Are you feeling down, hopeless, or just not yourself? It can be tough to know when it’s time to seek help. This simple test is a starting point to help you understand if you might be experiencing symptoms of depression. It’s free, requires no sign-up, and can give you some initial insights.
Important Note: This test is not a diagnostic tool. It’s designed for informational purposes only and does not replace the expertise of a mental health professional. If you’re concerned about your mental health, it’s crucial to consult with a qualified healthcare provider.
Interrupting Your Results
If you answered “Yes” to two or more questions: This suggests that you may be experiencing mental health conditions consistent with depression. It’s strongly recommended that you consider reaching out for support. This test is not a substitute for professional help, so scheduling an appointment with a health care professional, mental health professional, or healthcare provider is an important next step.
If you answered “Yes” to question #9 (suicidal thoughts): This requires immediate attention. Please call or text the Crisis Lifeline at 988 for immediate help. You can also seek help from local emergency services. Suicide prevention is critical, and there are people who want to support you.
Disclaimer: This depression test is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care professional with any questions you may have regarding a medical condition or health problems. The questions are inspired by evidence-based screening tools like the PHQ-9 (patient health questionnaire), developed by Kroenke and Pfizer, and the Beck Depression Inventory, but this specific test is a simplified version.
Understanding Depression: More Than Just Feeling Sad
Clinical depression is a serious mental health condition that affects millions of people. It’s different from temporary sadness or feeling “blue.” It’s a persistent problem that can significantly impact your daily life.
Common Symptoms of Depression (Beyond the Test):
Persistent sad, anxious, or “empty” mood
Feelings of hopelessness or pessimism
Irritability
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy or fatigue
Changes in appetite or weight
Changes in sleep patterns (insomnia or oversleeping)
Difficulty concentrating, remembering, or making decisions
Physical aches or pains that have no clear cause
Thoughts of death or suicide (suicidal thoughts)
For women, postpartum depression is a concern after giving birth.
Impact on Well-being: Depression can affect every aspect of your life, including your relationships, work, school, and overall well-being. It can also contribute to physical health problems.
When to Seek Professional Help
If you’re experiencing several symptoms of depression that are persistent and interfering with your daily life, it’s time to seek professional help.
Who to See:
Mental health professional: This includes therapists, counselors, psychologists, and psychiatry professionals.
Your primary medical professional or healthcare provider: They can assess your symptoms and refer you to a specialist.
What to Expect During a Depression Screening: A depression screening typically involves a discussion of your symptoms, medical history, and sometimes the use of standardized screening tools like the PHQ-9.
Importance of Early Intervention: Seeking help early can improve outcomes and reduce the stigma associated with mental health care.
Treatment and Support Options
Depression is treatable. There are many effective options available.
Therapy (Psychotherapy/Counseling): This can include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and other approaches.
Medication (Antidepressants): These medications can help regulate mood and are prescribed by a doctor.
Lifestyle Adjustments: Exercise, a healthy diet, and good sleep hygiene can significantly improve your mood.
Support Systems: Connecting with support groups (like those offered by NAMI), family members, friends, and caregiver support can provide invaluable help.
Crisis Resources: If you are in crisis, please call or text the Crisis Lifeline at 988.
Remember, recovery is possible. Prioritizing self-care and ongoing wellness is essential for maintaining good mental health.
Q: Is this test a diagnosis? A: No, it’s a screening tool to help you understand if you should seek further evaluation.
Q: Do I need to sign up to take the test? A: No, it’s free and no sign-up required.
Q: What if I don’t have health insurance for mental health care? A: Many community clinics and public health initiatives offer services on a sliding scale fee basis.
Q: Can depression be cured? A: While there may not be a “cure,” depression is highly treatable, and symptoms can be managed effectively.
Q:What is the PHQ-9? A: It’s a common patient health questionnaire used for depression screening. Each question is scored on a scale from 0 to 3:
0 = Not at all 1 = Several days 2 = More than half the days 3 = Nearly every day
Respondents are asked: “Over the last two weeks, how often have you been bothered by any of the following problems?”
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
Trouble falling or staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself—or that you are a failure or have let yourself or your family down
Trouble concentrating on things, such as reading the newspaper or watching television
Moving or speaking so slowly that other people could have noticed —or the opposite—being so fidgety or restless that you have been moving around a lot more than usual
Thoughts that you would be better off dead or of hurting yourself in some way
Score Range: 0 to 27
Severity Levels:
0–4: Minimal or none
5–9: Mild
10–14: Moderate
15–19: Moderately severe
20–27: Severe
A score of 10 or more is commonly used as a threshold for identifying possible major depression, but clinical follow-up is always necessary.
When you’re dealing with mental health challenges or addiction, figuring out what kind of help you need can feel confusing and overwhelming. Maybe you’ve tried regular therapy sessions once a week, but it doesn’t feel like enough. Or perhaps you’re worried that checking into a hospital means being away from home for weeks.
That’s where the partial hospitalization program (PHP) comes in. It’s designed for people who need more support than weekly therapy sessions can provide, but don’t require round-the-clock medical supervision. Think of it as a middle ground—you’ll receive intensive treatment during the day, but you still get to sleep in your own bed at night.
Here’s everything you need to know about PHPs, from what to expect during treatment to whether this option might be right for you.
One quick note: You may see some programs called “high-intensity outpatient” instead of “partial hospitalization program.” The addiction medicine field updated their terminology in 2023 because these programs aren’t actually delivered in hospitals. It’s the same type of treatment. Throughout this article, we’ll use “PHP” since that’s the common term, but if you’re searching for programs, you might find them listed under either name.
1. What Is the Purpose of Partial Hospitalization?
The purpose of partial hospitalization programs is to provide intensive, structured treatment for those with mental health and substance use disorders while allowing them to live at home and attend to their daily lives. PHPs bridge the gap between inpatient care and outpatient therapy,1 offering a higher level of support than traditional outpatient services without requiring full-time hospitalization.
These treatment programs focus on stabilizing patients, improving their daily functioning, and equipping them with coping strategies necessary for recovery. PHPs also emphasize family involvement, helping to strengthen the support networks that are vital to long-term recovery success.
Assessment and evaluation: You’ll undergo a thorough assessment of your mental health status, substance use history, and individual needs to create a tailored treatment plan.
Individual therapy: One-on-one psychotherapy sessions with a licensed mental health professional help you explore personal issues, develop coping strategies, and address specific challenges.
Group therapy: Structured group sessions facilitate peer support, allowing you to share experiences and learn from others through approaches like cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).
Medication management: If you’re prescribed psychiatric medications, your clinicians can evaluate and adjust your medication plan.
Psychoeducation: Educational sessions provide information about mental health conditions, coping strategies, and recovery resources.
Holistic therapies: Some PHPs incorporate complementary therapies like art therapy, music therapy, mindfulness practices, or yoga to enhance your comfort and well-being.
Crisis intervention: Programs teach strategies to help you manage acute symptoms and prevent future hospitalizations.
Discharge planning: Providers work with you to develop a relapse prevention and continuing care plan, including referrals to outpatient therapy and community resources.
Severity of symptoms: You have significant symptoms of a mental health disorder or substance use disorder that need more intensive treatment than a standard outpatient setting can provide. This can include factors like suicidal thoughts, severe mood swings, or uncontrolled substance abuse.
Functional impairment: You’re experiencing considerable difficulty in daily functioning—work, relationships, or self-care—due to mental health or addiction issues.
Previous treatment history: PHPs work well for people who haven’t responded adequately to outpatient treatment or need transition support after inpatient care.
Stabilization needs: You need help stabilizing symptoms to prevent hospitalization or relapse, but you’re not in immediate danger.
Treatment commitment: You’re willing and able to actively participate in daily sessions and therapeutic activities.
PHPs especially benefit people with severe mental health disorders like major depression or bipolar disorder, those with co-occurring mental health and substance use disorders, people transitioning from inpatient care, and those who are at risk of hospitalization but not in immediate crisis.
4. How Does PHP Compare to Other Treatment Options?
PHPs provide more comprehensive care than intensive outpatient programs (IOPs) but less restriction than inpatient treatment. Here’s how they compare:
PHP vs. Inpatient
A PHP allows you to return home each evening, while inpatient treatment requires 24/7 facility residence until you’re stable enough for a lower level of care.
PHP vs. Intensive Outpatient (IOP)
PHPs typically involve 3-6 hours of treatment daily, 5-7 days per week, while intensive outpatient programs (IOPs) usually offer 3-4 hours of treatment, 3-5 days per week. PHPs provide more intensive crisis intervention, while IOPs focus more on ongoing recovery skills.
This step-down approach often works well—you might start with PHP to stabilize your condition, then transition to IOP as you progress.
5. How Long Does PHP Treatment Last?
PHP duration varies significantly based on your treatment facility and your individual needs. Generally, programs last from several weeks to several months, with treatment offered 5-7 days per week for 3-6 hours daily.
Several factors influence length of stay:
The severity of your condition
Your response to treatment
Specific treatment goals
The presence of co-occurring disorders
Those with more severe issues may need longer programs, while people who show rapid improvement might transition to outpatient care sooner.
Is a PHP the Middle Ground You Need?
Partial hospitalization programs offer intensive support while letting you maintain important connections to home and family. If you or your loved one are struggling with mental health challenges or addiction, PHP could be the structured pathway to recovery you’ve been looking for.
Don’t wait for things to get worse. Find a program in your area and speak with an admissions advisor today to see if PHP is right for you.
FAQs
Q: Is transportation provided for PHP participants?
A: Many PHPs do not provide transportation, so participants are typically responsible for their own travel to and from the program. Some facilities may offer resources or referrals to assist with transportation options.
Q: Can I continue my medication while in a PHP?
A: Yes, PHPs often include medication management as part of the treatment plan. Participants can work with a psychiatrist or physician to evaluate and adjust their medications as needed throughout the program.
