When to get help for mental health disorders and addiction — and where to find it

When to get help for mental health disorders and addiction — and where to find it

When we think of mental health challenges and addiction issues, we probably think of extremes. Sober or alcoholic. Healthy or not. Panic attacks where you’re bed-bound for days. Liver problems from excessive drinking.

You might start asking yourself questions like ‘Do I need help, or will this go away eventually?’ This article is designed to help you find the answer. Now, when it comes to struggling with addiction, depression or anxiety, there’s no substitute for being diagnosed and treated by a qualified medical professional. However, this article will give you some insight into where you or a loved one’s symptoms might fall within the range of mental health and addiction conditions, when you should start thinking about getting help, and what your options are.

 

Canada’s growing mental health and addiction crisis

 

Let’s begin with a little background. “Mental illness” and “addiction” can apply to a wide range of disorders that may affect how you think, your mood, and the way you behave. When we talk about these disorders, we are generally referring to depression, anxiety, and substance abuse. While many people will struggle with varying degrees of these disorders, they become more and more worrying as they begin to get more frequent and/or harder to resist.

These disorders are incredibly common and affect people of all ages and lifestyles. In fact, every year, at least one in five Canadians experiences a mental health condition. The Canadian Mental Health Association (CMHA) points out:

  • About 8% of adults will experience major depression at some time in their lives
  • will have or have had a mental illness
  • Anxiety disorders affect 5% of the household population, causing mild to severe impairment
  • Substance use disorders affect approximately 6% of Canadians.

CMHA also states that 21% of the population (six million people or so) will meet the criteria for addiction in their lifetime. Alcohol and cannabis are the substances that most commonly meet the criteria for addiction, but opioid use has also become a crisis.

 

Mental health, depression, and COVID-19

If Canada had a mental illness and addiction problem before, it was kicked into overdrive by the COVID-19 pandemic.

In its “Survey on COVID-19 and Mental Health,” the federal government revealed that 21% of adults aged 18 and older screened positive for at least one of three mental disorders: major depressive disorder, generalized anxiety disorder and post traumatic stress disorder (PTSD). The survey also said that mental disorders were four times higher among adults who were isolated by the pandemic, and 40% of Canadians who had financial troubles because of COVID-19 screened positive for one of three mental disorders.

“Since the beginning of COVID-19, we have been seeing some very troubling trends in mental health and addiction,” said Lanie Schachter-Snipper, the National Director of Outpatient Services at EHN Canada, in an interview with Georgia Straight.

“There are increased rates of addiction, overdoses, and addiction-related deaths, as well as an increase in rates of anxiety, depression, and suicide. Those who never or rarely experienced mental health issues pre-pandemic are reporting new issues emerging and those who had preexisting conditions are reporting the worsening of symptoms.”

 

How depression and anxiety affect your mental wellbeing

For some people, mood and anxiety disorders can hinder their ability to successfully manage life’s ups and downs. For others, mood and anxiety disorders prevent them from living life at all, creating such severe anxiety they can’t leave their house, work their jobs, or enjoy time with family. These disorders can make life incredibly difficult, leaving people feeling lost, isolated, and hopeless.

Depression can cause an unshakeable feeling of sadness, leaving people unable to engage in everyday activities — even enjoyable ones. People affected by depression, especially major clinical depression, can’t “just snap out of it,” and may require treatment, including psychotherapy, medication, or both.

Other mood disorders include bipolar disorder, dysthymia, and disorders related to health conditions and substance use.

Anxiety disorders often come with excessive and persistent feelings of stress, anxiety, and fear. Of course, occasional anxiety is a part of life, but anxiety disorders leave people with intense and excessive worries and fears about everyday situations. People may suffer from debilitating panic or anxiety attacks, forcing them to retreat and start avoiding places or situations that might trigger an attack.

When you couple these existing mood and anxiety disorders with the pressures of the COVID-19 pandemic (such as isolation, fear about an uncertain future, and concerns about economic hardships), it’s no wonder that many people found their symptoms becoming even more pervasive.

 

When is it time for depression and/or anxiety therapy?

Many people wonder if their symptoms are normal, or if they might require some kind of treatment. The truth is that symptoms can range from minimal, to mild, to moderate, to severe. Where you fall on this range will determine whether you need to seek treatment, and also impacts what kind of treatment will be right for you.

At to identify where symptoms fall in the minimal to severe range. We encourage you to use these questions to help determine whether you or a loved one might be ready to seek help.

