Please help me put my life back together.
October 5, 2009 9:09 PM   Subscribe

I've finally realized that I have a gigantic mess of mental issues that almost certainly require therapy and medication. Depression, multiple kinds of anxiety, who knows what else. Please help me figure out how to get better.

Me: late 20s, male, educated, in the US.

I've finally decided that I have a serious mess of mental issues that require sorting out. It's going to take a while to get everything sorted out. I am all for therapy and medication. This is not a situation where I need to be convinced that there is something wrong.

My challenges are as follows:

* I'm unemployed. More than this, I worry that I'm unemployable as things currently are. My experiences with work have generally been horrible. When I have worked professional jobs, it gets where I dread going in, I feel numb when I come home, I think about quitting constantly. I don't entirely blame the jobs, some of it was probably me and some of it was probably just a mismatch between type-of-work and me. But, the thought of work terrifies me because of the bad experiences I have had. Also (see below) my current living situation makes looking for work very difficult. On the other hand, I am a very hard and conscientious worker, I value work and I think it is psychologically very helpful and important. But getting from where I am now, to steady employment, well it just seems impossible.

* I'm essentially homeless. I have some savings which are keeping me in cheap motels and fed with fast food. Exercise and diet are simply awful right now. I don't know where I'm going to be sleeping more than a couple days out, if that. I find myself completely unwilling to put down roots anywhere.

* I have essentially no social network. Currently I'm in a city far away from where I come from and where the few friends and family that I can confide in are. I refuse to go back there because the area is frankly toxic to me (not because of my friends and family). In any case I have already leaned very heavily on them, more than is healthy for me or fair to them. I can't do that any more.

Anyway if anyone has any ideas to make my life suck less, that would be great. I'm terrified that I'm going to run out of money before I figure things out, and then I'll be on the literal street like so many other people I see.

I don't really know what kind of solution I'm looking for. I basically need a place where I can retreat and pull myself together. I guess I'm asking how to get things started. I've scoured AskMeFi and read a zillion questions plus searching elsewhere. Most of these questions are submitted by people who have their lives somewhat together already even though they don't know it, so they have resources to draw on in one area to improve things in other areas. But I have nothing together and nothing to draw on. I'm hoping to get answers that are more helpful than just to buck up and slog through. If it were as easy as just getting a room and a job then I would do it, I would have done it already.

I haven't said where I'm located right now and that is on purpose. I don't like where I am now and I don't plan to or want to stay. I'm open to almost anything almost anyplace.
posted by MyMetaAccount to Health & Fitness (24 answers total) 7 users marked this as a favorite
Go join the Coast Guard. Go rescue people for a living.
posted by Cool Papa Bell at 9:13 PM on October 5, 2009 [1 favorite]

Here's a couple of thoughts. I believe that work, especially physical work, can be very therapeutic. Forget getting a career or "fulfilling" job for now. Just get something where you have to go there every day and do your work. Wash dishes at Denny's, anything honest, and stick with it for a while. Next get to a real doctor. You need a physical checkup. Tell the doc what you have told us and the doc will hook you up with counseling. Look in the yellow pages for free clinics, they are out there. If you stay at Denny's for three months, you will be eligible for their medical insurance.

One very important suggestion. Stay away from the bible thumpers, "spiritual healers," etc. They will take advantage of your situation and exploit it. Find a legitimate counselor.

Just my 2 cents, hope it helps and good luck.
posted by charlesminus at 9:26 PM on October 5, 2009 [1 favorite]

Realize that to get better, you'll probably have to do something you've been avoiding for a very long time.
posted by Ironmouth at 9:31 PM on October 5, 2009 [2 favorites]

In the town where I live there's an organization that helps men find jobs and get back on their feet. Someone who volunteers there wrote this piece recently where he walks through step by step what he would do if he ever needed the center's services. Maybe this will be helpful as a possible guide.
posted by MsMolly at 9:41 PM on October 5, 2009

I'm unemployed

Exercise and diet are simply awful right now.