Q: What is the expected outcome of completing a PHP?
A: The goal of a PHP is to help you develop coping skills, stabilize your mental health, and prepare for a successful transition to outpatient care, ensuring you have the tools and support necessary for ongoing recovery.
Q: How can I find a suitable partial hospitalization program?
A: To find a PHP that fits your needs, consider speaking with a mental health professional, researching local facilities, or checking with your insurance provider for covered programs in your area.
It’s normal to have days when we feel uncomfortable in our own skin. But for some, those feelings go far beyond everyday insecurity. If you find yourself obsessing over perceived flaws in your appearance—flaws that others may not even notice—you might be wondering if it’s something more serious.
Body dysmorphic disorder (BDD) is a mental health condition that affects the way people see and think about their bodies, often causing them significant distress and interfering with their daily life. In this article, we’ll explore what body dysmorphia really is, how to recognize the signs, and when it’s time to seek support.
What Is Body Dysmorphia?
Body dysmorphic disorder (BDD)1 is a mental health condition “where a person experiences a preoccupation with a perceived defect or flaw in one’s physical appearance when, in fact, they appear normal.”
People with BDD tend to fixate on specific body parts or features, most commonly the skin, nose, hair, or body shape. This obsessive focus often leads to repeated behaviors such as mirror checking, grooming, or comparing themselves to others in an attempt to “fix” or hide the flaw. It can also cause the person a lot of stress.
What sets BDD apart from general body dissatisfaction is the intensity and persistence of these thoughts. The distress caused by the perceived imperfection can interfere with your daily life, relationships, and emotional well-being.
BDD isn’t just about wanting to look better or not being happy with a part of your body. It’s about feeling unable to stop thinking about the flaw, no matter how many times others reassure you or how much effort you put into changing it.
Signs and Symptoms of BDD
Many people struggle for years before realizing their intense appearance concerns have a name—recognizing these signs of BDD2 can be validating and the first step toward getting help:
1. Excessive Worry About a Specific Part of the Body
People with BDD experience intense, uncontrollable worry about a particular body part. They feel unable to calm or manage these concerns, no matter how hard they try.
2. Hiding or Concealing Perceived Flaws
People with BDD go to great lengths to conceal the area they’re focused on. They use hats, scarves, makeup, strategic clothing, or certain hairstyles to mask or distract from the perceived imperfection.
3. Dismissing Compliments or Reassurances
It feels impossible to believe when loved ones say you look fine or beautiful. People with BDD often dismiss positive feedback, convinced that others are just being kind or dishonest.
4. Avoiding Social Situations
Intense self-consciousness or shame leads to skipping school, work, dates, or social events. The fear of being seen or judged becomes overwhelming and interferes with normal activities.
5. Feeling Distress Over Photos
Many people with BDD feel extreme anxiety or panic at the thought of having their picture taken. They fear that images will highlight or expose their perceived flaw to others.
6. Engaging in Repetitive Appearance-Related Behaviors
These behaviors include frequently checking mirrors or avoiding them entirely, skin picking, excessive grooming, or constantly trying to “fix” the perceived flaw. People may spend hours using makeup, adjusting clothing, or even seeking cosmetic procedures.
7. Seeking Constant Reassurance
People with BDD repeatedly ask friends, family, or even strangers for validation about their appearance. They hope to feel better, though any relief is typically short-lived and the need for reassurance returns quickly.
8. Constantly Comparing Yourself to Others
People with BDD obsessively compare their appearance to others on social media or in real life. These comparisons often leave them feeling inferior or deeply flawed, reinforcing their negative self-perception.
9. Feeling Defined by the Perceived Flaw
It’s common for someone with BDD to believe that their “flaw” makes them unlovable, broken, or even repulsive. This belief persists despite reassurances from others who don’t see the same imperfection.
10. Overexercising or Overtraining
Some people have muscle dysmorphia,3 which involves a preoccupation with the idea that their body build is too small or insufficiently muscular. This may lead to excessive exercise, steroid use, or unhealthy supplement usage in an attempt to control their body’s appearance.
11. Seeking Multiple Healthcare Providers
People with BDD visit numerous dermatologists, cosmetic surgeons, or other specialists in search of a “fix” for their perceived flaw. They continue this search even after being told repeatedly that nothing is wrong.
12. Undergoing Unnecessary Cosmetic Procedures
Some people pursue plastic surgery or aesthetic treatments that aren’t medically needed. These procedures rarely provide lasting relief and may worsen distress when the results don’t “solve” the internal struggle, often causing the obsession to shift to different body parts.
13. Having Thoughts of Self-Harm or Suicide
In severe cases, the emotional pain becomes overwhelming and leads to feelings of hopelessness and worthlessness. Some people may experience thoughts of self-harm or suicide as a way to escape the distress caused by their body image concerns.
Thoughts of suicide and self-harm are serious warning signs that should never be ignored. If you or someone you know is experiencing these thoughts, seek immediate help by calling the 988 Suicide & Crisis Lifeline (call or text 988) or contact your local emergency services. Remember that these feelings are symptoms of the disorder, not a reflection of reality, and professional help can provide relief.
Could I Have Body Dysmorphia? A Quick Self-Reflection Quiz
Do you often worry about a specific part of your appearance that others say looks fine or don’t seem to notice?
Do you frequently check mirrors, photos, or reflective surfaces to look at this area of concern?
Do you avoid social situations, photos, or video calls because of how you feel about your appearance?
Do you spend more than an hour a day thinking about your appearance or trying to “fix” your flaw?
Have you tried to hide or cover up this part of your body with makeup, clothing, or accessories?
Do you seek frequent reassurance from others about how you look, but rarely feel reassured?
Have you seen multiple doctors, dermatologists, or plastic surgeons about this concern?
Have you ever felt hopeless, depressed, or had thoughts of self-harm related to your appearance?
Scoring
0–2 “yes” answers: You may have occasional appearance concerns, which are common.
3–5 “yes” answers: Your concerns might be affecting your quality of life. It may be helpful to talk to a therapist.
6+ “yes” answers: You may be experiencing signs consistent with body dysmorphic disorder. Consider seeking professional support.
Note: This quiz is inspired by the Body Dysmorphic Disorder Questionnaire (BDDQ) and clinical criteria in the DSM-5. It is for educational use only and is not a substitute for a professional diagnosis.
What Causes Body Dysmorphic Disorder?
The exact cause of body dysmorphic disorder (BDD) is not fully understood, but several risk factors5 are believed to contribute:
Genetics: A family history of BDD, obsessive-compulsive disorder (OCD), or other mental health conditions may increase the risk.
Brain chemistry: Imbalances in serotonin, a neurotransmitter that affects mood and anxiety, may play a role.
Trauma or bullying: Negative experiences, such as childhood trauma or being bullied for appearance, can increase the likelihood of developing BDD.
Cultural factors: Societal pressures and unrealistic beauty standards in media can exacerbate body image concerns and may contribute to the development of BDD.
When Should You Seek Help?
If you’re experiencing any of the signs or symptoms of body dysmorphic disorder (BDD), it’s important to know that you don’t have to manage it alone. While everyone has moments of insecurity or self-doubt, BDD can be overwhelming and may require professional support to manage.
Here are some signs that it’s time to seek help:
The Distress Affects Your Daily Life
If your preoccupation with your appearance is interfering with your ability to work, study, maintain relationships, or enjoy social activities, it’s a clear indication that your body image concerns may be more than just a passing insecurity.
Repetitive Behaviors Are Difficult to Control
If you find yourself unable to stop behaviors like mirror checking, skin picking, or seeking constant reassurance, and these actions are consuming a significant amount of time each day, it might be time to reach out for help.
Seeking Medical or Cosmetic Treatments Does Not Bring Relief
If you’ve tried multiple cosmetic procedures, seen various healthcare providers, or spent significant time and money trying to “fix” a perceived flaw, but continue to feel unsatisfied or worse, this is a signal that the issue is rooted in a deeper psychological concern, not a physical flaw.
Reassurance From Others Doesn’t Ease Your Anxiety
If loved ones consistently reassure you that you look fine or that your concerns are unfounded, but you continue to feel distressed, it may indicate the need for professional intervention. BDD is not about vanity—it’s a mental health issue that requires treatment.
Self-Harm or Suicidal Thoughts Arise
If you experience thoughts of self-harm or suicide due to your appearance or body image distress, it is critical to seek immediate support. These thoughts are a sign of the severe emotional toll BDD can have and should be addressed by a mental health professional right away.
How Is BDD Treated?
Seeking help is a positive step toward healing. Body dysmorphic disorder (BDD) can be a challenging condition to manage on your own, but effective treatment options6 are available. The goal of treatment is to help people recognize and address the distorted thoughts and behaviors that fuel their distress, allowing them to improve their quality of life.
Common treatment approaches for BDD include:
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy helps people challenge distorted thoughts and behaviors related to their body image concerns. This evidence-based approach teaches patients to recognize and change negative thought patterns that fuel their distress.
Medication
Medication can be a helpful part of treatment, particularly when someone also has symptoms of related disorders like anxiety, depression, or obsessive-compulsive disorder (OCD), which often co-occur with BDD. Psychiatrists also commonly prescribe a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) to help manage these symptoms. While medication can provide relief from the emotional distress and obsessive behaviors associated with BDD, it’s usually most effective when combined with psychotherapy.
Support Groups
Participating in support groups can be beneficial for people struggling with BDD. Being able to share experiences with others who understand the challenges of living with BDD provides emotional support and a sense of community. These groups offer a safe space to discuss body image struggles and help people feel less isolated in their journey toward recovery.
Family Therapy & Education
BDD can significantly impact your relationships, making it incredibly helpful to involve family members in the treatment process. Family therapy helps your loved ones understand the condition and learn how to provide positive, supportive responses. Educating family members about the nature of BDD reduces misunderstandings and helps them better support your recovery journey.
