I was first diagnosed with depression on November 27, 2018.
I was ill for quite some time, and one day a friend suggested that I seek professional help. I remember that it was strange for me. I had no idea why I should see a doctor with my “laziness”, apathy and the fact that I just sleep for 16-19 hours.
How it all started
Then I was finishing my master’s degree in computer science in Connecticut where I moved from Ohio. This state continued for several months. I literally slept most of my life, missed every possible deadline for my dissertation, and when I didn’t sleep, I watched “Friends” for the millionth time. Simple serials perfectly save you from complex inner experiences: as if you put your life on pause while watching them. With the series and sleep, my whole life has been one big pause.
Later, while working with a psychotherapist, we discussed what could trigger such a state. At that time, there were several factors at once. At least – a new city in which I spent a long time in deep loneliness. Then I made a couple of friends, but it was very difficult for me to be so far from my family, relatives and home. The journey to Ohio by train takes about 12 hours covers a distance of around 597 miles.
But the biggest impact was the internal conflict over the dissertation. I did not have a leader who understood the scope of my work, and I did not understand the topic I wanted to write about. But to be honest, no one on the course knew anything about it. And you had to write.
My expectations from my work were not only high, they were sky-high. I have to write a text on the topic I still did not understand anything. I understood that in the remaining time I could not write a work that met my standards. I imagined myself dying of shame in front of the professional community.
Then I thought about leaving the university, which would have saved me from a shameful death, but I did not want to disappoint my parents who were proud of its graduate student, and especially my mother who sponsored my first year of living in Connecticut. I locked myself in this circle and began to slip out of reality into depression as I saw no way out.
Homecoming and the first psychotherapist
Having returned to Ohio for some time, I did not know where to go, and there was not much money for paid assistance. I went to the free psychoneurological dispensary.
It was easy to tell everything to my mother: we have a trusting relationship with her, she had been worried about my condition for a long time. But telling dad about what was happening was utter horror. I immediately imagined all the possible answers like “just pull yourself together”, “you have to try” or “it is not easy now for anyone”. But, apparently, my condition was so frightening that my mother managed to tell my father to treat it as a disease. He said: “Of course, come and have a rest.” It was a new feeling of father’s support.
It was also difficult with my grandma. How can I tell a post-war person that I have a mental illness? But one meeting with me was also enough for her to decide that the main thing is that I smile again, and it doesn’t matter what exactly I will be treated for.
A special question for newcomers to this topic is which doctor exactly to see? There are three types of professionals: psychologists, psychotherapists and psychiatrists. I didn’t know anything the difference, I read a lot on the Internet and decided to start with a psychiatrist because my condition really scared me.
In the reception window, a woman called the number of the office where I should go. The dialogue with the psychiatrist was “impressive”:
– Do you hear voices?
– No.
– Any hallucinations?
– I don’t think so.
– Well, then go to psychotherapists.
I was sent to a psychotherapist, and I signed up for hour-long sessions with her. I want to note that this is not a universal story and now I am being treated by a psychiatrist. Things work a little differently in different areas, so you need to find out specialists in your area who can prescribe drugs.
So I went to my first psychotherapist. I felt so bad that it seemed as if I was the only one on the planet going through this – I really wanted to trust someone and shift some of the responsibility. I was lucky with a psychotherapist: she is a medical worker and explained a lot with the help of evidence-based medicine, so I relaxed and turned off critical thinking almost completely. Thus began my first therapy, which included meetings once a week and medication.
Then the first expenses began. I was prescribed two drugs. I spent an average of $270 per month, the psychotherapy sessions were free. The treatment lasted six months, it cost $1,620. I do not take into account the cost of tickets to Ohio. Sometimes it was hard to buy medication as I have no job. A few times I had to find cash very quickly as I could not miss pills. It was embarrassing to ask parents to buy expensive medicines so I decided to use ciboakhill payday loans. I borrow $300 in May and then $300 more in June. The funds were in my bank account the following morning so I purchased the drugs on time and continued treatment. Applying for a payday loan was the easiest way to get money for me. The main thing is to repay the loan as agreed with the lender. I repaid both loans within 1-2 weeks – as soon as I received my scholarship.
