How do I know when I should get help?

It's completely normal to feel down sometimes. But when these feelings become persistent, unmanageable or are accompanied by physical changes it may be time to talk with someone who can help. Trust that you know yourself. Chances are if you are exploring this information, you know something is not as it should be or you are struggling and it is time to look into seeing a professional to discuss how you are feeling.

Symptoms of anxiety, depression and mental health conditions can include:

  • Physical changes such as nausea or muscle tension
  • Withdrawal from family or friends
  • Excessive worry or fear
  • Feeling sad, lonely, isolated
  • Confusion or problems concentrating
  • Extreme mood changes
  • Often feeling irritable or angry
  • Changes in sleeping habits
  • Difficulty concentrating on daily tasks
  • Nervous energy or restlessness
  • Overeating or appetite loss
  • Loss of interest in things you once enjoyed
  • Having thoughts of harm to self or others
  • Progressive memory loss or confusion
  • Difficulty perceiving reality
  • Other emotional or behavioral changes

If you or a loved one are considering taking actions related to ending one's own life, exhibit behaviors or actions that could lead to self-harm, overdose, or danger to yourself or others, this is considered an emergency. Please dial 9-1-1.


 What is the purpose and goal of treatment?

Most individuals who seek mental health care, utilize medications, counseling, or other modalities are overall healthy and are experiencing some emotional troubles, or have at some point in life. Some individuals who seek care are very emotionally disturbed, but the majority are not. Seeking mental health care to help in dealing with stress, emotional troubles, or symptoms is no indication in itself of having a psychiatric disorder. On the contrary, it often represents a strong, self-caring, mature and responsible decision for yourself and for those you love.

 What is my role in the process?

When seeking mental health care, the more of an active participant you are in the process the greater the benefit will be. You will be asked to identify goals for yourself, which will provide the framework for your care plan. It is important for you to express your feelings and thoughts openly. With that said, being able to get your thoughts and feelings out is generally not a sufficient condition for successful therapy.

The work you do outside of therapy is often as important as the work you do in therapy. You will most likely need to be open to changing some patterns of thought and/or behavior in your life. You may be assigned reading material or homework to assist you with your goals to complete between sessions. You may spend the week processing what was discussed in session. Through the therapy process it is not unusual to have "light bulb" experiences where you gain insight into problems that have had you stuck. We will work together on uncovering what changes in thinking or behavior may be of benefit to you.

 Can I talk about anything?

Yes, this is a safe space to talk about anything on your mind. You may speak about any topic that you feel is creating emotional hardship for you. Megan treats a wide range of presenting problems and in some cases she may suggest referring a client to an additional counselor or provider who specializes in the specific problem for which you struggle.

What you share remains confidential and and has special HIPPA considerations to protect your privacy. An exception to this is if you share information that you have thoughts/intentions to harm yourself (suicidal) or others (homicidal) and we believe you are a danger to self or others. We must contact the proper authorities and will make reasonable effort to contact family members and anyone who might be in danger. This may require an increased level of care, such as inpatient hospitalization, and necessitate collaborating care with other professionals, family members, or others who may need to be involved in a safety situation.

The other exception is for any suspected child or dependent adult abuse. Iowa Code section 232.69 and section 235B.3(2) define that healthcare professionals are mandatory reports and by law have a responsibility to report any suspected or reasonable belief that child or dependent adult abuse that is occurring. 

 How long before I feel better?

Research overwhelmingly finds that best outcomes come from a treatment combination with both medications and counseling.

Depending on your diagnosis and medication, it can take a couple of days to a several weeks to start feeling relief of symptoms from medication.

With counseling, you may feel some relief after the first few sessions, however counseling may take some time to be optimally beneficial. Just as the issues you may have most likely did not begin yesterday, processing and working through takes time. With that said, therapy does not have to be "long term" to be effective.


 Who will know I am in treatment?

Clients often wish to allow their mental health provider to have contact with their primary care provider, counselor or other care provider, a family member, or other person involved in their care; however this decision is up to you. The only way others would become aware of your choice to seek mental health care is if you decide to tell them. Mental Health care is confidential, unless you sign a Release of Information (ROI) allowing your provider to communicate with another individual about your treatment; however, there are a few exceptions.

See below for the limits to confidentiality found in Iowa Code Chapter 228, which are also listed in the Informed Consent and Notice of Privacy Practices (reviewed at your first appointment).

  1. Suspected past or present abuse or neglect of children, adults, and elders must be reported to the proper authorities, including the Department of Human Services and/or law enforcement.
  2. If we believe that you are seriously in danger or harming yourself, or you have threatened to harm yourself or another person, we must contact the proper authorities and make a reasonable effort to contact family members and anyone who might be in danger.
  3. If you use your health insurance to pay for services, the health insurance provider and other third-party payers have the right to review your records.
  4. When a court orders the disclosure in a civil, criminal, or administrative proceeding or as otherwise required by state or federal laws.
  5. In natural disasters whereby protected records may become exposed.
  6. When otherwise required by law (public health or national emergency).