1) Deciding whether or not treatment would be helpful.
2) Figuring out what sort of professional would be best: psychologist, therapist, psychiatrist, social worker, etc.
3) Wondering whether your choice of professional will influence the type of outcome you desire. For e.g. a psychiatrist is likely to prescribe meds while other professionals may prefer mindfulness, CBT, talk therapy, etc.
4) "Will they throw me into a mental hospital? I want to lead a normal life, I'm not one of those people!"
5) "Is it covered by insurance? How much will it cost?"
6) "How can I find a good professional? I've heard there are a bunch of shitty ones. I need a good one."
7) "I'm too scared to even pick up the phone. How do I determine availability? Can I schedule this online?"
8) etc, etc, etc.
This is something that needs to be solved with an online questionnaire that spits out an appointment time and location at the end. Telling depressed people to go through the aforementioned steps is like telling someone with a broken leg to just walk to the hospital that's a couple miles away.
To the OP: my suggestion is to Google around, find 3 people who accept your insurance or are affordable out-of-pocket, pick one, and make an appointment. It's 10x more important to make an appt, any appt, and go than it is to worry about finding the best person. You don't have to stick with the first person you see anyway. If you're still overwhelmed, I've found the average PsyD to be better than the average therapist/social worker.
Pick a therapist. Tell them you're shopping, you'd like both a trial session and recommendations for alternatives. If they're not willing to do that, they're not the right person. Most are.
A few years ago, I had decided on my own that I needed medication; the depression was so overwhelming that I felt like the problem had to be chemical, and no "touchy-feely" talking therapy could possibly help. I went to a few psychiatrists, with varying degrees of success (I caught one reading side effects of a medication off of wikipedia) and stopped going several times because I felt like it wasnt helping. It was only when things got bad that I found a therapist (I think I just googled "therapist <my neighborhood>") -- who I liked -- and she convinced me to just give her way a try. It worked.
I am on medication again, and its helping, but it was really the therapy that I was so against thats making the biggest difference. All of this is to say that find someone you like, and then be open. Deciding how you want to be treated from the outset doesn't necessarily make sense. Mental health issues are like any other illness -- we go to doctors for their advice and expertise. But you need to go.
I'm really not kidding. The range of usefulness of therapists is so large that "any therapist is a good starting point" usually works. It's better when you can ask friends, but if you can't, any therapist will do.
Then go for a brief session with each of them. You should pick the person you feel most comfortable talking to EASILY. This person should be someone you don't feel judged or threatened by. You should be able to understand them clearly and they you.
Think about it like it's a date. In a way, it kinda is.
But outside of "pick one and start there", what would you recommend if somebody can't get a recommendation from friends/family? How do you find a decent practitioner?
Fwiw I’m fortunate that many friends are open with me that they are/have been seeing s professional. So I would go to them for a referral. As one good friend put it, “we get help for our bodies, so why not our minds?”
I've since moved out of the area though and have been trying to find a replacement and its been such a painful experience.
My brother just got some (charitable) funding to develop an app to do exactly this! Very early stages of the project so it's hard to say how well it will go but his hope is to solve exactly the problem you're talking about. (I might be helping to develop the app, depending on scheduling.)
Besides, some schools of therapy would think the expectations of a patient that expects you deliver a 5/5 stars therapy, would taint the natural therapy process.
Google, however, is prohibitive. You end up having to either comb through thousands of individual results to find ones that are nearby and take your insurance, or you end up on an aggregator site with literally thousands (at least in NYC) of matches and the same problem with slightly more structured data.
It's just so daunting to make any decision when faced with too much data and insufficient information on how to use that data, that the depressive brain just kind of shuts down and says "fuck it, I can't deal with this now."
I wish. (I'm imagining a filtering system that either prevents you from seeing providers not on your insurance, or flags them appropriately)
I researched bio's for months before making an appointment. I picked the one person in Vegas that had the experience I was looking for with "Mindfulness Techniques, Neurofeedback, Transcranial Magnetic Stimulation"....