It is almost impossible to find the perfect drug immediately. In psychiatry, everything is subtle and you often have to experiment. It was the same for me: they changed my medicines several times before finding the right ones. This led to financial costs – there were many started but unfinished packages. But I saved on wine because alcohol is incompatible with antidepressants.
The treatment helped but not as effectively as I expected. The level of anxiety remained high, the mood was unstable – I felt that I was balancing on the edge of the abyss. I survived the winter, finished my master’s degree with a classic student story about a dissertation written in 10 days, and returned to Ohio.
In the summer it got worse: I lived with my parents and looked for a job. I had to live by my parents’ rules again, but I couldn’t find an interesting job in my city – all this did not contribute to inner comfort.
Treatment in a hospital and moving to Washington
In September 2019, the condition worsened, and this time the psychotherapist suggested a day hospital. A number of drugs act faster and more efficiently if they are administered intravenously, but this can only be done in a hospital.
I went to the clinic for almost a month. Every day I was waiting for droppers, several sessions with a psychotherapist and exercise therapy. It was hard for me to even lift my leg.
Also, I consulted another psychotherapist and it was a terribly traumatic experience. She was an impenetrable woman, confident in her genius. For 90% of the session, she talked about her difficult life as a novice doctor and about her granddaughter, who “also dreamed of a cool job, but this is all youthful maximalism, nothing, she went to work as a secretary, her arrogance diminished in a couple of years.” I suppose it was all about the fact that I need to get settled somewhere. It was impossible to change the psychotherapist in the clinic.
The advantage of this format is free treatment, which also helps to comply with the regimen. But I did not finish the treatment course: I managed to find a job in Washington, and I left. For another four months, I continued to take pills – on average, it took about $100 monthly.
The salary then was very small, and I spent half on renting a room, so I could not get support from paid therapists. When I went to Ohio to visit my family or on business trips, I tried to get a free session with my doctor, but after a while she went on maternity leave.
In Washington, I was very lonely: I missed my family and friends. It seemed that I would never find friends there – in five years this belief has not changed much. I started looking for at least some support, and in June 2021 I discovered free psychological help centers in Washington. There is not much choice here: just sign up with someone who has free time.
I came across a specific psychologist: he quoted a lot of poets, liked to delve into dreams and signs of fate.
I didn’t really understand why I was seeing him, since there was no help either with depressive episodes or with feelings about relationships that I couldn’t deal with. Although a couple of times he referred me to free trainings at the center, they were great.
According to the rules, the center offered ten free consultations a year, which I tried to stretch out longer. But in fact, it seems that we only had about five meetings. I think the main help is that at the beginning of 2022, the psychologist offered to see a doctor since my condition was beyond his competence.
Then I began to look for a psychiatrist in Washington. I studied with my mother for a couple of doctors’ profiles on websites and read reviews.
I went to a couple of specialists in private and public centers, but none of them was credible. All doctors listened to me detachedly for a few minutes, then prescribed various incomprehensible pills, including neuroleptics, and said “well, come back in a month”. I never came to see them again. I spent $700 on consultations.
In April 2022, I found a psychiatrist in a special clinic, and I still see her. She is cool, moderately compassionate and moderately straightforward. And she understands my condition. One visit costs $300. At first, I visited her once a week or two, which cost $900 a month. Then I visited her once a month to monitor treatment.
A month in a private clinic
In the summer, I again ended up in a day hospital in Ohio for the same reason: droppers were supposed to help more effectively. After that, my conditions floundered at the bottom mark of acceptability, but in late autumn it became unbearable. In addition, confident suicidal thoughts appeared, which scared everyone well. As a result, I went to a paid psychiatric clinic. It was a very difficult decision.
There were no phones, no internet, no real world. Only a strict daily routine, rest, safety, pills, personal and group psychotherapy. There was no treatment, like in One Flew Over the Cuckoo’s Nest: another reason why I did not go to state psychiatric clinics. It was more like a maximum-security sanatorium than a hospital. The attendants were very sympathetic and kind, the psychologists also tried hard, although there were concerns about the qualifications of some doctors.
The clinic had good rooms and delicious food. True, the doors to the toilet were not locked, but this was for the sake of safety.
