Free or low-cost mental health care?

[Dave1982]

I'm not prepared to go into all the gory details on a public forum right now, but I'm starting to seriously think that I might be suffering from clinical depression, or am teetering on the edge of it. I've been in a generally....well....depressed mood for weeks, and the more I reflect on it, the more I've come to realize that this has more or less been the norm for months, if not years. To be sure, there have been good times, but I really can't think of any extended period (ie, more than a day) of being happy or content since last summer.

Today was just awful. There was no one thing that really set me off, but there were times today where I was laughing one minute, and the next minute I was so upset that I was on the verge of tears. And there have been a lot of days recently where I've just wanted to break down and cry, but frustratingly, haven't been able to. I think the release might do some good, but for some reason it just hasn't happened.

Thankfully, I've come to this realization before any serious drama has occurred. I haven't had any big fights/arguments, I haven't (at least to my knowledge) allowed this to affect my day to day living, and (you'll have to take my word on this, but it's true) I haven't done anything to hurt myself or devoted any thought to doing so.

That having been said, I've got a few practical issues....

The biggest is that I do not have any health insurance at all. That is a whole separate can of worms that is far beyond the scope of this thread, but suffice it to say, I don't have insurance nor do I think I can get any in the near-future. If I did, I would probably be on the phone with my primary care physician first thing tomorrow looking for a psych referral, but I can't afford that right now.

Second, I don't feel like I can go to my parents for help. It's complicated, and like I said I don't want to go into specifics right now, but there are certain things that I might have to reveal to them that I don't want to, plus they are part of the reason that I am feeling the way I am.

So right now.....I'm just wondering if anyone knows about any resources that might exist in the Massachusetts area for free or low-cost mental health care. Is there such a thing as a depression screening? Sort of like how some places do blood-pressure/cardiovascular screenings? I've tried searching online but haven't found anything useful. Mostly self-administered online screenings (the one I took so far says I would benefit from additional evaluation) or free medical clinics, but not ones that offer psychiatric care.

[AccountingDrone]

I don't know anybody up there I can ask but a quick google turns up a listing of mental health agencies in Mass ... I would guess that one of the advocacy ones might be able to make some suggestions?

[Dave1982]

I saw that. Unfortunately, some of their links are out of date because I get 404 errors.

[trailerparkmedic]

Does your company have an Employee Assistance Program? I know you work for a big company and I've seen the same bland pamphlets at several different big companies I worked for. There's normally an 800 number to call and then you can talk to someone on the phone or they can hook you up with someone local. I doubt it would cover prescriptions but might be able to get you a few appointments for free. A friend of mine even got marriage counseling for like 6 sessions for free through the program.

I know you don't want to go to your parents and spill secrets, but is it possible to say "Hey Mom, I'm sick and need some money to go to the doctor?" Maybe if you're general it will help? Just a thought.

*hug*

[Dave1982]

Does your company have an Employee Assistance Program?

Ah..one of a couple of things I forgot to mention....

I did mention this to my boss, mostly because he could tell I was upset and wanted to know if he could help. He's going to make some discreet inquiries about this for me.

The other thing is that I do have a vacation already set up that is less than a month away. I already have the time off lined up, the hotel reservations made, and the money set aside. The time away from work and the other things in my life that are causing me stress certainly can't hurt. On the off chance that this is "only" stress related, then maybe that will help me come around. If it does not, then I'll definitely have to seek out some professional help.

Aaaaaaand I'm feeling on the verge of tears again....

[fireheart]

Am consistently there, done that.

Also look up free emergency phone counselling services.

[The Last to Know]

I know most places around here have a fee-based on income - BUT - the university hospital in Charlottesville where you can get a degree in that field offers it free after a screening. Usually you are assigned a student who has been studying for a long time & has back up from doctors & others. I would suggest trying a medical school first & foremost. I don't know exactly where in MA you are & what would be close to you. Also I have family up there - my cousin is about to marry a nurse next month & his sister just got her doctorate in Microbiology or something like that from UMASS-Amherst. If you would like I will absolutely contact them & get any info that they might have in the area. Just say the word & in the meantime -
BIG HUGS!

[ArcticChicken]

I don't know if this would help you, but you may want to look into Re-Evaluation Counseling.

I don't really know how to explain it, it's not something I do, myself, but I know people who find it helpful.

[Exaspera]

Is there a Crisis Hotline? They would have references.