Lifestyle Changes
Exercise, mindfulness, and relaxation techniques can help manage the anxiety and stress that often accompany BDD. Regular physical activity improves mood, boosts self-esteem, and reduces compulsive behaviors. Mindfulness practices such as meditation or deep breathing exercises help individuals manage intrusive thoughts and stay grounded in the present moment, rather than becoming fixated on appearance-related concerns.
Getting the Help You Deserve
If you recognize these signs in yourself, remember that BDD is a real and treatable condition: You’re not being vain, and you’re not alone in your struggle.
Taking the step to acknowledge these symptoms shows incredible strength and self-awareness. Reaching out to a mental health professional who specializes in body image disorders or BDD can be life-changing. With the right support and treatment, you can find relief from the distressing thoughts and behaviors that have been controlling your life, and start to see yourself with greater compassion and clarity.
FAQs
Q. How is BDD different from low self-esteem or insecurity?
A. While many people experience occasional doubts about their appearance, BDD involves obsessive, uncontrollable thoughts about perceived flaws that consume hours each day and significantly interfere with daily functioning. Unlike general insecurity, BDD typically focuses on specific body parts and drives compulsive behaviors like excessive mirror checking, grooming rituals, or seeking multiple cosmetic procedures. The emotional distress is much more severe than typical self-esteem issues and can lead to social isolation, depression, and in severe cases, thoughts of self-harm.
Q. Am I insecure or do I have body dysmorphia?
A. While insecurity about appearance is common, BDD involves obsessive, overwhelming thoughts about perceived flaws that significantly interfere with your daily life, relationships, and functioning. If your appearance concerns consume hours of your day or cause you to avoid social situations, it may be more than typical insecurity.
Q. Do people with body dysmorphia realize they have it?
A. Many people with BDD are unaware of their condition and don’t recognize that their perception of their appearance is distorted. The shame and isolation associated with BDD makes it difficult to see that their concerns are excessive, and they often believe others notice their perceived flaws just as intensely as they do.
Q. Can you self-diagnose body dysmorphia?
A. You cannot reliably self-diagnose BDD, as it requires identifying complex patterns of thought and behavior that are difficult to recognize in yourself. While you may notice some symptoms, only a mental health professional can properly diagnose BDD, rule out other conditions, and recommend appropriate treatment.
Q. Is it body dysmorphia or dysphoria?
A. The correct term is “body dysmorphia” or “body dysmorphic disorder (BDD),” not “body dysphoria.”
Q. How is an eating disorder different from BDD?
A. Eating disorders primarily focus on weight and food intake, while BDD involves obsessive preoccupation with specific body parts or features like skin, nose, or hair that are unrelated to weight.
Q. How do I help a loved one showing signs of body dysmorphia?
A. Approach them with patience and empathy and avoid phrases like “it’s not a big deal” that minimize their concerns. Gently encourage professional help from a mental health specialist, offer to help them find a therapist, and provide emotional support while emphasizing that professional treatment is necessary for recovery.
When you’re in your darkest moment, the last thing you should have to worry about is whether help will be there when you call. Yet recent changes to funding for the 988 Suicide & Crisis Lifeline have left many wondering if this life-saving resource still be there when people need it most.
The short answer is yes: 988 is still active and available 24/7. But the longer story involves budget cuts that could affect how quickly you get help and what kind of support is available, especially for communities that already face higher needs—and—barriers to mental health care.
What Is the 988 Lifeline?
The 988 Suicide & Crisis Lifeline launched in 2022 as a game-changer for mental health support in the U.S. Instead of remembering a long phone number, anyone in crisis can simply dial 988 to reach trained counselors who provide immediate support and connect people to local resources.
The lifeline is managed by SAMHSA (the Substance Abuse and Mental Health Services Administration) under the Department of Health and Human Services (HHS). It serves everyone, but it has specialized services for groups at higher risk, including LGBTQ+ youth and veterans.
Robert Gebbia, CEO of the American Foundation for Suicide Prevention explains:
Suicide remains a serious public health concern in the U.S.,1 and we know from research that certain groups have higher risk, including veterans and LGBTQ+ youth. This is why these groups have dedicated services within the 988 Suicide and Crisis Lifeline, where uniquely trained counselors help prevent suicide in these disproportionately impacted populations.
What’s Changed With Funding
In early 2025, a leaked budget proposal2 draft revealed troubling news: the federal government has proposed to eliminate all funding for the 988 Suicide & Crisis Lifeline’s LGBTQ+ Youth Specialized Services. The proposed cuts would take effect October 1, 2025.
While the lifeline itself remains operational, defunding affects the system’s ability to meet increasing demand. This doesn’t mean 988 is shutting down, but it does mean fewer resources for hiring staff, training specialized counselors, and expanding outreach programs.
Who Gets Hit Hardest
Unfortunately, funding cuts rarely affect everyone equally. According to the American Foundation for Suicide Prevention, “Certain populations uniquely at risk continue to be underrepresented in suicide research and face disproportionate inequities in accessing the care,4 support, and services needed to improve mental health and prevent suicide.”
The communities most likely to feel the impact include:
BIPOC communities who already face barriers to accessing culturally competent mental health care
LGBTQ+ communities, especially youth, who have significantly higher rates of suicidal thoughts
Rural residents who have limited access to mental health resources to begin with
People without insurance who rely heavily on free crisis services
How do recent cuts to the 988 Suicide & Crisis Lifeline affect access to care, especially in underserved or marginalized communities? What are the potential long-term implications?
The Suicide & Crisis Lifeline helps reduce suicide, mental health hospitalizations, and reduces healthcare costs overall because people are less likely to turn to higher levels of care that are more expensive. For marginalized communities, it provides access to someone who can listen and provide support as well as resources they may not have access to otherwise, which saves lives. The long-term implications of the recent cuts include staffing shortages, which lead to longer response times, diminishing the effectiveness of the Lifeline during crises. Without adequate funding, more individuals in crisis may end up in emergency rooms or encounter law enforcement—situations that the 988 Lifeline aims to prevent. Underserved communities may experience greater barriers to accessing mental health support, exacerbating existing inequalities and increasing health disparities. Inconsistent funding and availability can lead the public to feel less trusting of mental health resources, potentially discouraging individuals from seeking help.
These funding reductions create staffing shortages, which lead to longer response times and reduce how effectively the Lifeline can help during crises.
Here’s what you might experience:
Longer wait times when calling for help
Fewer culturally competent counselors available
Reduced outreach programs in underserved communities
Less specialized support for high-risk groups
The broader concern is that without adequate mental health crisis support, more people may end up in emergency rooms or encounters with law enforcement—exactly the situations 988 was designed to prevent.
Why This Matters Beyond Individual Calls
The 988 lifeline doesn’t just save lives in the moment. It reduces overall healthcare costs by preventing more expensive interventions like psychiatric hospitalizations. For marginalized communities especially, it provides access to support and resources that might otherwise be unavailable.
Other Crisis Resources Still Available
While concerns about national suicide prevention lifeline funding are serious, it’s important to know that other crisis support options are still available. If you can’t get through to 988 or need specialized support, these resources can help:
National Crisis Text Line: Text HOME to 741741 for free, confidential support 24/7. This service operates independently of 988 and connects you with trained crisis counselors via text message.
The Trevor Project: Provides crisis support specifically for LGBTQ+ youth through phone (1-866-488-7386), text (START to 678-678), and online chat. Available 24/7 with counselors trained in LGBTQ+ issues.
Veterans Crisis Line: Call 988 and press 1, text 838255, or chat online. This specialized service for veterans, service members, and their families has dedicated funding and staff.
Crisis Text Line en Español: Text HOLA to 741741 for Spanish-language crisis support. Many local crisis centers also offer bilingual services.
Many communities also have local crisis hotlines, mobile crisis teams, and walk-in crisis centers. Your local 211 service (dial 2-1-1) can help you find nearby mental health resources and crisis support options.
The Advocacy Response
Mental health advocates nationwide are actively responding to the threat of funding cuts to the national suicide hotline. Leading organizations have issued press releases and public statements urging Congress and the White House to restore and expand funding, emphasizing that access to crisis services is a matter of life and death for vulnerable communities.
Advocates stress that mental health is a bipartisan issue. “Suicide prevention is about risk, not identity,”5 says Jaymes Black, CEO of The Trevor Project. But Black also reminds affected communities that not all hope is lost:
I want to be clear to all LGBTQ+ young people: This news, while upsetting, is not final. And regardless of federal funding shifts, The Trevor Project remains available 24/7 for anyone who needs us, just as we always have.6
What You Can Do
If you’re concerned about these changes, here are ways to help:
Contact your elected officials to express support for 988 funding
Support nonprofit organizations working on mental health advocacy
Share accurate information about available resources in your community
For now, 988 remains available around the clock for anyone in crisis. The system’s long-term capacity, however, depends on sustained and equitable investment from federal and state governments.
Make a safety plan, connect with support, and remember—your story isn’t over yet.
FAQs
Q: Did Trump administration budget cuts affect the suicide hotline services?
A: Funding reductions were proposed in early 20257 as part of broader budget constraints from the Office of Management and Budget during the current administration. While the 988 hotline remains operational, the cuts will affect crucial services for LGBTQ+ youth as well as affect expansion and capacity-building.
Q: Did Trump’s suicide helpline cuts push Canada to step in for Americans?
A: There’s no evidence that Canada has stepped in8 to provide crisis services for Americans due to these funding changes. This false claim stems from a viral social media post. The 988 lifeline continues to operate in the United States, though with reduced capacity.
Q: Did President Trump make any changes to the national suicide prevention hotline?
A: The 988 Suicide & Crisis Lifeline itself wasn’t changed or eliminated. However, federal budget for expanding the program were proposed in early 2025, which will affect the system’s ability to meet increasing demand.
