What To Do If You Can’t Afford A Therapist

You can beat the Sunday Scaries on your own!


The first time I ever went to therapy I was sixteen and not having it. I had been goaded into seeing a psychologist by my parents, who were exhausted by my unpredictable mood swings and one step away from sending me to troubled kid wilderness school. While the first few sessions were chock-full of silent, teen brooding, it didn’t take long for me to realize I loved talking about myself, and more so, needed to. Having a professional to bounce my feelings and ideas off of proved incredibly helpful to my mental health for the rest of high school and all of college.

That is, until I started having to pay for it myself. The crappy reality of adulthood means that I’m paying for my own health insurance, and that my health insurance will pay for therapy — once I meet a deductible that’s many times my monthly rent. Not exactly feasible for someone with an entry-level salary.

I spoke to my two favorite clinical psychologists, Dr. Kathleen Boykin McElhaney and Dr. Julia Sheehy (you may remember them from their musings on that whole boy/girl friendship thing — Kathleen is my sister) about their tips and tricks for monitoring your mental wellness solo, and how to better fight those Sunday Scaries.

First thing’s first — how would you advise someone to determine whether or not her feelings are too big for her to handle alone? What’s a good marker of when someone may need professional help?

JS: I suggest contacting a professional, meaning a licensed social worker, psychologist, psychiatrist, or accredited mental health clinic, when symptoms significantly interfere with one’s quality of life and ability to uphold responsibilities, and whenever there is a question of safety, such as with suicidal thoughts. Feelings of anxiety and depression, low self-esteem, recurring thoughts and many other symptoms are common reactions to everyday stressors. When symptoms compromise functioning and the ability to enjoy aspects of life, however, and if symptoms potentially pose any danger, a need for professional help is indicated.

Whenever I’ve looked to therapy in the past, it’s been a result of a changed circumstance — I’d become unhappy in my job or broken up with a boyfriend. Are there any coping mechanisms you recommend for someone dealing with something temporary but difficult that may be contributing to light, circumstantial depression?

KM: I always start with recommending basic, good self-care: eating well, exercising, getting enough sleep. Also: know thyself. Pay attention to what activities bring you pleasure (assuming these are not illegal and/or self-destructive) and DO THESE THINGS. Take an art class. Go for a walk. Visit with a friend. Drink a cup of tea on your balcony. Take a bubble bath. Watch goofy old TV shows.

The number one thing that tends to affect our mood most is perspective.  It is obviously difficult to maintain perspective when you are in a slump. But slumps often take hold and morph into more serious mental health issues when we start to feel like things not only suck now, but they have always sucked and will always suck. It can help to remind oneself that you have made it through hard times before and that you will again.

I feel like the greatest mental health issue facing twenty-somethings adjusting to working life are “The Sunday Scaries,” or, the feeling you get on a Sunday when you realize you’ve got to go back to work tomorrow for the whole week. Are there any behaviors or actions you’d recommend to help alleviate this kind of dread-based anxiety?

KM: I think the answer in part depends a lot on why this dread exists. Is it coming from real, external stressors or imaginary, internally created ones? If it is the former, then I suggest a three-step problem-solving exercise.

1) What is stressing you out, and can you get it out of your life/off your plate? If you chronically dread something, maybe it is time to re-evaluate its place in your life.  All of us have had experiences with toxic relationships, over-commitments and other things that at one point seemed like a good idea and now, not so much.  Maybe it is time to look for new friends, a new job, a new boyfriend, a new place to live, etc. if there are aspects to one or more of those parts of your life that are causing ongoing strife.

2) If you have done a thorough, honest evaluation and you simply can’t remove the thing that is stressing you out, can you do some good problem-solving? Can you change a deadline at work, minimize your exposure to a toxic co-worker (move your desk?), tell an intrusive relative to back off, etc.?