[Der Cute]

Dave-

I'll go into some details for you, and please feel free to PM me later if you have more questions.

I currently HAVE depression. I have had it since I was 25. My mother has it, my sister, and I all have different styles but long term depression.

When I first was thinking I might have it, I would have mood swings like you described earlier. Cry, then fine, then sad then cry then meltdown then dark....all over the place.

It took me awhile to get the guts to treat it- and am glad I did.

You don't necessarily have to go to a psych doc for treatment.
I didn't.

I went to my Primary Care doc, and explained my symptoms, and he asked a few questions, and then prescribed Celexa. Told me to take it slow, to call in every few days to check in, and to gradually up the dosage, with visit #2 in a month. Worked fine.

Go ask your doc right now. The PCP is the person to ask for referrals, and it doesn't always mean straight to the $10000/hour doc. You specify: I need doc who costs low/sliding scale, and I need help NOW. Can you help me doc, or do I need counseling too?

There are a bunch of different kind of mood stabilizers out there. Please remember to check for side effects in the beginning of treatment. Keep a journal, and write down issues you have in your head. It will take up to 2 weeks to feel any different, so remember that you ARE working on it and THINGS will get better.

Hugs, and good luck.
Cutenoob

PS I'm no longer on Celexa. I'm on Effexor. Celexa stopped doing its job for me.

[fireheart]

Dave-



I currently HAVE depression. I have had it since I was 25. My mother has it, my sister, and I all have different styles but long term depression.

When I first was thinking I might have it, I would have mood swings like you described earlier. Cry, then fine, then sad then cry then meltdown then dark....all over the place.

Same situation. Except that I tend to think of it as "flaring up" when something sets it off. I've been in and out of hospital for it-very suicidal at one point, almost attempted it, but was stopped before anything could happen.
Some people might have one episode of depression, others will have it for life.
Me? I fall into the latter somewhat. I'll be good for a while, then it'll come back, I'll get meds, then I'll end up better, I'll come off of them, then it'll flare up again.

If you're not on any other medication, ask your doc about St. Johns Wort as well. It can help mild/moderate depression.

As for work, if you think you're going to have a breakdown, tell a few members of staff that you trust and work out a code word. My current one at work is "code 45." This basically means that "I'm going to breakdown, get me away from the registers ASAP!" That way, the public don't have to know what it means. To them, Code 45 could simply mean that you're out of something and need to order more.

[trailerparkmedic]

Dave, call HR. They'll know about the employee assistance program if they have it.

[Solumina]

Something that nobody else has mentioned that you really should look into is a licensed clinical social worker. All the ones that I know of charge on a sliding scale (they may actually be required to but I’m not 100% sure about that) and even their base rates are much cheaper than either a psychiatrist or psychologist. The one thing that they cannot do is prescribe meds, then again neither can a psychologist, but they can tell if you need them and make recommendations to your PCP (there are also those that work in the clinic of a psychiatrist who they can get medications from). Also your PCP can write you a prescription without you going to someone else but I would recommend against it as drugs really don’t fix anything, they just ease the symptoms so they really should be used in combination with therapy if you want them to be any more than a band-aid.

If you do go on meds (and it sounds like they would really help you) then be sure to remember that there are a lot of different types and a lot of different formulas of each type but no real way of knowing which exact medication is right for you so it can take a but of trial and error before you find something that works and since most take at least a month to really show a noticeable change it can be a long process. On the up side most PCPs and psychiatrists have a lot of samples so be sure to ask if they have any before you pony up the cash to fill a new prescription.

[BookstoreEscapee]

I've only skimmed, so I don't know if anyone's mentioned this, but check with your county social services department; they should be able to give you some low-cost referrals. But yeah, your doctor is a good place to start.

There is actually a National Depression Screening Day, but it's in October.

[Squeaksmyalias]

Talk to a doctor you are considering going to about not being able to afford treatment. My doctor when I lost my insurance actually let me continue treatment and had me just pay the copay I was paying before. Also your primary care doctor might know of a doctor who is willing to make you a deal like that. It can't hurt. Just try and make sure to talk to a mental health doc (therapist, counselor or what ever you end up seeing) too and not just a primary care doc. I'm not saying in all cases, but in some the primary care doesn't always know how to handle or have the time for the talking and teaching to cope and deal with things part of the treatment. It might keep you off meds you don't actually need.