Dr. Wilona Annunciation, MD | Mental Health & Emotional Wellbeing Blog

Fifteen years is a long time to sit across from people at their most vulnerable.

In that time, I’ve heard things that have moved me to my core, witnessed breakthroughs that reminded me why I chose this profession, and yes noticed patterns. Beautifully human, completely understandable, occasionally maddening patterns.

This isn’t a post to judge anyone. Quite the opposite. It’s a post that says: I see you, I’ve seen you before, and I understand why you do what you do even when it gets in the way of you getting better.

Consider this fifteen years of observations, served with honesty, a little humour, and a lot of genuine affection for every person who has ever walked through my door.

1. The Self-Diagnosers (a.k.a. “I Googled It and…”)

They arrive with a confident diagnosis, a printed article, and occasionally a treatment plan.

“I have ADHD.” “I’m pretty sure it’s bipolar.” “I know my partner is a diagnosable Narcissist and I’m Self-Defeating.”

Here’s what I want to say to every self-diagnoser: I am genuinely glad you came prepared. Curiosity about your own mind is a wonderful thing. But Google has no idea what your childhood looked like, how you sleep, what runs in your family, or what you were like before all of this started. I do because I ask.

Self-diagnosis is often the mind’s way of trying to make sense of suffering. That impulse is human and valid. But a label from the internet is not a diagnosis. Come in with your questions, absolutely. Just leave a little room for the possibility that the answer might be more nuanced and more treatable than what showed up on page one of your search results.

2. The Ones Who Came for Someone Else

“My wife asked me to come.” “My mother wouldn’t stop calling.” “My manager suggested it.”

I call this one the Reluctant Visitor. They sit down, arms subtly crossed, radiating the energy of someone who has been dropped off against their will. They’re polite. They answer questions.

And for the first twenty minutes, they make very clear without saying it that they don’t really think they need to be here.

And then, somewhere around minute twenty-five, something shifts. Because here’s what fifteen years has taught me: the person who came for someone else almost always discovers, quietly and a little reluctantly, that they came for themselves too. The wife who “made them come” was onto something. The mother who called was not being dramatic. If someone who loves you thought it was worth bringing up that’s information worth sitting with.

Sometimes, they actually finish the session without this learning though. And thats also OK, because the thought has now found a place in their minds and they reflect, pause and come back when they’re actually ready. And that’s just amazing, because then we’ve done some wonderful work together.

3. “I’m Fine.” (a.k.a I don’t need your help but I’m still here….)

Fine is doing a lot of heavy lifting for a lot of people.

I’ve heard “I’m fine” from people who hadn’t slept properly in eight months. From people whose hands were shaking as they said it. From people who cried in the car on the way here and reapplied their makeup in the parking lot before coming in.

I understand “I’m fine.” It’s armour. It’s years of being told not to make a fuss. It’s not wanting to be a burden. It’s not being sure if what you’re feeling is “bad enough” to count.

Here’s my answer to that last one, after fifteen years: if you’re in my office, it counts. You don’t need to earn the right to not be fine. You just have to be honest with me, and more importantly, with yourself.

4. The High Achievers Who’d Rather Solve Themselves

These are some of my favourite people, and also the ones who make my job the most interesting.

They are accomplished, articulate, and used to being the most capable person in the room. They’ve read the books. They’ve done the personality tests. They’ve listened to the podcasts. They approach their mental health the way they approach a work problem with research, frameworks, and a timeline for resolution.

The vulnerability required in therapy? Deeply uncomfortable for them. Because vulnerability has never been part of the success formula that got them here. What I want them to know is this: intelligence is an asset in therapy, not an obstacle. But insight alone doesn’t heal. At some point, the books have to be put down and the feelings have to be felt not analysed, not optimised, just felt. That’s not a step backwards. That’s the work.

5. The Ones Who Leave Just as It Starts Working

This one is the hardest to watch.

Therapy has a strange rhythm. The first few sessions can feel like relief finally being heard, finally having a space. Then comes the middle phase, where the real work begins, and it’s uncomfortable. Old patterns get named. Difficult truths surface. And right at this point, some people decide they’re “better” and stop coming.

They’re not better. They’re at the threshold. I think of it like physiotherapy for a knee injury. You start, the initial pain eases, you feel good and then you stop before the muscle is actually strong enough to hold you. Six months later, you’re back at square one. If your therapist or psychiatrist is asking harder questions than they used to, that’s not a sign something is wrong. That’s a sign something is working. Stay.

6. “It’s Not That Serious” The Family Member

Behind many patients who took too long to seek help is a loved one who, with complete love and complete unhelpfulness, told them it wasn’t that serious. I’ve watched parents, siblings, partners, children, even friends and teachers and other doctors too say this.

“Everyone feels like that sometimes.” “You just need to stay busy.” “In our family, we don’t believe in depression.” “Have you tried exercising more?”

I don’t write this to vilify them I genuinely don’t because honestly social support is a huge determinant of recovery in mental health and I’ll take all the support I can get. Most of the time, this comes from a place of deep discomfort with the idea that someone they love is struggling. Or from their own unexamined relationship with mental health. Or from a cultural script that was handed to them long before you were born.

But the impact is real. Dismissal from a loved one can delay someone seeking help by years. If someone in your life has told you they’re not okay, please believe them first, fix them never, and support them always.

7. “I Only Want Therapy, Not Medication”

I respect this position. I really do. Autonomy over one’s own treatment matters enormously to me. But I’ll be honest with you the way I’m honest with my patients: sometimes, wanting only therapy when medication is indicated is a little like refusing a cast for a broken leg because you’d prefer physiotherapy. Both have their place. One of them needs to come first.

Medication, when needed, doesn’t replace therapy. It creates the conditions in which therapy can actually work it quiets the noise enough for the real conversations to happen. It’s not a crutch. It’s not a life sentence. For many people, it’s the bridge that gets them from barely surviving to actually living.

The stigma around psychiatric medication is real and understandable. But please have an open conversation with your doctor before you decide. You might be surprised.

8. “I Tried Therapy Once. It Didn’t Work.”

This one deserves to be said clearly: a bad experience with a mental health professional is a bad experience with that professional. It is not a verdict on therapy, on psychiatry, or on whether help is possible for you.

The therapeutic relationship is everything. If the fit was wrong, the approach didn’t suit you, or you simply didn’t feel safe — that’s real and it matters. But it means you need a different person, not that you need to give up.

I’ve had patients who saw two or three professionals before finding the right match. And when they did, everything changed. Please don’t let one disappointing experience be the reason you stop looking for the support you deserve.

A Final Word

If you saw yourself in any of these welcome. You’re in good company. Every single one of these patterns comes from a deeply human place: self-protection, hope, fear, love, pride, or pain.

My job has never been to judge why you arrived the way you did. It’s to meet you where you are and help you get somewhere better.

Fifteen years in, that part still doesn’t get old.

Have a question you’ve always wanted to ask a psychiatrist? We’d love to hear it drop us a message or leave a comment below. Your question might just become our next post.