How to tell if you would benefit from an emotional support animal, plus tips for getting one

• Emotional support animals don't have special training, but they can offer comfort and stress relief.
• Living with depression, anxiety disorders, PTSD, or bipolar disorder may qualify you for an ESA.
• A mental health professional can write a letter stating your need for an ESA based on your symptoms.

Animals can provide wonderful companionship, but they can also be trained to do more for their owners. If you live with a mental health condition, for example, emotional support animals (ESAs) can offer therapeutic benefits.

Emotional support animals are not formally trained to perform any specific task for their owners. Instead, they can provide comfort to people dealing with mental health symptoms and emotional concerns ranging from depression and anxiety to loneliness.

It's important to note that ESAs are different from service animals, which are specially trained to assist people living with a disability. For example, a service animal can be trained to sense when its owner is about to have a panic attack and take action to prevent the attack or soften its impact. An ESA, by contrast, offers more generalized comfort.

Moreover, because service animals are recognized by the Americans with Disabilities Act (ADA), owners can bring them into restaurants, stores, hotels, and airplanes — but the ADA does not extend these benefits to ESAs.

What animals can qualify as emotional support animals?

The most common ESAs are dogs and cats, says William Chum, LMHC, a licensed psychotherapist in private practice. But other animals can also be considered ESAs, as long as a mental health professional determines that their presence offers emotional benefits.

Other types of ESAs:

• Rabbits
• Snakes
• Horses
• Birds
• Ferrets
• Guinea pigs
• Llamas

Here's what to know about the possible benefits of an ESA, who qualifies, and how to go about getting one.

What are the benefits?

Not only do ESAs offer companionship on a day-to-day basis, but they can also provide comfort during times of distress, says Ernesto Lira de la Rosa, PhD, a licensed clinical psychologist and media advisor for the Hope for Depression Research Foundation. Other potential benefits include easing loneliness, stress, and anxiety while increasing feelings of pleasure and relaxation.

A small 2021 study found that people with diagnosed mental health or psychiatric disorders experienced a statistically significant decrease in depression, anxiety, and loneliness after getting emotional support animals. Researchers also observed an increase in oxytocin — the "bonding hormone" associated with feelings of well-being — and lower amounts of the stress hormone cortisol after participants had 10-minute focused interactions with their emotional support animal.

Meanwhile, a 2018 review found evidence to suggest that ESAs were particularly helpful for people with mental health conditions during a time of crisis, as their presence seemed to distract from upsetting symptoms and experiences.

While emotional support animals and their owners have some rights under Fair Housing Laws that protect against discrimination, other public places are not required to accommodate them, says Chum.

Important: Since state laws can vary, Lira de la Rosa recommends researching local regulations if you'd like to have an ESA in an apartment that doesn't allow pets. What's more, as of January 2021, the United States Department of Transportation no longer recognizes ESAs as service animals, and not all airlines permit them.

Who qualifies?

Examples of some conditions that might qualify you for an ESA:

• Major depressive disorder
• Generalized anxiety disorder
• Bipolar disorder
• Post-traumatic stress disorder (PTSD)
• Panic disorder
• Agoraphobia

Conversely, in order to qualify for a service dog, you would need to have a disability recognized by the ADA, such as:

• Blindness (including partial)
• Deafness (including partial)
• Epilepsy/Seizures
• Diabetes
• Panic attacks
• Autism
• PTSD

How to get one

If you're interested in getting an emotional support animal, start by contacting a licensed mental health professional, says Lira de la Rosa.

During your first therapy session, they'll typically ask about:

• Your medical history
• Previous traumatic experiences
• Current mental and emotional health symptoms, including how long you've had them and how they affect your daily life

These questions help them get a clearer picture of your overall mental health, which can help them better understand whether you might benefit from an ESA. If they think you might benefit, they'll write a formal letter indicating that you have an emotional or mental disability — which they do not need to label or define — and stating their recommendation for an ESA to help with this issue.

It's important to recognize they won't make this decision after just one session. It takes time for a therapist to get enough insight into your mental and emotional state of mind to determine whether an ESA could offer the support you need, so they might ask that you attend a few sessions before they write that letter.

What's the cost? The cost of an ESA letter can vary. Some mental health professionals charge a one-time fee, which can range from $100 to $600, says Lira de la Rosa. A therapist already providing therapy to you may include this service in their regular session fee.

Training a pet you already have

A pet you have right now could qualify as an emotional support animal since there currently aren't many criteria for ESAs, says Lira de la Rosa. As long as your pet is able to provide support and comfort and a mental health professional agrees that this pet can meet your needs, they can likely qualify as an ESA.

However, if your pet ever acts overly aggressive or disrupts the home environment, they may not be suitable as an ESA, says Chum.

Important: Given that formalized training requirements for ESAs don't yet exist, there's always the possibility your animal could behave unpredictably and do more harm than good. For this reason, it's a good idea to have an animal behaviorist conduct a temperament evaluation to ensure your potential ESA is well-suited to this role.

Fake or unethical ESA letters

You may have heard of people drafting fake ESA letters in order to bring their pet places where animals typically aren't allowed, but taking advantage of the system in this way can complicate things for people who actually need an ESA. In particular, animals that aren't well-behaved can erode businesses' sense of trust in ESAs. Some airlines recently stopped accommodating ESAs because too many people brought pets on flights, says Lira de La Rosa.

Many for-profit websites, often referred to as "ESA mills," offer an ESA letter without ever requiring you to attend in-person treatment. While these letters may be considered legitimate, provided that they're signed by a licensed mental health professional, doctor, or social worker, Chum says these businesses are unethical when they promise instant approvals. That's because it takes time for a provider to evaluate whether or not an ESA is right for you, not to mention how best to implement an emotional support animal into your overall treatment plan, says Chum.

Important: There's a difference between having a therapist-recognized need for an emotional support animal and getting everyday, basic emotional support from your pet. Petting your dog can certainly soothe and calm you — but for someone living with diagnosed anxiety, having their dog nearby could make it possible for them to function in everyday situations.

Insider's takeaway

An ESA can provide comfort, companionship, and emotional support for people living with anxiety, depression, and other mental health concerns.

A licensed mental health professional can evaluate your current mental and emotional health and assess how an ESA might fit into your treatment plan. If they believe an ESA may be right for you, they'll write a letter you can show landlords and school residences that don't allow pets. Remember, though, that ESAs aren't the same as service animals, and not all businesses are required by law to allow them.