  • How you feel inside: Do you find little interest or pleasure in doing things? Do you feel down, depressed or hopeless? Do you feel bad about yourself — that you are a failure or that you have let your family down? Have you thought that you would be better off dead, or about hurting yourself in some way?
  • Physical effects: Have you felt tired or had little energy? Have you had trouble with insomnia or sleeping too much? Has your appetite been poor, or have you been overeating?
  • Behaviours or interactions with others changing: Have you had trouble concentrating on things like reading, work or watching TV? Have people noticed that you moved or spoke slowly? Or the opposite — that you’ve been fidgety or restless?

 

To identify where you fall within the range of anxiety symptoms, the EHN Online team looks for:

  • How you feel inside: Do you feel anxious, worried or nervous? Do you have moments of sudden terror, fear or fright? Have you had thoughts of bad things happening, such as family tragedy, ill-health, job loss or accidents?
  • Physical effects: Have you felt your heart racing, sweaty, trouble breathing, faint or shaky? Have you felt tense muscles, jaw clenching or teeth grinding, on edge or restless, or had trouble relaxing or sleeping?
  • Behaviours or interactions with others changing: Have you avoided situations that you’re worried about? Have you left situations or participated only minimally due to worries? Have you spent lots of time making decisions, putting off making decisions or preparing for situations?

 

Alcohol and drugs: how much is too much?

Substance use disorder affects a person’s brain and behaviour and can lead to uncontrolled use of a drug or medication, even when the person knows these substances are causing them harm. It’s important to remember that the legality or illegality of a substance doesn’t play a role in diagnosing substance use disorder, which is why alcohol, cannabis and nicotine can all become problematic.

Substance use disorder can sometimes begin by experimenting with alcohol or drugs recreationally, ‘just for fun,’ but getting drawn deeper and deeper into a complete dependency. In other cases, addiction can start with prescribed medications like opioids. In both cases, users will quickly notice they need more and more to achieve the desired effect, despite the physical, emotional, or financial toll it takes on them and the people they love.

While there are many possible different symptoms of substance use disorder, some signs to look for include:

  • Overwhelming urges to consume the substance
  • Experiencing withdrawal symptoms if you stop consuming
  • Needing more of the substance to get the same effect
  • Spending money on the substance, even if you can’t afford it

Deep down, people often know their substance use is getting out of hand, but that’s a terrifying thing to admit to yourself and others. It takes honesty and immense bravery to admit you need help and to reach out for it, and people who do so require support from trained professionals and caring peers, friends, or family to reclaim their lives and start truly living again.

 

From self-rehabilitation to intensive outpatient programs: which is right for you?

When determining substance abuse and addiction issues, the EHN Online Team looks for the following. We encourage you to use these questions to help determine whether you or a loved one might be struggling.

  • How much do you consume and how do you consume it? Do you drink or take drugs in a particular way to increase the effect? Do you consume in the morning, afternoon and evening?
  • How do substances fit in with the rest of your day? Have you found yourself thinking about when you will next be able to have another drink or take drugs? Have you identified substance use as more important than anything else you might do during the day? Have you felt that your need for drink or drugs was too strong to control? Have you planned your day around getting/taking alcohol or drugs? Have you found it difficult to cope with life without drink or drugs?

 

A closer look at the range of addiction and mental health conditions

We’ve used the answers to our screening questions to create the infographic below. Use your answers to find where exactly you fall in the range of addiction and mental health conditions.

Download the full infographic here.

Minimal: Everyone should take care of their physical and mental wellbeing

If you look at the infographic and determine that you identify as “not using” on the addiction spectrum, and “healthy” on the mental health spectrum, that’s great news. You don’t need to seek professional help for these.

But mental health is like physical health — the more you maintain it, the better you’ll feel. Consider using online apps designed to support good mental health habits and check out free online mental health and addiction communities like the forums from the Mood Disorders Society of Canada.

 

Mild to moderate: try early intervention

If you found yourself in the mild-to-moderate section of the infographic, there are a few ways you can find help.

For mild-to-moderate use of drugs and alcohol, you may still be at the experimental stage. Perhaps you’re feeling peer pressure or find yourself turning to them a little too often. You might be able to stop using the drugs on your own initiative at this stage. Perhaps reach out to a close friend or trusted family member with whom you can be honest. Ask for their support and to hold you accountable as you begin cutting these substances out.

But what if your use becomes more habitual, if you’re consuming substances regularly and increasing doses to get the same effect, and you find yourself having trouble controlling your urge to use them?

 

If early intervention is not enough, it’s time for structured help

Structured help can come in the form of an intensive outpatient program, an industry term for a program made up of individual, group, or family therapy sessions, support groups, medications, and behavioural therapy conducted by a licensed addictions or mental health therapist.

