When Pokémon content creator Stepho Wilson met her psychiatric service animal, she could hardly believe it came to her already named Joy. Fellow Pokémon trainers understand why.
“There’s a character named Nurse Joy, and she’s a healer,” Wilson explains. “And I love Pokémon, so it’s kind of crazy how that worked out.”
Wilson introduced her own personal Nurse Joy, a 2-year-old black Labradoodle, to her 40.3K followers with a post in which the two donned pink nurse’s caps with Wilson in a full Nurse Joy costume. In the caption, Wilson told followers she lives with major depressive disorder and generalized anxiety disorder.
In most of her posts, Wilson wears bright Pokémon prints and flashes a big grin alongside her menagerie of colorful Pokémon plushies. It’s this persona that has earned her more than 40,000 followers on Instagram. But as with any social media user, there’s more to her life than meets the eye.
“Social media is just a highlight reel,” she says. “I may appear very outgoing and bubbly and happy in a lot of my posts, but I do deal with this thing silently to an extent that people don't always realize.”
Joy, her psychiatric service animal, has been a game-changer.
“Just her presence is very comforting to me,” Wilson says, “but she’s also trained in specific tasks that help regulate me and help me have more confidence going out in public, which is something I struggled with a lot before.”
What’s a Psychiatric Service Dog?
While they might be best known for this, service dogs aren’t only for the vision impaired. They can be trained to support people with other disabilities, too.
Psychiatric service dogs can help people with PTSD, psychosis, major depressive disorder, or other debilitating mental health conditions. They are trained to pick up on an oncoming psychiatric episode and deescalate the situation. They can also be trained to:
- Remind their handler to take their medicine
- Make safety checks
- Do room searches or turn on lights for people with PTSD
- Interrupt acts of self-harm
- Keep disoriented people, such as those with psychosis having a hallucination, out of harm’s way
“These tasks are designed to mitigate disability,” says Michael J. Allen, MD, a family medicine doctor at Houston Methodist.
Service Dogs for Disabling Depression
When depression becomes a disability, as it had for Wilson who is no longer able to work because of the debilitating symptoms of her depression and anxiety, a service animal can be useful.
“For someone who has depression, a service animal might prevent self-harm, remind them to take their medications, or just provide grounding by lying on the patient,” Allen says.
Wilson’s service dog has helped her overcome extreme social anxiety. When the COVID shutdown came to an end, Wilson found that after spending so much time isolated in her home, she’d grown extremely apprehensive about leaving the house and socializing.
Now that she has Joy, she says, “Going out in public, just her presence has helped ground me so much to where I have more confidence going out on my own.”
Joy can sense when Wilson is becoming anxious or on the verge of a panic attack. Besides picking up on behaviors and body language that might be signs of stress, research shows that dogs can smell the chemical changes that take place in a body under stress. When Joy detects these changes in Wilson, she may give Wilson a nudge to shift her focus away from the anxiety or she may lie on top of Wilson like a warm, sentient weighted blanket.
“She is very good for grounding me,” Wilson says.
Is a Service Dog an Emotional Support Animal?
While a service dog may provide emotional support, this animal does so much more than that. As such, a disabled person’s right to be accompanied by a service dog is protected by the Americans with Disabilities Act.
“Service animals have to be trained and certified and have the highest degree of legal protections,” says Sunia Choudhury, PsyD, a clinical psychologist at Massachusetts General Hospital in Boston.
Two key factors distinguish a service dog from an emotional support animal (ESA). First, a service dog has been individually trained to do work or perform tasks that help a person with a specific disability, such as vision impairment, seizure disorder, hearing loss, or autism. Second, according to the ADA, service animals must be permitted anywhere their handler goes regardless of whether other animals are allowed into these spaces.
An ESA is any pet — typically a pet that the patient already has — that provides support, comfort, or stress or anxiety relief to its person. There’s no training or certification required. What makes it an ESA is a letter from a doctor or mental health professional stating that the patient needs the animal for their emotional well-being. This letter doesn’t grant the pet entry into all public spaces. But under the Fair Housing Act, landlords cannot deny leases to tenants with ESAs, regardless of the property’s pet policy, nor can they charge a pet deposit for ESAs. Few airlines allow ESAs to fly on planes with their person free of charge. Besides these two areas, ESAs are not allowed in other places that don’t allow animals, such as restaurants.
“There’s no current guidelines for who can receive a letter for an emotional support animal,” Choudhury says. “They just have to have a DSM [mental health] diagnosis and say that the animal makes them feel better.” When you don’t have a doctor who can write that letter, she adds, “there are certain companies and agencies out there that make it very easy for folks to get a letter to have an emotional support animal.”
Can Anyone With Depression Get a Service Dog?
Depression is one of the most common mental health diagnoses in the United States. But not everyone with depression could use the help of a service dog.
“They’re going to help a very small group of people with severe function-limiting depression or mood disorders,” Allen says. That’s people whose depression, even with medication and therapy, impairs their ability to get through day-to-day life. “Service animals are an adjunct to rather than the mainstay of treatment. It’s meant to go along with therapy, medications, and lifestyle modifications.”
Wilson was on a waiting list before she was able to get her service dog, which she says was the best thing for her. “In that interim time, I built a little more resilience. I think it’s important to have other tools under your belt first and not rely solely on a dog to help regulate you or help you with your disability. Having a service dog as your first line of defense isn’t the best idea.”
For people who are ready to take steps to get a service dog, Wilson recommends they do their research to understand:
- All the costs associated with getting a service dog and whether insurance will cover any portion of that
- How taking responsibility for an animal will impact their lifestyle and budget
- The additional needs, such as ongoing training, of a service dog beyond the needs of a regular pet
“It’s not a lot of people,” Allen says, “but there is definitely a subset of people with mood disorders who very much benefit from having a service animal.”
