Based on my self-defined overview of the phases of mental health maintenance, you might be thinking I'll kick the next phase of the series off with a deeper look into my thoughts on "The Shallow End." A lie detector test determined that is a lie.
Instead, I'm starting with the heavy hitter, the spot where the rubber hits the road and the real work happens: therapy and psychiatry. Fortunately for me, there's nothing new under the sun, no feeling not yet felt, no sentiment not yet shared. So, I'd like to lead this piece by sharing a few words that hit every nail square on the head for this topic:
"Once you finally decide you want to find a therapist in New York, it is so hard. You want someone trustworthy, so ideally you’d go off of personal referrals, but that gets complicated. Plus, finding somebody who takes your insurance and has availability outside of 9-5, is incredibly difficult. It was even more challenging because I was in such a bad place when I was looking for help, so I didn’t want to talk on the phone to a bunch of strangers even if they were trying to help me. Basically, I would say, don’t get discouraged because it’s a process that takes time."
Refinery29 Money Diaries aren't for everyone, that I can admit. These accounts of life in big cities lived by young people with big paychecks aren't extremely relatable to your average reader. Nonetheless, the Money Diaries follow-up quote above was a refreshing take on the familiar for me. So often, when it comes to mental health remedies and advice, therapy is named as the first, and most prominent recommendation. I, too, am a fervent therapy advocate. I think therapy changes lives and saves them all in the same stead. But I also know that I'd be remiss in acknowledging the truth so perfectly worded by the New York City dweller dealing with depression behind the italics: therapy journeys are often just as difficult to start as they are to maintain.
To illustrate that fact, take a walk with me down memory lane, to the beginning of my own foray into the realm of professional mental health help.
Spring 2015: I was about to graduate and I was also about to fall apart. I had long struggled with depression in some form or fashion, though at the time, I didn't know Depression well enough to address it by name. I suppose you could say that in this season, we were finally formally introduced. I was fortunate; someone cared enough about me to make the introduction, to tell me in their tough-loving way that I either stayed down forever or I did something about it. That something was taking a trip to see the counselor at school (shout out to the University of Maryland Counseling Center). So, during the weeks preceding my graduation, I started seeing a therapist - a black, woman therapist at that. The pros: I couldn't beat the convenience of having a mental health provider on campus that was covered by my insurance. The cons: my relocation to New York City was just around the corner and I'd have to start this process from scratch post-move.
Fall 2015: I moved in July, but I didn't actually start making calls to the short list of black, woman, NY-based therapists my college counselor recommended before I moved until a few months into my move. Folk will tell you that you shouldn't be afraid to shop around for a therapist. The ultimate goal is to find the best match for you, after all. While I wholeheartedly agree with that line of thinking, sometimes a girl gets lazy and good enough turns into great. In hindsight, that's what led me to my first long-term therapist. Although many years my senior (if I had to guess, I'd say Dr. C. - yes, another black woman - was in her early 60s), we shared the exact same birthday, and I took that as a good sign. Between the straightforward Capricorn candor that filled each session to the worldly wisdom that came from the lessons of age, Dr. C. freed me from the weight I was able to get off of my shoulders during these sessions. But do you know what occupied the bulk of my sessions with Dr. C. in the year and some change that I saw her on a weekly basis? My immediate family and men. Yes, you read that right - I didn't spend my time in therapy working on me. I spent the time trying to understand others. Once I realized the lack of growth I was having, despite the amount of unfettered venting I was being afforded, I realized it was time to send my thank you card and part ways.
Winter 2017: I stopped seeing Dr. C. early 2017. The thought of searching for a new therapist was a trial in and of itself. The real barrier, though, was the realization that I would have to start from scratch once I finally found a new provider. So, I put it off. For months. I eventually picked the search back up and found Dr. G. by way of ZocDoc. I like ZocDoc because the platform has pictures (and as I mentioned, I prefer black women as health professionals to the extent that I can both find and recognize them). She also has a profile on the Therapy for Black Girls website, though I didn't discover her that way. Again, I intended to shop around for a therapist, I truly did, but, I just didn't feel the need to look further after getting started with Dr. G. Her methods were a pleasant shift away from my experience with Dr. C. Our sessions were characterized by ongoing discussions during which I dug into and covered off on thoughts and feelings I raised during earlier sessions and new ones I'd come across during the week leading up to the session in question. This time, though, I noticed a new trend: I felt myself confining these meetings to certain topics, based on personal choice, not based on the restrictions of my counselor. I didn't want men to occupy the same space they had occupied in past sessions for me, so I didn't talk about them. I didn't want to admit how poorly I was recovering from certain dark spells, so I didn't talk about them. For some reason, I had the bright idea that curating some, but not all, of my experiences during therapy would help me become the happier person I thought I was working to be.
