Dear Alice,

Sometimes I feel like I don't want to live anymore. I know in my heart that I would never kill myself. Sometimes I just feel unhappy. I am at college and would like to speak to someone, but I am scared that they would make me go to the hospital. I don't want to do that, but I just need to talk. Do you think if I mentioned this, they would hospitalize me?

Dear Reader,

You’re not alone in feeling unhappy or hopeless — many people experience these feelings at some point in their lives. Recognizing and naming these feelings can be a helpful place to start. However, if these feelings continue to escalate, seeking care as soon as possible is advised. You may also want to reach out to the National Suicide Prevention Lifeline (1-800-273-8255) for more immediate support. Meeting with a mental health professional and sharing how you feel doesn’t necessarily mean you’ll automatically go to the hospital. They may encourage trying a few treatment options before considering a recommendation for hospitalization – every person and experience is different. Reaching out for help isn’t always easy, so kudos to you for being honest with yourself about the way you’re feeling.

Seeking support from a mental health professional can seem intimidating, perhaps because of misconceptions or your own fears about what happens in these appointments. While there are some individuals whose conditions are best treated in a hospital setting, there are just as many who aren’t at risk for hurting themselves or others and can be treated in mental health professional appointments. Generally speaking, simply sharing with a mental health professional that you've had thoughts about not wanting to live anymore doesn't automatically trigger hospitalization. That being said, in your sessions they might try to gauge whether or not they believe it to be an emergency situation. Based on those conversations, you’ll be able to explore some ways of dealing with your thoughts and feelings together. They can also use those conversations to guide what form of support they’ll provide.

To help clear up some of the mystery around counseling, here's some information on what you might experience in a typical session related to feeling sad or depressed:

  • They might ask a series of questions to assess how you’ve been feeling, what motivated you to come in for an appointment, and what kinds of services will best meet your needs. In your case, they may assess your level of depression by gathering information related to your thoughts of hopelessness, sadness, or emptiness (all common symptoms of depression), and can help you explore the things in your life that are making you feel unhappy.
  • Similar to what you’ve been experiencing, some people who feel depressed also think about ways to hurt or kill themselves, or some think about hurting other people. That's why you may be asked questions such as, "Do you ever feel like you don't want to live anymore?" "Do you have a plan to hurt yourself?" "Have you ever attempted suicide in the past?" "How long have you been feeling this way?" Your answers can help your mental health professional figure out whether or not it rises to the level of an emergency that needs immediate treatment.
  • After the initial meeting, you’ll determine together if or when you need to come back. You may also talk about fees for services, people you can call in an emergency, and your meeting schedule.
  • Through the treatment process, your mental health professional may offer a variety of strategies to help you feel better, which may include taking antidepressant or anti-anxiety medication. They may also recommend that you join a support group for additional social support.
  • In some situations, they might recommend that you see another mental health professional who may better support you. If they refer you to another professional, it doesn’t mean that they don’t like you or aren’t a skilled at their job. They want to make sure you get the best care possible and sometimes they may know of a more appropriate resource.
  • If after trying a number of different strategies a patient’s symptoms continue to get worse and their suicide risk is high, the mental health professional may then consider having the individual stay in an inpatient treatment facility. The goal is to help the individual get more specialized treatment and also minimize their access to end their life.

All that said, a counseling center on your campus or in your community may be a good place to start. You can also check out some other resources, such as the American Psychological Association and the American Psychiatric Association, that may be helpful.

Hopefully having more information about the counseling process will help you feel more empowered to take that next brave action and get help. If you’re still feeling unsure, maybe you can talk with others who have seen a mental health professional in the past. They may be able to recommend someone with whom they’ve had a good experience. With the assistance of a professional, your sources of social support, and perhaps some medication, you may start to feel better.

For many people, taking the first act to meet with a counselor is often the most difficult part. Know that you’re not alone in your feelings and that help is available. You've already been really brave by reaching out.

Alice!

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