Therapy can be an expensive commitment that unfortunately, not everyone can afford. In episode 266, I received a question from an individual who is struggling with their mental health but finds themselves in a position where therapy is not currently an option. In this post, I dive into more detail and look at the alternatives available when traditional therapy is beyond reach.
The Question
I am in my mid-twenties and have struggled with depression and anxiety since I was a teenager and have had my ups and downs. My mom is aware of my struggles and is very understanding and helpful, since she and my grandmother have struggled with depression too and it, unfortunately, seems to run in our family.
I have been on medication for a while now and it’s been working out all right, but life changes, disruptions in my regular routine, etc. seem to have brought my mental issues back full force. I feel flat and disaffected, to say the least. But I can’t afford therapy and I don’t want to put the burden on my family and ask for help any more than I already have.
Are there any alternatives/free resources/etc. that you would recommend for when you’re slipping back into a dark place and can’t get the exact help you need?
My Thoughts
Thanks for writing in. I’m glad to hear that you have an understanding and supportive family. That’s one of the things about mental health difficulties. Sometimes it does run in families, but that also can make your family uniquely equipped to understand and support you. I also appreciate your level of self-awareness. That’s awesome and will serve you really well.
So you’re in a situation where you are aware of your depression, have taken medication to good effect, but now that life is cranking up the intensity, you see symptoms that are breaking through. Aside from full-price professional therapy, there are definitely some options to consider.
Exercise, sunlight, and sleep
First off, I hate to even mention this because of how cliche it is, but I need to mention physical exercise, sunlight, and sleep. Make sure you are taking care of your basics. The research says that moderate physical exercise is comparable to medication in its efficacy in reducing depression symptoms. That’s something that is presumably free. Obviously, there are other factors to consider like your body’s tolerance for exercise and the fact that depression makes it f**king hard to find the motivation to exercise, but it’s something that is an option. If you can’t drop $800 per month on therapy, maybe you could invest in an exercise class or some fun equipment at a lower price and see how that impacts things.
Therapy Options
In terms of therapy itself, there are definitely options there too. If you are on insurance, you should have mental health coverage. You might have to pay a copay, but insurance plans typically cover psychotherapy. I have a page on my website (duffthepsych.com/findatherapist) that shows you how to find a therapist that takes your insurance. If you are in school, you may have access to counseling as well through your school’s counseling center or health center. Typically this is free for students.
Even if you aren’t a student, you might look to see if there are any university counseling centers or training departments in your area. Therapists in training have to work hours in training clinics. Often you can access these clinicians for free or at quite a reduced cost. There are also online resources like Betterhelp or 7cups. These programs are typically less expensive than traditional in-person therapy. People have mixed feelings about the business model and I can totally understand that. BUT in terms of the efficacy, there is no reason that you can’t make it work well for you if you find a good match.
A lot of therapists also provide reduced-cost treatment on what’s called a sliding scale. This means that they scale their price to match your level of income. You can use the popular therapist search tools to find sliding scale therapists in your area. Even if you don’t have access to therapists that fit any of these criteria around you, you may be able to find someone elsewhere in your state through online counseling. That’s one of the fringe benefits of COVID-19 – a lot of people are now providing online therapy. There are also a number of free or cheap support groups out there. If you search for depression support groups on Google, you will find many peer-led groups where you can at least get some contact and accountability from other people going through similar issues.
If you do have insurance and it’s more an issue of big copays or problems with coverage, you might at least take a look at their website to see if they have resources available. It’s becoming more common for insurance companies to offer online courses and other free materials about mental health topics to their members.
Support and Self Help
Aside from this, asking for more support from friends, and making more plans with people can be helpful. Depression loves when you isolate, so forcing yourself out can sometimes be helpful. And then of course there are lots of resources such as books, podcasts, blog posts, etc. that can give you some great ideas for coping with the symptoms you have. The more you consume, the more you will have a chance of hearing something that clicks. I just did a recent episode with some tips that would be helpful (episode 264) and if you use the search bar on my website to look up depression you will find many more.
You can listen to this on Episode 266 of the podcast!
Thank you for the great question!
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