May 2018: Dr. G. went out of my insurance network. She notified me a few months in advance that she would, unfortunately, be rolling off of the network soon. At the time I thought nothing of it. I somehow allowed myself to believe that I would find a way to stomach the jump from a $25 copay per session (every week) to a $150 full base fee per session (maybe every other week, maybe monthly). For additional context, Dr. G. recommended I start seeing a psychiatrist after what I'll call an "incident" in March of 2018. Because I was seeing Dr. D., my psychiatrist, regularly and working my way through the physical and mental adjustments to my newly-prescribed antidepressant, I thought weaning off of therapy some would be okay until I could find a new provider. So, I started my search, albeit extremely halfheartedly. I thought I had a plan and that plan didn't involve moving on from Dr. G.
November 2018: I was hospitalized for mental health reasons. I'm not yet ready to re-open that can of worms/hurt by way of explaining the what and why, but let's just say that plan I just mentioned didn't work out so well. I found myself increasing the dosage of my medication and even the type of my antidepressants at my doctor's suggestion in the typical course of finding what worked best for me. Not to mention I am terrible with daily pills. I always have been. Despite that fact, I found myself faced with a new daily pill that I was skipping extremely frequently, yet still expecting to work effectively. At the same time, my visits to Dr. G. had become few and far between because, yea - that $150 per session fee stopped being the wave so, so quickly it wasn't even funny. Nothing about the situation made sense and I didn't come to terms with that until I hit a rock bottom.
December 2018: I was working on getting back to normal. After a supervised visit back to Dr. G., I was told that I really needed to figure something out that would allow me to see a therapist twice a week until I could get myself back on even terrain mentally. Unfortunately, that didn't change my insurance coverage or Dr. G.'s acceptance of it. I briefly considered moving off of my parents' insurance and onto the insurance provider offered by my employer solely for the purpose of regaining the ability to see my therapist at reasonable cost.
May 2019: I wish I could tell you shortly after my most recent "incident" I found a provider that accepted my insurance and lived happily and non-anxiously ever after, but, I can't. After spending two weeks on a medical leave of absence from work, I got back into a new swing of things, and that swing didn't include therapy. But this time, it wasn't because I hadn't tried. Over the course of the month of December 2018 and early January 2019, I called 25 therapists in the New York Metro area. Which is why I included the Refinery29 quote that opened this post. I could not - not I "did" not try to, I COULD NOT - find a provider who had any room to take on new clients, accepted my insurance, and/or had availability that worked with my schedule. I was as flexible as I could be given my (weekly) work travel schedule, but at the end of the day, I'm not at a place where I can completely re-arrange my work schedule to accommodate a Monday afternoon or a Thursday morning appointment if it happens to be the only slot a provider has to offer. I broadened my search (first, it was black women, then, it was women of color, and finally, it was just women period) to no avail. I mentally prepared myself to ask for time off or for a flexible work arrangement. But it turns out, I didn't need to. Almost every phone call I made ended with the same weary, apologetic "I wish you the best of luck in your search."
So, while I've gotten through a very rough, very low patch this year, I've landed on a much better mocktail of medication and I've realized that sometimes with therapy, all I can do is try.
"Now after I’ve done all this work, I really feel like my eyes have opened to not only the potential of this city, but the potential in myself and my day-to-day life. I feel like I can get excited about things again. For months on end, I just never felt anything. Now, I feel like I’ve woken up and realized there’s a really great world out there."
I feel the truth in this second quote from the Money Diaries article, and that's a great thing after the frustrations the past year has seen me through. And I hope that you'll take that sentiment away from what was a very detailed and very long timeline review. For the first time in my life, despite the lack of professional help I have, despite the isolation I tend toward and the depression and anxiety I've always faced and have done my best to talk through and work through, I'm holding my own weight. I'm allowing myself to be excited.
Part of that is due in large part to the practices I have been able to develop during my time in therapy. Word of affirmation cards, healing mantras, journaling (sometimes), creating space in relationships, clearing my extracurricular plate. Understanding the importance of therapy, both seeking it and utilizing it.
I've found that there is power in the search. There's grit and there's dedication in that first step, that willingness to do what it takes to get better. Passing that first hurdle is the hardest for that reason. This Mental Health Awareness Month, I want to continue to encourage others to seek the help they need to heal and/or to build. But, I also want to be painfully transparent and honest about how difficult that can be for so many for financial, for personal, and for professional reasons. If you can look into digital platforms that host online therapy like Talkspace, please do. If you're a student and you have access to campus facilities that include mental health service offerings (small group therapy, private sessions, etc.), do not let the services go to waste. If you realize therapy alone isn't enough and you think supplements may be a necessary precaution, ask the question, and keep asking it until you're heard and you have a path forward.
These are the heavy lifting activities. Just keep building that strength and filling the deep dive mental health maintenance gaps wherever you can with the knee deep and shallow activities that can serve as band-aids until you do the work you need to do to patch the hole for good. Give yourself grace within reason: develop a flexible course of action for therapy and for psychiatry and take that course one day at a time.
Let's keep the conversation around Mental Health maintenance and around ways to cope when healthy coping mechanisms are hard to come by over on Instagram.