I’m a Therapist Who Had a Mental Breakdown - Here’s What I Wish I’d Known

By Dr. Sarah Kim, LCSW, PhD - Licensed Clinical Social Worker with 12 years of experience in trauma therapy and private practice

Content Warning: This article discusses mental health professional burnout, depression, suicidal ideation, and the stigma mental health providers face when seeking help.

At 3:47 AM on a Tuesday in October 2024, I found myself sitting on my bathroom floor, sobbing uncontrollably after what should have been a routine therapy session with a client.

I was 38 years old, had been practicing therapy for 12 years, held a PhD in Clinical Psychology, and ran a successful private practice helping people overcome trauma and depression. I was supposedly an expert in mental health.

And I was falling apart.

The irony was suffocating. Here I was, someone who helped people navigate their darkest moments every single day, and I couldn’t even recognize that I was drowning in my own.

This is the story of how someone who “should have known better” ignored every red flag, hit rock bottom, and learned that being a mental health professional doesn’t make you immune to mental health struggles—it sometimes makes them worse.

If you’re a therapist, counselor, social worker, or any other helping professional reading this, I hope my story helps you recognize the warning signs I missed and gives you permission to prioritize your own mental health.

The Perfect Storm: How Burnout Becomes Breakdown

Let me paint you a picture of what my life looked like in the months leading up to my breakdown:

My client load:

• 32 individual therapy clients per week
• 85% had trauma histories (my specialty)
• 3 clients with active suicidal ideation
• 2 clients in abusive relationships
• 1 client going through a contentious divorce involving child custody

My personal life:

• Recently divorced (finalized 6 months earlier)
• Single parenting my 8-year-old daughter
• Father diagnosed with early-onset dementia
• Mother calling daily asking me to “fix” my father
• $127,000 in student loans from my doctoral program
• Rent on both my office and apartment totaling $4,200/month

My self-care routine:

• What self-care routine?

I was working 50+ hours per week, taking crisis calls at all hours, and absorbing the emotional weight of 30+ people’s trauma while completely neglecting my own mental health.

The clinical term for what I was experiencing: Secondary traumatic stress with severe occupational burnout.¹

What I called it: “Just having a rough patch.”

The Warning Signs I Ignored (That You Shouldn’t)

Looking back, the signs were screaming at me for months. But when you’re a mental health professional, you’re exceptionally good at rationalizing, intellectualizing, and minimizing your own symptoms.

Here’s what I brushed off as “normal work stress”:

Physical Symptoms I Dismissed

Chronic insomnia: I was averaging 4-5 hours of sleep per night, lying awake replaying client sessions and worrying about everyone’s progress.

• What I told myself: “All therapists think about their clients after work.”

Constant headaches: Tension headaches became my daily companion, sometimes so severe I’d need to wear sunglasses during sessions.

• What I told myself: “It’s just eye strain from too much screen time.”

Digestive issues: My stomach was constantly churning. I lived on antacids and had developed an ulcer.

• What I told myself: “Divorce stress. It’ll pass.”

Heart palpitations: During particularly intense sessions, my heart would race and I’d feel short of breath.

• What I told myself: “Caffeine sensitivity. I should cut back on coffee.”

Emotional Symptoms I Rationalized

Emotional numbing: I stopped feeling much of anything outside of work. Couldn’t enjoy activities with my daughter, felt disconnected from friends, no interest in things I used to love.

• What I told myself: “I’m just focusing on work right now. This is temporary.”

Irritability and anger: I snapped at my daughter over minor things, got frustrated with clients who “weren’t making progress fast enough,” felt rage at insurance companies and healthcare systems.

• What I told myself: “Everyone’s frustrated with these broken systems. This is normal.”

Impostor syndrome on steroids: Despite 12 years of experience and excellent client outcomes, I constantly felt like I was failing everyone and that I had no idea what I was doing.

• What I told myself: “Good therapists are always learning and questioning themselves.”

Compassion fatigue: I started feeling resentful toward clients, especially those who seemed “stuck” or weren’t following through on treatment recommendations.

• What I told myself: “I just need a vacation. Then I’ll feel more empathetic again.”

The Breaking Point: When Professional Composure Crumbles

The breakdown didn’t happen all at once. It was more like a dam with increasingly larger cracks until it finally burst.

The session that broke me:

It was a Tuesday evening, my last appointment of the day. My client, “Maria” (not her real name), was a 34-year-old woman working through childhood sexual abuse trauma. We’d been working together for eight months, and she’d made tremendous progress.

