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[Courtney]

Anyone know of where to start when looking for psychiatrists and therapists when your insurance doesn't cover it?

I do have insurance, but Aetna HMO is weird and isn't accepted a lot around here (I'm assuming because Tricare is a lot easier to deal with in a military town). I could theoretically afford about $200 or so a month for psychiatry and therapy, in which case I may as well just get off my mom's insurance (I have to by the end of the year anyway) and find a plan that covers local doctors.

Thoughts, adults of the pix board?

[pronetoaccidents]

i'm guessing you're 25 if you're still on your mothers insurance because i went through that same problem recently. I just turned 26 and got cut off my dads insurance. he's a captain in the FDNY so he had the works, GHI blue cross blue shield and all that good stuff. now i'm squandering in a similar situation but i have options by me in NYC.

maybe i'm just spoiled because i live in one of manhattans 5 boroughs and each one of them has plenty of mental health clinics. I went to a few legitimate ones for awhile with compassionate counselors and psychiatrists who actually had the clients well being in mind.

now i'm stuck going to this quack doctor in china town. i pay him 60 dollars cash each time and he gives me my script for xanax, ambien and he throws in an anti-depressant just so it looks like on paper he's a step above a general doctor feelgood. i wish i could go to a real, respectable pysciatrist but i lost my medicaid, have no time now that i'm working full time to go to the office and get it back on, and i'm working off the books so there's no insurance provided. I'd just say fuck it and stop going but there's the little things like seizures and hell and agony and death if i stop taking my xanax cold turkey so yeah, there's that. so um, i don't think this is of any help to you. anything i said at all so yeah, sorry. But try looking into mental health clinics. see if you can find one. they are hit or miss but better than nothing especially if you don't want a gap in between whatever psychiatric prescriptions you are prescribed. 

[BlakeK]

Wow, Ryan, 60 bucks is low for self payment, especially for a psychiatrist.

The only thing I could suggest is to try and find somewhere with a sliding scale. I know you have a lot of knowledge about this stuff and probably considered that.

I charge 70 per session for self pay clients and 50 if they are at or below the poverty level. If they cannot afford it, I send them to Centerstone which in Indiana is a mental health corporation with a lot of clinics who do sliding scale. They do have high turnover so it's hard to find a good therapist who is going to be around for a long time with who you can build a good relationship.

[Courtney]

Good news, everyone!

I was able to find a local clinic that offers both psychiatrists and therapists. I've made an appointment with a psychiatrist because I NEED MEDS NOWWW before I have to commit myself, but I'm also considering therapy.

Blake, you know how behaviorists feel about counseling. I'm very well aware of my own behavior, I realize when I'm being a complete dickhead (and oftentimes act that way anyway), and in general and am just pretty aware of my behavior. The only thing I will say that I do not understand is where my personality ends (I've always been dangerously adventurous, overly analytical, etc.) and where that behavior becomes disordered. Basically, do you think therapy would help? If this doesn't cross ethical boundaries, is there a specific therapy you'd recommend?

[Pwoink]

How did you end up finding that local clinic, Courtney? The steps you took might be helpful info for other folks in a similar predicament who read this thread later.

I know you asked Blake, not me, but based on what I've studied both counseling and meds are hit or miss -- it depends on the therapy/type of drug, the person, the person's issue, and so on -- but overall, counseling is helpful. For something like depression, for example, meds in conjunction to counseling is far preferred to just meds, and counseling alone has better long-term outcomes than meds alone. Heck, even with a disorder as medication-reliant as schizophrenia, counseling helps.

It's not about just being aware of your own behaviour -- although it's great that you are, you're already way ahead -- it's about finding new approaches to deal with it. There may even be things you coulda figured out on your own, but faster now that you have someone to think about this stuff with, or an allotted time to think about it during.

As a self-aware, critically thinking person, you can check out this rundown of a few popular therapy styles and see what, to you, sounds potentially helpful. 'Course, lotsa therapists use a mix of techniques, but it can help steer you in the right direction.

[Courtney]

I actually ended up finding one locally that's covered through my insurance. I thought it was only therapy, not psychiatry, but when I called they said they offer both under my insurance.

When I see the psychiatrist (July 7th!), I'm going to ask about therapy. I'm actually really interested in a behavior therapy called acceptance and commitment therapy, but it's hard to find therapists who specialize in it. Failing that, CBT seems like the best route given my current and possible diagnoses (I'm comfortable telling you guys my dx, but several people from my past know I post on here).

[BlakeK]

Good news, everyone!

I was able to find a local clinic that offers both psychiatrists and therapists. I've made an appointment with a psychiatrist because I NEED MEDS NOWWW before I have to commit myself, but I'm also considering therapy.

Blake, you know how behaviorists feel about counseling. I'm very well aware of my own behavior, I realize when I'm being a complete dickhead (and oftentimes act that way anyway), and in general and am just pretty aware of my behavior. The only thing I will say that I do not understand is where my personality ends (I've always been dangerously adventurous, overly analytical, etc.) and where that behavior becomes disordered. Basically, do you think therapy would help? If this doesn't cross ethical boundaries, is there a specific therapy you'd recommend?

