The Cost of Teen Depression: Affording Mental Illness

Mental Illness, like any other chronic condition, is expensive to treat. Over the years I’ve spent who knows how much on therapy and help, not even counting lost wages due to being let go from jobs over my depression and anxiety getting the best of me. For the first time, I find myself in the situation advising a family member whose daughter is struggling with depression and suicidal ideation. High School is tough. I want her to survive it.

I don’t want to go into too many details on the rare chance that someone finds my blog who knows my family and who this is. But, I wanted to write this post because I think it’s an important topic, and helping depressed teens get the appropriate treatment is sometimes cost prohibitive. Whether or not she will actually go through with her plans to kill herself is a moot point, she’s very depressed and is in a dark place. Due to writing a letter to a school counselor she ended up in a 72 hour hold and then her parents opted to send her to a residential program for teens with mental illness – but that only lasts 10 days and then they have to figure out – what’s next?

She really hates her mother but seems troubled beyond just family issues. It doesn’t help the high school she goes to is extremely competitive and sends tons of kids to Ivys (I think my high school maybe sent one or two students of over 1000 in my class to Ivy League schools, in comparison.) I’m sure not every kid in the school is going to Harvard/Stanford et al, but the pressure is real. And with ADHD, which I can relate to, it’s very hard to focus and thrive in a traditional school environment. She puts so much pressure on herself – more than I ever did – and I want to get through to her that there’s so much more to life than high school, but I know when you’re 15 hearing that doesn’t mean a heck of a lot.

The family is worried about her coming home after she finishes in the program, and rightly so. I spoke to her recently and she’s definitely not “cured.” They put her on an SSRI, which is extremely concerning to me because they’ve been shown to increase suicidal ideation, especially in teens. It’s one thing for her to be medicated when she’s in a safe space – not so much when she can easily access a variety of substances and instances which could end her life should she really want to. Her moods are so all over the place to begin with, from super sad to very irritable, and being home with her family won’t help.

The parents have met their insurance deductible for the year so they can go to see a therapist until the end of december for “free,” outside of copays and such, but they’ll be back to paying in January which is just around the corner. However, the real issue may be the school itself – a big, highly competitive public school may not be the right place for this girl to thrive. Yet private schools and boarding schools apparently reject outright anyone who has been hospitalized for mental illness in the past. This leave three options – stay put in her current school, have her parents move to a new school district, or send her to a boarding school for special needs.

What’s crazy is the boarding schools for mental illness cost $9000 or more PER MONTH. That’s insane. I’m not sure if one is supposed to go for all of high school, but that would be $90k a year or $360k for four years of high school. Who can afford that?

And what should anyone do to help a depressed teen? I remember in high school when I gave my counselor a note that explained I was super depressed (and it clearly stated that I DID NOT WANT TO KILL MYSELF) the counselor called in my parents and recommended I go to a therapist. I went to the hospital once for taking 6 tylenol because I told my dad I had started to try to overdose but then got too scared. What happened after that? Nothing, life just went back to normal. I was still depressed. I went to college and was super depressed through those four dark years. I saw psychologist here and there, and I made it through somehow.  It wasn’t until a year after I graduated when I met my now husband that things started to get better. I was still depressed through most of my 20s, but it wasn’t as bad as it had been in the past. I didn’t get sent away to a program for depressed teens. No one really thought it was a big issue. And maybe it wasn’t. Nowadays with teen suicides being publicized so much, I think the schools are taking these kind of threats more seriously…

That said, it is troubling to me that she is basically being told she shouldn’t tell anyone if she’s having these feelings because she’ll get pulled out of school and put into a locked down facility. I know they HAVE to do that for legal issues, but it doesn’t help solve the problem, it only pauses dealing with it.

I went to visit her at the home for troubled youth and on the wall there was a sign with what I imagine are the house rules, or something written in a therapy session. On it, the words “No Depression” rattled me. I don’t know the context of what was discussed, but it hit me that these programs are just telling their guests to be happy and not depressed, as if being depressed is so horrible. I came up with a new mission – to teach her that it’s OK to be depressed, and it’s even ok and normal to think about killing yourself, but it’s NOT OK to actually try to do it. I want her to understand the difference between the two.  I want her to know that I love her and will always be there for her, even though it’s tough to get through to her as she’s so far removed from reality right now. I want her to feel comfortable with dark thoughts and feel in control of not acting on them. I worry this whole “just be happy” bullshit the therapy is teaching will only push her further off the deep end.

I’m going back to visit her tomorrow. I’m very scared I’ll say something wrong or give her the wrong idea. I’m trying to just present myself as an adult who is still young enough to be cool and a friend, even though we’re over 15 years apart. She doesn’t like to talk about her depression, she likes to change the subject, and I don’t want to push her or push myself away. She needs someone she can trust. I also don’t want to be the person she calls when she’s about to swallow a bottle of pills and accidentally miss the call because I’m out or asleep or just don’t hear the phone ring. It’s a lot of responsibility and I worry about putting myself in that position – even though I do want to be there for her when I can be.

For now, she’ll prob just go back to the public high school and everyone will see how it goes. I don’t know how this is supposed to work. Her parents are divorced and her mom is extremely worried and her father thinks things should go back to normal. I really don’t know what to advise them other than that I’m concerned too. I’m more concerned that she will feel she can’t tell anyone when she is feeling suicidal above everything else. The system is set up like that. More than anything, it’s important to show that many successful people have been depressed and have these thoughts – that it’s normal, though not good for you, but it’s normal and it’s ok to be sad. It’s ok to feel like you don’t fit in. Some of the best and most successful people in the world have felt exactly that way.  I’m hoping if anything I can get that across to her so that she doesn’t feel so alone. I definitely wish someone had connected with me like that when I was that age, but I had no one to talk to. I turned to the internet and was also dealing with coming out as bisexual at the time so I talked to a lot of random people anonymously and just trudged my way through those four years. I know what it’s like to feel extremely alone and out of place.

Yesterday, when I told her how I have depression and anxiety and ADHD, like she does, I did see something get through to her– she said, “wow, I just realized that we’re more alike than I thought we were.” She’s definitely got her own thing going on too — but there’s enough that I can relate to that maybe, just maybe, I can get through to her. I really hope in 15 years when she’s 30 and I’m (fucking A) almost 50 we can look back and reminisce about this time and be glad that we’ve both come so far.

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