This article is a longform summary of a powerful episode of the Giving Voice to Depression podcast, hosted by Terry McGuire. In this conversation, guest Cara McErlain shares what it’s like to live with long-term depression, the profound lessons she’s learned through therapy, and why the fleeting moments of happiness after darkness are so deeply meaningful. With insight, warmth, and hard-won wisdom, Cara offers hope for anyone struggling to hold on in their darkest moments.
The podcast continues its mission to reduce stigma and normalize conversations about mental health by amplifying the voices of those who live with these experiences every day. This particular episode resonates not just because of the pain described, but because of the unmistakable humanity, humor, and insight Cara brings to her recovery journey. Whether you live with depression yourself or love someone who does, this episode offers vital reminders that healing is possible and that no one is ever truly alone in their struggle.
1. Depression Isn’t Just Sadness — It’s a Whole-Body Experience
Many people associate depression with sadness, but as Cara explains, it can show up in many ways:
A deep numbness or emotional “nothingness”
A sinking feeling in your stomach
Grayness tinting your view of life
Dread of the day ahead
As Cara described:
You don’t think you’re ever going to feel the happiness again… your surroundings are almost like tinted as gray.
Cara emphasized that the experience of depression is not simply about feeling blue; it can completely consume your thoughts, energy, and sense of self.
2. It’s Easy to Mistake Depression for Normalcy
Cara began experiencing symptoms of depression as a teenager. But like many, she didn’t recognize it at the time:
Emotional numbness felt like her natural state
She thought everyone lived without joy or hope
She didn’t grow up surrounded by happiness, so sadness felt normal
As Cara reflected:
I thought that’s how we lived, really.
When we grow up in emotionally difficult environments, it’s hard to realize our suffering isn’t normal. Naming depression is the first step to healing.
3. Depression Can Cloud Your Will to Live
Cara bravely opened up about experiencing suicidal thoughts and attempts. This wasn’t about wanting attention — it was a desperate attempt to escape unrelenting pain:
Depression told her life wasn’t worth living
The darkness felt endless and absolute
These thoughts went unspoken for years
As Cara candidly shared:
There were times where I just didn’t want to be here… that thought was there for quite some time.
Her story reinforces the urgency of talking openly about suicidal ideation and the critical importance of early intervention.
4. Therapy Can Get Worse Before It Gets Better
Cara says starting therapy again in 2021 was the best thing she ever did — but it wasn’t easy:
Unpacking trauma made her feel worse at first
Naming her past experiences as trauma was painful but validating
Therapy involved facing uncomfortable truths
As Cara explained:
It made me feel worse in a sense. But I had to do this… It was the first time where we validated the word trauma.
Healing doesn’t follow a straight line. Sometimes it means making a bigger mess before putting things back together.
5. Validation Is a Critical Part of Recovery
One of Cara’s most profound turning points was when her therapist helped her realize that what she experienced was trauma:
She had minimized her pain for years
Being told she didn’t deserve what happened to her helped shift her self-perception
She began to appreciate how her struggles shaped her growth
As Cara noted:
I actually didn’t deserve that… There’s a sense of paying gratitude to my difficulties because of how it’s made me grow.
This kind of validation can break the shame cycle that keeps so many stuck.
6. Rock Bottom Isn’t Always the End
Cara describes a night in 2021 when she broke down crying while driving. She felt hopeless. Lost. But somehow, she reached out:
She Googled nearby counselors and sent an email
She went to her first session and spoke her truth
Her therapist told her, “You’re on to something amazing here”
As Cara recalled:
I was so proud of myself that session. It was the wee bit of light I needed in a very, very dark time.
You don’t have to be fully ready to heal to take the first step. Sometimes, survival is enough.
7. Recovery Is Never Linear
Cara’s story highlights the unpredictable nature of mental health recovery:
One week she felt amazing
The next, she sobbed uncontrollably in therapy
She kept going anyway
As Cara shared:
It just shows the bumpiness of it… knowing that in the really dark times, you felt happiness the week before.
Recovery isn’t a straight line. It’s a winding road filled with both setbacks and breakthroughs.
8. Light Can Appear in Small, Beautiful Moments
Cara finds hope in what she calls “snippets of happiness”:
Watching strangers hug
Drinking coffee without racing thoughts
Noticing 10 seconds of contentment
As Cara described:
I was actually content there for 10 seconds. I never thought I would actually be able to just enjoy coffee.
These glimpses remind us that healing is not only possible, but already happening.
9. Document the Good Days
To help her remember that light exists, Cara journals on good days:
She writes about moments of joy
She snaps pictures of coffee or her dog
She stores proof of happiness for future dark days
As Cara advised:
Let’s also journal whenever we’re feeling good… It’ll remind us that it’s possible.
In moments of hopelessness, that proof can be a lifeline.
10. Peer Support and Reassurance Carry Special Weight
Hearing hope from someone who’s been hopeless can be transformative:
Cara reminds us not to believe everything depression tells us
She urges people to hold on until tomorrow, not forever
She emphasizes taking tiny steps, not big leaps
As Cara encouraged:
You are a human being and you deserve to live and you deserve to live a happy life.
That message lands differently when it comes from someone who’s lived the truth of it.
11. Don’t Forecast Misery Forever — Focus on the Present
Dr. Anita Sanz offers a powerful reminder:
Depression often convinces us the future holds only pain
But we can survive the present
Like a flu or a cold, this will pass
As Dr. Anita Sanz explained:
Force yourself… as hard as it is, to stay in the present moment when the present moment is awful.
Staying present doesn’t mean pretending things are fine. It means trusting that this too shall pass.
Final Thoughts: Choosing Hope, Even When It’s Hard
Cara’s story serves as a vivid reminder that light often follows darkness — not in fairy-tale ways, but in deeply real and often subtle ones. Her lived experience affirms something essential: even in our lowest moments, even when we feel broken or empty, we still hold the power to make the smallest of choices — to hold on, to speak up, to reach out. And those choices can lead us back to the light.
As Terry McGuire beautifully reflected:
We as humans — not even just humans with depression — tend to find what we’re looking for. So if we look for reasons and ways that our value in the world is affirmed, we can usually find something.
We’re not guaranteed a life free of struggle, but we can create one rich with meaning, connection, and resilience. We can build it one small step, one deep breath, one whispered reminder at a time: hold on. Light is possible.
Moments of hope may feel fleeting at first, but with time and attention, they can multiply. They may begin as brief flashes — a sip of coffee savored, a comforting hug, a moment of peace on a quiet walk — but those flashes matter. They are proof. And they are the very building blocks of recovery. For anyone in darkness right now, take heart in knowing that you do not have to wait for a full cure or transformation to start feeling better. You only have to start by holding on — until tomorrow, until the next moment of light, and then the next.
Key Takeaways
Here are a few essential lessons from Cara’s story to carry with you or share with someone in need:
Depression is more than sadness — it impacts every part of our being.
Validation matters — especially when it comes from others or from within.
Therapy can feel worse before it feels better — but it’s worth it.
Recovery is not linear — ups and downs are part of the process.
Small moments of joy are powerful — even 10 seconds of peace counts.
Documenting the good helps you remember hope during the hard times.
Peer support is uniquely powerful — lived experience builds trust and connection.
You don’t need to hold on forever — just hold on for today.
You deserve to live — and not just survive, but to feel happiness, too.
The stories we tell ourselves shape what we believe — choose self-compassion over self-criticism whenever you can.
Even when happiness feels out of reach, it still exists — and it is not reserved for others. You are worthy of it.
Reaching out is an act of strength — asking for help doesn’t mean you’ve failed, it means you are still fighting.
If you or someone you know is struggling with depression, consider sharing this episode of Giving Voice to Depression or reaching out to a trusted support resource. There is no shame in needing help. And there is always hope — even when we can’t yet see it.
As Cara urged:
Don’t believe everything that your depression tells you. Please don’t believe it.
June is Men’s Mental Health Awareness Month, a time to uplift and validate the emotional lives of men. These 25 mental health quotes spotlight the power of vulnerability, healing, and self-love while also highlighting important mental health challenges that many men face.
As a therapist who works primarily with men, I’ve learned this: most guys aren’t taught how to name what they feel, so instead they manage it quietly. Their mental well-being suffers from it. These quotes aren’t just feel-good messages. They’re reminders from real men with real stories that your mental health matters and it being honest about it doesn’t make you soft— it makes you strong.
25 Quotes to Inspire and Live By
These quotes are reminders that mental health struggles don’t define you and recovery is possible.
These voices range from artists and athletes to philosophers and advocates, offering encouragement for mental well-being, vulnerability, and resilience.
25 Quotes to Inspire and Live By (By Men, For Men)
“There is hope, even when your brain tells you there isn’t.” – John Green
“You’re only given a little spark of madness. You mustn’t lose it.” – Robin Williams
“Being vulnerable is not a weakness—it’s a strength.” – Dwayne “The Rock” Johnson
“Don’t give in to stigma. A diagnosis does not determine who you are or what you can do.” – Pete Wentz
“The heart of man’s pain is the pain of not being seen.” – Frederick Buechner
“Mental health is just as important as physical health. You have to nurture your inner world the same way.” – Lewis Hamilton
“I believe the biggest stigma right now with mental health is that a lot of men are afraid to talk about it.” – Michael Phelps
“You don’t control the situation, but you control what you think about it and how you respond.” – Ryan Holiday
“We are all broken. That’s how the light gets in.” – Ernest Hemingway
“It’s okay not to be okay.” – Prince Harry
“Out of your vulnerabilities will come your strength.” – Sigmund Freud
“The times in my life when I’ve been happiest are when I’ve let myself be the most vulnerable.” – Chris Evans
“It is not death that a man should fear, but never beginning to live.” – Marcus Aurelius
“My dark days made me stronger. Or maybe I already was strong, and they made me prove it.” – Emery Lord
“I am seeking. I am striving. I am in it with all my heart.” – Vincent van Gogh
“Success is not final, failure is not fatal: it is the courage to continue that counts.” – Winston Churchill
“You cannot swim for new horizons until you have courage to lose sight of the shore.” – William Faulkner
“Life is not easy. Life is not fair. But life is beautiful if you choose to see it that way.” – Steve Gleason
“Self-worth comes from one thing—thinking that you are worthy.” – Wayne Dyer
“Our greatest glory is not in never falling, but in rising every time we fall.” – Confucius
“Everyone is going through something that we can’t see.” – Kevin Love
“When we are no longer able to change a situation, we are challenged to change ourselves.” – Viktor Frankl
“He who conquers himself is the mightiest warrior.” – Confucius
“There is no education like adversity.” – Benjamin Disraeli
“Try not to become a man of success, but rather try to become a man of value.” – Albert Einstein
Men’s Mental Health Treatment
Men often experience unique mental health struggles2 that can make asking for help feel overwhelming. But with the right support, healing is possible.