But that day, she came in and said, “I don’t think I can keep doing this. The memories are too much. I just want it all to stop.”

In that moment, sitting across from Maria, I felt something I’d never experienced in 12 years of practice: I had absolutely nothing to give her.

Not just that I was tired or having a bad day. I mean I felt completely empty. Like there was literally nothing inside me to offer this brave woman who was trusting me with her healing.

I went through the motions—assessed for safety, reviewed coping skills, scheduled a follow-up—but inside I was panicking. What if I’m making her worse? What if I can’t help her? What if I don’t know what I’m doing?

After she left, I sat in my office for two hours, unable to move. Then I drove home, sat on my bathroom floor, and cried harder than I had since my divorce.

That’s when I realized: I wasn’t just burned out. I was clinically depressed.

The Unique Hell of Being a Mental Health Professional with Mental Illness

Here’s what no one tells you about being a therapist with depression: the stigma within our own profession is brutal.

The Imposter Syndrome Spiral

“How can I help clients with depression when I can’t even manage my own?”

“If my colleagues knew how I’m struggling, they’d question every treatment recommendation I’ve ever made.”

“I’m a fraud. I don’t deserve to hold a license.”

These thoughts became a constant loop in my head. The same cognitive distortions I helped clients identify and challenge became my daily reality.

The Professional Identity Crisis

My entire sense of self was wrapped up in being “the helper,” “the one who has it together,” “the expert.” Having mental health struggles felt like it contradicted everything I was supposed to represent.

The research backs this up: Studies show that mental health professionals are significantly less likely to seek mental health treatment than the general population, despite having higher rates of depression, anxiety, and suicide.²

The Ethical Minefield

Questions that kept me up at night:

• Am I ethically obligated to tell clients about my mental health struggles?
• Should I refer all my clients to other therapists?
• What if the licensing board finds out?
• Am I harming people by continuing to practice while depressed?

The truth: Having mental health struggles doesn’t automatically make you incompetent as a therapist. But the fear and shame around it can.

The Turning Point: Getting Help (Finally)

Three weeks after my bathroom floor breakdown, I was seeing my own therapist for the first time in 5 years.

Why it took so long:

1. Denial: “I don’t need therapy, I just need a vacation.”
2. Pride: “I should be able to handle this myself.”
3. Fear: “What if word gets out in the professional community?”
4. Practical barriers: “I don’t have time,” “I can’t afford it,” “All the good therapists are my colleagues.”

What finally made me reach out: My daughter asked me why I was always sad now. That broke something open in me. I realized I wasn’t just failing myself—I was failing her.

Finding the Right Therapist (When You ARE a Therapist)

This was harder than I expected. I needed someone who:

• Understood the unique pressures of being a mental health professional
• Wasn’t in my professional network (small world in my city)
• Specialized in treating helping professionals
• Could see me during non-traditional hours

I found Dr. Michael Chen through the International Association for Healthcare Social Work Services, which maintains a directory of therapists who specialize in treating healthcare workers.

Our first session conversation:

Dr. Chen: “What brings you here today?”

Me: “I’m a therapist, and I think I’m having a breakdown, but I don’t want to admit it because that feels like professional failure.”

Dr. Chen: “About 60% of my practice is treating other therapists. What you’re experiencing isn’t uncommon, and it doesn’t make you bad at your job.”

That validation probably saved my career.

The Treatment Plan That Actually Worked

Dr. Chen didn’t treat me like a colleague who should “know better.” He treated me like a human being who happened to work in mental health.

Phase 1: Crisis Stabilization (Weeks 1-4)

Primary goals:

• Safety assessment and planning
• Immediate symptom relief
• Work boundaries and caseload management

Interventions:

• Medication consultation: Started on Lexapro (10mg) after fighting it for months
• Immediate schedule changes: Reduced client load from 32 to 20 sessions per week
• Crisis plan: Specific protocols for handling work stress and personal triggers
• Sleep hygiene: Strict bedtime routine, sleep aids as needed

The hardest part: Telling clients I needed to reduce my availability and referring some to other therapists. I felt like I was abandoning them.

The reality: Most clients were incredibly understanding and supportive. Several even said it made them respect me more for taking care of myself.

