The Cost of Mental Health Treatment

    Something has recently come to my attention repeatedly, and that something is the cost of mental health treatment without health insurance. I recently found myself in a discussion with someone who wanted to seek treatment, but that person was worried that they couldn't afford to see a therapist. I've even found myself on social media websites, discussing possible ways someone could receive treatment, and the price they saw on Google or on websites for one-hour therapy sessions made them think that they were unable to get the help they needed.
     A one-hour counseling session can cost anywhere from $100 to $200, depending on the therapist, with private therapists generally costing more than a therapist that works out of a community mental health facility or community crisis center, and on the location. People tend to think the cost means therapy is completely off limits to them, and they view it as more of a luxury than a medical treatment. (I thought that before I got to college and majored in psychology because the only things involving mental health treatment I had seen were scenes on TV with rich ladies lying on couches in posh offices.) That isn't actually the case, especially not in community mental health.
     If a person needs mental healthcare and they don't have insurance or, if for some reason, their insurance doesn't cover mental healthcare, the community mental health agencies will work with the person seeking treatment on the cost of that treatment. In other words, just like community medical healthcare without insurance, mental healthcare without insurance works on a sliding scale for fees. You pay an amount that you can afford, even as low as $10 per hour session in some places, or sometimes a person can see a therapist in community mental health for free if a person is out of work with no source of income like unemployment or disability benefits.
     I even know that some private therapists also treat people on a sliding fee scale, but private therapists will usually be a little more expensive than a community mental health agency. My therapist, a private therapist, told me when I had trouble with my insurance that she wouldn't stop my treatment if the insurance couldn't pay. We could have worked something out, and I could have paid an amount that wasn't the whole $160 (I believe that was the price of my sessions, but I can't be certain) for each session. I know of someone else who went to see a private therapist I my rural, Southern area without insurance coverage for $10 per visit.
     If you need mental health treatment, but you don't seek treatment because you don't have $100 to $200 to pay per visit, please, don't let that be the only obstacle keeping you from getting help. Most therapists, especially those in community mental health agencies and community mental health crisis centers, won't ask someone to pay the whole $100 to $200 per visit. They will work with you and help you at a price you can afford because they want to help people. You honestly just have to talk to the people in the community mental health agencies or call the agencies to ask them about fees and if they can work with you, or even ask some friends (if you know any that have sought mental health treatment).
     I'll end with this: Mental health treatment isn't a luxury to which only rich people or people with great insurance have access. Maybe you've been trying some self help books or workbooks or those free apps for your phone that I mentioned in a previous post, but if that isn't helping you, you don't have to just suffer through it on your own. You can call a community mental health agency or even a private therapist if you have those in your area, and you can talk to them about the help you need and whether or not they work with people who can't afford the whole price of treatment. Most community mental health agencies won't turn someone away just because they can't pay.

