MENTAL HEALTH, THERAPY & BEHAVIORAL HEALTH FAQS

You have questions. That’s part of figuring out what you need.

Mental health doesn’t always fit neatly into a diagnosis or a specific type of therapy. You might know what you’re experiencing without knowing what it means. Or you might know something needs to change without knowing where to start.

We’ve answered some of the questions people commonly have about symptoms, therapy, testing, evaluations, and specialized behavioral health care.

UNDERSTANDING WHAT YOU'RE EXPERIENCING

  • Anxiety may be worth addressing when worry, fear, overthinking, physical tension, panic, avoidance, or the need for reassurance begins interfering with everyday life.

    Some anxiety is a normal part of being human. But when it takes up significant mental space, affects relationships or sleep, changes what you do or avoid, or makes it difficult to feel present, therapy can help you understand the pattern and learn different ways of responding to it.

  • Yes. Depression does not always feel like being visibly sad.

    For some people, depression shows up as exhaustion, irritability, numbness, isolation, difficulty concentrating, loss of motivation, changes in sleep or appetite, or feeling disconnected from things they normally care about.

    A therapist can help explore whether these experiences may be related to depression or something else.

  • Anxiety and OCD can overlap, but OCD typically involves a cycle of intrusive thoughts, images, sensations, or fears followed by compulsions or mental behaviors intended to reduce distress or prevent something from happening.

    Compulsions aren't always visible. They can include reassurance-seeking, mentally reviewing events, checking feelings, repeating phrases internally, researching, or trying to reach absolute certainty.

    A mental health professional can help distinguish OCD from generalized anxiety and recommend appropriate treatment.

  • Yes. Someone can be affected by difficult, frightening, overwhelming, or destabilizing experiences without meeting diagnostic criteria for PTSD.

    Trauma-related responses can include hypervigilance, avoidance, emotional numbness, intrusive memories, difficulty trusting others, relationship patterns, physical reactions, or feeling unsafe even when you logically know you're safe.

    Therapy does not require you to prove that an experience was “bad enough” before you can talk about how it affected you.

  • Grief can involve sadness, anger, numbness, guilt, relief, anxiety, difficulty concentrating, changes in identity, or feeling disconnected from everyday life.

    And grief isn't limited to death. People can grieve relationships, health, fertility, family changes, careers, identities, opportunities, or versions of life they expected to have.

    There isn't one correct way or timeline for grief.

  • Yes. ADHD, anxiety, depression, stress, sleep difficulties, trauma, and burnout can share symptoms such as difficulty concentrating, procrastination, forgetfulness, overwhelm, low motivation, and problems completing tasks.

    That overlap is one reason a comprehensive ADHD evaluation looks at more than whether someone checks boxes on an ADHD questionnaire.

FIGURING OUT WHAT KIND OF THERAPY YOU NEED

  • Therapy may be worth considering when something is causing distress, repeating in ways you don't understand, interfering with your relationships or daily life, or simply feels difficult to manage alone.

    You also don't need to be in crisis to go to therapy. People seek therapy to understand themselves, navigate transitions, improve relationships, process experiences, or change patterns they've started noticing.

  • No. You do not need to arrive at therapy already knowing what diagnosis fits your experience.

    You can start with what you've noticed: what feels different, what's becoming difficult, what keeps happening, or what you'd like to understand better.

    Determining whether a diagnosis is clinically appropriate can be part of the assessment and treatment process.

  • There isn't one therapy approach that is best for every person or every mental health concern.

    Depending on the concern and the individual, treatment may draw from approaches including CBT, DBT, ACT, IFS, Trauma-Focused CBT, EMDR, mindfulness-based interventions, or other evidence-based and evidence-informed therapies.

    The diagnosis matters, but so do the person's history, age, goals, preferences, relationships, and how symptoms are showing up in everyday life.

  • Cognitive Behavioral Therapy (CBT) is a structured therapy approach that looks at connections between thoughts, emotions, behaviors, and patterns of responding.

    CBT can be used in treatment for concerns including anxiety, depression, trauma-related symptoms, stress, and other mental health difficulties.

    How CBT is used varies depending on the person and their treatment goals.

  • Dialectical Behavior Therapy (DBT) teaches skills related to emotional regulation, distress tolerance, mindfulness, and relationships.

    Elements of DBT may be helpful for people who experience intense emotions, difficulty tolerating distress, impulsive responses, relationship difficulties, or challenges managing emotions effectively.

  • Internal Family Systems (IFS) is a therapy model that explores different internal “parts” of a person's experience and the roles those parts may have developed over time.

    Rather than treating difficult thoughts or reactions as something that simply needs to disappear, IFS can help people become curious about where those responses came from and what they may be trying to accomplish or protect.

CHILDREN & TEENS

  • Changes in mood, behavior, sleep, school performance, relationships, emotional regulation, anxiety, withdrawal, or the way a child responds to stress can all be reasons to consider therapy.

    Sometimes parents can identify exactly what changed. Other times they simply notice that their child doesn't seem like themselves.

    An evaluation with a clinician who works with children or teens can help determine what support may be appropriate.

  • Children do not have to communicate the same way adults do for therapy to be meaningful.

    Depending on a child's age and needs, clinicians may use conversation alongside play, creative activities, skill-building, games, or other developmentally appropriate ways of communicating and processing experiences.

