Personal Questions Your Therapist May Ask
The beginning stages of therapy can be a bit weird at times. You’re trying to get to know your therapist and build some trust with them while also wanting to begin addressing the reasons you sought out therapy. You’ve already filled out quite a bit of paperwork and then they ask you even more questions during an assessment session. Some of those questions may seem a little weird, leaving you wondering how it’s relevant to your mental health. I always encourage people to ask questions and I am happy to explain why it may be important to know these things. Here are some of the questions your therapist or counselor may ask you and why they are important.
Do you have any medical conditions?
Photo by MedicAlert UK on Unsplash downloaded 10/10/22
On the surface, this question somewhat makes sense as to why it would be included. If someone was experiencing some major medical condition, it would probably be adding stress or anxiety to their life. That’s absolutely true. There’s also another reason this may be asked. Did you know some medical conditions can mimic mental health symptoms? The thyroid is a common one. When the thyroid is not regulating its hormone properly, it can result in mood changes leading to anxiety or depression. In more severe cases, it can even mimic psychosis! Infection, traumatic brain injury, dementia, medication side effects, and even diabetes can produce episodes that look like they require psychiatric care. As a result, we always want to rule out any medical causes for your symptoms to ensure we approach it from the correct angle.
Photo by Alexandr Podvalny on Unsplash downloaded 10/10/22
When was the last time you went to the doctor?
I usually ask this question as a follow-up to the first one. If someone does have chronic medical concerns, it’s helpful to know how long it has been since they were evaluated by a healthcare provider. If there has been a sudden change in your mental or physical health lately, we want to be sure someone has ruled out the medical causes first. In fact, anyone that can diagnose you is required to rule out medical causes as part of the diagnosis process. If you have a dysregulated thyroid, I will probably also ask you how long it has been since your last TSH level was drawn. This helps give me a clue as to how likely it is that we can rule out your thyroid as a concern.
Do any of your relatives experience any mental health issues?
We are learning more about mental disorders all the time. One thing we have learned about some disorders is that they can be genetic. I do often see people whose family members also struggle with anxiety and/or depression in similar ways as them. While these can be genetic and this is very helpful information to know, they can also be largely influenced by environment. Other disorders, such as schizophrenia or bipolar, typically have a greater correlation with being hereditary. Please note, if someone in your family has schizophrenia or bipolar disorder, it does not mean that you will get one of those disorders. It is possible to have a genetic connection to someone with one of those disorders and never experience it yourself. It may mean, however, that we are asking you about different things on a regular basis. Think about having high blood pressure. If there is a significant family history of high blood pressure, your doctor will probably want to monitor for that each time they see you. It doesn’t mean you’ll get it, but knowing about it helps us keep track of those things.
Are you currently using any substances?
This question may make more sense as to why it may be asked. We have a much better grip on how substance use disorders are truly disorders that may warrant treatment, hence how someone may end up in therapy. It is also becoming increasingly common for people to use marijuana to ease anxiety or relax. You may have a drink to unwind or decompress from a stressful work week. Maybe going out to the bars and having a few drinks is part of your social routine and how you hang out with friends. Whatever your relationship is with substances, it is helpful for your therapist to know. There are a couple of things I am assessing for when I ask this question: are you using substances as a coping mechanism for your mental health; and could your substance use be worsening your mental health? There is research surrounding how substances, including marijuana, can worsen things such as anxiety and depression. When we use substances to help us deal with our problems, our problems don’t actually go away. In fact, people often feel even worse when the problem is still there and the substances aren’t there anymore to make them feel better. Additionally, substance use can actually trigger an onset of a mental illness. It is not my job to tell you to stop using substances if that is not your goal. It is my job to educate you the risks that may accompany substance use so we can create a plan, together, to keep you safe and on track with your own goals.
These are only a few of the more personal questions that your therapist or counselor may ask you, but I believe they may be some of the more surprising ones. It can be difficult to talk about this to someone you just met, and ultimately, it’s your choice on how much you share. In the end, we ask these questions to help us understand how to best help you. If you feel uncomfortable with a subject or don’t understand why it’s important, let us know! We would love to talk about it with you.
About the Author
Mikayla Wichern LMSW at Aspire Counseling is a wonderful addition to our team. Mikayla believes strongly in creating a trusting relationship with her clients and creating an inviting and healthy environment. She primarily works with adults and college students experiencing anxiety, depression, trauma, life transitions, stress, and much more.
Mikayla Wichern (LMSW) is a wonderful addition to Aspire Counseling. She works with adults of all ages, and primarily works with anxiety, depression, trauma/PTSD, stress, life transitions, and so much more. Mikayla is very passionate about providing support, to all of her clients, along with hanging out with her dog on her days off!