The challenge is sometimes these types of intensive outpatient programs can be hard to come by. The treatment facilities only have limited spaces available or can be too far for people to get to.

This is where EHN Online’s Intensive Outpatient Program (IOP) services come in. With EHN Online, geography doesn’t matter. You get the support you need for your mild-to-moderate symptoms at home, helping you change your path with the guidance of credentialled, caring staff. You get virtual mental health and addiction solutions, delivered by the professionals at EHN Canada, who have more than 75 years of experience successfully treating mental health and addiction issues.

The different online therapy programs include nine hours of group and individual therapy sessions for eight weeks, followed by 10 months of aftercare support. The programs also come with access to EHN’s online platform and app, Wagon, which gives you a personalized recovery plan, as well as different tools, exercises, and ways to record your progress as you achieve your wellness goals.

 

Not sure if online therapy is for you?

It might be the right fit if…

  • You are having increasing trouble functioning at work
  • You have symptoms triggered by specific events or situations
  • Your levels of depression, anxiety or stress are increasing
  • You are relying more on substances to cope with daily life challenges
  • You would like to reevaluate your coping skills to maintain your recovery
  • Your current coping strategies aren’t working

 

Severe symptoms: consider inpatient care

If the infographic places you on the far end of the range, you are grappling with the most serious symptoms and possible harms. You may be at risk for a full-blown mental health crisis, with outbursts of anger, excessive panic attacks, thoughts of suicide, constant fatigue, and falling prey to different addictions.

With symptoms as severe as these, you will require inpatient care with a stay at a professional mental illness and addiction treatment facility for your safety.

This may be unwelcome news, or perhaps you’ve known you needed help for a long time. Either way, you will soon be getting the help you need to take back control of the life that has been stolen from you by addiction or mental health issues. Inpatient care doesn’t just treat immediate issues — such as detoxing — but it will also help you identify and address underlying problems that cause your symptoms, teaching you better ways to cope. With the right help, you can avoid rock bottom, and begin your climb toward a healthy future.

 

A general guide, not a diagnosis

The information about where you may lie on the range of mental health or addiction issues is only offered as a general guide. To get an accurate diagnosis, you need to consult an experienced professional.

EHN Online makes the process of getting the qualified help you need easy. You can simply book a free consultation online, or do so by telephone or email. After the consultation, you can pick the program best suited to your needs.

Then you can start on the road to recovery, supported by EHN Online, a recognized leader in addiction and related mental health services. Wherever your symptoms fall, we can help you find a new and better place to thrive.

 

Begin the journey towards recovery today.

 

How much does online therapy cost?

How much does online therapy cost?

Online therapy is an excellent and convenient way to access mental health support. Even though it may seem that online therapy is a relatively new development, virtual therapy has existed in many forms for years. Over the past year and a half, with the COVID-19 pandemic, online therapy has grown even more popular, with most therapists and programs switching from in-person to an online format. Upon making the switch, many therapists, and their clients, found that online therapy offered several benefits. Aside from being more accessible, online therapy can also be a more affordable option than in-person treatment. If you are considering therapy, learning about the costs of online options can be a great start.

 

What is Online Therapy?

Individual Therapy

Online therapy can take many different forms. Traditionally, when we think of therapy, the image that comes to mind is one of individual counselling, where a therapist talks to a single patient, face-to-face in an office setting. Individual counselling is a popular and proven form of therapy that can, fortunately, be replicated quite easily over the phone through a secure online platform.

Through teletherapy or video therapy, you will meet with a therapist on a call or video call and talk to them for a set amount of time. The platform your therapist chooses will be both secure and private. You can work through any issues you are having and learn coping mechanisms just as you would in person.

While an in-person session can typically run anywhere from $100-200 per appointment, there may be a slight decrease in cost if this session takes place virtually. This can be due to fewer operating costs for the therapists or if your individual

In a treatment plan like this, you may do online counselling in both a group and individual setting for a set period of weeks, as well as have other accountability tools at your disposal like an app and continued access to clinicians. Because it is , the cost breakdown works out to less than if you were to seek out all the elements of the program individually. For example, the cost of a one-hour individual counselling session becomes less than as part of an IOP, while a single session with an independent therapist might run around $150 per hour.

 

Group Therapy

Online group therapy is a form of psychotherapy in which one or two therapists work with several clients at the same time. Therapy groups typically have up to 12 members and meet for one or more hours, weekly. The therapists guide the group process and provide structure. Groups may be open or closed. In an open group, members may join at any time, while a closed group has a set start and end date (like in an IOP).

Often, community support can take the form of group therapy. Online community support is often less expensive or free to use but may not provide the amount of guidance or support on its own that you need to fully recover.

