OP: Life can be good and does indeed gets better, if you are not in a good place, please do talk to someone, try to make a change, no matter how small, and stay strong.
I say this as someone who rather successfully turned things around with a therapist - I simply did not have it in me to have those conversations with others and I didn't feel I had the relationships or support to do so (in retrospect I probably did, but that's the thing about mental health).
I don't think your diagnosis is wrong, particularly - there's a lot in the modern world that promotes alienation, feelings of low self esteem, and depression, but I think a lot of people find themselves at the bottom of the well before realizing quite what's happening and without the support structures to get out on their own.
(Edit just to note that, like physical health, mental health is not just the consequences of one's own actions - both genetic predispositions and unexpected life events can necessitate professional intervention by no fault of one's own. It's not what we're talking about, but just so nobody takes my post to be a psalm from the church of the self-sufficient.)
It's just a sad state of affairs that there are so few other options for people. I continue to pin the blame on the remote-first nature of society, which seems to make in person interaction secondary. It perpetuates loneliness which perpetuates mental health issues.
I suspect that the number of people who could benefit from quality therapy, greatly outnumbers the amount of quality therapists that exist in the world.
To the point where, I surmise, a vast majority of the world's population simply would not have meaningful access to it, due to location, finances, availability, introversion, etc.
So for me, it's not that "get therapy" is bad advice. Good thing is good. Therapy has proven techniques and results. But that doesn't help the majority of the world's population, who do not have access to the luxury of visits to high end trained professionals that only exist in suitably affluent settlements of certain countries.
I also suspect that the broad lack of coverage for therapy and other kinds of mental care in most medical plans, as well as a "treatment/cure"-type paradigm when it IS covered ("we expect your 40 years of accumulated neurosis to be adequately addressed within 6 months, otherwise we're not going to pay anymore") is part of why this is out of reach for many people.
(I also suspect providing the population with broad access to mental health care would almost immediately pay for itself in terms of better physical health outcomes, improvements in the crime rate, and better economic outcomes, but that's the kind of second- and third-order thinking we're pretty notoriously bad at in this country, policy-wise)
1) what I refer to as "psychiatric" therapy, with a specifically "medical" way of doing things. It's based on diagnosis and pathology, with a focus on treating the underlying causes of mental health problems. This typically amounts to chemical intervention. The provider will always be someone with a medical license, typically an M.D. or PsyD, although it can also be an RN or PA; someone who can prescribe drugs. While not always the case, talking with them is generally limited in scope to what is necessary to provide a diagnosis and appropriate medication management. It's normal to have appointments on a monthly basis initially, often stretching to a brief visit every 3 months as one's condition stabilizes. You will need to continue to see them for as long as you take medication (although you can sometimes convince a primary care physician to take over medication management once an effective treatment regimen is established).
2) what I refer to as "psychological" therapy, this is often in the form of talk therapy, and focuses more on cognitive understanding and behavioral modification, and can even be as simple as having someone listen to your shit, put it into a reasonable perspective, and provide emotional support or even just providing human interaction. Often the provider will have a Master's or Doctorate in psychology, which is NOT a medical degree. While some psychiatric doctors will also handle this type of therapy, it's much more often they'll refer you to someone who does this. It's quite common to see this person for an hour each week, but can be more or less often and may also include group therapy. They focus on teaching coping skills and can provide CBT and the like. Some people may continue to benefit from this therapy and go for years, others may stick around just until they establish the coping skills needed for their situation.
I'm probably over generalizing, but it's uncommon to start out not knowing what to expect at all, so if even one person reads this and benefits, it was worth me writing this long post on my phone at 2 a.m.
I also have a bit of a warning, with either type of therapy, it's not uncommon for patients to think they should see results pretty quickly, and when they don't they will assume it's not working and discontinue treatment or assume their therapist is inept and jump between several in short order. Imo, this is the worst thing someone can do, it may take a few months for medication to show results and more often than not the first few tries can fail to help, and it can literally take years to develop behavioral changes and coping skills to the point they show real benefit. People that give up on therapy too quickly can end up losing all faith in therapy for the rest of their life, and losing that kind of hope can even worsen their problems. I struggled from my late teens and all the way into my 30s before I really began to really feel like I hit an appropriate balance in daily life, and that isn't guaranteed. However now if I fall apart, I can put myself back together in a matter of days instead of wallowing for years.
