Illustrated by Jihyang Lim


The Staggering Costs Of Being Mentally Ill

“This is how much it costs to be crazy”

by Ashley Laderer

“That will be $50, please.”

I handed my debit card over to the receptionist. She swiped the card and checked her texts as the transaction took place. An older man behind me in line paced back and forth, talking to himself. He must be new here.

She handed me the receipt, and, as I signed it, I cried a little. This was my Tuesday afternoon ritual. Therapy sessions leave me emotional, and spending money I don't really have doesn't help the matter. Handing the signed copy back, the receptionist looked me dead in the eye, with what seemed like zero sympathy. If she cared about my well-being, she sure didn’t show it. We were at a mental health clinic. Did she know what it’s like to be on the other side of the counter? 

Living in New York City for the last five years while battling mental illness has taken a toll on me. The cost has been tremendous. From co-pays to prescription prices and private psychiatrist fees, there are huge expenses I bear that a person who hasn't dealt with mental illness would never believe. Sometimes I imagine the nice apartment (or shoes) I could have afforded if it weren't for all of this. I long for a simple sense of normalcy.

One time, after therapy, I went to the supermarket near my dorm to buy some essentials, and my card got declined. This can’t be right. I yelled and yelled at the poor cashier to run it again. It must’ve been her mistake. I called my bank, only to learn I had nine dollars to my name. Out on the street, I cried. In New York City, you can cry as much as you want in the open air and no one will even look twice. You don’t have to feel embarrassed because no one will look directly at you. They don’t want to catch what you have.

I was a mentally ill college student, and that’s just how it went. 

In retrospect, I could’ve tried harder and made more money. I could’ve worked retail between classes or waited tables, but in college, my anxiety and depression were so crippling that my daily routine included crying for one hour, minimum. How would I ever work if I could barely even get out of bed?

In college in New York City, I was excited to have a mental health center where I could get free treatment. After a couple months, though, they told me I needed to find an outside therapist. Against my supportive parents’ wishes, I decided I had to pay for myself when it came to mental health expenses. I was overflowing with guilt thinking about the money my parents had spent on medical bills for the past near-decade. I couldn't stop thinking about how much of a burden I was. It was my turn to take responsibility. No matter how much they tried to comfort me and let me know it was okay, I still couldn't let them pay. They wanted me to be happy, but I felt like I couldn’t give that to them. Now, I think, How much did that cost them, mentally?

As college went on, my mental health got worse. Oftentimes, I’d end up at an urgent care center for whatever ailment I was dealing with at the time, like a panic attack that felt like an imminent heart attack. Urgent care co-pays were $75. If I had an ongoing problem (Stomach aches! Nausea! Heart Palpitations!) and I’d go to my primary doctor, it would be $35. Monthly prescriptions added up to be about $40. If I had to go get special tests done, like CT scans or MRIs or ultrasounds, there would be even more bills.

I was wasting away hours of my life in doctors’ offices, and, you know, it's funny because it's true, but time is, in fact, money. And all of it—the time, the money—was flying away from me. I was probably spending $300 to $400 a month total. Every time I swiped my debit card and signed a receipt, I thought to myself, This is how much it costs to be crazy. 

I attended the Fashion Institute of Technology. Why couldn’t I be a cliche and save up for a pair of Louboutins instead? 

Upon graduation, I didn’t have a job lined up, so I moved back with my parents on Long Island. I felt as though I still needed to go to therapy, and my doctor's office was in New York City. So every week when I’d go, on top of my co-pay, I’d have to pay $18 for my train ticket. It made everything feel that much worse, and I constantly felt like a failure. The thought of having a real job was terrifying, and even just applying gave me anxiety attacks. But I knew I needed to work. I felt obligated to go to an office every day, because that’s what you’re supposed to do after college, right? I couldn’t live with my parents forever and, at the very least, I needed a few hundred a month for health bills.

Later, when I did get a full-time job, I stopped going to therapy because I was too embarrassed and scared to ask my managers if I could leave for an hour for an appointment. Reluctantly, I signed up for online therapy, which was $99 a month. I stopped going to a psychiatrist and asked my primary doctor to prescribe me what I needed. I promised that I was doing better. But actually, I wasn’t. I just couldn't afford the time or the money to take care of what was wrong with me. The reality is, it's almost impossible to find a therapist or psychiatrist who accepts insurance who will hold appointments outside of normal working hours. The insurance companies don’t care. They won’t help you.

I haven't felt healthy for a long time, and it’s hard when your bank statement confirms that. For my online therapy and prescriptions, plus visits to my primary doctor, I’m now spending about $2,000 a year on my mental health. It sucks, but there’s not much I can do about it. That’s how much it costs to be “okay.”

I don't always feel amazing, but I’m feeling better than I have before. I feel stable. And that’s kind of priceless.