What are the signs you need therapy? You don't need a diagnosis, a crisis or a “good enough” reason to start. The bar is much lower than people think — and the people who arrive thinking they're “not bad enough” are often exactly the people therapy is built for.
This is a working guide from Keeley Taverner, a Psychotherapist, BACP Accredited. It's not a quiz, not a diagnostic tool, and not a list designed to make you book something. It's the answer I give when someone asks: how do I know if I should?
What counts as a reason to see a therapist?
If you're asking the question, that itself is information. People who genuinely don't need therapy generally don't sit there wondering whether they do.
Therapy isn't reserved for crisis. Most of the work that happens in this profession is with capable, functioning adults who have noticed that something isn't quite right — or has been off for a long time — and want a space to work it out.
Signs you need therapy: what to look out for
- You're carrying something you can't shift on your own
- The same kind of relationship, conflict or job keeps showing up
- You're stuck on a decision and can't see straight
- You've recently been through a big loss or change
- Anxiety is interfering with sleep, work, food or relationships
- You're flat, joyless or hopeless in a way you can't explain
- Something from your past is showing up uninvited in the present
- You're using alcohol, food, scrolling or work to take the edge off, more than you used to
- You don't recognise yourself any more
The quieter signs people talk themselves out of
These are the ones I most often hear in a first session, retrospectively — usually with the line “in hindsight, I think this had been going on for years”:
- You're “fine” but you can't quite remember when you last felt like yourself
- You're tired in a way sleep doesn't fix
- You apologise reflexively, even when you've done nothing wrong
- You can't enjoy your achievements — the next thing arrives before you've felt this one
- You walk on eggshells around someone close to you
- You replay conversations for hours after they're over
- You over-explain, over-prepare, over-deliver — just in case
- You've quietly stopped doing things you used to love
- You can hold it together for everyone except yourself
- You'd be relieved if someone “made” you have a break
None of these on their own prove anything. The point isn't to put you in a category — it's to notice the cumulative cost. If you'd struggle to recognise the version of you from three or five years ago, that's information worth listening to.
Specific things people often arrive for
Some of the most common reasons people start work, in plain language:
- Stuck after a relationship. A breakup, separation or divorce that hasn't resolved emotionally even if it has practically. (More on this kind of work.)
- Something doesn't feel right about a current relationship. Often hard to name — not quite “abuse”, not quite “fine”. (Toxic relationship counselling.)
- The aftermath of a narcissistic or coercive relationship. Reality-restoration, self-trust, rebuilding. (Narcissistic abuse recovery.)
- Anxiety that's running the show. Sleep, rumination, physical symptoms, avoidance. (Anxiety counselling.)
- Low mood, flatness or burnout. Often without an obvious cause. (Depression counselling.)
- Bereavement. Recent or long-standing — grief doesn't have a deadline. (Bereavement counselling.)
- Work stress, burnout or imposter syndrome. Often the safest place to start if other parts of life feel off-limits. (Work stress & burnout.)
- A specific traumatic memory that's still “live”. (Trauma & PTSD counselling; sometimes EMDR.)
- A big life transition — new parenthood, midlife, retirement, an identity shift. (Life transitions counselling.)
You don't need a “good enough” reason
One of the most common things I hear in a first session is some version of: I know other people have it worse. That's almost always true and almost never relevant. Therapy isn't a finite resource you have to ration against people in greater need.
If you've been carrying something for a long time, “people have it worse” is not the test. The test is whether what you're carrying is affecting how you live, work, love or sleep.
You also don't have to wait until you're falling apart. Plenty of useful therapy happens with people who are still functioning. Doing it earlier is usually quicker and less painful than doing it after a collapse.
When to look for specialist support specifically
Some situations benefit from a practitioner with specific specialism, rather than a generalist:
- Eating disorders — specialist services exist (Beat).
- Active addiction — specialist addictions services usually run alongside therapy, not instead of it.
- Significant trauma — childhood abuse, sexual violence, complex PTSD — ask explicitly about trauma training.
- Perinatal mental health — the period from conception to a year after birth has its own specialist services.
- Severe and enduring mental illness — therapy may be useful, but secondary mental-health services and a psychiatrist are usually the lead.
When something more urgent is needed
Therapy is not an emergency service. If you're thinking about ending your life, are unable to keep yourself safe, or someone close is in immediate danger, please use one of these — today, not after an appointment:
- 999 — for an immediate emergency.
- 111 — NHS, for urgent (non-999) mental-health help; press option 2 for mental-health support in many areas.
- Samaritans — 116 123, 24/7, free.
- Shout — text SHOUT to 85258, 24/7, free, text-based crisis support.
- National Domestic Abuse Helpline — 0808 2000 247.
But do I really need therapy?
Do I really need it? Other people have it worse.
Almost everyone in a first session offers some version of this. It's almost always true and almost never relevant. Therapy isn't a finite resource you have to ration against people in greater need. If what you're carrying is affecting how you live, work, love or sleep — that's the test, not a comparative scoreboard.
Can't I just talk to a friend?
Friends are precious and irreplaceable. They're also (rightly) part of your life and have their own stake in your decisions. A therapist sits outside that web: no opinion on your ex, no opinion on your boss, no investment in the outcome. That neutrality is what lets you think out loud without managing the listener's feelings at the same time.
I'm not 'bad enough' — I'm still functioning.
Plenty of useful therapy happens with people who are still functioning — sometimes immaculately. In fact, the people who hold it together for everyone else are often exactly the ones who benefit most from a room where they don't have to. You don't have to wait until you collapse to qualify.
I tried therapy once and it didn't click. Should I try again?
Fit matters more than any single technique. A poor fit a few years ago doesn't tell you much about the next person you'd see, or what's possible now. Most ethical practitioners offer a free 30-minute call specifically so you can check fit before committing.
Will it open a can of worms I can't close again?
A good therapist paces the work to your nervous system, not to a schedule. You set the pace, you decide what to bring, and nothing has to be unpacked before it's ready. The fear of “opening it all up” is usually a sign that something's already half-open — the room just helps you put it down safely.
A small, manageable first step
If you've recognised yourself anywhere in this article — or you've been searching for a therapist near me in Marlow or Buckinghamshire — the next step is a free 30-minute consultation. It's a no-pressure conversation about what's been going on and whether this is the right fit. You don't need a list of symptoms, a diagnosis or a plan — just a willingness to talk for a quarter of an hour.
For more, see what to expect in your first session, counselling vs psychotherapy or any of the service pages linked above.