Even though that was what he was expert at, he let me know that those services were not what I needed at that point. After getting actual medications to stabilize, I was in a much better position to try the more hippy-esque treatments and go from ok to happy.
So really trust doctors to get you where you need to go... especially if they have good reviews on ZocDoc (Damnit... I'm doing it again).
> Transcranial Magnetic Stimulation
yeah because a treatment that might induce a seizure is just what one needs.
People, do research and be extremely wary of anything hyped.
For me, dance movement therapy worked. It's not trendy, it takes time and effort but -- it was worth it.
In that first tweet she's talking about English NHS Mental Health Trusts.
Here's the guidance from NICE: https://www.nice.org.uk/guidance/ipg542
NICE don't seem to have anything for "Dance Movement Therapy".
For some patients, a treatment that does exactly induce a seizure (i.e. ECT) is what they need. Of course, because of the risk of harm, it's still reserved as something of a last resort and only for particularly severe cases.
I'm pretty sure rTMS has nowhere near the same risk profile, even in the reported cases where seizure did occur.
> do research and be extremely wary of anything hyped
I would offer the same advice for anything that is hyped against with scare tactics, if not just, more broadly, any proposed medical treatment.
It does a lot of what you suggest. I've started from a position of "so you know you want a psychologist" because otherwise the scope is just overwhelming.
Like people have found, fit is the most difficult thing. I think we can improve this with data. But until someone's figured it out, I recommend always calling a therapist on the phone and talking to them a bit, before committing to a session. The phone is scary, but a bad intro call is much less draining and expensive than a bad session.
We're working on enabling online appointment scheduling for the reasons you say, but getting a uniform booking interface for thousands of individual psychologists turns out to be a huge task.
If people wanted to have a look around we have a test link  so the human clinical staff know that you don't need help.
Does anyone actually have any experience with these services, and were they effective?
Even the process of getting up, driving to their office, writing the check, the fact that you have to be on time and have only this one window of time to talk, it all matters because it's a series of tangible steps you're completing for your own self improvement. The computer elides all of this in the name of "convenience"
In my very humble opinion this is the way a bad therapist works.
I've gone to therapy to deal with real problems - attention issues, a bout of anxiety - and having somebody mostly repeat back to me what I said was so, so unhelpful.
> real problems
Do you hear what you just said?
I guess that phone and videochat have the necessary "bandwidth" to convey mental issues. After all, people talk for hours via phone or videochat about their lives and problems. And the availability and convenience these media enable helps address the ancestor comment about the difficulty of seeking treatment.
They are usually students, but I found they were better than the licensed MFCC, and PhDs. The sessions are recorded, and listened to by a licensed therapist.
I believe most medi-cal doctors will prescribe antidepressants. Yes--the medi-Cal system is not great. The drug formulary is workable though. There are some very good medi-cal doctors though. They don't have the much time with the patients, but if you go in with depressive symptoms they will prescribe. A nurse might give you a depression screening. They never worked for myself, but I was told I'm not really depressed. And as my doctor always said, "All my patients are different."
The average medi-cal doctor writes prescriptions for psychotropic drugs daily.
Hang in there. I don't know your age, but the twenties/thirties are a bitch. Just a cluster puck of hormones, expectations, etc.
Don't let this society drive you nuts. The economy is suspose to be blissful. I don't see it. I just see the wealthy getting ahead. I notice so many very unhappy people. We are at a weird time in history?
If I had a do-over, I don't think I would have tried so many anti-depressants. I fell for the advertising. But--but, I'm no Psychiatrist.
Oh yea, too much alcohol can make depressive symptoms worse. I'm not preaching, but I know first hand.
(A bit off topic, but sometimes not having great insurance is not a bad thing in the long run. I have met a few people with good insurance that are vastly overmedicated.)
If you say "I'm struggling with X, what is the right type of provider for me", you'll probably have a productive conversation.