When ‘Fine’ Isn’t Enough – Recognizing the Need for Mental Health Support
- Aug 6, 2025
- 4 min read
Dr. Deborah Brown is a psychotherapist and behavioral health entrepreneur. She developed Brownstone Mental Health Services and can be heard on the My Session with Dr. Deborah Brown podcast.
The standard greeting, “How are you today?” is mostly answered with “fine, thank you.” Are we really fine? Many of us smile and push through our day, pretending to be “fine.” What is the cost of doing that, day after day? Too often, the price we pay for pushing through our busy life is lack of sleep, poor eating habits, sedentary behaviors, overuse of substances and technology to escape, and all too often, symptoms of anxiety and depression. Walking through our lives feeling stressed, tired, and in survival mode is not the best way to enjoy our lives and can result in a persistent sense of not feeling well. Help from a professional could change this path for you. Have you asked for help, or are you fighting alone?
Do I have a mental health disorder?
Not everyone who experiences symptoms has a serious mental health issue, but one in five adults in America is experiencing a diagnosable mental health disorder. What’s the difference between experiencing symptoms of a mental health disorder versus having one? A mental health counselor can help you to determine what’s happening and show you how to make things better. There was a time when going to counseling was often kept secret, as the shame of being labeled as “crazy” or as having something “not right in the head” were unfortunate labels that kept folks from entering treatment. Now, most of us know someone who is in therapy, and even better, some of us have experienced improvements in our relationships because someone close to us got help when they needed it.
Understanding mental health treatment
Many people are confused about the mental health system and how and when to access appropriate treatment, and it’s not hard to see why. Mental health treatment is alternately described as behavioral health, psychotherapy, therapy, or counseling. Generally, these can be interchangeable labels, and typically include talk therapy with a professional, one-on-one. Many offices also offer couples therapy, and family therapy, where you can work as a group to manage conflict and promote healthy relationships. More intensive treatment programs can be labeled IOP, Partial Care, and Outpatient, and these typically include group therapy and psychiatry, as a higher level of care. If you cannot wait, there are programs that offer walk-in support, and emergency treatment that can be accessed through the Emergency Department at the hospital.
There are psychiatrists, psychologists, psychotherapists, counselors, and clinical social workers. Let’s sort out the titles! Psychiatrists are medical doctors who specialize in mental health and can prescribe psychotropic medications. Psychiatric Nurse Practitioners can also prescribe medication. Psychologists, Psychotherapists, Counselors and Clinical Social Workers do not prescribe medication: they provide therapy in different modalities, based on individual needs. The difference between those is primarily the type of training they receive, but they all are regulated through state licensure. Sometimes you engage with a therapist, and they will refer you to a psychiatrist to see as well, to consider medication. If you see a psychiatrist, they will often suggest that you enter therapy while taking medication. However, many people go to therapy and do not take medication. It is not required and is simply a tool that can be added to your toolbox to manage symptoms if needed.
So, where do I start?
Accessing your health insurance provider directory is a good start. Some providers do accept insurance, and you will likely pay only a copay for each visit. Not all providers accept insurance, so you may find others that are on a private pay basis only. Waiting lists can be long, but don’t get discouraged. If you can wait, and there is a list, get on it. If the appointment is scheduled for a few months out, it is better to schedule than to wait several months and have no appointment. Many therapists offer websites with photos, bios and even videos to help you choose the best provider for you. Don’t worry, if your provider is not what you are looking for, you can choose another and try again. Sometimes it does take a few tries to get the right match. Once you have found the right provider, you now have a guide for the change journey you are about to begin!
This is making me nervous
Most people arrive at their first appointment a bit nervous. A good therapist understands this and is warm and knowledgeable and will work very hard to ensure that you are comfortable. Typical sessions are an hour or less, and you will be encouraged to share at a level at which you feel comfortable. They will ask questions about your history, symptoms, and your decision to start therapy. You may be seen ongoing every week or twice a month, depending on their availability and your needs; and length of treatment varies depending on the plan you make with your provider. You are a driving force in your treatment and how it unfolds.
Change is possible
In conclusion, asking for treatment for your mental health is a sign of strength, not weakness. Call your local counseling center and take the first step! Health and healing are possible, so don’t let fear or stigma stop you or someone you love from accessing resources that can improve your life. Then, the next time someone asks, “how are you?” the answer might be a little different.
Read more from Deborah Brown
Deborah Brown, Psychotherapist and Behavioral Health Entrepreneur
Dr. Deborah Brown is a psychotherapist and behavioral health entrepreneur. She is a thought leader in the field of mental health, working to fight mental health stigma and increase public awareness about mental health related issues. Dr. Brown developed Brownstone Mental Health Services, a large group practice that is revolutionizing the way that mental health therapy is provided. She can be heard on the My Session with Dr. Deborah Brown podcast.
