When I first meet with clients, we discuss how to reduce unnecessary suffering. We often don’t realize how much suffering we can address by asking the right questions.

Here are the main areas that come up as starting points to begin to feel relief and see change.

Meds. This is controversial, but hear me out. In therapy, we can address non-chemical influences that exacerbate symptoms. There are biological contributions to our makeup that may wait for an environmental trigger to manifest. Looking into family history, if others have experienced similar symptoms and have had success with certain medications, it is a good place to start. Medication is not a magic cure. It can address the chemical imbalances that therapy alone may not necessarily be able to.

There are reasons people may definitely NOT want to start medications, and those reasons are valid. It’s helpful to make a conscious decision about it. Objections include: intolerance to medications, prior adverse reactions, distrust of the pharmaceutical industry, etc. People will also often say that they don’t want to “be dependent” or “rely on” a medication to feel better. Many psychotropic medications are a supplement to overall mental wellness, and a piece of the puzzle. It does not take away personal agency or success. It is just a booster. Moreover, medication may not be needed forever. The knowledge of how to achieve balance and wellness in other ways is also what therapy is about.

A caveat to this is how trauma affects our brains and physical response to stress. This can be treated in therapy, with or without medication. It is a personal choice. If reducing suffering is the goal, it is important to consider this.

Ruling out or treating physical contributions to mental health symptoms. Many come to therapy not realizing how much a medical condition or conditions can influence depression, anxiety, restlessness, fatigue, inability to concentrate, etc. Common medical conditions that can masquerade as mental health: PCOS and hormonal problems, thyroid conditions, Fibromyalgia, sleep conditions, chronic illness, and more. The interaction between medical conditions and mental health cannot be ignored and can often be a chicken and egg problem. This is why I am eager to collaborate with a client’s physicians in order to find the best course of treatment for him or her- both medically and psychologically. While not medical, Attention Deficit Disorder is commonly overlooked in adults and can lead to compensatory anxiety. It is relatively easy to screen for Adult ADD; clients who have addressed this have seen a dramatic reduction in symptoms of depression and anxiety without medication for the latter.

Communication skills. The way we communicate personally and professionally has a huge impact on how we feel. It’s not only talking but listening. Understanding how we perceive what others are saying to us. This is a process, but can yield so much relief. It involves setting boundaries, asking for clarity, and not making negative assumptions about what others are saying to us. Because this issue is so common, I’ve created scripts for people to help them communicate more clearly in their close relationships. Find them here.

Coping: breathing. Box breathing is a simple but extraordinarily effective technique to bring down our heart rate and get our thinking brain back online. It can be used anywhere, it is discrete, it is easy to remember, and very effective. So… imagine a box. Breathe in for 4 counts, hold for 4 counts, breathe out for 4 counts, hold for 4. Repeat several times. Alternatives to this method: 4-7-8. Breathe in 4, hold 7, exhale 8. Make sure your stomach is expanding on the inhale, as we tend to only breathe into our chests when anxious.

Time management. There are so many different reasons we struggle to manage our time. The key is identifying yours and working to find manageable solutions. Contributors include: social media, numbing out in myriad ways, lack of productivity, depression and lack of motivation, etc. There are so many tools to improve time management. Apps galore, Pinterest boards aplenty. One great tool is called the Pomodoro Method. Set a timer to work for 25 minutes; take a break for 5 minutes and repeat. Breaking time and tasks into workable chunks can alleviate overwhelm and help increase motivation.

We want quick wins in the beginning of therapy. After we remove the initial layer of unnecessary suffering, we get to the deeper sources of suffering that take more effort, consistency, and belief in oneself to have success. By succeeding on the aforementioned issues, there is evidence in the ability to do just that.

For these and additional resources, click here.