Visitors could only come a couple of times a week. The phone was given for five minutes a day to call the parents but only in the presence of a psychologist. Once every few days we were taken out for a walk in the yard. My first group therapy took place in the clinic, it evoked different feelings in me: at one time the meetings irritated and angered me, but sometimes I felt support and interest.
The patients were very different: a schoolgirl with an incomprehensible disorder who stole my chocolates, peers with depression and bipolar disorders, adult women, and even 80-year-old foreigners who hardly speak English.
It is difficult to assess the success of this venture, but it definitely gave me the opportunity to slow down and find time for myself. A month in the clinic cost $6000.
How to know when it’s time to sound the alarm
- Remember what kind of person you were before. When visiting the clinic in Ohio, the psychiatrist asked my mother: “Well, tell me what your daughter was like, you are a mother.” We were a little confused, but then she asked me to describe what I was before and what state I am in now. Mom controlled her indignation and answered: “Before, she was joyful, cheerful, active. She liked a lot in life, and now it’s like she is turned off.” I think this is a good way to appreciate that something is going wrong – to remember how it was before.
- Take out the depression test. There are many tests for depression that are easy to find on the Internet.
- Monitor your emotional state. Notice yourself and your condition: if you feel bad and it has been going on for quite some time, then you should seek help. I read a lot of books about depression. It helps to understand what is happening to you and how to explain it to others. If you think that something is really wrong with you, you can first go to a psychologist. Perhaps the specialist will help unwind the tangles of emotional problems, and you will feel better, or they will recommend a doctor and treatment. Don’t be afraid of prescription drugs. Doctors are careful in prescribing them, and modern pills are much more advanced than those used 50 years ago. If you have doubts about your prescribed medications, find a doctor you can trust. Just please don’t select the medicines on your own.
- My personal warning signs that something is not right: sleep seems more attractive than being awake, distancing from reality and problems, feeling that life is not real and everything has no meaning. At such moments, I don’t understand why people even go to work and do something.
When I notice these thoughts, I try to give myself more time to rest and do something pleasant. If it gets worse, I see my doctor: we adjust the treatment and discuss a plan of action.
Conclusions and results
After the clinic, I see my psychiatrist regularly, receive outpatient treatment when necessary, and almost always receive supportive care. The cost of drugs per month can vary from $50 to $300, but on average they cost about $150. For 28 months of treatment, I spent $4,200.
Now everyone knows that depression needs to be approached comprehensively and that you won’t last long on pills alone. I searched hard for the right psychologist. I visited a psychologist from a narcological dispensary for only $50. Then I visited a doctor recommended by my friends – $200 per visit, but I had neither progress nor comfort. I attended sessions with a psychologist who used the technique of cognitive-behavioral therapy for $400: it is really useful, but it was the only thing I missed. I even went to a woman from a psychologist search service for $250, and I said goodbye after talking about male and female roles in the family.
My spending during the search for a suitable psychologist – $10,800:
- 4 sessions with a psychologist from a drug dispensary – $200
- 12 sessions with a psychologist recommended by friends – $2,400
- 8 sessions with a CBT specialist – $3,200
- 20 sessions with a psychologist from the psychologist search service – $5,000
Now I have finally found a psychologist I like. I have progress and receive support. She was recommended to me by friends who attended her sessions and whose life beliefs I share. Before meeting her, I was already in despair and it seemed to me that something was wrong with me since I could not find a psychologist. But it all worked out, which makes me very happy. Now I pay $200 for a session, I visit a psychologist once a week. I spent $1,600 in two months.
Monthly expenses for mental health – 1,350
- Appointment with a psychiatrist – $300
- 4 sessions with a psychologist – $800
- Supportive drug therapy – $250
For six years of treatment, I spent $34,500 on expenses directly related to mental health.
I don’t want you to get the impression that my life is all depressive horror. Through these states and between them, I managed to advance at work, be in relationships, go on vacation, and much more. It was hard, sometimes even harder. The fear that I had no control over depression and that it could start at any moment was numbing. But at the same time, the understanding that I coped with it gives me the strength to believe that I can do it again. Now I know how to support myself, and I can recognize such states. I understand how to act and I realize that there are people who will help me, and this is very cool.