 

Text Therapy

With advances in technology, teletherapy now extends to texting as well. Text therapy services generally operate through a platform that will match you with a therapist who can offer the kind of support you need. Once you have a therapist, you can start sending messages detailing what you want to work through. Text therapy is often priced at a monthly rate and can be much cheaper.

It is also important to keep in mind that even if the cost of the service is the same price online, you might be saving in other ways. Consider and factor in your travel costs or what you might save in childcare if you are doing therapy from home.

 

Is Online Therapy Worth It?

The short answer is yes. While internet-based therapy might seem like a rather new offering, as mentioned above, it’s been around for quite some time and improvements in technology have only made the practice more secure, easier to navigate, and optimal. There is already strong evidence that online therapy is as effective as in-person treatment. A trial in the Journal of Effective Disorders found that “internet-based intervention for depression is equally beneficial to regular face-to-face therapy. However, more long-term efficacy, indicated by continued symptom reduction three months after treatment, could only be found for the online group.”1 In another meta-review of apps for anxiety and depression, researchers found that apps “hold great promise with clear clinical advantages, either as stand-alone self-management or as adjunctive treatments.”2

You may also find that online therapy works best for your lifestyle. It provides access to services you may not otherwise have in your local area and allows you to work on yourself from the comfort of your home. For those who deal with social anxiety, online therapy has been found to be “effective for reducing the symptoms of social anxiety disorder” without the triggering symptoms of face-to-face, which may lead some to avoid or quit treatment.3 Increasingly, smartphone-based options, like apps, are being taken up by organizations like universities to support student mental health.

With a rise in mental health related issues this past year, online and teletherapy helped to increase the capacity for care and aided many individuals to stay on track and continue to make progress with their therapeutic goals.

 

Do Insurance Providers Cover Online Therapy?

While many insurance providers do cover some forms of online therapy, it is always best to check with your provider directly to ensure you know what is included in your plan. Often, whether you are covered or not depends on the credentials of the therapist. Make sure to check with the therapist or program you are interested in to confirm what they are certified in so you can give your insurance provider as much information as possible before investing in a service.

If your insurance providers do not provide coverage, investigate charities that run programs or will help you to fund your therapy. There is more support out there than you might imagine.

 

How Much Should You Expect to Pay for an Online Therapy Program?

The most important thing to keep in mind when considering cost is to think about what is going to be most effective for you. While some services may cost less, they may not be what you need to recover. Going for the cheaper option, instead of the right option, will not only lead to delayed recovery, but money and time wasted.

Something like an IOP may seem like a larger investment, but when you break down the services and amount of hours you are getting, the value for the cost is greater than the average price of a therapy session or standalone text service. It is useful to always consider the cost against the amount and quality of service.

The cost of EHN Online’s IOP works out to $38/hr for 173 hours of treatment at a bundled price. If you were to choose everything the program offers in a self-directed manner, you would end up paying almost twice the price. Therefore, an IOP may be the best option.

All in all, online therapy is a great way to get help for less money and easier accessibility. Prices range, but there are options like insurance and charities that can help. No matter which option, or combination of options you choose, the aims remain the same. Online therapy, like in person therapy, is there to help you relieve distress through discussing and expressing feelings; helping to change attitudes and habits that may be unhelpful, and promoting more constructive ways of coping.

 

Struggling with mental health or addiction? Sign up for an online Intensive Outpatient Program today.

 

References

  1. Lecomte, T., Potvin, S., Corbière, M., Guay, S., Samson, C., Cloutier, B., Francoeur, A., Pennou, A., & Khazaal, Y. (2020). Mobile Apps for Mental Health Issues: Meta-Review of Meta-Analyses. JMIR MHealth and UHealth, 8(5), e17458. https://doi.org/10.2196/17458
  2. “Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial.” Journal of Affective Disorders, Volumes 152–154, January 2014, Pages 113-121. https://www.sciencedirect.com/science/article/abs/pii/S0165032713005120?via%3Dihub
  3. McCall HC, Helgadottir FD, Menzies RG, Hadjistavropoulos HD, Chen FS. Evaluating a Web-Based Social Anxiety Intervention Among Community Users: Analysis of Real-World Data. J Med Internet Res. 2019;21(1):e11566. doi:10.2196/11566

Five signs your teen is struggling with their mental health

Five signs your teen is struggling with their mental health

Our teenage years are meant to be a care-free and exciting, filled with self-discovery and exploration that prepares us emotionally for pending adulthood. But, as most of us can easily recall, the reality of being a teenager is rarely this simple. 

