So in the past few months I’ve been trying to get educated on my mental health and part of that has been listening to this podcast (really enjoy it by the way) and another part has been venturing into some online support groups. Sometimes people are very kind and helpful, a lot of the times they’re not, actually they’re downright awful. Do you have any tips for navigating support groups and group therapy? The competition to prove who is the most sick really makes me feel invalidated and like I’m an imposter for even being in that group. It probably doesn’t help that I can be overly sensitive to criticism, something I’m trying to work on. Did I just have bad luck, or is this a common problem?

Thank you for reaching out and great job working so hard on your mental health. Support groups can be an awesome resource. I’ve been talking about them quite a bit recently with people that I’m working with. They are a good way to continue the work outside of therapy. But yes sometimes you can run into this problem. It’s hard to say whether it’s a “common” problem or not, but it’s something you definitely do run into.

The first thing that I’m wondering is if you are referring to peer support groups or therapy groups. There can be a pretty big difference between them. A lot of times when you are talking about support groups, they are hosted by an organization such as a non-profit but they are essentially peer groups. You don’t have a therapy or healthcare relationship with the facilitator and they may or may not be mental health professionals. On the other hand, you have what are typically referred to as therapy groups. These can come in many different shapes and sizes. I’ve run groups from 2-3 people up to 30+ people. These groups are considered group therapy and are run by a licensed mental health professional. They are commonly offered in big healthcare organizations but you can also find them in smaller clinics and private practices. I’ve actually run both kinds of groups and they were different experiences. And there are pros and cons for both.

Let’s start with the support groups

Pros:

• They are often free
• They are looser in format and rules
• There is sometimes less commitment
• There are a lot of them out there for a wide variety of issues
• More accessible

Cons:

• Less structured
• May have a less skilled facilitator
• Fewer rules and boundaries in place

Now let’s talk about therapy groups

Pros:

• More resources, planning, and structure
• Sometimes the makeup of the group is taken into account
• Licensed professional or intern facilitators
• Group dynamics can be addressed
• There is sometimes more assurance that everyone in the group is DOING something about their issues

Cons:

• Not free
• Can be more difficult to find (in person)
• May require more commitment and effort
• Less social

A lot of it is luck of the draw. Some support groups are amazing. This is especially relevant for groups that might be family members of people with a given disorder or issue, caretakers, etc. to vent about things they don’t want to take out on their family members and get advice about how to deal with certain situations.

Some of them can turn into competitions or toxic places, though when the facilitator isn’t skilled and when there are certain people that tend to dominate conversation. My advice to you about support groups would be to not discard them entirely, but be aware that this is a possibility and be okay with sampling a few until you find a good fit. Nothing wrong with shopping around. Usually, the commitment is lower so you don’t have to make a big deal about “quitting” the group. You can just sample a few and not come back to any that you don’t like so much.

Sometimes just being busy and keeping your mind productive on these issues is helpful in and of itself. On the podcast, I talked with my wife about her IOP program. She didn’t love every group, but having a consistent schedule and a reason to think about what she’d like to work on was beneficial in itself. If you want to dive into group therapy, there are a few ways to do this. Psychology today has groups listed on their site just like you would look for therapists. You might also look for specific clinics in your area or simply google “group therapy _____”. One of the good things about most health appointments being online these days is that you are not limited to just your area. For group therapy, you attend a group that is centered anywhere within your state. For peer support groups, it doesn’t matter where they are geographically since there is no medical care taking place.

There are sometimes therapy groups around a specific issue like bipolar or anxiety. Other times, they are themed like “doing what works” or DBT skills. You can often call and ask about the group before participating. Like if you want to know about how many people they get and what the vibe of the group is, these would all be reasonable questions to ask before trying to sign up. Some groups are more process type groups and others are more like classes. You can always do more than one! You have more space in therapy groups to talk about what happens in the therapy group. For instance, if you feel attacked you can say that and there will be a facilitator to help process and address that. In a peer-led group, that likely doesn’t feel as comfortable and safe.

