Happy New Year. So what now?

This is the time of year when the news industry is busy reviewing the past and looking to the future. What will the New Year bring? There are a lot of things we can count on besides death and taxes. As unhappy as it is, we can count on conflict, depression, homelessness and a sizable dose of human misery in all its forms. If you are starting the New Year feeling depressed it may be time face the facts and get some help. If you have made the courageous decision to seek help for an emotional, psychological or psychiatric problem, what can you expect when you decide to discuss this with your doctor or a mental health professional?

First and foremost what you hope to find is someone who listens to what you have to say. That in itself can be helpful and nothing much else can happen to help unless you speak and someone listens. Everything else starts with that. That sounds simple but between people not speaking and others not listening lays a world of missed opportunities.

You also should be prepared to listen. You see things in a particular way. The chances are quite good that the person you speak to will have a novel perspective to offer. If nothing else they are not in your situation and may be more objective. They may have experience and knowledge that you do not have. If you cannot admit to that possibility the chances are not very good that you will get much out of the consultation.

It is also likely that you are going to have to do something different. That could be anything from leaving a failing relationship to stopping an addictive behaviour to taking medication. If nothing changes, neither will your misery.

You will want to find someone you can trust to work with. This is not the same as finding a trustworthy person. There may be many trustworthy people that you cannot trust for some reason. Be prepared to examine your own role or that of your own personal experience in creating your inability to trust.

Whatever your particular problem or circumstances, the chances are high that there is something irrational contributing to it. That is likely just because irrationality is everywhere. Some of it is culturally sanctioned and even promoted. People are not especially rational—particularly other people! If you doubt me, pick up any newspaper and read the headlines or talk to your friends, family or colleagues for half an hour over lunch and listen for examples of irrational beliefs. Consider Tiger Woods—just one glaring, example of the irrational in every day culture. Psychiatric problems are the special, but by no means unique, domain of the irrational. Just remember that however irrational you may be, you will have plenty of high class company.

Hopefully, having gotten up the nerve to spill your guts to someone, they will have listened at least enough to be able to point you in the right direction for additional help. Changing irrational behaviour is sometimes amazingly quick and easy and at other times impossible. It is not always obvious which it will be for a particular person. Also never forget that all behaviour has a biological basis and originates in the brain. Just because we are talking about behaviour and irrational beliefs it does not follow that only cognitive behavioural therapy will be effective. Irrational beliefs can be learned, drug induced or result from brain injury. The converse is also true. Irrational beliefs, however they originate, may be changed by discussion, medications or other physical means (e.g. direct brain simulation). These approaches are not mutually exclusive and are most commonly used together. Don’t be a purist at the cost of getting better.


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