I may be being extremely naive, but if you are unemployed then potentially you have quite a bit of spare time on your hands. Perhaps you should go for a run, or do some pushups/situps, or just something physical. Set the alarm to get up early, do some exercise in the morning.

You might find the extra endorphins and energy motivate you to fix other areas of your life... get a job, make some friends etc.

I'm not sure why it isn't as easy as "getting a room and a job" as you say, perhaps you can elaborate on why you can't go and do as charlesminus suggested, get a job, any job, find somewhere permanent to live, meet people, and enjoy yourself rather than wallowing in self defeat.
posted by Admira at 10:14 PM on October 5, 2009

I just have one suggestion, about the 'relocation' part of your questions. Correct me if I'm wrong but I'm hearing the following: There's an unwillingness to put down roots, yet the place where your family and friends are feels toxic, and the current place isn't anywhere you want to stay.

So this means you want a direction to go, yet you don't feel comfortable committing; does that sound right? In that case it would seem to me that any place you decide to go next you'll be faced with those same stated problems as you have now.

Perhaps it's better to focus on figuring out the main reasons why you have these rootless feelings, and put the thoughts behind them to a test to see if there are any cognitive distortions among those thoughts. For example, ask yourself what it is about your family hometown that feels toxic. If the thoughts that come up are almost exclusively about certain work-related events, ask whether or not the labeling of the whole town as toxic for you might be magnification. If there are thoughts that 'things will never change for people in Hometownia,' consider that this might be a bit of 'Fortune telling'. And so on. My past crises have largely been fueled by a number of these cognitive distortions.

Do this at your own pace; if you find that just examining your feelings brings up too much emotional pain, don't force it right away. Try to shrink the focus to specific thoughts, and deal with only a few at a time.

Advice like this is definitely not for the long-term; it wouldn't be reasonable for you to expect to solve all the problems yourself. Getting help and a support system is the most important thing to work towards when feeling overwhelmed. So please make that one of your first goals. Good luck.
posted by Hardcore Poser at 10:25 PM on October 5, 2009 [1 favorite]

You seem earnest and write well, and you also seem very scared and confused. Are you hoping for some kind of reset or reboot, like if you could just find the right place to go, you'll be able to get the help you need and get it going in the right direction? I'm sorry to say that I don't know if there is such a place. It doesn't sound like you're in a place yet where you could enlist in the service, or go on some kind of spiritual retreat where you could live and work/practice.

You seem like you're headed to a very scary "bottoming out" experience of being homeless and broke and depressed and anxious - are you using alcohol or drugs? I was wondering if that was the "toxic" you referred to when you said you couldn't go back to the place where you have supportive people because it's toxic, though not referring to the family and friends.

Bottoming out experiences are where you come to a realization that you can't change things on your own. That you need help. You say you're ready to accept that - but why can't you accept it from your actual support system of family and friends, as a place to start? If those family and friends are willing to help you (not enable you, but help you), can you find a way to avail yourself of their support while taking small steps toward recovery? Like going to self-help meetings, working menial jobs, humbly staying out of trouble.

If you can't find a way to consider availing yourself of help from your family and friends, then it's up to you where you go. Big cities will tend to have more places like shelters and mental health services for poor people, though they also can be very toxic, particularly if you have proclivities toward getting yourself into trouble (drugs, violence, exploitation, etc.). Small places probably have fewer services, but maybe you can find a niche that isn't dangerous. Is there a county hospital where you are that you could go to the emergency room or urgent care center and explain the kind of trouble you're in? It might be scary to go, but you've got to start somewhere, and it sounds like you recognize that the path you're on is leading someplace bad.

I've suggested Recovery International quite a few times to people. You might want to check it out. You've likely got a long journey ahead of you, and long journeys are accomplished by taking small steps.
posted by jasper411 at 10:33 PM on October 5, 2009

Winter's coming on, in the U.S.