As young people go through the physical, emotional and social changes that are expected in their teens, they’re vulnerable to mental health problems. In fact, 70% of people with a mental illness begin experiencing symptoms before age 18, and young people aged 15 to 24 are more likely to experience mental illness and/or substance use disorders than any other age group [1].

As a parent or guardian, you are in an excellent position to start a dialogue with your teenage kids about their mental health. But, it can be tricky to differentiate between typical teenage moodiness and a mental health issue. Continue reading for five signs your child might be struggling with their mental health and some tips on what to do next.

Teen and youth mental health in Canada

Common mental health issues among youth include:

  • Emotional disorders: Includes depression, anxiety, excessive irritability, frustration or anger, unexpected emotional outbursts, etc. Depression is the fourth leading cause of illness and disability among adolescents aged 15 to 19 globally [2].
  • Eating disorders: Including anorexia nervosa, bulimia nervosa, and binge eating disorder. They typically begin in adolescence or young adulthood and affect women ten times more than men [3, 4].
  • Suicide and self harm: Canada has the third-highest youth suicide rate in the industrialized world [5]. Canadian youth aged 15-24 have a higher risk of suicide than the general population [6]. Risk factors include harmful use of alcohol, depression, stigma, and barriers to healthcare.

 

How can I tell if my teen is struggling with their mental health?

1. They’re falling behind in school

Mental illness can negatively impact concentration, motivation, sleep and energy level all of which can make focusing on school pretty difficult. Your child doesn’t have to have perfect grades, but a drop in marks might be a red flag for concurrent mental health disorders. As well, a 2021 study in the journal Social Psychiatry and Psychiatric Epidemiology found that mental health problems in early childhood and adolescence increase the risk for poor academic performance.

Pressure to succeed academically, test anxiety, bullying at school, poor sleep, poor nutrition and more can all negatively impact a student’s mental wellness and keep them from excelling. You might also notice your child skipping class or not handing in assignments.

2. They’ve experienced unexplained weight loss/weight gain 

If a teenager is rapidly losing or gaining weight, they could be struggling mentally. When experiencing stress or anxiety, teenagers might turn to extreme dieting or overeating regain a sense of control over their lives or conform to societal beauty standards.

 Anxiety, depression, and obsessive-compulsive disorder (OCD) are just a few additional mental health diagnoses that frequently co-occur with eating disorders [7].

3. They’re withdrawing socially and losing interest in their hobbies

While it is normal to lose interest in childhood hobbies as we age, an abrupt avoidance of activities that once brought joy can be a sign of depression. Depression is common across all age groups but can present differently in teens than adults. Some common symptoms include feelings of sadness or crying spells with no apparent cause, excessive anger or frustration, trouble concentrating, weight loss/gain, or thoughts about self-harm and suicide.

4. They’re using drugs or alcohol frequently

Many people start to experiment with drugs, alcohol or tobacco in their teens. According to Statistics Canada, 60 per cent of illicit drug users in Canada are between 15 and 24. The illicit market aside, youth are also vulnerable to prescription drug addiction. For example, in 2019, CAMH found that 11 per cent of Ontario students in Grades 7 to 12 reported taking an opioid pain reliever (i.e. Tylenol 3, Percocet etc.) that was not prescribed to them.  The same study found that high school students were using e-cigarettes (vapes) significantly more often than years before [8].

Many people who have an addiction also develop other mental illnesses, and vice versa. With the right treatment program, these co-occurring disorders can be addressed together.

5. Their sleeping patterns have changed dramatically

Mood and sleep are closely linked. If your teen is struggling with stress and/or anxiety, for example, it can be harder for them to get the amount of rest they need to properly regulate their emotions. According to​​ Harvard Medical School,15 to 20 percent of people diagnosed with insomnia will develop major depression, and even partial sleep deprivation has a significant effect on mood [9].

There are plenty of reasons your child’s sleep schedule might change in high school, but consistent exhaustion is detrimental to their physical and mental health. 

What should I do to help my child struggling with mental health?

If you suspect your teen might be struggling with a mental illness or addiction, the first step is initiating a conversation from a place of compassion and understanding. Here are some tips to prepare: 

1. Learn and listen 

There is plenty of misunderstanding and stigma attached to mental illness and addiction; this creates barriers to accessing proper treatment. If you know or suspect that your teen is struggling, educate yourself on their symptoms or condition to demonstrate how much you care. Some great resources include the Canadian Mental Health Association, Children’s Mental Health Ontario, the Centre for Addiction and Mental Health, and Youth Mental Health Canada. You can also check out EHN Online’s blogs on enabling a loved one’s addiction or speaking to a loved one about their addiction.

