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Health

I Spend Almost a Quarter of My Income on Therapy

My insurance doesn't cover any kind of mental health visits or offer any partial reimbursement for my eating disorder and anxiety treatment.
eating disorder
Lia Kantrowitz

Ah, therapy, the elusive grande dame of mental healthcare. It has been shown to help for a wide range of mental health issues, but for so many people it's inaccessible.

First of all, it's expensive. Often, insurance doesn't cover it. Other times, insurance does cover it and it's still too expensive. Or maybe you just can't find a good therapist. Or you did, but you feel weird about telling your boss and family you need to carve out time to see them.

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Here at Tonic, we wanted to know: How are people making it work despite all these challenges? How are they paying for therapy, and how do their lives change when they do actually make it to the couch? Welcome to Therapy Diaries, where we explore all this and more.

To submit your experience to the therapy diaries, answer a few questions here.

Sarah, 29 Brooklyn, NY

Are you in therapy now? What type and for what reason?

Yes. I do psychotherapy and I also meet with a registered dietician. I see them for anxiety and an eating disorder.

How often do you go, and how much does each session cost?

I do one session of talk therapy and one session with the registered dietician a week. The talk therapy is $150/session (60 mins) and the meeting with the registered dietician is $75/session (45 mins).

Does your insurance help pay for this? Have you had any difficulty trying to get reimbursed for your therapy sessions?

Since I don't receive health insurance through my work I have a catastrophic health insurance plan that I purchased through the New York State of Health marketplace. My insurance doesn't cover any kind of mental health office visits or offer any partial reimbursement.

Has the cost ever deterred you from seeing the right therapist or a therapist at all?

Yes, without a doubt. Therapy accounts for about a quarter of my weekly income. I used to see a less expensive therapist who was a graduate student working to get their certification. After I stopped seeing that therapist I wanted to find a more experience therapist who but I knew this meant that he/she would probably cost more. I definitely waited longer than I should have before returning to therapy because I didn't want to take on the added expense.

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Have you had to turn alternate ways, other than therapy, for dealing with mental health?

Not really. I've tried yoga, reading self-help kind of stuff, and plain old avoidance!

What would you be spending that money on instead, if insurance actually covered therapy?

So many things: acting classes, travel, savings!

When you're able to do it consistently, how does being in therapy make you feel?

So much better. It provides me with a weekly space and time to talk about my mental health issues. It's taken me a while to realize that I can't manage them on my own. It's a relief to be able to talk to an experienced professional who really understands what it's like to deal with anxiety and an eating disorder. Of course I have friends and family who I can talk to and confide in but they don't have the skill set or knowledge that my talk therapist and dietician have (nor do I want to share every detail of my mental health issues with them!). My anxiety and eating disorder can often feel very consuming in a way that prevents me from being fully present when I'm at work, with friends and in other social settings. Seeing the therapist and dietician regularly gives me the tools I need to feel like I can manage my issues so that they don't have complete control over my life. Therapy gives me relief, comfort, practical strategies, sound advice, encouragement and reassurance.

This interview has been edited and condensed for clarity.

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