Depressed and uninsured. What now?

January 29, 2007 11:31 AM

I've finally acknowledged that I'm pretty seriously depressed. I don't have insurance and live in San Francisco. What should I do?

After a tough weekend, I’m willing to (finally) admit that I’m depressed. I have been for at least a year, but that year was so filled with external difficulties that I was able to blame all the bad feelings on what was going on outside to avoid dealing with what was going on inside. I mean, my abusive, alcoholic father died, my fiance and I both spent a significant period of time unemployed (which led to some very scary, no money for food-type financial problems), and there have been some almost hilarious, Southern Gothic extended family issues. Those things are starting to resolve, but I’m feeling worse rather than better.

I have a history of anxiety and depression, so I don’t know why I’ve been so reluctant to call this particular emotional spade a spade. The last time I felt this bad was during my senior year in high school when I had a nice little nervous breakdown that almost resulted in hospitalization. I feel myself nearing that point again and I’d certainly like to avoid it.

When this happened in the past, I had insurance to pay for meds and counseling. Now I don’t and I don’t even know where to start looking for the help I know I need. I’m scared that this cycle of depression and panic attacks is going to take over my life again. What now? I live in San Francisco. What kind of resources are there and where do I start?

posted by mostlymartha to health & fitness (12 comments total)

San Francisco has a network of low- and no-cost public health clinics. Basic links are here and here. There's also a City-wide intake system you can contact at [phone]. I'm personally a fan of Westside Community Services, which is where I take my kids (though they have MediCal, FYI). Helen Wong at [phone] is the intake person I've dealt with there (although I'm not sure if she's only for people 21 and younger).
posted by ClaudiaCenter at 11:42 AM on January 29, 2007

I was the girlfriend of someone in your position. Get a (not depressed) friend of yours to help you with the legwork. Here's what they should do:
Contact your local chapter of NAMI

Ask the question you have above. What they told me (this was in NYC) was that a particular hospital (Metropolitan on the UES) was the best for people in this situation.

My bf and I went there (again, nice to have a not-depressed friend with you, I think), and he was interviewed by a mental health conselor and given a prescription by a psychiatrist. He paid on a sliding scale.

Good luck with this. And congrats for surviving what sounds like a tough few years.
posted by tk at 11:44 AM on January 29, 2007

One resource that does not seem to be listed on ClaudiaCenter's (excellent!) links is the California Institute for Integral Studies' Counseling Center. It's sliding scale (starts at $28/session, according to the site), and might be worth looking into if you are into holistic health. (If you're not, then avoid -- they're seriously into holistic health!)

I also found that many of the private-practice therapists in the area are willing to work out reduced rates; I suspect the therapists who do not accept insurance are more likely to do so, but I could be wrong. If you enter your zip code here and find a therapist in your area who sounds appealing, it may be worth contacting that person just to see if they're willing to lower their charges for you.
posted by occhiblu at 11:53 AM on January 29, 2007

Mostlymartha, you're already doing one of the hardest things....asking. I unfortunately don't live in SF, or I would have the leg (phone)work already done for you, as I have gone thru the help available in my area 4 times so far.

Look at what helps you most. If it's the medicine, all the drug companies are making a big deal about providing medicines to those who can't afford it. If it's counseling, there is someone who is offering it in SF in some way you can manage. I offer this; check the addtional links at the bottom. http://www.dph.sf.ca.us/PHP/MHP.htm

I'm sure there's applications to be done for meds and a lot of phone calls to find counseling, but don't forget there is help to get thru that here on the 'net. Somebody has gone thru getting all this arranged while in your shoes and blogged about it, or started a messageboard for help with dealing with depression. If I find anything, I'll let you know here.

Take care of yourself!
posted by mattfn at 11:59 AM on January 29, 2007

I wish I could give you something more concrete, but I just want to wish you luck.
posted by walla at 12:26 PM on January 29, 2007

The San Francisco Psychological Association has a website which lists private providers, some of whom have reduced fees. You can also call their referral number and talk to someone for a reduced fee recommendation if you like ([phone]).

Also, check out the Depession Bipolar Support Alliance . They have lots of information and also some very helpful support groups.
posted by jasper411 at 1:06 PM on January 29, 2007

Also, set up a daily routine that requires you to get out of the house, see a friendly face, and get at least 1/2 hour of exercise that raises your pulse. If you are in the phase of depression where you can't make yourself do things, see if you can ask a friend (or fiance?) to be your "coach" on this simple routine -- ie the person who will call and hassle you if you try to skip exercising.
posted by LobsterMitten at 2:43 PM on January 29, 2007

Check out SF Jewish Family Services. You don't need to be Jewish.
posted by spork at 2:49 PM on January 29, 2007

A general practitioner can prescribe antidepressants -- you don't necessarily need to see a psychiatrist to get a prescription. Also, the older (pre-ssri) antidepressants worked for a lot of people, and they cost a lot less than the newer drugs.
posted by wryly at 3:01 PM on January 29, 2007

Everyone's posted the good links like NAMI. Check also (or have a friend who can do some of the legwork) for local support groups (via the NAMI page, I think), as they can be a good source of emotional support when you need it. It can be a tremendous help to be around people who are understanding of what you're going through - as opposed to those who still live in that 'just pull yourself up by your boostraps' 18th century mentality. And when you're feeling well again - and you will, believe me (I know whereof I speak, sadly) - it's good to attend the groups and help others who need the help from someone who's thinking clearly.

good luck - keep us posted if you find help, and email me if you need support.
posted by rmm at 3:40 PM on January 29, 2007

I just want to nth my support... Depression is crap.

For me, admitting it was a problem, and actively seeking help was what pulled me out of my deepest patches though.

I find if I give myself space, allow myself to feel like crap, and then force myself to do something to get out of it, I feel better.

I tackle the little things I can, just to make a start. So maybe go for a walk. Eat more vegetables, that kind of thing. I don't beat myself up if I don't do it, and I try not to let that defeatest voice within me that says 'you've missed a day, you've already stuffed it up, you'll never be able to continue with this' win.

But, with depression, its much easier to say what needs to be done than to do it. I find everyone is generally so full of great advice on what to do to get out of depression, that I end up just feeling overwhelmed, and more depressed that I can't bring myself to do any of it!

In short, my suggestions are these: try to get some exercise - I'm the worlds worst at this, and have only really started in the last week and a bit, but it does help.
eat more healthy foods - I find if I eat piles and piles of fresh vegetables I start feeling much much better about myself.

they are both quite cheap and easy to do, and hope they help!

Good luck...
posted by jonathanstrange at 4:13 PM on January 29, 2007 [1 favorite has favorites]

Your prescription medicine might be on the list of $4 refills at WalMart. Right now, those are:
- Amitriptyline (Elavil)
- Citalopram (Celexa, which is the older version of Lexapro)
- Doxepin (Adapine or Sinquan)
- Fluoxetine (Prozac)
- Nortriptyline (Aventyl)
- Paroxetine (Paxil)
- Trazodone (Desyrel or Trialodine)
posted by Houstonian at 6:52 PM on January 29, 2007 [1 favorite has favorites]