If you're really near down-'n-out, and north of the seasonal freeze line, don't wait to head south. If you do wind up not being able to afford shelter, your survival is likelier in a warmer climate. So use what available money you have prudently, to get where being outdoors a lot, isn't going to make you immediately sick, if it does come to that. To extend your money, look for shelter in places where Single Room Occupancy (SRO) hotels, usually with 1 or 2 bathrooms shared on a floor, are available. Look into the local YMCA, or renting rooms in people's houses as low cost options for living. Money you don't spend renting motel rooms can immediately improve your diet, buy you clothes at Goodwill, get you a haircut, etc.

Next, if are going to relocate, try to find a travel partner. For the truly down and out, having a partner who can watch a squat, while you go work, or recycle, or look for food, as well as sleep in shifts with you, if you have to stay somewhere dicey, can vastly improve the odds of successful subsistence living for both. If you have to hitchhike, hitchhiking in pairs is safer, if harder to get rides doing. Chinatown buses, like GoToBus provide cheap inter-city transporation, for cash.

It's a tough time to be looking for a job, but if you can't afford to pay for shelter, look for night shift work, preferably indoors. Warehouse shifts, shipping company sorting crews, building cleaning and maintenance, security guards, hospital and industrial laundries, retail distribution centers, etc. all work at night, and it's better to be indoors at night, working, if you can't otherwise afford shelter. Also, it's harder for employers to find people willing to work nights, particularly the graveyard shift, and so they often pay a bit more, in shift differentials, for those that will. If you do get to be a "vampire" (i.e., a person who preferentially works night shifts), you may find that you get chances for overtime and other perks the day workers don't, just because management likes to keep stable, dependable night workers happy.

Above all, stay in touch with your family and friends, if only by e-mail, phone, or postcards, particularly if you are relocating. You say that you don't want to tap any of them any more than you have, but if it comes to a point where $50 or $100 is vital to you, better they've been kept up to date on your struggle to avoid coming to them hat in hand, than to only hear from you in extremis. You can always thank someone who has helped you, even if you can't, at the moment, make any repayment of their kindness; having their concern validated by your continuing thanks is, surprisingly, enough for many of the people closest to you (your parents, relatives, etc.).
posted by paulsc at 10:42 PM on October 5, 2009 [3 favorites]

There are a couple realities you need to face, and face soon if you want to pull yourself out of this and gain some direction. Apologies in advance if this comes off as harsh but I'm all for tough love and I don't like sugar coating things.

Reality #1
Work sucks, get used to it. How you feel about a job is how most of America feels about theirs (those fortunate enough to still have them). If you are ABLE to find a job, hold onto it for dear life. It will provide you with the income you need to start saving money, pull yourself out of motels and start renting a cheap apartment with 2-3 roommates which you can find online.

This allows you to start building savings which you can use to start eating better. Apply for food stamps, do whatever it takes to start eating healthier. If you are truly that broke, a lot of homeless shelters will provide food for you. You are in a SURVIVAL SITUATION and that means putting a lid on whatever pride you may have and doing whatever it takes.

Reality #2
Make like a tree and grow some damned roots. You say you need to go somewhere to retreat and pull yourself together, but you have a hard time putting down roots. Those two things do not go hand in hand. Based on the description of your current situation, you are going to need a substantial amount of time to get it together since you need to A. get a steady enough job to get some income and savings and improve your living situation, B. get health insurance to start seeing a professional (which should be your top priority) and C. taking the time necessary to truly come to terms with your mental issues and resolve them.

Reality #3
Take action NOW. I disagree with Hardcore Poser who says to do it at your own pace. If you are truly in this desperate of a survival situation where you don't know where you will stay the next night, you do not have the luxury of doing it at your own pace. Spend the ample free time you have being unemployed to find any job that will give you the pay you need to get a cheap apartment and healthcare. Take two jobs if you need to. There are people out there right now working 3-4 jobs and it is stressful as hell, but they do it because they need to in order to survive. You may have to do the same.

Again, I can't stress enough how important it is for you to take a cold hard look at the realities of your situation. We all go through crisis in our lives, and you alone have the power to pull yourself out of it. There is not some magical button you can push to get a Free Ride card. Hard work, discipline and perseverance will be your savior, but you must truly commit and focus on nothing other than improving your circumstances.