Men are often taught to manage quietly, power through, or downplay their struggles altogether. I see it all the time in the therapy office. Clients who’ve spent years in high-functioning survival mode without realizing how lonely or exhausted they’ve become. The truth is, asking for help is often the most courageous step in a man’s healing journey.3
Men-Only Rehab
Men-only treatment centers offer a safe space to explore personal trauma, mental health challenges, and substance use in a nonjudgmental setting. They provide a gender-responsive approach to care, helping men reconnect with their emotional well-being without societal pressure to appear “tough” and surrounded by other men who truly get it.
Burnout and Stress
Burnout can look like overcommitment, irritability, numbness, or quietly feeling like you’re failing at everything. Plenty of men say things like, “I’m just tired,” but what they may mean is, “I feel like I’m not allowed to stop.” Chronic stress can impact both mental and physical health, leading to anxiety, depression, or even substance misuse. Men’s programs address these mental health conditions with evidence-based therapies focused on stress management and emotional regulation.
Loneliness
Men are lonely. I share this in a recent article in my weekly newsletter, More to the Story:4
There is a crucial difference between being alone and being lonely. Loneliness is an emotion that, like all others, tries to communicate something to us. It is neither inherently good nor bad; instead, it indicates that we lack connection and intimacy—two fundamental human needs. When someone asks, “How are you doing?” and you respond with, “Oh, I’m good!” but the truth is that you are not good at that moment, you will inevitably feel lonely. This discomfort arises from a lack of genuine connection and intimacy.
Loneliness isn’t a flaw or failure—it’s a signal. For many men, it can feel shameful or weak to admit feeling isolated, but the truth is that loneliness may be pointing you toward the connection and support your mind and body deeply need. If that’s hard to believe—if your lived experience tells you that connection isn’t safe or possible—you’re not alone in that, either. That pain is real, and it deserves compassion.
Dual Diagnosis
Many men experience co-occurring mental health and substance use disorders. Dual diagnosis treatment tackles both issues at the same time, recognizing how depression, PTSD, or bipolar disorder may be driving unhealthy behaviors.
Eating Disorders
Although often overlooked, eating disorders like binge eating and body dysmorphia affect men, too. These conditions can be tied to trauma, shame, and perfectionism. When we trace it back, and unhealthy relationship with food can often be rooted in unprocessed grief, body-based trauma, or a desperate attempt to feel in control. Specialized care is critical to promoting long-term wellness and better mental health.
Explore Men’s Treatment Centers
Not all treatment centers are created equal. When searching for support, it’s important to look for men’s programs that are trauma-informed, personalized, and led by licensed mental health professionals. From support groups to inpatient rehab, men have options for addressing their mental health needs.
FAQs
Q: What are some inspiring quotes to support men’s mental health?
A: Inspiring quotes like “It’s not weak to speak” or “Real strength is asking for help” remind men that vulnerability is a part of courage, not a contradiction to it. These messages help normalize emotional expression and support seeking help.
Q: Can quotes about mental health help men open up about their struggles?
A: Yes, quotes can be powerful conversation starters. They provide language for feelings that may be hard to express and let men know they’re not alone in their experiences.
Q: What to say to a man struggling with mental health?
A: Offer validation and support: “You don’t have to go through this alone—I’m here for you,” or “It’s okay to not be okay, and it’s okay to ask for help.”
Q: Why is men’s mental health overlooked?
A: Cultural expectations and stigma around masculinity often discourage men from expressing emotions or seeking help, leading to underdiagnosed and untreated mental health issues.
Q: Are men less prone to mental illnesses than women?
A: No. While women are more likely to be diagnosed with certain conditions like depression or anxiety, men often experience mental health issues differently—and may be less likely to seek help, which can increase the risk of substance use or suicide.
In mental health care, we often treat interventions like compartments—one tool for anxiety, another for trauma, another for family systems. But healing rarely lives in silos. It moves in circles, overlaps, and reemerges across seemingly unrelated landscapes.
When we step back, we begin to see how foundational ERP principles—tolerance, trust, and transformation—can also offer structure and insight in areas like reunification therapy, family systems2 work, and court-ordered treatment plans.
ERP is most commonly known for treating OCD symptoms, specifically obsessions, intrusive thoughts, and compulsive behaviors. But it’s not just a type of therapy reserved for those battling contamination fears or checking rituals. Its roots in cognitive behavioral therapy (CBT)3 and its reliance on gradual, anxiety-provoking exposures make it surprisingly adaptable to relational spaces—especially when those spaces are defined by avoidance, fear, or rupture.
What ERP Really Teaches Us
Exposure and response prevention therapy is about facing fear—and doing it differently. It invites the client to approach a feared situation or stimulus (real or imagined), while resisting the urge to engage in the habitual safety behaviors that once offered relief. That might look like resisting a hand-washing compulsion, or sitting with the discomfort of not seeking reassurance.
ERP isn’t just for obsessive thoughts—it’s for any place where fear keeps us from connection. In reunification therapy, it becomes a path back to trust, one tolerable step at a time.
The process is structured, intentional, and often uncomfortable. But in that discomfort is possibility: a new way of relating to fear. And over time, with practice, the nervous system learns something crucial—this feeling won’t last forever. I can survive it. This is the mechanism of habituation, and it’s a cornerstone of ERP’s effectiveness.
In the world of OCD treatment, this model has revolutionized care. From in vivo exposures to imaginal exposure, ERP has helped countless individuals reclaim their lives from obsessive thoughts, perfectionism, and debilitating rituals.
But what if we considered ERP’s logic not only in treating OCD, but in addressing the relational phobias that often show up in families experiencing estrangement or high-conflict divorce?
The Therapist’s Role: Skilled Guide, Not Enforcer
In this context, the mental health professional becomes a kind of behavioral cartographer—charting the terrain of fear and walking alongside families as they navigate it. Just as ERP therapists track rituals and avoidance patterns in OCD, reunification therapists can identify emotional compulsions: the urge to withdraw, to vilify, to control.
The clinician’s job is not to insist on connection, but to foster capacity—to help the child sit with what’s hard, to help the parent resist reactive behaviors, and to guide both toward emotional flexibility. These are evidence-based treatment strategies, grounded in CBT, but translated to a relational domain.4
This is particularly powerful when considered as a tool for court-ordered therapy, such as in cases involving CPS, family law, or mandated co-parenting plans. ERP’s deliberate pacing, collaborative structure, and emphasis on inhibitory learning (rewriting what the brain has learned about safety) align well with the delicate pacing required for long-term family reunification.
Healing doesn’t live in compartments. The same tools that help us face intrusive thoughts can help families face each other again—with honesty, discomfort, and the courage to try.
While ERP therapy is an effective treatment for many anxiety-related disorders,5 including social anxiety, panic disorder, and OCD, it must be used with deep ethical care when applied in family contexts. This is not about forcing reconciliation. It is not about exposure for exposure’s sake. In families where child abuse, domestic abuse, or ongoing mental health conditions have created genuine safety concerns, no exposure should be initiated without comprehensive evaluations, trauma-informed oversight, and clear legal and clinical safeguards.
ERP is a tool—not a shortcut. And in complex family systems, it must be paired with humility, cultural sensitivity, and attunement to each individual’s readiness and consent.
The gifts of ERP reach far beyond the treatment of obsessive-compulsive disorder. Its structure teaches distress tolerance, insight into cognitive distortions, and the courage to face relational fears. These skills are invaluable in reunification therapy, co-parenting relationships, and even outpatient psychotherapy with adolescents who are navigating estrangement, identity confusion, or loyalty binds between caregivers.
For clinicians, ERP reminds us that healing doesn’t always look like comfort—it looks like commitment. A commitment to therapy, to presence, to uncertainty. And for families,6 it offers something far more sustainable than a quick fix: the possibility of true, hard-earned repair.
Whether we are helping someone resist a compulsion, sit with shame, or face a loved one they haven’t spoken to in years, the heart of the work is the same: exposure to fear, and the slow, steady unlearning of resistance.
ERP as a Bridge Between Clinical Rigor and Human Repair
At its best, exposure and response prevention is about more than treating OCD symptoms. It is a way of saying: we can face what scares us, and still move toward love. That principle doesn’t just belong in psychiatry textbooks or first-line treatment guidelines—it belongs in family rooms, courtrooms, and therapy spaces where pain and possibility sit side by side.
ERP works because it reflects how healing actually happens—not in perfect conditions, but in real life, with real people, doing the brave work of showing up again and again.
In this light, we don’t just see ERP as an effective treatment for anxiety—we see it as a roadmap for restoration. Not just of functioning, but of family, belonging, and hope.
FAQs
Q: What is exposure and response prevention (ERP) therapy?