Approach a conversation with your teen from a place of empathy, not judgement or accusation. Find a private place to speak, address their emotions and concerns with compassion, and use your research to discuss possible solutions. 

Avoid being confrontational or using a judgemental tone, as this could make your child feel guilty or ashamed. Remind your child that you are initiating this conversation because you care and want what’s best for them.

2. Take care of yourself

Mental health problems are extremely common, especially among young people, and are nothing to be ashamed of. Remember that talking about mental health should be as easy as talking about physical health. 

As you’re helping your child through their mental health struggle, make sure you’re tending to your own health as well and have healthy habits in place to handle stress.

3. Look into treatment options

There are several treatment options and solutions to help better your teen’s mental health that are proven to be effective. A great place to start is talking to your family doctor so they can refer you to a mental health specialist if needed. Publicly-funded treatment options are available through your provincial healthcare system, but keep in mind that wait times can be significant.

If you’re interested in private services, try looking at directories on different professional college’s websites, such as The Ontario College for Psychologists or the Ontario College of Social Workers. Group and individual therapy, medication and stress management techniques have all been proven to help improve mental health. No two journeys to mental wellness are the same. Speaking to a professional can help determine the best course of action for you and your teen.

Finally, if your child is dealing with mild-to-moderate symptoms, a structured outpatient teen program is a great alternative to a residential program.

What does a structured outpatient program look like?

If you suspect your teen might be in need of mental health treatment, a structured, evidence-based outpatient program is an effective and affordable alternative to inpatient (residential) treatment. Virtual outpatient programs allow youth to continue living at home and participating in daily activities such as school, while connecting with like minded individuals and receiving the personalized care they deserve.

EHN Online’s Healthy Minds Comprehensive Teen Program is a nine-week program that helps youth aged 14-18 mend their mental health virtually. With flexible scheduling options, your child can receive the highest standard of mental health care and connect with other teens experiencing similar symptoms from the comfort of their own home. Research shows that outpatient therapy can be as effective as residential treatment, [10] and with EHN Online’s program being tailored specifically to teens, they’ll be able to stay engaged and practice coping skills and strategies in their daily lives.

Structured online treatment programs are a great option for people who have a mild-to-moderate case of mental illness or addiction, and need more support than counselling or medication alone can provide.

The Healthy Minds Comprehensive Teen Program can be accessed virtually across Canada. 

Learn more.

 

Resources for Teens

  • Kids Help Phone: 1-800-668-6868 
  • Hope for Wellness Help Line: 1-855-242-3310 / Online chat: www.hopeforwellness.ca 
  • Indian Residential Schools Crisis Line: 1-866-925-4419
  • Canada Suicide Prevention Service: 1-833-456-4566 (24/7)
  • For Quebec residents: 1-866-APPELLE (277-3553) (24/7) 

 

EHN Online can help. Contact us to learn more about the Healthy Minds Comprehensive Teen Program.

 

Sources

[1] Government of Canada (2006). The human face of mental health and mental illness in Canada. Ottawa: Minister of Public Works and Government Services Canada.

[2] Pearson, Janz and Ali (2013). Health at a glance: Mental and substance use disorders in Canada. Statistics Canada Catalogue no. 82-624-X.

[3] Kessler RC, Angermeyer M, Anthony JC, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 2007; 6: 168–76

[4] Government of Canada. The Human Face of Mental Health and Mental Illness in Canada, 2006. Minister of Public Works and Government Services Canada. Catalogue no.: HP5-19/2006E.

[5] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association; 1995.

[6] Mental Health Commission of Canada (2013). Making the case for investing in mental health in Canada.

[7] Findlay L. Depression and suicidal ideation among Canadians aged 15 to 24. Health Rep. 2017 Jan 18;28(1):3-11. PMID: 28098916.

[8] Anxiety, Depression and Obsessive-Compulsive Disorder. (n.d.). The National Eating Disorders Association (NEDA). Retrieved July 18, 2021, from https://www.nationaleatingdisorders.org/anxiety-depression-obsessive-compulsive-disorder

[9] Centre for Addiction and Mental Health. (2020). Ontario Student Drug Use and Health Study, 1977–2019. https://www.camh.ca//-/media/files/pdf—osduhs/drugusereport_2019osduhs-pdf.pdf

[10] Breslau, N. et al., Sleep Disturbance and Psychiatric Disorders: A Longitudinal Epidemiological Study of Young Adults, Biological Psychiatry. Mar 1996; 39(6): 411–418.

[11] McCarty, D., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Substance abuse intensive outpatient programs: assessing the evidence. Psychiatric services (Washington, D.C.)65(6), 718–726. https://doi.org/10.1176/appi.ps.201300249

Does online counselling work for depression?