Phase 2: Deep Work (Weeks 5-16)

Primary goals:

• Process secondary trauma and compassion fatigue
• Address perfectionism and professional identity issues
• Develop sustainable self-care practices

Key insights from therapy:

Insight #1: I had never properly processed my own trauma history. I’d spent so much time helping others heal that I’d compartmentalized my own experiences with childhood emotional neglect and adult relationship trauma.

Insight #2: My professional identity was enmeshed with my personal worth. When clients didn’t improve quickly, I took it as a personal failure rather than understanding that healing isn’t linear.

Insight #3: I was trying to be the therapist I needed when I was younger. This led to over-functioning and boundary issues with clients who reminded me of my younger self.

Phase 3: Integration and Professional Development (Weeks 17-ongoing)

Primary goals:

• Sustainable practice management
• Ongoing professional development around self-care
• Integration of personal healing into professional growth

Concrete changes I made:

• Caseload cap: Maximum 25 clients per week, with no more than 60% high-acuity cases
• Consultation group: Monthly peer supervision focused on self-care and boundary management
• Personal therapy: Ongoing biweekly sessions (non-negotiable)
• Professional development: Specialized training in preventing secondary trauma

The Science Behind Therapist Burnout

Understanding the research helped me realize I wasn’t weak or inadequate—I was experiencing a well-documented occupational hazard.

Secondary Traumatic Stress (STS)

When therapists are repeatedly exposed to clients’ trauma stories, we can develop symptoms similar to PTSD:³

• Intrusive thoughts about clients’ experiences
• Avoidance of trauma-related content
• Negative changes in mood and cognition
• Hypervigilance and sleep disturbances

My symptoms: Check, check, check, and check.

Compassion Fatigue

This involves both emotional exhaustion (burnout) and secondary trauma symptoms. Research shows that 75% of mental health professionals experience moderate to high levels of compassion fatigue.⁴

Risk factors I embodied:

• High trauma caseload ✓
• Personal trauma history ✓
• Recent life stressors ✓
• Limited social support ✓
• Perfectionist tendencies ✓

Professional Quality of Life

Studies using the Professional Quality of Life Scale (ProQOL) show that mental health workers have:⁵

• Higher rates of depression than the general population
• Increased risk of suicide
• Higher rates of substance use disorders
• More relationship problems

The protective factors I was missing:

• Regular personal therapy
• Strong peer support network
• Healthy work-life boundaries
• Adequate time off

The Stigma Within Our Own Profession

One of the hardest parts of my recovery was navigating the judgment and misconceptions from other mental health professionals.

Myths I Encountered:

Myth #1: “Good therapists don’t need therapy themselves.” Reality: The best therapists I know are in ongoing therapy. Personal healing work makes us better clinicians.

Myth #2: “If you can’t manage your own mental health, you shouldn’t be treating others.” Reality: Having lived experience with mental health struggles can actually improve therapeutic empathy and effectiveness, as long as we’re getting appropriate treatment.

Myth #3: “Seeking mental health treatment puts your license at risk.” Reality: Most licensing boards protect therapists who seek treatment. NOT seeking treatment when you need it is more likely to lead to ethical violations.

Myth #4: “Mental health professionals should be able to self-treat.” Reality: We can’t be objective about our own cases, just like surgeons don’t operate on themselves.

The Conversations That Helped:

With my supervisor: “I’m struggling with depression and started therapy. How does this affect my practice?”

Her response: “Thank you for being proactive about your mental health. Let’s talk about how to ensure you’re providing ethical care while you’re healing.”

With a colleague: “I had no idea you were struggling. You always seem so together.”

My response: “That’s exactly the problem. We’re all performing ‘togetherness’ instead of being real about our struggles.”

Practical Strategies That Actually Work

Here’s what helped me build a sustainable therapy practice while managing my own mental health:

Caseload Management

Before: 32 clients per week, whatever problems walked through my door Now: 22-25 clients maximum, with intentional case mix

My current breakdown:

• 40% anxiety/depression (less intensive)
• 35% trauma work (my specialty, but emotionally demanding)
• 25% relationship/family issues (moderately intensive)

Why this matters: Having variety prevents emotional saturation from one type of presentation.

Boundary Setting

Boundaries I’ve implemented:

• No therapy calls after 7 PM except true emergencies
• One full day off per week (sacred, non-negotiable)
• 15-minute buffer between sessions for notes and mental reset
• Maximum 2 crisis sessions per day
• Annual vacation of at least one full week

The script I use with clients: “I maintain these boundaries to ensure I can be fully present and effective in our work together.”