So, I hope this gives you something to think about. I definitely don’t want you to give up. Your experience is pretty normal, but that doesn’t mean that there aren’t some group matches out there!

I’m a grad student in a mathematics program that is a non-thesis track. Although I’m doing well in the program, I feel like I ended up here by accident and can’t handle grad work. I’m passionate about my field, but feel like I’m missing out when I see my non-grad student friends or former love interests making career moves, starting relationships, or moving away. I’ve been dealing with anxiety and depression since grad school started. The anxiety isn’t much of an issue, but the depression has began to worsen; I’m in the process of restarting regular therapy. Any thoughts?

What you’re going through is so hard. I’m glad that you are starting therapy to try to get some help with this. I know it can be confusing to tease apart what is the depression vs imposter syndrome vs legitimately being out of your depth vs realizing that grad school isn’t the path for you vs still just adjusting.

The first thing I’d want to make sure that you do is talk to your advisors or mentors about this. I’m not sure how your program works, it may be a bit different than mine, but if you have a faculty member who has seen a lot of people come and go and is somewhat familiar with you, you might be able to pick their brain about this. If they see you struggling, but feel like you definitely have it in you they might be honest about that. If it seems like you aren’t really jiving with the program, they might also be honest about that and suggest some adjustments that they think could be helpful. I think your concerns about your friends moving forward with their lives is totally legitimate. Grad school is an investment. Financially sure but also in time, stress, etc. It’s a lot and you are basically saying to yourself that the end goal will be worth it. You DO give up certain things in the short term with the hope of something that is worth it in the long term.

There are obviously many ways to tackle grad school and it’s very common that people need to work hard to find a better balance so that they don’t burn out. But it’s also okay if you are having doubts about whether you need to be in the program at all. This is something that nobody can give you the “right” answer to. I would advise a lot of journaling, self-reflection, and collecting thoughts from other people you trust. Maybe it’s time to break out a piece of paper and think about what things will look like in 5 years if you continue this trajectory and what things will look like in 5 years if you don’t. Perhaps you need to take a step back and look at where you would like to go with your life and career. Then consider whether graduate school is the best or only option. For instance, some people in my field go into a PhD program and then realize that they just want to do therapy and only need a master’s for that. So they decide to not spend the extra money and heartache on a PhD program and instead start MAKING money sooner and doing what they want with an MFT. So asking these scary questions is totally reasonable. BUT you also need to make sure that you are questioning your assumptions and not just seeing the situation through shit colored glasses.

Your language makes me think that you feel like you are running out of time. You are NOT. It’s hard to see past your scope when you are in the thick of it, but even drawing your life out on a timeline can help to clarify how little time this is. You have time. You need to survive and make it through that time, but you have time. You also may have an unrealistic understanding of how everyone else in your program is doing. You might feel like they all naturally get it more or are smarter than you, when in reality they are also struggling in their own way. Talking to them is one great way to see if this is the case. Working on your own self and finding a balance between work and health will benefit you whether you decide to go through with the program or not.

Grad school isn’t worth throwing your mental health totally away. So maybe now is the time to invest in yourself and your self-care. To try to find that balance. To process this with a lot of people. Lead into the issue. The point is not to keep you in grad school. The point is to remove the barriers and determine whether grad school is going to be healthy and useful for you. In the end, if you find that it’s not going to be a good idea to continue, you will be in a less mentally devastated state and you will be able to move in a new direction more easily.

If you do decide that the program is not right for you. That does NOT mean you failed. That doesn’t mean that you are a bad person and couldn’t hack it. I have seen people go through an entire program and not do ANYTHING with the degree, which makes them miserable. I have also seen people who are just a terrible fit for the program push and push and push and end up taking numerous years to get through the program. Sometimes you only know whether something is right for you by taking the leap. If you decide to leave, you still took the leap. You were still brave. You still got into the program in the first place. You stilled learned some stuff while you were there. Nothing can take that away from you. All of that still counts.

So I hope that you can begin to move toward a place of balance and understanding. I hope that you can start to gain some clarity about whether this is the right place for you or not. You are not alone. Use your resources, challenge your assumptions, and take good care of yourself.