Does online counselling work for depression?

Man-thinking

It is estimated that 1 in 3 Canadians will be affected by a mental illness during their lifetime.1 With mental health conditions like depression on the rise in Canada,2 access to treatment and care are more important than ever. Therapy has long been studied and proven as a positive treatment for many mental illnesses, but online or virtual treatment is a relatively newer endeavour. While teletherapy has existed for over twenty years,13 interest in virtual treatment for mental health concerns grew significantly in 2020 when most in person services had to quickly switch to virtual due to the COVID-19 pandemic. This switch increased both the study of and interest surrounding online counselling for conditions like depression and anxiety. Research shows that both modes of delivery are effective and there may even be some lifestyle benefits to online treatment.

What makes therapy effective?

To decide whether online treatment may be the right choice for you, it helps to understand what therapy is and what makes therapy effective. In psychotherapy, professionals apply scientifically validated procedures to help people develop healthier, more effective habits. There are several approaches to therapy—including cognitive behavioural (CBT), interpersonal, and other kinds of talk therapy—that help individuals work through their problems.3 Psychotherapy offers people the opportunity to identify the factors that contribute to their mental conditions and to deal effectively with the causes. Skilled therapists work with individuals so they can identify negative thought patterns, pinpoint and solve certain life problems, and regain a sense of control and pleasure in life.4

Effective therapy can be determined by several factors. Broadly speaking, a person may notice a reduction in their symptoms, an increase in overall happiness, more energy, and better self-worth. 5,6

Differences and similarities between virtual and in person therapy

All of the above outcomes can be achieved whether someone chooses to seek therapy in person or online. When thinking about which option is right for you, consider how the two modes are similar and how they differ.

Keep in mind is that both are effective for treating a mental disorder. A 2014 study found that online treatment was just as effective as face-to-face treatment for depression,7 while a 2018 study found that online CBT was equally as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.8

Reading body language

Both in person and online treatment also offer the opportunity to make a personal connection with your counsellor and have one-on-one time with them for a personal assessment and to identify any potential concerns. Therapists that operate virtually are often trained to pick up on social and body language cues even in a virtual session and can take similar, if not the same, steps to intervene in a crisis. Before selecting a virtual therapist, you can inquire about their online training and how crises are addressed to ensure that you are satisfied with their approach.

Location and time

The largest difference between the delivery of in person and online therapy is the logistics surrounding sessions, such as time and place. While virtual treatment can be done from your own home and requires no commute time, in person therapy involves travelling to and from a therapist’s office.

Because virtual treatment takes place remotely, your location does not matter. With face-to-face treatment, the therapist must be in a vicinity close to you and your choices are limited to those that practice in your area. When geographical location is eliminated from the mix, more specialized treatment can often be found online with a larger pool of services to choose from.

Cost of treatment

Cost is another thing that might differ between in person and virtual. While some therapists may charge the same for online and in person sessions, certain virtual programs may be more cost-effective, where the price breakdown per hour comes out to less than a typical session.

Anonymity and privacy

You may also want to consider the varying levels of anonymity that come with programs. With in-person, there is always the chance of running into someone you recognize in a waiting room or in front of the therapist’s office, particularly if you live in a small town. In virtual programs, there may be a group session where other participants are involved. As with many programs that deal with private subject matter, measures are taken to ensure a level of privacy. These measures are another thing to consider when inquiring about programs that may include a group component.

Privacy and confidentiality are among common concerns for those who consider online treatment programs. Despite popular belief, online therapy can be equally as confidential as in person therapy. If you are feeling unsure about your privacy, inquire about whether your service is compliant with the Health Insurance Portability and Accountability Act (HIPAA). In short, this act works to protect the confidentiality of people receiving medical treatment, including mental health services.

Suitability

Lastly, consider what option is truly right for your condition and symptoms. Some individuals may not be suitable for online therapy. Individuals with severe mental health disorders such as schizophrenia, intellectual disabilities, or high suicidality may not be a good fit for some online therapy services.9 On the other hand, those with severe social anxiety might benefit from testing the waters of socialization through virtual group meetings where the perceived risks are much lower.

Proven benefits of online counselling

Flexibility

There are several benefits to online therapy. For many people, being able to partake in therapy from their own home saves them the time it takes to commute to and from treatment. It also allows for greater flexibility if the person cannot leave the house to attend a session. Those with younger children, for example, can attend a virtual session from their own home without having to arrange childcare.