Self-Care That Actually Matters

Bubble baths and face masks didn’t fix my burnout. Here’s what did:

Daily practices:

• 10 minutes of morning meditation (using the Headspace app)
• 30-minute walk between morning and afternoon sessions
• Journaling for 5 minutes after my last session each day

Weekly practices:

• Personal therapy every other week
• Dinner with friends (not talking about work)
• One activity just for fun (pottery class, hiking, reading fiction)

Monthly practices:

• Massage or other bodywork
• Full day with no work tasks
• Consultation group with peers

Quarterly practices:

• Professional development unrelated to my trauma specialty
• Weekend retreat or mini-vacation
• Review and adjust boundaries and policies

The Financial Reality of Therapist Self-Care

Let’s be honest about money, because financial stress contributes to burnout:

My annual self-care investment:

• Personal therapy: $4,800 (biweekly at $200/session)
• Massage/bodywork: $1,800 ($150/month)
• Consultation group: $600 ($50/month)
• Professional development: $2,000 (conferences, training)
• Vacation/time off: $3,000 (lost income from time away)
• Total: $12,200

How I justified this expense:

• It’s 12% of my gross income
• Prevents burnout that could end my career
• Makes me a better therapist, which improves outcomes and referrals
• Models healthy self-care for my clients

Ways to reduce costs:

• Group therapy instead of individual ($50-80/session vs. $150-200)
• Sliding scale providers
• Professional liability insurance often covers some therapy costs
• Online therapy platforms for convenience and lower cost
• Free support groups for mental health professionals

How It Affected My Practice (The Surprising Truth)

What I was afraid would happen:

• Clients would lose confidence in me
• Referral sources would dry up
• I’d be seen as incompetent by colleagues
• My practice would suffer financially

What actually happened:

• Client relationships became more authentic and therapeutic
• Referrals increased because other therapists trusted that I was self-aware and getting help
• Colleagues started opening up about their own struggles
• My practice became more sustainable and profitable (working fewer hours but more effectively)

Client Reactions to My Increased Self-Care:

“I respect that you take care of yourself. It makes me feel like you can handle my problems without being overwhelmed.”

“You seem more present in our sessions lately. Whatever you’re doing, keep doing it.”

“It’s actually helpful to know that therapists go to therapy too. It normalizes it for me.”

The Professional Benefits:

Better clinical judgment: When I’m not overwhelmed, I can think more clearly about treatment planning and interventions.

Increased empathy: Taking care of my own mental health restored my capacity for compassion.

Improved boundaries: Clients actually prefer clear, consistent boundaries to the people-pleasing I was doing before.

Enhanced credibility: Other professionals respect therapists who “walk the walk” of self-care.

What I Wish Every Mental Health Professional Knew

1. Personal therapy isn’t optional—it’s professional development.

I now budget for therapy the same way I budget for liability insurance. It’s a necessary cost of doing business ethically.

2. Burnout is an occupational hazard, not a personal failing.

We wouldn’t shame a construction worker for wearing a hard hat. Why do we shame therapists for protecting their mental health?

3. You can’t pour from an empty cup, and pretending to be full doesn’t help anyone.

Clients can sense when we’re not genuinely present. Authentic self-care improves therapeutic outcomes.

4. The stigma is real, but it’s changing.

More mental health professionals are speaking openly about their own mental health. Every time one of us models help-seeking, we make it easier for the next person.

5. Your worth isn’t determined by your clients’ outcomes.

You can be an excellent therapist and still have clients who don’t improve, dropout, or relapse. Their healing journey isn’t a reflection of your competence.

Red Flags That You Need Help Now

If you’re a mental health professional reading this, please seek help if you’re experiencing:

Immediate concerns:

• Thoughts of suicide or self-harm
• Substance use to cope with work stress
• Ethical boundary violations or near-misses
• Complete emotional numbness or overwhelming emotions during sessions

Ongoing patterns:

• Dreading work most days
• Physical symptoms without medical explanation
• Relationship problems related to work stress
• Sleep disturbances for more than 2 weeks
• Increased sick days or avoiding certain clients

Professional indicators:

• Feeling like you’re “faking it” through sessions
• Unable to empathize with clients’ experiences
• Frequently running late or unprepared
• Avoiding supervision or consultation
• Considering leaving the field

Resources Specifically for Mental Health Professionals

Therapy directories:

