A person talks to a medical professional on their mental health.
Learning to accept situations that you have no control over can help you adapt to change—a skill that can be learned in therapy. (For Spectrum Health Beat)

The specter of COVID-19 has no doubt worsened anxiety and depression, but make no mistake: Folks experienced challenges well before the pandemic.

Nearly 1 in 5 U.S. adults reported having a mental illness in the past year and upwards of 17 million adults and 3 million children suffered a major depressive episode, according to one recent study.

About a third of adults felt worried, nervous or anxious on a daily, weekly or monthly basis, the study found.

And that’s before COVID-19.

If you’ve counted yourself lately among the anxious or worried, take solace in knowing that mental health services are well within reach.

Spectrum Health has an online resource for mental health services, which people can access without a doctor’s referral.

Unsure about what to expect in a therapy session?

Spectrum Health psychotherapist Melanie Grube, LMSW, offers some insights.

Find your fellow

It’s a fairly clear tip, but it bears pointing out: Choose the right type of therapist.

Each professional will have different specialties and areas of training. You need to find someone who can speak to your needs, Grube said.

If your 12-year-old could benefit from therapy, find a therapist who has worked with that age group. If you’re looking for a marriage counselor, choose someone with expertise in couple’s therapy. If you’re suffering from trauma, find a specialist in that area.

“It’s like dating,” Grube said. “Are they a good fit for you? Are they not a good fit for you?”

If you’re unsatisfied with those initial sessions, you can always switch.

Matter of degrees

Confused about the various licensures and credentials? Psychiatrists and psychologists can both diagnose and treat mental health conditions, but at differing levels.

A psychiatrist is a medical doctor—they’ve attended medical school and a residency program and they can prescribe medication.

A fully licensed psychologist has a PhD, but is not an MD. They primarily focus on mental and emotional psychotherapy, although some states do allow psychologists to prescribe medication.

Beyond this are limited license psychologists and fully licensed counselors or social workers, such as LMSW or LPC, all of which have a master’s degree or higher.

These therapists will often specialize in particular areas, such as family counseling, marriage counseling or individual counseling.

A quick look at a few of the behavioral and talk therapies you may encounter:

Cognitive behavioral therapy

You’ve likely heard of this before—and for good reason, Grube said.

This therapy can help you see how distorted thoughts or thinking errors affect feelings, which in turn affect behaviors. It helps treat a wide range of issues, such as depression, anxiety, substance abuse, eating disorders and severe mental illness.

By learning to challenge negative thoughts, you can improve your outlook.

Dialectical behavior therapy

This is a type of cognitive behavioral therapy, originally developed for people with borderline personality disorder and severe emotional swings.

It involves mindfulness to help calm, distress tolerance to help you learn to work with stressful situations, interpersonal effectiveness to interact with people, and emotional regulation to help handle emotions.

“Those are the four big pieces,” Grube said.

In its strictest form it’s a more intense therapy, but components are often applied in various therapy to help people build emotional and interpersonal skills.

Acceptance and commitment therapy

This has gained ground recently, Grube said, as it encourages acceptance, mindfulness, commitment and behavior change.

It’s especially suited to today’s climate.

In this therapy, you work toward being more present in the moment.

“There’s power behind accepting what you cannot change,” Grube said. “It sounds very Zen. And it kind of is. You commit to change.”

The various forms of therapy are often quite specific to a patient’s needs, such as trauma therapy or behavioral therapy, or even motivational interviewing.

“It depends on what issues you’re looking at,” Grube said.

Motivational interviewing is well-suited for people struggling with substance use, or those who aren’t necessarily sure they’re battling a problem.

“They’re not sure they want help, or they’re court-ordered,” Grube said. “It’s a lot of technique (in which) a therapist asks questions that aim to reflect and come together with the client.”

The therapist isn’t just telling someone what’s wrong or what they need to do—they’re helping them build motivation and insight.

The bigger push in recent months: providing these services virtually.

“It’s pretty much becoming the standard,” Grube said.