A: ERP is a type of cognitive behavioral therapy (CBT) specifically designed to help individuals confront their fears and anxieties without falling into the trap of avoidance or compulsions. It involves two key steps: exposure to anxiety-provoking situations or thoughts, and response prevention, which is the practice of resisting the usual reactive behaviors that follow. Over time, this helps the brain learn that fear doesn’t need to control your life.
Q: What is the history of exposure and response prevention techniques?
ERP emerged in the 1960s as a treatment for obsessive-compulsive disorder (OCD), rooted in behaviorism and the understanding that avoidance reinforces fear. Over decades, research has consistently validated ERP as one of the most effective treatments for OCD and other anxiety-related disorders. It’s evolved to address a wide range of compulsive behaviors, including health anxiety, perfectionism, and intrusive thoughts.
Q: Can I do ERP therapy on my own?
While some people can begin exploring ERP principles on their own (especially with guided workbooks or digital tools), working with a trained therapist is strongly recommended—especially for complex or deeply distressing fears. A therapist can tailor the exposures, monitor progress, and help prevent unintentional re-traumatization or avoidance cycles.
Q: What is the difference between CBT and ERP?
CBT (cognitive behavioral therapy) is the umbrella under which ERP falls. CBT focuses broadly on identifying and challenging unhelpful thoughts and behaviors. ERP zeroes in on the behavioral aspect of anxiety disorders—specifically how rituals and avoidance maintain distress—and aims to break that cycle through repeated, supported exposure.
Q: How long does ERP therapy take?
ERP is often short-term and structured. Many people begin to see improvement within 12 to 20 sessions. However, the length can vary depending on the severity and complexity of symptoms. What’s important is consistency—change happens through repetition and support, not overnight.
“You know, but some of us need to speak out because too many people are dying. And there’s these, you know, back in the day when AA started, there weren’t these drugs that were killing people first time. Yes. And it’s a scary place. So we need a few soldiers out there that are willing to do this.” – Ben Fisher
The journey of addiction and recovery is deeply personal, often marked by profound challenges and ultimately, immense triumph. For many, the path to sobriety is not just about abstaining from substances, but about rediscovering purpose, rebuilding connections, and transforming past experiences into powerful tools for change. Ben Fisher, the creative force behind “A String of Hope,” embodies this transformation, channeling his own battles with addiction into a platform that resonates with millions seeking mental health and addiction recovery.
1. The Genesis of a Troubled Connection: Music, Identity, and Early Exposure
Ben Fisher’s journey with addiction began at a surprisingly young age, interwoven with his passion for music and the perceived glamour of the rock and roll lifestyle. At just 12 years old, while playing guitar at a family gathering, he was handed a Budweiser by a “drunk uncle.” The experience was immediate and profound. “That wave hit me of, you know, feeling that for the first time at 12. And my 12-year-old brain was like, this is it. This is what I need to feel normal. It was like a switch flipped in me.”
This pivotal moment, however, wasn’t an isolated incident but rather a culmination of earlier influences. At seven, watching Jimi Hendrix at Woodstock, Ben was captivated, feeling a deep connection to the artist’s ability to move people through music. He began to idolize musicians who, despite their artistic brilliance, were also known for their struggles with addiction and alcoholism. This early association between rock stardom and substance abuse became a dangerous blueprint in his young mind. “I idolized them and I’m like, okay. So I have to live that lifestyle if I want to be that person. So I leaned into that at an early age.” This narrative highlights how formative experiences and environmental factors can inadvertently lay the groundwork for future struggles.
2. The Illusion of Control: Balancing Dual Lives
As Ben grew older, his addiction progressed, but so did his ability to compartmentalize. He maintained a starkly contrasting dual life: the party-hardy musician embracing the “rockstar lifestyle” and the dedicated worship leader at his church. “My entire drinking career and drinking and drug career, I was living two different people,” he recounts. “One was the party rockstar lifestyle and the other was the guy playing music at church.”
This ability to hide his struggles, particularly his burgeoning addiction to opiate pain medication, became a defining characteristic of his early adult life. He meticulously concealed his substance use from his girlfriend, who would later become his wife. “She knows nothing about it,” he said of his wife’s unawareness of his opiate addiction. “I was really good at hiding it and I hid it all, all through my life.” This functional addiction, where individuals maintain a semblance of normalcy despite severe substance use, can prolong the denial phase and delay seeking help. The façade of functionality can be incredibly isolating, as the individual carries the immense burden of their secret.
3. The Progressive Nature of Addiction: From Beer to Opiates
Ben’s story serves as a stark reminder of addiction’s progressive nature. What began with underage drinking escalated significantly in college, where he engaged in heavy pot use and occasional cocaine use. The turning point, however, came after a painful breakup when a coworker introduced him to opiate pain medication. “I tried them and they made me feel better. They made me feel way better.” This moment marked a new and more insidious phase of his addiction, as opiates offered an even more potent escape from emotional discomfort.
His reliance on opiates became so entrenched that he eventually sought Suboxone, initially buying it on the street before obtaining a legitimate prescription. The fear of his then-fiancée discovering his secret prompted a dangerous decision: cold-turkey withdrawal from Suboxone. This decision, made without medical supervision, led to a grueling, month-long withdrawal period that he endured alone, further illustrating the desperate lengths individuals will go to hide their addiction. “If you know anything about that, I know it’s a medication that’s great for helping people get off, but you have to taper down, step down very slowly. I went cold Turkey. It was the worst experience I’ve ever gone through. And nobody knew I was going through it. I went through it alone.” This dangerous self-detoxification further entrenched his alcohol use as a coping mechanism.
4. The Crushing Weight of Secrecy: Hiding in Plain Sight
The emotional toll of leading a double life, particularly from the person he loved most, was immense. Ben’s wife was unaware of his opiate addiction for seven years, even as they fell in love, got engaged, and bought a house. “That’s gotta be heavy on you,” the podcast host observes. “To not only just going through that addiction, but to hide such a huge part of you and what you’re going through from the person that you care so much about.”
The constant vigilance required to maintain this deception, coupled with the escalating demands of his addiction, undoubtedly contributed to his internal suffering. The pressure to maintain a “functional” exterior, even as his internal world crumbled, is a common theme in addiction. This sustained psychological burden can lead to increased anxiety, depression, and a deeper sense of shame.
5. The Fall from Grace: Losing Purpose and Community
A crucial turning point in Ben’s descent was the exposure of his addiction to his church community. His daily ritual of buying and consuming cheap vodka, even while driving, highlights the pervasive nature of his alcohol dependence. The moment of reckoning came when his eight-month pregnant wife found him passed out in his car, a bottle of vodka beside him. Her call to a friend at the church, whose husband was in recovery, ultimately led to Ben being pushed out of his role as worship leader.
“I ended up later in life becoming a worship leader, music director at a church… That broke me in my drinking. Then I was already at blackout stage. So then we were at the point where it’s like treatment, like what are we gonna do here?” This loss of his perceived identity and community, a place where he had found a sense of purpose through music, was devastating. While initially harboring resentment, Ben later recognized the complex dynamics at play, acknowledging that the church, in its vulnerable state, was also trying to protect itself. This incident underscores the profound impact addiction can have on relationships and one’s sense of self-worth.
6. The “Rock Bottom” That Changed Everything: His Daughter’s Safety
Ben’s true rock bottom arrived on Easter Sunday, 2016. After blacking out while caring for his infant daughter the day before, he woke up on his parents’ couch with no recollection of the events. The realization that his addiction had jeopardized his daughter’s safety was the jolt he needed.
“What she told me, just, it absolutely scared the life outta me because again, my daughter is everything to me. I, I love her more than the world. And, um, like I, I get emotional just thinking about it because, you know, something bad could have happened and, and I, if I didn’t go to jail, if something bad happened, I, I can tell you I probably wouldn’t be here ’cause I wouldn’t wanna live after that.” This moment, devoid of grand dramatic consequences like incarceration or near-death experiences, was nonetheless profoundly impactful. It demonstrates that “rock bottom” is subjective and deeply personal; for Ben, the threat to his child’s well-being was enough to trigger a fundamental shift. The immediate consequence of being asked to leave his home until he sought help further solidified his resolve.
7. The First Steps of Recovery: 90 Meetings in 90 Days
With his marriage on the line and the terrifying realization of his actions, Ben committed to recovery. His first concrete step was embracing the “90 meetings in 90 days” approach, a common recommendation in 12-Step programs. Despite his introverted nature, he dedicated himself to attending meetings daily. “I was going to meetings every day. I was sitting there and I never talked at any meetings. Like, you would’ve never seen me doing anything like this.”
This initial immersion in the recovery community, even without active participation in sharing, provided a crucial foundation of support and exposure to the principles of sobriety. It allowed him to absorb the experiences of others, gradually eroding the isolation that had characterized his addiction. This structured approach to early recovery provides consistency and a sense of routine, which can be invaluable in navigating the initial turbulent stages of sobriety.
8. Redefining Higher Power: A Personal Journey of Spirituality
Ben’s past role as a worship leader presented a unique challenge in his recovery journey, particularly concerning the concept of a “higher power” in 12-Step programs. He admitted to holding resentment towards organized religion. However, the flexibility of “God of your understanding” resonated deeply. “I loved how they said God of your understanding. And I latched onto that ’cause I’m like, I don’t understand the God that I have been leading worship too for other people. I don’t understand him right now.”
This willingness to redefine his spiritual beliefs on his own terms allowed him to engage with the spiritual aspect of recovery without feeling constrained by traditional religious dogma. This personal interpretation of a higher power is a cornerstone of many recovery programs, allowing individuals from diverse backgrounds to find a spiritual path that supports their sobriety.
9. Finding New Obsessions: The Power of Purposeful Action
Beyond attending meetings, Ben recognized the vital need to actively engage in something meaningful. He embraced the idea of finding “new addictions” or, more accurately, healthy obsessions. “I gotta, I gotta do something with myself. Yeah. You have to find something to kind of like dive into. That’s a huge part of my recovery story and what I..tell people is like, get busy doing something. Find something you love and do it. Find a new addiction, really obsession.”