I wish you the best of luck in your situation and again, please forgive me for my bluntness...I just figured there's no sense in beating around the bush about the realities you need to deal with.
posted by Elminster24 at 10:46 PM on October 5, 2009 [2 favorites]

paulsc and I are on the same page.

1) Find a way you can camp out for a while.
- Either go south and low elevation (Tucson) or coastal (Santa Cruz).
- You can generally camp free on national forest or BLM land. (US advice here.)

2) Consider jobs with free room and board e.g., working at a hostel.

3) Start earning a little money.
- In California, a shopping cart of cans earns around $35.
- LaborReady. 1-800-24-LABOR. Holding up signs on construction sites, e.g. Work Today, Get Paid Today (TM). If it's raining or snowing, there's much less construction. This might be pretty slow, given the economy. The catch is that you have to be there at the crack of dawn; first come, first hired. I think they'll hire catering help, too.
- Look at office temp companies if you have computer skills through companies like Manpower.

4) Consider "real" but seasonal jobs.
- Ski resorts will start hiring winter help in early November. (The trick is that most ski towns are really cold, so camping is harder. Some exceptions: Salt Lake City, Sedona AZ (near Flagstaff)).
- FedEx hires many holiday drivers.
- Retail hires around holidays, too.

5) Ask around for jobs with health insurance.
- Starbucks? Staples?

6) As you start to get your life a bit stable, ask around for a sliding scale therapy clinic.

7) If you still find yourself slipping, start looking for resources for the homeless. Many cities have a variety of resources like food banks, shelters, job placement services, and potentially also some mental health resources. Don't be afraid to ask for help, since that is why they're there.
posted by salvia at 12:41 AM on October 6, 2009 [1 favorite]

You don't need a life plan right now, you need triage. You say you've already leaned heavily on family and friends back home, but ask yourself if they'd be more upset at you reaching out to them now, when you're close to the end of your rope, or if you never reached out to them, wound up on the street, and hurt somehow.

The toxicity you mention that's tied to a geographic area sets off red flags of either substance abuse or psychological abuse from someone outside your family/friends situation. In either case, it sounds like (I'm reading way way way inbetween the lines here, so forgive me if I'm totally off the track) you haven't told your family and friends back home what the issue is, entirely. I'm not suggesting you move back there, but call your family. Call your friends. Tell them everything that's going on, no matter how embarassing you think it is, and don't let your pride get in the way. If you absolutely can't go back to that area, the best resource may be something that someone you know can set up for you. Do you have relatives in another area? Do your friends from home know people in another area with whom you can crash for an extended period of time?

The essentials are most important. You need to have a roof over your head and food in your stomach, and it's really tough to secure those while you're drifting from place to place. Asking strangers (whether it be here or through social services) may feel "safer" to you right now, but generally, the people you know, provided they're not abusing you in some way, are almost always the best first step towards getting back on your feet.

Good luck. Please keep us posted as to how you're doing.
posted by xingcat at 5:29 AM on October 6, 2009

paulsc and salvia have got you covered.
#1 is heading south and maybe finding a job in a hostel or putting your hotel money towards cheap rent in one of those "SRO"'s mentioned above.

Once you have a space and a job and hopefully a mental health professional to talk to- then you need some goals - what do you want out of life? What makes you happy? What would you do in your "dream" job/life? How can you get those things? However, you can't really honestly start thinking about those things until you have a roof over your head and some sort of regular income.

Also - look into welfare. This is what it's there for.
posted by smartypantz at 5:54 AM on October 6, 2009

Go to your local social security office and fill out an application for SSDI. If you are awarded a benefit due to your mental health disability it will be based on your prior employment income and may be substantial, if nothing else it will provide you with enough income for housing. If you get your mental health disbility under control and want to return to work later, you can do so. You will need to go to doctor's appointments scheduled by social security and provide medical records for any psychiatric treatment you have received so far, so some stable address where you can receive mail will be beneficial. If you fear you won't have one contact some local homeless service agencies and ask them who provides this service, as many agencies generally do. Also, you can designate someone to receive mail on your behalf, so if you know someone who would do this, talk to them. Get started on this immediately, it's a time consuming process.