3) IF you can’t get the stress out of your life AND you’ve done all of your best problem-solving and the stressor (and dread) is still there, you need to address how you are thinking about it:  “Okay, this sucks but I can get through it,” or “Okay, this sucks but I can treat myself to a pedicure once I meet this deadline.” Emphasizing your ability to cope with difficult circumstances and rewarding yourself for doing so can help you get through.

Lastly, are there any sort of daily, preventative exercises you would recommend to keep anxiety in check–a kind of teeth-brushing for the nervous brain? 

JS: Research suggests that mindfulness and yoga are effective means of stilling the mind, calming the body and promoting well-being. Journaling and analytic meditation are also excellent ways to use focus and emotional awareness to arrive at understanding and resolutions.

KM: Yes, journaling is probably the number one activity to recommend.  It doesn’t have to be writing long hand in a diary, which makes many people feel sort of silly and self conscious or evokes the 12-year-old that most of us would like to put behind us. Making pro/con lists, top ten lists, writing down adjectives to describe yourself/a situation/another person/whatever. Having a good, empathic and non-judgmental friend to talk things over with. All of those are helpful.

Finally, so much angst is generated at worrying about ourselves. Lots of research suggests that doing something nice for someone else generates a positive sense of well-being. If you find yourself overcome by anxious thoughts or feeling sorry for yourself about something, find something to do for someone else. It doesn’t have to be something major, but taking the focus off of yourself for even a short time can often yield a lot of positive results, especially if you do this habitually.

Photographed by Krista Anna Lewis, creative direction by Emily Zirimis.


  • Harling Ross

    This advice is so helpful!! An MR twitter follower who read the story had another great tip: the National Alliance on Mental Illness offers FREE peer-to-peer group meetings! http://www.nami.org/Find-Support/NAMI-Programs/NAMI-Peer-to-Peer

  • Celeste

    You guys are reading my miiiind lately. Seems therapy is most needed when you can least afford it. Thanks for doing pieces like this!

  • Kelly

    This is great, practical advice. MR mental health month is just what i need right now, thanks ladies!

  • People don’t really do therapy in the UK, is it just an American thing? x


    • Meg

      Nope. You tend to call it counselling (though in general I think that it’s more integrated as part of NIH.) And about the same percentage of the populations have seen counsellors/therapists. Maybe you talk about it less openly, though.

      • We definitely talk about it less openly. We have a campaign here at the moment called The Big Conversation where we are trying to get people to talk more about taboo subjects such as death etc x

  • This is really great – bookmarking for the next dose of the Sunday Scaries.


  • meesh L

    can you talk about how to find a therapist. I don’t even know where to start or how to know if one I found is good.

    • Vicki

      Hi Meesh, you can call your insurance company and ask them who they cover in your area. They will give you a list of names of therapists who participate in your insurance plan and how many sessions you are eligible for. Then you can start researching the names you’re given online to look at practice areas (family therapy vs individual psychotherapy etc) and reviews. I think Psychology Today has a section where you can look up therapists in your area and links to their profile or web pages.

    • Lil

      Or if you don’t have insurance, contact local churches and colleges. They usually have low cost or sliding scale therapy based on your income.

      Generally, church therapies aren’t faith based. They just tend to skew more spiritual than religious (there’s a difference). Whereas the college ones are usually conducted by graduate students who need the hours with you to get their license.

  • Tami Brooks

    I think this page is very helpful too! http://www.7cups.com

  • Elizabeth

    Just to be clear – readers who can’t afford a therapist should drink tea on their balcony? I’d like to know who has a balcony but not money for a therapist.

  • puh-po

    Sometimes you can also find low-income specific counseling centers that could provide sliding scale costs and are mostly master’s level graduates that need to do a certain amount of hands-on work before becoming accredited! In San Francisco, the Integral Counseling Center is a place like that. I’m sure there’s a few in NY as well!

    • Nick Fortin

      Yes going to someone with little to no experience is a great idea. These people only care about their hours, not your problems