This proactive approach to filling the void left by substance use is crucial for sustained recovery. For Ben, this translated into tangible projects, like building a playhouse, which provided a sense of accomplishment and a healthy outlet for his energy.
10. A String of Hope: Connecting Through Vulnerability
Ben’s journey eventually led him to create “A String of Hope,” a platform dedicated to mental health, addiction recovery, and personal growth. This endeavor is a powerful manifestation of his core desire, recognized only in recovery, to connect deeply with others. “I thought when I saw Jimi Hendrix that day, I thought what I wanted to be was a rockstar. And what I really wanted to do is harness what he had to connect to people.”
Through candid storytelling and motivational insights, Ben fosters a community of support and resilience, turning his past struggles into a beacon of hope for others. This act of service, of sharing his vulnerability and insights, has become his ultimate purpose, allowing him to impact millions. “I know now, today with the cute little videos that I do, I’m able to do that… Now I’m realizing like it was never about being a rock star and like performance, it was about connecting to people.” This demonstrates the profound healing that can occur when individuals transform their personal pain into a source of inspiration for others.
11. The Ongoing Journey: Life Beyond Addiction
Ben Fisher’s story is a testament to the transformative power of recovery. His life, now marked by sobriety and purpose, is rich with opportunities to connect and inspire. From a young boy captivated by a rockstar’s image to a man who understands the true meaning of connection, Ben’s journey highlights the continuous process of growth and self-discovery in sobriety. His story underscores the importance of seeking help, even when the path is difficult, and the profound impact that finding a new purpose can have on long-term recovery.
“Here I am today and life is so much better. And I’ve had so many opportunities like this to do.” His ongoing commitment to sharing his story, even as an introverted individual, showcases the strength and conviction that can emerge from overcoming adversity. Recovery is not a destination but a continuous process of self-improvement, resilience, and a commitment to a life lived fully and authentically.
On this episode of the Giving Voice to Addiction Podcast, we sit down with Roger, a man who has not only navigated the treacherous waters of addiction but has emerged with a profound message of hope and resilience. Roger’s story is a testament to the human spirit’s capacity to overcome immense challenges, offering invaluable insights for anyone struggling with addiction or supporting a loved one through it.
1. The Overpowering Force of Hope: A Counter to Addiction’s Grip
Addiction often feels like an insurmountable force, an overpowering entity that leaves individuals feeling trapped and hopeless. However, Roger’s journey reveals a crucial truth: hope can be an even more potent force. For those entrenched in the depths of addiction, the very concept of hope can seem elusive, a forgotten dream. Yet, Roger, having lived through decades of active addiction and trauma, emphasizes its transformative power. He states, “It’s possible. It’s possible to find hope, and it’s possible that that hope can overpower everything that tries to stop us, and we can move towards the life that we’re trying to have.“
This isn’t a naive optimism but a hard-won conviction born from personal experience. Roger understands that addiction often leads to a sense of undeserving suffering, a belief that one is inherently flawed and destined for failure. He candidly shares his own past struggles with mental health and suicidal ideation, revealing that he once believed, “My addiction, my poor mental health, my time messing around with suicide. It’s a lie. I’m worth something. And for a long time I didn’t think I was.” This realization, that one’s worth is not diminished by addiction, is a cornerstone of true recovery.
The idea of standing “a millimeter taller” than one’s pain is a powerful metaphor Roger uses to illustrate the incremental victories in recovery. It signifies that even the smallest shift in perspective or effort can create a foothold, a spark of possibility that can ignite a larger transformation. This resonates deeply with the understanding that recovery is not a single event but a continuous process of small, deliberate steps.
2. Unpacking a Lifetime of Trauma and Addiction
Roger’s narrative is a stark reminder that addiction rarely exists in a vacuum. His story begins at a tender age, with his mother’s incarceration due to mental health issues when he was just four, followed by her subsequent homelessness. This early exposure to instability and profound loss laid a fertile ground for trauma. He began using drugs at 12, a rapid escalation from marijuana to speed, acid, and cocaine within a year. For Roger, drugs were initially a form of self-medication, a perceived source of comfort and safety in a chaotic world. He describes them as “my mother and my father all at the same time. It was comfort, nature, nurture. It was an escape. It was warm, especially when I started shooting heroin. It was warm, felt good. It was safe until it tried to kill me.“
The allure of drug dealing, though dangerous, provided a perverse sense of purpose and engagement that was otherwise lacking. This highlights how addiction can fulfill unmet needs, even in destructive ways. However, this illusion of safety and purpose eventually shattered. The constant threat of violence, including having a gun to his head multiple times, coupled with a cocaine overdose, signaled a turning point. The realization that his lifestyle was not only endangering himself but also his innocent family members became a powerful motivator for change. “Now I’m putting other people at risk,” he recalls, a clear indication that his addiction’s reach extended far beyond himself.
The journey to discontinue drug use was not immediate but a five-year “de-escalation,” starting with breaking free from the needle and gradually tapering off harder substances. This gradual process underscores that recovery is often a marathon, not a sprint, requiring sustained effort and commitment.
3. The Power of a Vision: Turning Point to Recovery
One of the most profound catalysts for Roger’s initial sobriety was a vivid dream of his own funeral, where he witnessed the devastation it wrought on his father and sister. This dream, coupled with a subsequent “day vision,” solidified his resolve to change. “I had a dream and the dream was my funeral. Then I looked around the funeral scene and I saw my dad and my middle sister, who I’m very close with, and they were just wrecked.” This powerful emotional experience transcended his love for being high, offering a clear and devastating consequence of continuing his path. It shifted his motivation from self-preservation to protecting those he loved.
This deeply personal turning point illustrates that while external pressures can play a role, true and lasting change often stems from an internal shift in values and priorities. Roger’s decision was not driven by a desire to simply stop using, but by a profound realization of the impact his addiction had on his loved ones.
After finally quitting drugs, Roger channeled his addictive tendencies into a new, healthier pursuit: professional mountain biking. While this brought its own set of challenges, including head injuries, it was a significantly less destructive path than his previous drug use. This demonstrates the concept of addiction transfer, where individuals in recovery might replace one addictive behavior with another. While not ideal, it can sometimes be a stepping stone towards healthier coping mechanisms, provided it doesn’t lead to equally destructive outcomes.
4. The Continuous Journey: Sobriety, Clean Time, and Recovery
Roger’s commitment to his recovery is evident in his meticulous counting of clean time: “36 years, one month, and four days.” This unwavering awareness of his sobriety date is not a burden but a source of strength, a tangible representation of his dedication. He explains, “I have to count the days. The days give me strength if I let myself go, I’d be dead tonight because if I’m gonna give up that time, I’m going all the way.” This highlights the ever-present temptation for those in recovery and the importance of recognizing the significant investment made in staying clean.
However, Roger’s journey also includes a relapse with alcohol after his first divorce, underscoring that recovery is not a linear path. Despite being clean from drugs for 15 years, the emotional devastation of his divorce led him to heavy alcohol use, consuming a fifth of tequila daily and later two to three bottles of wine. This period of alcohol abuse lasted five years. His experience demonstrates that past sobriety from one substance doesn’t grant immunity from addiction to others, especially during periods of intense emotional distress.
His eventual cessation of alcohol came after a work trip in Spain where he drank himself unconscious and missed a flight, followed by his second wife being hospitalized for alcohol poisoning. This dual crisis, coupled with the realization of the impact on their three young children, spurred him and his wife to quit drinking together. This collective decision highlights the power of shared commitment and accountability in recovery, especially when children are involved. Roger now differentiates between his “clean” time from drugs and his “sober” time from alcohol, emphasizing that true recovery encompasses addressing all addictive behaviors and underlying issues. He states, “I’m 14 years sober. 14 years, and 21 days, April 17th. So I count that too.”
5. Beyond Abstinence: The Essence of True Recovery
For Roger, being “clean” and “sober” is distinct from being “in recovery.” His past experience with suicidal ideation, even years after achieving drug sobriety, revealed that abstinence alone isn’t enough. He discovered that his suicidal thoughts were a side effect of antidepressant medication, emphasizing the complex interplay between mental health and substance use. Roger’s current recovery hinges on a structured life built on connection, engagement, and introspection. Living in a cabin in the woods without internet, cell service, or TV forces him to actively seek human connection. He elaborates, “I need structure. I need engagement. I need connection… I have to consciously get outta the house every day, or it puts me in trouble. But that connection is key for me and facing my truth.“
This active pursuit of connection and self-awareness through journaling, writing, and maintaining relationships with friends and family is central to his ongoing well-being. He also finds purpose in mentoring others, understanding that helping others strengthens his own resolve. This highlights the altruistic nature of recovery, where sharing one’s experience can create a virtuous cycle of support.
6. Understanding Addiction from the Family’s Perspective
Addiction’s ripple effect extends far beyond the individual, deeply impacting families who often grapple with immense pain, confusion, and a desperate desire to help. Roger offers crucial insights for families struggling to understand their loved one’s addiction. He emphasizes that judgmental attitudes towards behavior miss the underlying suffering. “For many people there is a mental health component that goes along with substance abuse. And more than anything, I think as a people, as humanity, we’re quick to judge the behavior. The behavior is the person people think. It’s not that person’s in trouble. That person’s hurting.“
This distinction between the person and their behavior is fundamental to fostering empathy and effective support. Roger advises families to “love the person no matter what” while simultaneously establishing healthy boundaries. He acknowledges the fine line between tough love and enabling, urging understanding that individuals, even in addiction, are often doing what they believe is best, however misguided it may seem.
Roger asserts that genuine change must come from within: “If we want to go to rehab, we have to want to go to rehab. If we want to quit, we have to want to quit.” This speaks to the limitations of external pressure and the necessity of internal motivation. His personal experience of his mother’s homelessness serves as a poignant example of how societal judgment can dehumanize individuals struggling with addiction and mental illness, reminding us that “that’s somebody’s mother. That’s somebody’s sister. That’s somebody’s kid.”
