$1000 a month on a psychologist?

I’ve written before on my concerns on over-spending on healthcare, particularly mental healthcare, as my income has ranged from $50k to $100k. Even though today I make more money than I did years ago, it still seems a bit unreasonable to spend $1000 a month on a psychologist. However, that’s how much qualified mental health costs in my neck of the woods. I just spoke with a local psychologist who sounds like he may be able to help me reduce stress and be more functional, yet he costs $235 a 45 minute session. Does it make sense to spend $1000 a month on mental health therapy when my rent is only $600?

You could argue in the long run I’ll make more money if I get appropriate mental health help. I may be able to keep my job longer… be more successful in my tasks… prove to management that I’m capable of sustained success and therefore worthy of a raise… etc. But it certainly won’t help my bottom line in the short term. And wouldn’t something like yoga (even at the really expensive studios around here) or straight-up personal training be cheaper and actually make me healthier in the long run?

Perhaps I’m just resistant to allowing therapy to work because I don’t want to believe I can pay for someone to tell me how to fix something that isn’t physically broken. That said, these days I’ve been about at my wit’s end and need help. I need help enough that I’ve started to call local psychologists. Yet, then I remember that they charge $200 a session, and that means $800-$1000 a month, or $12,000 a year. Even though my take-home pay is $4200 a month after 401k and taxes, that’s still a lot. How much should I spend on mental health?

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6 comments

  1. Anonymous For This O says:

    Your blog has been enjoyable to follow over the years. One thing I've noticed is that you've explored quite a few mental health diagnoses, including Bipolar II, borderline, ADHD, and depression. I've traveled that road, my husband has, and so have many of my friends – and a few family members too. It's infinitely difficult to pursue the correct treatment for you when you're not even sure what you're treating. Many times, psychiatric patients are more educated than their doctors. Psychiatry is an inexact science at best and requires lots of guesswork. Mapping symptoms to disease is subjective. Patients may rotate through many doctors and "labels" for years before finding adequate care.

    Read Marya Hornbacher's Madness if you're ever in the mood for a true-life account of someone like you – a strong, creative professional woman who struggled for years to get the right kind of help. Marya is Bipolar I and is an alcoholic, so in that sense, you two don't have much in common. However, anyone who's been to more than 1-2 psychiatrists in their adult life will be able to relate. I have a pretty severe case of ADHD which was not elucidated until I was pretty far along in my career, preparing to get married, and settled into adult life. I've been reading, with much dismay, that ADHD patients receive false bipolar diagnoses, bipolar patients receive false ADHD diagnoses, borderline patients receive false diagnoses of both, and it just goes on.

    So here's what I'd suggest if you don't want to spend a fortune on mental health help, but do want an effective and enduring means of treatment. First, call your insurance company and have them help you find a psychiatrist who's known for evaluating their patients rigorously. Spend some money up front to get tested and get a concrete diagnosis. That person can then either treat you or refer you to a doctor who will manage your meds. Regardless of what you wind up on, you will only need to see the med doc once a month. If you wind up on SSRIs or other non-scheduled medication, you may be able to see that doctor every 2-3 months for med checks.

    Then, spend some time searching for a counselor who is really skilled at talk therapy. Good talk therapists and inexpensive talk therapists are NOT mutually exclusive, and San Francisco is a liberal city with some generous programs, from what I hear. Look into the local universities, as well as sliding-scale clinics and women's health centers like Planned Parenthood. Even my small city offers at least 3-4 low-cost clinics with excellent counselors. Depending on your diagnosis, you may need CBT, dialectical behavioral therapy, classical Freudian analysis – that is something you and your doctor will need to explore. But I think if you lay it out on the line with your meds doctor that you need a lower-cost counseling solution, s/he will work with you and that counselor to develop a treatment plan that works for you and is impeccably customized to your needs.

    I'm rooting for you, and I hope you'll update us as to how it's working out!

  2. omk says:

    I feel the same. You don't have to commit long term – why not just try it for a couple of months? Report back how it goes, and maybe you'll help others take that faltering first step too!

  3. Kerry says:

    All the money in the world isn't going to help you if you can't succeed in your career, form good relationships and be a loving, supportive parent to the children you want to have. It's no fun sabotaging yourself. I spent $600 a month on therapy in 2009-2010 when I screwed up my health insurance, and I don't regret it because I finally did good work with a great therapist who got me, was interested in my problems and who I could trust. I made less than $50,000 at the time. It was an investment in myself.

    Besides, you might not have to spend $12K a year on therapy for your whole life. Hopefully not. Maybe you should just give yourself a year with a good therapist that you've screened, and really work on your problems, and see what happens.

  4. slweal says:

    Post college makes me really miss all the on campus covered psychological help I should have utilized when in college! Those rates seem very high. Maybe you could ask for a referral to someone starting out who charges lower rates. They probably are more up to date with techniques if they graduated more recently.

  5. Anna Jensen says:

    On the contrary, I think the high fee for mental treatment or seeing a psychologist is justified as the harm that may result from that may be worse compared to physical ailment. Better spend that money that loose your health forever.

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