For me it took a long, long time to see results. Like 2 sessions a week for 6 months... then see slight improvement... then a major regression after some difficult life events... then another year of thinking I wasn't seeing progress... then rapid improvement.
But, in retrospect, there was constant progress that I wasn't in the right frame of mind to observe. One of my issues was that I had spent decades learning to ignore my issues. It took a lot of progress on that issue before I could see most of the other progress I had made.
One thing I could observe quickly was just how bad things were. Almost every session was revealing new ways my thought patterns were making things hard when they didn't need to be. Not what to do about those thought patterns yet, but just that they were there. That convinced me to keep doing the hard work. I'm glad I did.
That's really not how you framed your comment.
> There are friends, elders, books, and a number of other ways to climb out of a mental rut.
> I continue to pin the blame on the remote-first nature of society, which seems to make in person interaction secondary.
Which doesn't concern the majority.
> It perpetuates loneliness which perpetuates mental health issues.
You seem to think mental health issues originates in loneliness. I can see how convenient that outlook is but it's nowhere that simple.
This is an important data point and a general trend toward the cheapening of human relationships. Friendship means something very specific, and for a lot of people now it means only the superficial. Anything deeper than that is actively discouraged. I think of those surveys about friendship took this kind of friendship into account. The number of people without any friends at all would be outrageously high.
Person 2 is first of all, hard to find, unavailable, and extremely expensive. They don't know you, and in general aren't willing to share their own personal experiences with you. The interaction with Person 2 is transactional and does nothing to affirm the importance of your suffering to someone other than yourself.
It's a little like your suggesting to have sex with a prostitute because they're better at it. But that misses the point of what sex is even for. A lot of the time we just want to be assured that we matter, that our experience matters, and that we aren't alone. But yeah, a lot of people see it like you do, and I think that makes it a worse culture.
And then also there are just less and less friends. In any friend circle there are some people that are just better to lean on. As you get older these people move away, get married, etc.
I do agree that today's generations seem to be less deeply connected than older generations. Relationships take work and vulnerability, but today's distractions make everyone feel they are short on time and make us too absorbed with the perfection of the masks we wear. Its a shame, because deep friendships are truly something to be cherished.
"True friendship is a plant of slow growth, and must undergo and withstand the shocks of adversity, before it is entitled to the appellation." - George Washington
I tried lyra. All the wording and questions ask screamed to me "these are not my type of people". I'm not going to go into specifics but imagine you walked into a help conference and every table had energy stones, power of pyramids, astrology books, etc... If you're anything like me you'd walk out.
Once I made it past all that it recommended some therapists all of whom were white. The metro area I live in, 8 million people, is only 60% white in total and many areas are majority not white. I tried changing my location to an area known for being majority not white but it just gave me the same people.
It just got me wondering how much of therapy is a white culture thing because it seems statistically unlikely that of the 11 therapists it recommended, all 11 would be white if the demographics of the area say that only 60% of the population is white.
It was no different on BetterHelp.
I assume non-white majority countries also have psychologists/therapists, though.
https://www.huffpost.com/entry/what-therapy-is-like-around-t...
Poor people generally avoid discussing issues in public and then discuss them with family.
But far more frequently violence and alcohol are the default "therapy".
If you take this:
https://www.who.int/data/gho/data/indicators/indicator-detai...
and plot it against a GDP per capita data source, they're basically aligned.
Another possibility is there are cultural norms: psychotherapy originates in Europe / Central Europe where it had a blossoming in the late 19th century and spread, and became quite fashionable in among the educated classes (up to and especially in the 1960's, for example).
You should reword that. Otherwise how did humanity last this long? Psychotherapy is less than two centuries old. You should instead say something like, "One option is to see a therapist."
There are friends, elders, books, and a number of other ways to climb out of a mental rut. Traipsing "Psychology Today" for a therapist who will charge the insurance $150 for 40 minutes of a session, through Zoom no less, with your $40 co-pay after deductibles is such a commercial approach to what is fundamentally a human problem.
You know a very modern problem? You can't sit easily and talk with friends over a drink about your issues and have someone give you constructive advice. Everyone is remote, busy, prefers chatting online, and as a result a lot of loneliness manifests as "Oh my god, what am I doing with my life."