Accessibility

A virtual program is also ideal for those with less accessibility to individual counsellors, such as those who live in smaller towns or remote areas. In these cases, online therapy works well as distance is no longer an issue. This also allows people to access a particular kind of service or therapeutic program that might not be offered anywhere physically near to them.

Less intimidation, more connections

Online group programs create a safe space for participants to open up to one another, which increases the number of opportunities to access peer support and make connections. Online therapy also encourages the disinhibition effect. Knowing you can close your laptop, are in a safe space, and that your support system may be close by allows people to feel more relaxed and comfortable to share their experiences. This is especially true for those who deal with social anxiety. Not having to leave the house and being able to attend treatment from a safe space makes getting help less intimidating.

 

While online therapy does not have the century of research behind it that in person therapy does, several studies and research in the last decade have found that online treatment has equal efficacy to in person treatment. One study directly compared the effectiveness of the online CBT to in-person CBT and found that they were equally effective at reducing depression.10 In that study, those who stayed in therapy the longest saw the greatest benefit. It is not only CBT and the treatment of depression that works well online. Solution-Focused Brief Therapy, which focuses on setting goals and finding solutions to problems, has also been tested online. In one study, researchers assigned students with mild to moderate levels of anxiety to receive either online or in-person therapy. Both methods were equally effective.11 Online therapy has also been studied regarding teletherapy’s success for PTSD and proved to be an effective method of treatment.12

To summarize, online therapy can bypass factors such as transportation, accessibility, and affordability. Remember that while a lot happens in sessions, most of the growth work is done out in the world while you are experimenting with and practicing the things you learned in treatment. Whether doing counselling in person or online, deciding to focus on your mental health and well being is always a worthwhile commitment.

 

How to access online counselling

If you think online treatment would suit your needs and lifestyle, consider EHN Online’s Mood (Depression) and Anxiety Intensive Outpatient Program. This online therapeutic program is for individuals struggling with mood or anxiety disorders such as (but not limited to) depression, anxiety or panic disorders and are looking to manage or alleviate their symptoms.

This online intensive outpatient program provides a supportive and structured treatment experience that allows patients to make meaningful changes to sustain long-term recoveries. You can expect to receive evidence-based therapy and support in a safe and non-judgemental space.

 

 

Still not sure which type of treatment is right for you?

Chat with an admissions counsellor or take our self-assessment quiz to learn more!

 

 

References

1 Canadian Community Health Survey – Mental Health (CCHS – MH), 2012. Percentage of the household population aged 12+ living in the 10 provinces that met criteria for at least one of six mental disorders (including mood disorders, generalized anxiety disorder, and substance use disorders).

2 Mental Health in Canada: Covid-19 and Beyond. (2020). CAMH Policy Advice. https://www.camh.ca/-/media/files/pdfs—public-policy-submissions/covid-and-mh-policy-paper-pdf.pdf

3 Understanding psychotherapy and how it works. (2020, July 31). Https://www.Apa.Org. https://www.apa.org/topics/psychotherapy/understanding

4 Depression and how psychotherapy and other treatments can help people recover. (n.d.). Https://Www.Apa.Org. Retrieved July 20, 2021, from https://www.apa.org/topics/depression/recover

5 What is Psychotherapy? (2019, January). American Psychiatric Association. https://www.psychiatry.org/patients-families/psychotherapy

6 Gillihan, S. (2018, February 7). How Do You Know When Your Depression Is Improving? Psychology Today Canada. https://www.psychologytoday.com/ca/blog/think-act-be/201802/how-do-you-know-when-your-depression-is-improving

7 Wagner, B., Horn, A. B., & Maercker, A. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders, 152–154, 113–121. https://doi.org/10.1016/j.jad.2013.06.032

8 Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018). Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. Journal of Anxiety Disorders, 55, 70–78. https://doi.org/10.1016/j.janxdis.2018.01.001

9 Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical Issues in Online Psychotherapy: A Narrative Review. Frontiers in Psychiatry, 0. https://doi.org/10.3389/fpsyt.2019.00993

10 Carlbring P, Andersson G, Cuijpers P, Riper H, Hedman-Lagerlöf E. Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis. Cognitive Behaviour Therapy. 2018; 47(1):1-8.

11 Novella JK, Ng KM, Samuolis J. A comparison of online and in-person counseling outcomes using solution-focused brief therapy for college students with anxiety. Journal of American College Health. 2020:1-8.

12 Turgoose D, Ashwick R, Murphy D. Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder. Journal of Telemedicine and Telecare. 2018;24(9):575-85.

13 Novotney, A. (2017, February). A growing wave of online therapy. Https://www.Apa.Org. https://www.apa.org/monitor/2017/02/online-therapy