I've never had a therapist, but I have spent a ton of time studying therapy in an attempt to fix my own problems. I'd like to get a therapist, but I need one that can handle gender dysphoria, and I'd have to pay out of pocket for that ($100-$150 CAD a session).
I've talked to quite a few people who have had therapists and most of what I hear is that it doesn't help them much. I think with certain kinds of problems (schizophrenia, psychosis, mood disorders) medication can be useful and important. My sister and brother are both much better on meds than off meds. But when it comes to other kinds of problems, therapy as it's usually given isn't that much good. You have to keep trying new therapists until you find one that works for you (like
) and even then the improvements might be modest.
I think whether or not you get better depends a lot on whether or not you have a healthy state to go back to (ie. if your problems are acute, late-onset problems) and whether or not you currently live in an environment that fosters mental health. If your problems have been lifelong, and you still live in a toxic environment (like my friend), then it's extremely hard to get better. I think lifelong depression and anxiety disorders should be treated like personality disorders, but most therapists seem to treat them the same way they treat late-onset problems.
Most therapists seem to assume that everyone has been healthy at some point and they just need to find their way back to it. (You see that in case studies all the time, when they tell patients to remember "all the things they've accomplished" or "all the friends that they've made", etc. If you don't have that kind of experience in your background, hearing advice like that can be alienating and make the problem worse. The same thing can happen with exposure therapy if your therapist underestimates how serious your problems are and you find that your fears are
realistic when you try to complete your homework assignments (ie. you're trying something beyond your current abilities). If you don't have the resources that your therapist believes that you have (because they think you're exaggerating the extent of your problems) then the therapy they provide is probably not going to make you feel any better (and will probably make you feel worse).
Despite all of that, I have derived a great deal of benefit from studying therapy myself. (I wouldn't be here today if I hadn't.) I do think that therapy is potentially very helpful for many people. The problem is more a matter of resources: a handful of sessions teaching a person how to do CBT isn't going to help anyone with serious problems. Several years with a sharp, compatible therapist, who is willing to treat you like an individual instead of a "resistant" case of textbook SAD probably would. But where are you going to get the resources for that? Unless you're rich, you're probably SOL.