Breakthrough

     For the past couple of weeks in my sessions, my therapist and I have been working on desensitization exercises. I have to admit, after the way the first real exercise went, I was afraid to start them again. (Just to recap: during the first exposure exercise, I listened to a hymn, or, I tried to listen to a hymn. I barely made it five seconds into the song before my anxiety and guilt skyrocketed, and I had to back out of the exercise. I cried and felt like I was going to have a panic attack in the office. I had to retreat to my safe place, in my mind.)
     The desensitization exercises I did last week and this week went differently from my first real attempt. Last week, I went in, and I got so nervous that I broke out in sweats and my palms got super sweaty (gross!). I even caught myself stalling before I let myself play the music on my phone. I just kept talking because I was scared, even though in the back of my mind I'm practically screaming, "Shut up and just do it!"
     I tapped the play button on my phone, and "How Great Thou Art" started to play. I did the deep breathing, just like I'd learned to remain calm. My anxiety did a couple of jumps, but I hung in there. I made it through a verse and the chorus of the song before my anxiety got so high that I wanted to cry. Then I turned the song off. My hands were shaking, but panic didn't overwhelm me. I breathed, and I went to the safe place in my mind that I had constructed.
     I was fine, and I don't mean the pretend fine when I'm in public trying to keep my anxiety in check. I was genuinely fine, if a little shaky. I was even fine after I got home. No increased frequency of intrusive thoughts, no fear of being left alone. I was even able to take a nap (because therapy is exhausting).
     The desensitization exercises continued this week. I was anxious before we started because, let's face it, being exposed to something you know is going to trigger terrifying thoughts that could play on a loop in your mind for the rest of the day is terrifying. The fear that I may burst into flames or fall writhing onto the floor while my inner demons run free because of those terrifying blasphemous thoughts, makes me desperately want to avoid religious things at all costs. I was more confident this time because of how well everything went the week before, by I was still afraid. It gets a little hard to breathe when I pull out the list of songs that I choose from and my phone. At least this time, my therapist didn't ask me if I needed the window open or if I needed a glass of water, which sort of feels like an improvement.
     This time, things were a little better than fine. I actually made it through the whole song ("What a Friend We Have in Jesus, for that session). I was able to sit through a whole hymn, and the guilt I felt wasn't overwhelming. I also only experienced a slight rise in anxiety that I can't even really call a jump. My palms were sweaty, and my hands were shaking. But I didn't cry. I also didn't feel panicked. I felt okay the whole time. I did my deep breathing the whole time, and I remained mostly calm.
     I was so happy that I could have cried happy tears. After six years, and just over a year of weekly therapy sessions, I could listen to a hymn without sheer terror and panic and extreme guilt. I think that counts as some sort of therapeutic, breakthrough, doesn't it? I don't even know how to put the relief and happiness I felt into words so that people that aren't me can understand it.
     This doesn't mean that my funky brain is no longer funky. My brain will always be funky. I have other obsessions that I'll have to work through in therapy with more exposure and response prevention. However, after the events of this week's session, I feel like I'll be able to do it. I feel like I'll be able to work through this obsession and the other obsessions that torment me. Always in the back of my mind while I've been in therapy has been the question, "What if I don't ever really get better? What if I'm just like this forever?" I'm suddenly not so worried (at least for the moment).
     I'll end with this: I know that counseling with a therapist, or reading and working through a self help book, or any healthy way that you're trying to help yourself get well can be a long, grueling, and often terrifying process.  Sometimes, you can't see improvements when you want to, and that gets extremely frustrating. Putting in the work in counseling and getting the right kind of help whether it's a self help book, counseling services, and/or medications (or all three together) even when it gets frustrating or seems too scary or hopeless will pay off if you can just manage to hang in there. It took me six years to even just work up the nerve to tell someone what was happening, and then I went through debilitating panic for a week after that, plus a physician suggesting counseling before I went to see a therapist. Then I went through a year of weekly counseling sessions before I realized that everything might be somewhere in the ballpark of "okay". Sometimes, I think it's a miracle that I've gotten to the place that I am in right now. So please, don't give up on yourself even if you're feeling frustrated and hopeless.

I Don't Need Therapy, Thank You...

     I suggested to two different people over the year 2016 that they might feel better if they gave counseling a shot. They both acted like I had just insulted them, even after I told them that I went to therapy once every week to help manage my anxiety. I didn't even state it harshly. It was just a tentative suggestion of, "You might feel better if..." One person insisted that they only wanted some medication to calm their nerves. The other person quickly snapped that they were "fine".
     I saw something online earlier this week that suggested that this was a pretty common thing. People that have never sought counseling services think that counseling services are a bad thing (unless they know someone that had sought counseling or studied something like psychology, sociology, or social work in college). I'll admit that when I was younger and my mother (who had sought counseling for anxiety and some other things before) suggested I seek help for my anxiety, I burst into tears because I didn't want to get therapy. I didn't want to be one of those kids who had to go into therapy because she couldn't deal with something. Little childhood me was already different enough, and I didn't want the fact that people would think I was crazy or difficult to also be added into the mix.
     Then I had to seek help, and I realized that counseling was this thing that could make me a better human, a human that was kinder to myself and more understanding when it comes to dealing with the anxiety that has plagued my life since I can remember. After the initial fear that I couldn't be helped was put to rest, I couldn't understand what the big deal was with therapy. It's taking care of a part of your body (your brain) that might be a little bit sick. It's like going to the doctor and dealing with chronic allergies or diabetes. After I realized how helpful therapy was, I thought everyone could benefit from learning new, heathier ways to cope with life's stress and new ways to be kind to themselves. After I saw the improvements I was making and that I was getting back to the level of functioning that I experienced before the anxiety, I knew therapy saved my life.
     People give all kinds of reasons that they don't want to see a therapist. I've heard, "I can manage on my own, thank you very much." to "I just want some medication. I can get that from my regular doctor." to "I can't talk to a stranger about my problems. That's just weird." to, "I'm not crazy." all so people can avoid seeking out a counselor who could teach them helpful (and pretty cool) things about why they have anxiety, depression, or trouble adjusting, or complicated grief and how to cope from day-to-day.
     Even in 2016, the stigma around counseling is still alive and well, especially in the area of  the rural South where I live. Going to therapy still means you're crazy or that something is seriously wrong with you. When in reality, counseling is a thing, a service, that could make you a better, happier, more well-adjusted human. I mean, telling someone how helpful therapy can be is viewed as more out-of-the-box than suggesting they try Mindfulness (which is something that I also suggest to people). Telling someone they may benefit from therapy wasn't my way of insulting them. I wanted to help them because I cared about their well-being, and I was able to see how much counseling had helped me. I wasn't calling them crazy or weird or difficult.
     Most people seem surprised when I tell them that I have a counseling session with a "shrink" once a week. They sometimes say something like, "I would never have guessed." Well, the reason you wouldn't have guessed is because I'm getting help so that I can function almost as well as I did before the worst of the anxiety set in.
     Then some might ask how I can talk to a stranger about my problems. Going to a counseling session isn't like going in there and spilling all your beans to some random person on the street. It's like going to your regular doctor. How do people just go in to their regular doctor or and tell them that their urine is a funny color or something equally bodily-function-related? Even more awkward, how do women go to see their gynecologist/ OB-GYN? Simple: you trust their expertise and you have faith in their ability to help you or to fix your medical issue. It's the same way with a therapist, except the organ in question is your brain, and the bodily function in question is a possible imbalance in the chemicals your brain works with.
     I'll end with this: Even though mental health stigma tells you that therapy is a bad thing and it means you're crazy or that something is wrong with you, that isn't the case. Counseling services are a wonderful thing that actually can help you, and make you a better human to yourself and to others in the long run. If a loved one tells you (kindly!) that you might benefit from seeking counseling services, odds are they aren't doing it to hurt or offend you. They mentioned it only because they care about your well-being. We're only human after all, and we can't always manage every single thing life throws at us alone. If you wouldn't manage pneumonia alone, why would you try to manage anxiety or depression or grief alone?