7. The Role of Support and the Evolution of Treatment
While Roger’s journey was largely self-directed due to the limited resources available at the time, he acknowledges the critical role support plays. He recalls how two close friends intervened when he was desperate to quit the needle, physically preventing him from using and offering unwavering support. “I just told ’em, this is my life and this is how I’m gonna die. I was crying and they said, well, we’re gonna help you.” This demonstrates the profound impact of genuine care and intervention when an individual is ready to receive it. His move to Colorado, away from the triggers of Baltimore, also provided a crucial “break” from his active addiction.
Roger’s early attempt to seek professional help was met with a devastating response: “What’s your insurance? I don’t have any. And they’re like, sorry, we can’t help you.” This highlights the significant barriers to treatment that existed in the past, particularly for those without financial means. It underscores the vital progress made in the addiction treatment landscape, with increased access to resources like harm reduction strategies, needle exchange programs, and a greater emphasis on integrated care for co-occurring mental health disorders. While Roger didn’t attend his first 12-Step meeting until six years ago, he now recognizes their immense value: “They are helpful ’cause it’s a community that you don’t find elsewhere. You need people that can accept you as you are.”
8. Roger’s Enduring Message of Possibility
Roger’s ultimate message is one of unwavering hope and the boundless possibilities of change. He implores anyone struggling to believe in the potential for a different future: “It is possible. It’s possible for something else. It’s possible for change. Change is actually a given.” He challenges the ingrained cynicism and self-deprecating labels that often accompany addiction, such as “loser, low life piece of shit, junky, alcoholic, dropout.” Roger powerfully asserts, “No matter our worst behavior, we’re more than that. We can be anything we wanna be. We can start over every single morning.”
His call to action is simple yet profound: “Just get started. Try to try start there.” This emphasis on taking the first, often daunting, step resonates with anyone facing a significant challenge. Roger’s journey from a childhood marred by trauma and a devastating 13-year drug addiction to a life of profound purpose and continuous recovery is a powerful testament to the fact that even in the darkest moments, possibility exists.
Roger’s story is a beacon of hope for countless individuals. It underscores that recovery is a complex, non-linear journey often intertwined with trauma and mental health challenges. Yet, with internal motivation, external support, and an unwavering belief in the possibility of change, individuals can not only overcome addiction but also build lives of purpose and profound meaning. His message is a powerful reminder that “you’re beautiful. I love you, and you can do it. I know it. Absolutely know it. ‘Cause it is possible.”
Navigating the healthcare system can be overwhelming, especially when determining what type of care is best for you or a loved one. One of the most common distinctions you’ll encounter is between inpatient and outpatient care. Understanding the differences, benefits, and limitations of each can help you make an informed decision when seeking medical treatment or mental health support.
What’s the Main Difference Between Inpatient and Outpatient Care?
The main difference between inpatient vs. outpatient care1 lies in the need for an overnight stay. In inpatient treatment, patients are admitted to a hospital facility and remain under continuous medical supervision. This is typically required when a person needs more intensive medical care or mental health treatment.
In contrast, outpatient care involves treatment that does not require an overnight hospital stay. Patients visit a doctor’s office, clinic, or outpatient facility for procedures, therapy sessions, or evaluations and return home the same day.
Individuals and families can choose the best type of care2 for their needs and preferences.
NAMI shares that:
Mental health treatment can be thought of as a continuum, with patients moving up or down in levels of care3 as needed.
What Is Inpatient Care?
Inpatient care4 refers to any treatment or medical procedure that requires a person to be admitted to a hospital or care facility. This type of care is often reserved for serious or complex health conditions that need close monitoring by medical professionals. Patients undergoing major surgery, treatment for a heart attack, or severe mental health disorders typically receive inpatient care. During a hospital stay, the patient has access to round-the-clock medical staff, including nurses, doctors, and specialists, ensuring a high level of care.
Inpatient care is often necessary when a person requires stabilization, intensive care, or specialized interventions that cannot be safely provided on an outpatient basis. Facilities offering inpatient services include hospitals, psychiatric centers, and substance abuse treatment centers.
These services take place in inpatient facilities like hospitals, behavioral health centers, or residential treatment programs.
What Is Outpatient Care?
Outpatient care,6 also called ambulatory care,7 involves medical services that do not require a hospital stay. These include checkups, consultations, diagnostic tests such as CT scans, MRIs, x-rays, mammograms, and lab tests, as well as minor surgeries, colonoscopy, and outpatient mental health treatment.
Outpatient services are typically less intensive and more cost-effective than inpatient options. They can be provided in a variety of settings including doctor’s offices, community health clinics, and outpatient programs within larger healthcare systems. Outpatient care is especially beneficial for individuals who have a stable support system at home and don’t require 24/7 medical supervision.
What Are Some Examples of Outpatient Care?
Examples of outpatient services include:
Routine checkups and screenings
Outpatient surgery like hernia repair or cataract removal
Lab tests, x-rays, and MRIs
Therapy sessions and mental health treatment
Follow-up visits after hospitalization
Treatment programs for mild substance abuse issues
“While there’s a clear difference between an inpatient and an outpatient, there is a little bit of gray area as well. Occasionally, physicians will assign a patient observation status while they determine whether hospitalization is required. This period typically lasts for no more than 24 hours.”
Severity of the condition: Life-threatening or complex conditions often require inpatient care.
Type of treatment: Procedures that require intensive monitoring or specialized support usually involve hospitalization.
Mental health needs: Acute mental health disorders or crises may necessitate inpatient stabilization.
Recovery and support: Those without a safe home environment may benefit from the structured setting of an inpatient facility.
Recommendations from healthcare providers: Ultimately, medical professionals will assess and recommend the best type of care based on your specific needs.
What Are the Costs for Outpatient vs. Inpatient?
In general, inpatient care is significantly more expensive than outpatient care due to the costs associated with a hospital stay, including meals, facility use, and continuous medical supervision. Outpatient treatment10 is usually more affordable, especially for routine or preventive care. That said, the total cost of either option depends on:
Type of treatment or procedure
Length of hospital stay
Facility and provider fees
Diagnostic or imaging services (e.g., CT scans, mammograms)
Insurance coverage and co-pays
Do You Have Coverage for Inpatient vs. Outpatient Health Care?
Most health insurance plans provide some level of coverage for both inpatient and outpatient care, but the details can vary. It’s important to:
Check your plan’s insurance coverage for both inpatient programs and outpatient programs
Understand your deductible, co-pay, and out-of-pocket maximums
Get pre-authorization when required, especially for inpatient treatment
Many insurance providers categorize care based on medical necessity and type of treatment, so having a clear diagnosis and documented provider recommendation is essential. Some plans offer more generous coverage for preventive health services, like screenings and wellness checkups, which are typically done on an outpatient basis.
Understanding the difference between inpatient and outpatient care is crucial for making the right treatment decisions.
Each offers distinct benefits, and your choice should be guided by the severity of your health condition, the type of care required, and guidance from trusted healthcare providers. There may also be situations or conditions that benefit from an inpatient to outpatient transition.11
Whether you’re facing a medical emergency, managing chronic illness, or navigating mental health challenges, knowing your options can help you choose the right path to recovery.
FAQs
Q: What’s the difference between inpatient and outpatient?
A:Inpatient care requires a patient to stay overnight in a hospital or treatment facility, often for serious conditions needing close monitoring. Outpatient care involves treatment or services—like consultations, tests, or minor procedures—without an overnight stay.
Q: What is an example of an inpatient setting?
A: Inpatient settings include hospitals, psychiatric units, residential treatment centers, and rehabilitation facilities where patients are admitted for round-the-clock medical supervision.
Q: What counts as an outpatient?
A: An outpatient is a patient who receives medical care—such as a checkup, diagnostic imaging, or therapy session—without being admitted to a hospital or staying overnight.
Q: How many hours is considered inpatient?
A: While there’s no strict hourly definition, a patient is typically considered inpatient once they are formally admitted to the hospital and stay for at least one night under medical supervision.
Q: What is outpatient care?
A: Outpatient care refers to medical services that don’t require a hospital stay. It includes doctor visits, lab tests, outpatient surgeries, and mental health therapy.
Q: What are some examples of inpatient care?
A: Examples include emergency surgery, treatment for heart attacks, psychiatric hospitalization, and inpatient substance use rehab programs.
Q: What is Outpatient Mental Health Care?
A:Outpatient mental health care involves therapy, counseling, medication management, or group programs where patients return home after each session.
Q: When does someone need inpatient mental health care?
A:Inpatient mental health care is necessary when a person is in crisis, at risk of harming themselves or others, or needs intensive treatment and supervision not possible at home.
Q: Do you need inpatient or outpatient mental health treatments?
A: It depends on symptom severity, safety risks, support systems, and provider recommendations. Many start with outpatient care and may transition to inpatient if symptoms escalate.
Q: Is there a difference between inpatient vs outpatient surgery?
A: Yes. Inpatient surgery requires hospitalization for monitoring and recovery, while outpatient surgery (also called same-day surgery) allows patients to return home post-procedure.
Q: How do costs compare between inpatient and outpatient care?
A:Inpatient care is generally more expensive due to hospital stays, staffing, and intensive services. Outpatient care is usually more affordable and cost-effective for routine treatments.
Q: What are the benefits of outpatient treatment compared to inpatient care?
A:Outpatient treatment allows for greater flexibility, lower cost, continued daily life activities, and is ideal for stable conditions not requiring 24/7 monitoring.
Q: What factors determine whether a procedure is inpatient or outpatient?
A: Key factors include the complexity of the procedure, patient health status, need for anesthesia or monitoring, provider recommendations, and insurance policies.
