Ask For Help When You Need It

Musicians' Assistance Program

Volume CVII, No. 4April, 2007

Janet Becker, LCSW, Ph.D. and Emma Ditrinco

American values emphasize the importance of self-reliance. We are taught to pull ourselves up by our bootstraps and that we are responsible for our own destinies. Very often, however, this is simply not realistic or possible.

Steeped in the ethic of rugged individualism, it isn’t surprising that when in need of help, many Americans feel a sense of embarrassment or failure, which may discourage us from making use of resources that are available to help us.

At the MAP office, we believe that being able to reach out for assistance — financial, emotional, or otherwise — is a strength.

Whether you turn to a friend, religious leader, family member, social worker, or other mental health professional, the act of asking for help — and being open to receiving it — can be empowering.

While the reluctance to seek help with personal problems is a common issue, it is particularly critical among American men. In the area of mental health, statistics indicate that men are less likely to seek treatment for depression than women. And according to the National Institute of Mental Health, depression is reported among women twice as often as among men.

However, it is very possible that depression is not less common among men, but that it is underreported. Men may not recognize their symptoms as depression, or they may see them as signs of weakness or personal failure.

These symptoms — sadness, diminished sex drive, lack of interest in things formerly found pleasurable, low self-esteem, feelings of helplessness — aren’t consistent with the popular notions of what our society views as masculine.

Men, therefore, often try to tough it out alone, expecting themselves to overcome their suffering in silence, through sheer will power.

It follows, then, that although men may underreport depression, they enter treatment for drug and alcohol abuse more frequently than women (again, according to the National Institute of Mental Health).

It is theorized that men may turn more frequently to drugs or alcohol to hide their “non-manly” symptoms not only from others, but, more importantly, from themselves.

Men are also four times as likely to die by suicide as women, a fact which the National Institute of Mental Health suggests may have to do with the fact that men are less likely to seek treatment for depression.

Although the reasons that people do not seek help vary widely, there are some common themes that emerge.

First, many people are reluctant to seek professional help because of concerns about confidentiality.

Some fear that the very fact that they asked for help with their problem would be damaging if it were revealed to family members, colleagues or employers.

Therefore, it is important to understand that confidentiality is a central ethical principle, as well as a legal requirement, in the mental health professions.

In most states, and certainly in New York, the law requires a mental health care provider to break confidentiality only in situations of possible child abuse or planned physical harm to others or to oneself.

In all but these rare situations, patient confidentiality is taken very seriously by professionals.

At the MAP office, we adhere to these principles and hold personal information in the strictest of confidence, unless you give us explicit, written consent to share it in order to help you.

More difficult, however, are the feelings that often accompany asking for help.

Some feel that because they cannot solve their problems on their own, they are somehow diminished, or that they should feel ashamed. This can be a terribly lonely and isolating place to find oneself.

Many of us, at one time or another, have felt that a problem is so big and overwhelming that no one else can possibly understand it. Or some people may feel that revealing their difficulties to someone else will result in negative judgment and incrimination.

In reality, however, mental health providers are trained to be nonjudgmental of their clients’ feelings and actions, and see their role as one of listener and helper, rather than that of judge.

People often experience great relief in finding that it is safe to express their troubling thoughts, feelings and situations to someone who is accepting and able to empathize.

Very often, this experience becomes a first step in the process of restoring needed self-esteem, and mobilizing one’s internal strengths and resources.

While there are no quick fixes or easy answers, reaching for help when you need it can be potentially life-changing. Allowing someone else to help you truly is a way of helping yourself.

Despite our cultural ideal of the totally self-sufficient person, the truth is that no one is an island — we are interdependent beings who truly need each other — and that we need not — and should not — isolate ourselves when help is needed.

For more information on men and depression, see