  • Play therapy uses developmentally appropriate forms of communication to help children express emotions, process experiences, practice skills, and make sense of things they may not yet have the language to explain.

    The play itself isn't simply entertainment. It can become part of how a trained clinician understands and works with the child's emotional and behavioral experience.

  • Parents or caregivers may be involved in a child's treatment depending on the child's age, concerns, treatment goals, and clinical needs.

    The therapist can explain what parental involvement will look like while also maintaining appropriate privacy and therapeutic boundaries for the child.

COUPLES & RELATIONSHIPS

  • Couples don't have to wait until a relationship is close to ending before seeking therapy.

    Couples therapy may be helpful when communication repeatedly breaks down, the same conflicts keep happening, partners feel disconnected, trust has been affected, intimacy has changed, or a major life transition is putting strain on the relationship.

  • Yes. Repeating arguments are often about more than the surface-level topic being discussed.

    Couples therapy can help partners slow the interaction down, understand what happens underneath the conflict, recognize recurring patterns, and practice responding to one another differently.

  • The Gottman Method is an evidence-based approach to couples therapy informed by research on relationships and patterns associated with relationship stability and distress.

    Treatment may focus on friendship, communication, conflict management, emotional connection, and building healthier relationship patterns.

TRAUMA & EMDR

  • Eye Movement Desensitization and Reprocessing (EMDR) is a structured psychotherapy approach designed to help people process distressing experiences and memories.

    EMDR uses bilateral stimulation as part of a broader treatment protocol and does not require someone to repeatedly describe every detail of a traumatic experience.

  • No. EMDR is widely associated with trauma and PTSD, but trained clinicians may use EMDR when clinically appropriate for other distressing experiences or symptoms.

    Whether EMDR makes sense depends on the person, their history, symptoms, treatment goals, and readiness for the approach.

  • Not necessarily.

    EMDR differs from some forms of traditional talk therapy because clients generally do not need to give a detailed verbal account of every aspect of an experience for processing to occur.

    Your therapist should explain the process and work with you at a pace appropriate for your needs.

ADULT ADHD & TESTING

  • An ADHD evaluation may be worth considering when longstanding difficulties with attention, organization, time management, task initiation, follow-through, impulsivity, forgetfulness, or executive functioning consistently interfere with everyday life.

    The important word is longstanding. ADHD is a neurodevelopmental condition, so a comprehensive evaluation considers both current functioning and earlier patterns rather than only recent difficulty concentrating.

  • Yes. Academic achievement alone does not rule out ADHD.

    Some people compensate through structure, intelligence, anxiety, perfectionism, extensive effort, family support, or environments that happen to work well with their strengths.

    Difficulties may become more apparent later when adult life requires greater independent management of time, work, relationships, finances, household responsibilities, or parenting.

  • ADHD symptoms overlap with many other experiences and mental health conditions.

    An online screening can identify symptoms worth exploring, but a comprehensive ADHD evaluation considers developmental history, current functioning, impairment, other possible explanations, and the broader clinical picture.

  • Difficulty concentrating, procrastination, forgetfulness, overwhelm, restlessness, and executive-functioning problems can also occur with anxiety, depression, trauma, sleep problems, chronic stress, substance use, medical concerns, or burnout.

    More than one condition can also exist at the same time. Evaluation helps clarify what may be contributing to the symptoms rather than assuming every attention problem is ADHD.

SUBSTANCE USE

  • Substance use may be worth evaluating when it begins affecting relationships, responsibilities, physical or emotional health, safety, work, school, finances, or the ability to control how much or how often a substance is used.

    You don't have to wait until substance use reaches its most severe form before asking questions about it.

  • A substance use evaluation looks at patterns of alcohol or drug use alongside their impact on health, relationships, responsibilities, safety, and daily functioning.

    The clinician may also consider mental health history and other factors that can influence substance use before making recommendations for appropriate next steps.

KETAMINE-ASSISTED THERAPY

  • Ketamine-assisted therapy combines psychotherapy with medically supervised ketamine treatment for appropriately screened clients.

    The therapeutic component can provide structured preparation, support, and integration around the ketamine experience rather than treating medication administration as the entire intervention.

  • No. Ketamine-assisted therapy is a specialized treatment and isn't simply a standard therapy session with medication added.

    Appropriate screening, medical oversight, preparation, and integration are important parts of the process. At Tides of Change, ketamine-assisted therapy is offered in partnership with Journey Clinical.

EVALUATIONS

  • Therapy is generally an ongoing treatment process focused on mental health, emotional well-being, relationships, behavior, or other therapeutic goals.

    An evaluation is primarily designed to answer a specific clinical question. It may involve interviews, assessment tools, history, records, or other information before the clinician provides findings or recommendations.

    Tides of Change provides several types of behavioral health evaluations, including adult ADHD, substance use, diagnostic, DOT SAP, and certain professional evaluations.

  • A DOT Substance Abuse Professional (SAP) evaluation is part of the federally regulated return-to-duty process for safety-sensitive employees who have violated Department of Transportation drug or alcohol regulations.

    The SAP evaluates the employee and makes recommendations regarding education, treatment, follow-up, and the requirements that must be completed before moving forward in the return-to-duty process.