When it's time

One of the necessary limitations of being a living creature is that one only has access to one own's experiences and perspectives. (Perhaps this is why so many find the idea of reincarnation appealing.) The problem with this is that, by default, people tend to start out with the assumption that others are like them before gradually working out the differences.

Photo courtesy of @norwigger on Instagram.

A consequence of this phenomenon is that it's hard to tell whether something is normal or abnormal, or, rather, common or uncommon. A nurse can ask two different patients to rate their pain level on a scale from one to ten and get the same answer from someone with a dislocated shoulder and a mother in labor. Objectivity is elusive.

Just like one has to evaluate whether a cut is infected enough to seek medical attention, there is a necessity to evaluate when professional help might be needed in terms of mental health issues. The difference is that the scabs and infections are visible and documented, giving a guide as to when something becomes diseased.

• When does a fear become a phobia?
• When does sadness become depression?
• When does quirkiness become psychopathology?

There is no easy cutoff point and certainly not a universal one. But within the field of mental health, there is a standard that professionals use when evaluating and making diagnoses. To qualify as having a certain condition, one of the criteria is almost always the following:

The symptoms cause clinically significant distress or impairment is social, occupational, or other important areas of functioning.

Basically, if it's interfering with the ability to act within or experience a major aspect of normal life, it probably demands attention. As an analogy, a twisted ankle from a misstep will likely go away on its own within a few days. It's an inconvenience. Breaking a leg, on the other hand, can seriously affect someone's ability to go through their basic routines. In some fields, it eliminates the capacity to perform one's work altogether.

In mental health, the examples might look somewhere along this line:

• A broken-hearted man secludes himself and won't see his friends at all for months after his girlfriend breaks up with him.
• A student regularly cannot complete a quiz in the given time because her mind is highly distracted.
• A grieving widow experiences a complete and continuing lack of appetite for a full year after the unexpected loss of her husband.
• A worker loses his job because he becomes obsessively focused on certain trivial aspects of his duties instead of tackling what he is supposed to be doing.
• A teenager’s life becomes erratic because she comes to in a strange situation with no recollection of how she got there or why, especially if substance use was not involved.

While the amount of significant distress or impairment is a very important marker, it is also important to consider environmental factors. Hating one's job and thereby performing poorly is not necessarily an indication of a psychological disturbance. If one made a career change that would normally be exciting and invigorating, but then still retains the same negative feelings, it might be worth looking at oneself.

If there is still uncertainty after considering this guideline, many mental health practitioners offer a free initial consultation either by phone or in person. While they want clients and will generally be able to claim to help, take care to ask about what she thinks she had to offer. If it seems valuable, it might be worth trying treatment. It's also perfectly okay to consult with more than one practitioner and see which one is the best fit.

It’s often hard to seek help when at this point, so look out for this disturbance in the lives of loved ones. A sudden, huge personality/habit change or a continuing impairment should at least cause consideration for professional help.

If you are/have been in treatment or have helped someone else get it, how did you know it was time to take that step?