with substance use issues or addictions.
    • The Ontario structured psychotherapy program provides free resources for dealing with depression and anxiety.
    • The Assaulted Women’s Helpline provides a toll-free number and listings of related services across Ontario.

There are so many additional online resources for the range of emotional and relational topics we are facing, far too many to list here. A quick google search is likely to point you to resources that you could use.