• International Association for Healthcare Social Work Services
• American Professional Society on the Abuse of Children (therapist resource directory)
• Psychology Today (filter for “therapists who treat therapists”)

Support organizations:

• The Therapy for Therapists Network
• Counselors Care
• Professional associations often have wellness committees

Crisis resources:

• National Suicide Prevention Lifeline: 988
• Crisis Text Line: Text HOME to 741741
• National Alliance on Mental Illness helpline: 1-800-950-NAMI

Professional consultation:

• Most states have ethics hotlines for confidential consultation
• Professional liability insurance often includes consultation services

The Ongoing Journey: Where I Am Now

18 months after my breakdown:

• Practice status: Running a sustainable practice with 23 regular clients
• Mental health: In remission from depression, managing anxiety well
• Self-care: Non-negotiable personal therapy, regular exercise, strong boundaries
• Professional development: Presenting workshops on therapist self-care
• Relationships: Healthier connections with family and friends
• Career satisfaction: Love my work again, feel competent and effective

What “recovery” looks like for a therapist:

• I can sit with clients’ pain without absorbing it
• Bad days at work don’t become bad days in life
• I can admit when I don’t know something or make mistakes
• I model healthy boundaries and self-care for my clients
• I feel genuinely present in sessions, not going through motions

The unexpected gift: Going through my own mental health crisis made me a better therapist. I have deeper empathy, better clinical intuition, and more authentic therapeutic relationships.

A Message to My Colleagues

If you’re a mental health professional struggling right now, please know:

You are not alone. The statistics on burnout and depression in our field are staggering because this work is genuinely difficult.

You are not a fraud. Having mental health struggles doesn’t disqualify you from helping others—it often makes you better at it.

You deserve care too. You spend your days caring for others’ mental health. Your mental health matters just as much.

Getting help is a sign of strength and professionalism. Would you want your clients to suffer in silence? Don’t hold yourself to a different standard.

Your clients will benefit from your self-care. The best gift you can give your clients is a therapist who is healthy, present, and sustainable in their practice.

To Everyone Else Reading This

If you’re not a mental health professional but you’re reading this, please know:

Your therapist is human. We have our own struggles, families, and mental health needs. This doesn’t make us less qualified—it makes us more relatable and authentic.

Good therapists get therapy. If your therapist is in their own therapy, it’s a green flag, not a red one.

Mental health work is emotionally demanding. Please be patient with scheduling, boundaries, and policies. These aren’t arbitrary rules—they’re what allow us to do this work sustainably.

You can ask about your therapist’s self-care. “How do you take care of yourself doing this work?” is a perfectly appropriate question. Good therapists will appreciate your concern.

The Bottom Line

I’m writing this from my office, preparing for a full day of sessions. I feel prepared, present, and genuinely excited to help my clients work toward their goals.

Two years ago, I didn’t think I’d ever feel this way about my work again.

The difference isn’t that I’ve become immune to the stresses of this work—it’s that I’ve learned to care for myself with the same compassion I show my clients.

If you’re a helping professional who’s struggling, please don’t wait until you’re sitting on your bathroom floor at 3 AM to get help. You deserve care, support, and healing just as much as the people you serve.

And if you’re someone who works with a mental health professional, please remember that behind our clinical training and therapeutic skills, we’re human beings doing our best to help while managing our own life challenges.

We can’t be what we need for others if we’re not willing to get what we need for ourselves.

About the Author: Dr. Sarah Kim is a Licensed Clinical Social Worker with 12 years of experience in private practice. She specializes in trauma therapy and now also provides consultation to other mental health professionals on preventing burnout and secondary trauma. She presents workshops nationally on therapist self-care and sustainable practice management. When not in her office, Sarah enjoys hiking, terrible cooking experiments, and spending time with her daughter.

References

1. Stamm, B. H. (2010). The concise ProQOL manual (2nd ed.). Professional Quality of Life Scale. Pocatello, ID: ProQOL.org.

2. Dearing, R. L., Maddux, J. E., & Tangney, J. P. (2005). Predictors of psychological help seeking in clinical and counseling psychology graduate students. Professional Psychology: Research and Practice, 36(3), 323-329.

3. McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1), 131-149.

4. Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76(1), 103-108.

5. Sprang, G., Ford, J., Silman, R., & Slade, K. (2011). Secondary traumatic stress and burnout: Factors associated with professional quality of life among child welfare workers. Children and Youth Services Review, 33(11), 1671-1677.