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Health

When I Couldn’t Find a Therapist I Liked, I Tried Brain Stimulation

I originally wanted to find a talk therapist about my depression, but it didn’t seem like that was going to happen anytime soon.
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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.

Bryson, 28 San Francisco

Are you in therapy now?

No, but I've been to therapy for PTSD, depression, anxiety, and maybe some other neurodiversity (still figuring that out). Over the past few years I've been in and out of therapy due to changing health insurance. After my first therapist, I've been finding it difficult to find a therapist who is in my network, professional, and sympathetic to my issues.

When I lived in New York, I just didn't connect with one therapist. I told her about a traumatic experience and I remember her staring at me blankly saying something along the lines of "Are you a risk taker?" and "Why would you put yourself in that situation?" I left the session feeling unvalidated and guilty.

When I was unemployed, I was too much of a wreck to navigate affordable mental health options while looking for another job. I did, however, do a lot of yoga, meditating, and frequently visited the Zen Mountain Monastery in Downtown Brooklyn. I can't say it helped with my clinical depression, but it got me through a very difficult time.

Once in San Francisco with a new job and new healthcare I immediately began searching for a new psychiatrist and therapist. The psychiatrist was easy, finding a therapist has been tricky. One therapist waited until the end of our first session, after I told her my whole life story, to tell me that (in spite of listing my insurance as covered on Psychology Today) she wasn't in network. It was really disappointing.

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Another just seemed like she didn't care. I was trying virtual sessions through a network of therapists in the hopes that once an in-person therapist became available, I could do that. The first session was a little awkward but I was determined to make it work. The second session was pretty bad. After spending about a third of the session trying to find me another therapist in the network (there were none), I had to retell her very basic things, like what brought me to therapy and my goals for therapy. She didn't look at her notes, interrupted me when I told her about a recent anxiety-inducing event, and recommend a pretty strong anti-anxiety medication, and that I enroll in a meditation class at SF State. The session really ruined my day. Again, I left therapy feeling unvalidated and discouraged.

Then I started TMS [transcranial magnetic stimulation] with my psychiatrist. I originally wanted to find a talk therapist first, but it didn't seem like that was going to happen anytime soon.

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

For TMS, daily, for 15-20 minutes long sessions for a month. I also saw my psychiatrist weekly to make sure everything was going well. When I was in therapy, it was about once a week, if I didn't suddenly cancel.

Does your insurance help pay for this?

For TMS, yes. I had to get approval for the treatment first though. It's FDA approved and covered by my insurance but still new and pretty expensive. I had to be treating depression with medication for more than two years and have tried at least 5 medications (yup). I pay a $30 copay for each session and each psychiatric check in. Out of pocket, the entire treatment was around $1,100. I believe the full cost of the treatment without insurance is somewhere between $15,000 and $25,000.

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When I was seeing a therapist, it was about $25 per session.

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

Yes. If I could afford to see a therapist out of network, I would. I am making more money now than when I was in New York, but between TMS therapy and talk therapy, I wouldn't have money to live. I'm currently tapering off TMS so I'll be back to hunting for a talk therapist soon.

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

I wouldn't say that TMS is an alternative, it was always my intention to do a combination of TMS, medication, and talk therapy. TMS has helped tremendously with my anxiety and depression. When I take those anxiety and depression tests, I'm not depressed or anxious anymore. I've had many discussions with my psychiatrist about the benefits of a combining medication, TMS, and talk therapy for developing healthy coping skills and understanding what makes me feel so cognitively different from most folks. I told him about my struggles to find a therapist and he told me that a lot of his patients experience the same thing.

Also, the anxiety-reducing effects of TMS has allowed me to meet other "weirdos," which has also helped.

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

I have a very long Christmas List/Chart of Desires. At the very top is furniture for my apartment. Correction: if I had the money, I’d go to a dentist.

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

I have difficulty with long term goals, like remembering them. Being in therapy made me feel like I was emotionally, socially, psychologically developing. The best was when my therapist would tell me something about myself that is shatteringly true but something I could never never recognize on my own because I'm me, you know?

This interview has been edited and condensed for clarity.

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