Maintaining your mental health is expensive. Medicine is expensive. Many of the antidepressants are generic now, but still cost about $1/pill without insurance. Lithium is much cheaper at 30 cents a pill. Prices on anxiety meds vary depending on if they are generic or not. But the antipsychotics… woah! I take Geodon, which recently went generic, and without insurance the cost is $379/month! Fortunately I only have to pay $76 because I have insurance. Even Lamictal runs $170/month generic. These are only some prescription prices. What do you pay in supplements that aren’t covered by insurance?
Sadly, most of us can’t live without medications. Many of us have had breakdowns, hospital stays, and near death experiences and have come to accept that we need to live on medications. But medication is only one cost we pay. What about the costs associated with our personal finances, relationships, family and friends, our work, our future?
First, let’s examine the financial impact of mental illness on society. Severe mental illness costs American society in $193 billion dollars in lost wages 2002, according to the American Journal of Psychiatry. It costs employers to provide mental health coverage, which some do not provide. It costs employers in lost work hours while we sort out our meds, or find ourselves too depressed to get out of bed. NAMI (the National Alliance of Mentally Ill) reports workplace costs of depression are over $34 billion per year. The National Institute of Mental Health (NIMH) reports $57.5B in 2006 for mental health care in the U.S.
Numbers can be thrown around about financial costs to society. But consider what it costs us as human beings living with these conditions?
There are financial costs, beyond medications, the costs of therapy, insurance, and employers. Hundreds, even thousands, of dollars come out of our own pockets to pay for treatments to keep ourselves stable. And if we are not stable… the cost of “retail therapy” or manic spending sprees can land us in deep financial debt.
What about the cost of our careers? Some individuals have difficulty staying in college, leading to lower income potential. What if we need to take a lower paying job because we can’t effectively deal with the stress of a job that pays well but grinds our mind into dust? So many mentally ill individuals are highly educated, yet don’t reap their full economic potential because of the high stress levels that accompany high paying jobs. Many government jobs cannot be held by persons with severe mental health issues since they can’t qualify for a high level security clearance. This is the situation that I am faced with and I don’t like it. I feel like a failure because I couldn’t handle a high paying job with eccentrically abusive coworkers and the stress to constantly perform well under those conditions. This is a cost to me personally, both financially and emotionally.
What is the cost of stigma? I don’t dare tell an employer that I have a mental illness. I lost one job that way. They felt they couldn’t count on me to be in the office, even though I had hardly missed a day in the three years I worked there before my breakdown. What does it cost me personally because I am too afraid to tell my friends? I fear I will lose them. Maybe I just don’t have enough faith in them, or faith in myself, or perhaps just in general, but I am losing out on a valuable resource by not telling my friends. I feel isolated from them, and no matter how much I might want to, I feel like it would change something permanently between us. What am I losing to stigma?
There are costs to our relationships too. How does your spouse handle it when you are manic/depressed/OCD/have anxiety or panic attacks. For those of you who are spouses to someone with a severe mental illness, how do you handle it? What about friends? Do they know about your mental illness or not? How do they react when you are in an abnormal state? My friends tell me now that when I was extremely manic, they were afraid of me. How do you come across at work? I remember a conference one time where I embarrassed myself in front of a room full of scientists because my presentation was accidentally on automatic and my slides kept changing every 30 seconds. Worst of all, I just laughed. I was manic at the time and I thought it was funny. I wonder now what the audience thought.
What is the cost to myself? The cost to my self-esteem? The knowledge that I have a chronic illness that can never be cured, will progress as I age, and impacts what I say, what I do, and how I interact with people. It’s a heavy blow some days. Some days I have to fight to get out of bed. Some days I am hypomanic or so anxious I can’t think straight. Some days it’s just… what it is. A chronic illness that I have to deal with. The medications, the doctor’s appointments, the therapy. It’s my life.
What has mental illness cost you?
Medication prices from the prescription drug company Medco.
Thomas R. Insel, Assessing the Economic Costs of Serious Mental Illness, Am J Psychiatry 2008;165:663-665. doi: 10.1176/appi.ajp.2008.08030366
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