Wintertime Blues

     I typically love fall and winter, or at least, I used to love fall and winter. I like the chilly temperatures so I have an excuse to wear my favorite leather jacket and tights under my shorts, the color-changing leaves, and I even love a nice non-dangerous amount of snow. I also seemed to write more during fall and winter. These days, I don't love fall and winter so much.
     For the past couple of years, I've noticed that my mood changes during fall and winter. My mood is low, and I feel blah. I don't want to write as much or exercise as much. I basically just want to hang out in my room with my cat and binge watch Netflix or Hulu while I cram my face full of junk food. I wouldn't take it so far as to say that I feel depressed all the time, but I would say that I feel moderately unhappy for a great deal of the time during fall and winter these days.
     I mentioned this to my therapist, and she said it was a seasonal affective sort of thing. I learned about that in my Abnormal Psychology class in college as a mental health disorder. Cue a new freak out that something else wasn't quite right in my brain. Then my therapist explained that people that didn't have any diagnosis of a depressive disorder were also more likely to feel depressed during the fall and winter months because of the decreased amount of sunlight. So, people with healthy brains might also be feeling blah and unmotivated during fall and winter, too. I felt relieved after hearing that because, since one of my OCD obsessions is that I might become severely depressed and suicidal, I'm terrified that I'll be diagnosed with something that includes depression at some point.
     My therapist mentioned that some people even go on medication during fall and winter so they can feel better. She also mentioned that I could get this light machine that would simulate the sun rising while I was still sleeping, which would cut down on the depressing amount of dark I have to deal with while it's cold out. Both of those are good options.
     I thought about both of them. I decided against both. The medication is still a scary area for me that I'm not willing to dive back into just yet. Since my depressed feelings are mild, I also decided against the light for Seasonal Affective Disorder (they are available on Amazon). I thought the lights were too expensive while I could still cope on my own, but I might try one in the future. On Amazon, the lights are available for $60 to $150.
     So, instead, I am trying out the same extra coping efforts that I try out when my anxiety skyrockets the week before my period. I'm trying not to give in to the cravings for all the junk food, and instead I'm currently trying to clean up my diet (which isn't hard considering I like fruits, veggies, and all the other healthy things). I'm also trying to exercise more. Instead of three times a week or whenever I feel like it, I plan on doing my regular three-day workout and adding in going for a walk on the other two days of the week, so I'm doing something active five times a week. I'm also trying not to binge watch Netflix and Hulu, but I will let myself watch a few episodes of whatever show I'm into after dinner. (I'm working on the binge watching...)
     I'll end with this: The wintertime blues can hit anyone. If you have the money, I highly recommend trying out one of the Seasonal Affective Disorder lights for your bedroom because my therapist said they were quite effective. Exercise also helps, and it can be something as simple as going for a walk or a bicycle ride for twenty minutes. I even walk inside my house with a timer and my iPod when I don't want to go outside.