Women with endometriosis are at significantly higher risk for psychological disorders, especially anxiety and depression—but not only because of the hormone fluctuations, chronic pain, and the stress of invisible illness. Groundbreaking research suggests that endometriosis actually changes gene expression in the brain, leading to increased anxiety, depression, and sensitivity to pain (https://www.ncbi.nlm.nih.gov/pubmed/28553145) I know! Not fair, right?!

Contrary to popular opinion, clinical depression isn’t limited to a depressed mood—other symptoms include fatigue, loss of interest in activities that used to be enjoyable, change in appetite, insomnia or sleeping more than usual, unexplained feelings of guilt, body aches, and irritability. Similarly, anxiety often manifests as a racing heart, sweating, trouble concentrating, sense of impending doom, nervousness and gastrointestinal issues. Other signs that you may need additional support include feeling overwhelmed, using substances to cope, or having family or friends express concern over your wellbeing.

With all the ways that endometriosis affects us physically, it’s easy to underestimate the toll it takes on us mentally and emotionally. We’re warriors, after all, and we let nothing stop us! Besides, our weeks are already filled with hard work, doctor appointments, and self-care, and the idea of even just one more appointment can be overwhelming. Even so, it’s important to pause to look at how we’re doing emotionally and reach out when we need a little extra support.

Where do I start?

If you have a friend or family member who loves her therapist or if you know a therapist personally, ask her for a recommendation! I always find that good therapists are happy to help people find the resources they need.

Another way to find resources is by using Psychology Today (link to https://www.psychologytoday.com/us). Click “Find a Therapist” and enter your city or zip code to start (you can also choose “Find a Psychiatrist” from the dropdown here). After you enter your location, the results will include all registered therapists in the surrounding cities. Refine your search by using the bar on the left to select your insurance, the issues you’d like to address, preferred gender, types of therapy, and more.

Not sure what to include for “Issues”? Options pertinent to endometriosis include: “Women’s Issues”, “Stress”, “Sex Therapy”, “Pregnancy, Prenatal, Postpartum”, “Depression”, “Chronic Pain”, and “Anxiety”.

Lastly, if your insurance is limiting your options, Nystrom & Associates (link to https://www.nystromcounseling.com/) offers counseling, psychiatry, and group therapy at several locations across Minnesota, and accepts all insurances.

There are so many types of therapists – What’s the difference? What’s right for me?

You’ve taken the first step—you’ve begun to search for therapists, and as you scroll you start noticing how many different types of professionals there are… What’s the difference between a Marriage & Family Therapist (MA, LMFT), Psychologist (PhD or PsyD, LP), Clinical Social Worker (MSW, LICSW), and Counselor (MA, LPCC), and why do they need to make it so confusing??

Don’t worry, girl. We’ve got you.

Practically, there are not huge differences between therapists—all licensed mental health professionals are qualified to diagnose and treat mental conditions, and there are many different educational pathways to becoming a therapist. All mental health professionals will have areas of expertise (often advertised on a website), and these specialties will be the most important factor in finding the best match for you.

For example, if you’re grieving a miscarriage or experiencing infertility, look for someone experienced in bereavement. If you and your partner want to address the ways endometriosis affects your relationship, a marriage & family therapist who is trained in couples and family systems might be the best place to start.

Your biggest concern may be regaining healthy sexual functioning. Dyspareunia, or painful sex, is one of the most common complaints of women with endometriosis, both because of the painful endometrial adhesions and because hormonal suppression treatment increases vaginal dryness and thins the skin, increasing the occurrence of fissions (small tears) from friction. Specialized sex therapists can help. If you live in the Twin Cities area, the University of Minnesota’s Center for Sexual Health (link to https://www.sexualhealth.umn.edu/clinic-center-sexual-health/relationship-and-sex-therapy) is a great resource.

What comes next?

Finding the right therapist can take some patience and persistence. Research has shown that regardless of the therapist’s training and approach, the single factor that indicates the highest chance of success is the strength of the therapeutic alliance (that’s psychology jargon for the trusting relationship between you and your therapist).

Take some time to consider what you want most out of therapy, and don’t be afraid to interview multiple therapists. Before booking an appointment ask if you can schedule an initial phone consult to determine whether you’re compatible. Most therapists will lead the consult but don’t hesitate to ask questions! Some questions you could ask include: What experience do you have with chronic illness and pain? Would you say your approach is more talk/reflection oriented or more behaviorally oriented?

You deserve therapy that works for you. While the most lasting results won’t come instantly, a good therapist will make you feel heard, cared for, and understood. Within a few sessions you will be feeling hopeful about your work together. If you don’t feel like things are clicking or if you’re not seeing the progress you’d hoped for after a few sessions, don’t be afraid to communicate this to your therapist or to look for someone else.

Finally, know that reaching out for help when you’re down is incredibly difficult, but at the end of the day, being proactive and taking control of your emotional health can and will improve the quality of your life. Be patient with yourself through the roadblocks and be proud of each step you take in the journey to wellness. Keep fighting, warrior!

More

-If you need more immediate help, please know that you are not alone. If you live in Minnesota, Mental Health Crisis Line phone numbers are listed by county at this link (link to: https://mn.gov/dhs/people-we-serve/adults/health-care/mental-health/resources/crisis-contacts.jsp).

-If you are having thoughts of harming yourself, please call 911 or go to the emergency room right away.

-The National Suicide Prevention hotline is 1-800-273-8255

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