I have never met a strict behaviorist so while I learned how behaviorists have been very skeptical of therapists such as myself and the effectiveness of treatment, I learned this in school. I absolutely think that therapy would be good for you and think CBT would be good for you. I believe behaviorists are okay with CBT, too, so maybe it would be appealing to you. I think that talk therapy would be great for you to explore your thoughts and personality and to help make changes as to how you think about things and figure out how you can change your thinking. I'm all for you doing counseling and think that you've been so focused on behaviors and measurable results that you haven't explored your thoughts and thought patterns. Try and be open minded and do some exploration as to who you are and what more you would like to get out of life to feel more comfortable with yourself as well as more confident and less anxious.

Pwoink, everything you said is right on. In all surrounding areas, the vast majority of people on psychotropic meds are required to attend counseling. I have seen many schizophrenics helped immensely by counseling. Of course all other disorders are helped, I just wanted to make that comment on schizophrenia due to your comment.

[Courtney]

We begrudgingly promote CBT for less severe clients, even though they admittedly stole the majority of our techniques ;). I do think CBT would be helpful for the anxiety issues I have if I'm unable to find an ACT therapist.

Talk therapy gives me so many mixed emotions. I see where it'd be helpful to just flesh out some stuff that I normally hold in because it's things I can't control. It's also entirely possible that I have very little idea of who I actually am after being partnered with another person for over 5 years of my early adulthood.

My appointment is a week from tomorrow. Right now I'm just trying to make it through. My friends have been really good about checking to make sure I'm doing ok.

Thank you guys for being so wonderful and supportive.

[Pwoink]

Yeah! Let us know how it goes -- I hope the appointment itself is a positive experience for you.

[momitsnowme]

I think CBT would be really helpful for me and I wish there was a low cost option near here. I am planning to start the mindfulness based stress reduction program July 1, though,  and see how it goes

[kw]

you'd think that living in canada i'd have easier access to mental health care, eh?

wrong. it is not really covered under our health care system, and is extremely expensive otherwise. The last few months I have come to terms, for the first time in probably 6 years, that I should probably seek some medication to help me control some issues. Naturally, now that I am confidant in that decision, I don't have the resources to see someone who can properly prescribe me that medication, and help me choose which one is best.

[Courtney]

The psych appointment I thought I had next week turned out to be a therapy appointment and there was no way to get into a psychiatrist today or even in the next week... So here I sit in the psych ward, where they've surprisingly let me keep my phone but not my charger. I'll be seeing the psychiatrist in the morning and will hopefully be out of here in a day or so.

[Graphix]

So here I sit in the psych ward, where they've surprisingly let me keep my phone but not my charger.

I can confirm snapchat contact with Courtney from the ward, safe and sound.
inb4nudez.

[Courtney]

Apparently I'm not actually in the ward yet! Just in a windowless room with a bed and the door has to stay open.

Inbetween bouts of utter despair and anxiety, this place is so goddamn boring.

[pronetoaccidents]

i feel for you and i know you don't want to get cut off your meds and are in our bind but make sure to do the research. i legitmately got on xanax because i had bad anxiety.. i didn't know that 2 mg (the big ol' sticks) 3 times a day was excessive. i thought it was just medicine and that a doctor wouldn't prescribe anything that would hurt me. low and behold a few months pass, i ran out and next thing i know i'm curled up on the floor in the fetal position shitting my pants and puking and i was told i was a hop skip and jump away from a full blown seizure. i could of died. literally.. like, not just "ah it hurts so much i feel like i'm gonna die" but no, like truly ceased to exist among the living. cold turkey xanax withdrawal can kill you. so careful who you consult.

[pronetoaccidents]

i tried the pyschward thing and it was a nightmare.. shoelaces go first so you don't hang yourself.. "pudding hour" made me wanna vomit because i'm sitting at a table like it's kindergarden snack time with haldor bloated zombies falling asleep in a cup of vanilla pudding and because i didn't wanna sit there i was "non-compliant" and what originally was supposed to be an in-out thing just to refill some meds turned into one flew over the fucking cuckoos nest... or am i really... CRAZYY wahahaha (translated as a diabolical laugh)

[Courtney]

I never took enough xanax to go through withdrawal. They actually still have me on it, just 1mg at night.

Going to the psych ward was the best decision I've made in a long time. I've been misdiagnosed for quite some time and they got me on the correct meds for my new dx and I feel FANTASTIC. I seriously went from suicidal to manic in less than 24 hours, and while mania isn't good either, it meant the meds were working! We got them sorted out to where I'm just... happy now. I only wish I'd gone to get help sooner.

[Phitney]

Courtney, I'm so glad you got the help that you needed! It's really shitty that it's so difficult to find a doctor who is going to make the correct diagnosis and work with you on remedying that rather than just throwing meds at you that don't necessarily help. Hopefully you can continue to get the help you need!

I keep toying with the thought of going to at least a therapist. I went to one a few years ago, but it was one my mom picked out and he was uber Christian and didn't help much. I think I'd get more out of it if the therapist didn't try to pray for/with me three times per session.