Go to your local public assistance office and apply for Medicaid, food stamps and cash benefits. I can't glean from your post when it was that you were working most recently, if you had recent employment income you may not qualify for the cash but the food stamps and medical you will probably get. Once your Medicaid application is completed, select a local community mental health services agency and contact them asking for an intake appointment. At the intake appointment tell them your situation and let them know you already started a Medicaid application. At this point you will be scheduled for an appointment with an evaluator, probably a psychologist though maybe a social worker, who will do what's called biopsychosocial with you. This will give the agency a good idea of what your needs are and what you are struggling with. Then you will receive an appointment with a psychiatrist who will do a psychiatric evaluation and determine if medication is necessary.

You will likely be given an outpatient treatment schedule at this point that will include group sessions and an individual therapy session, both will most likely be lead by a social worker.

You can contact me if you have any questions.
posted by The Straightener at 8:06 AM on October 6, 2009 [3 favorites]

paulsc, did you mean to link to this for chinatown busses?
posted by nomisxid at 8:33 AM on October 6, 2009

"paulsc, did you mean to link to this for chinatown busses?"
posted by nomisxid at 11:33 AM on October 6

Oops! Chinatown buses. Coverage map. Routes. More routes (now including destinations in Alabama, Mississippi and Lousiana, too).
posted by paulsc at 9:30 AM on October 6, 2009

Start with small steps. First, your physical health. Do you have a refrigerator? It is probably cheaper for you to eat healthy sandwiches, than fast food. Go to the grocery store, buy some decent food. You have some time: exercise. Find a place you feel comfortable, and take a long walk every day. Do a couple of sets of situps an pushups every day. It might suck at first, but in a month you'll be a new man. If you don't take care of your physical health, nothing else you do will have a lasting impact.

Next step is to get some stability in your life: a job. If you are planning on moving, do some research and try to find a city that would offer you plenty of opportunities. Find something part-time. Telemarketing? Pretty focused work without a lot of interaction with annoying coworkers. What are you interests? Engage them as hobbies in the meantime. If you are into computers or writing, start a blog. If you are an artist, practice your medium. Engage you mind. If you sit around all day fretting, you'll never get anywhere. Find something to focus your mind on.

Develop a network of friends and acquaintances: start online, then in real-life. Get interacting with people. Once you've made some strides, let your family know. Let them know where you are, write to them.

Expect that you will have good days and bad days. Just say "fuck you" to the bad days.

You say you have nothing to draw on, but you are wrong. You are (very) young, educated, and currently have the means to keep a roof over your head. Make a plan and write it down. You have to work hard to get out of your situation, but it is infinitely-rewarding work.
posted by whiskeyspider at 11:13 AM on October 6, 2009

This is what family and friends are for.

Your parents/siblings/cousins/friends/whoever absolutely do not want to see you homeless, poorly fed, and in distress. You say that you need stability in your life to move forward and get help with your depression and anxiety. If it has affected you so seriously that it is interfering with your daily life, I don't think you should assume that you can or should try to do this on your own. It's all well and good to have a "I'm just gonna get up and pull myself up by my bootstraps every day until I get better" attitude, but it sounds like you've already been trying to do that and things have been getting worse. Please consider heading back home and getting some stability so you can get your life back on track. Three squares a day, a space to live where you don't have to worry about being kicked out, and someone to talk to are invaluable if you've hit rock-bottom like you have. I regret every day my pride and other excuses prevented me from asking for help- I wasted so much time when I could have been getting better and regaining my confidence.

You've been purposefully vague about why the location where your friends and family live is toxic. I have no idea what that means, and I wish you'd explain it. But since you haven't, I hope you'll read this with an open mind.
posted by Mouse Army at 2:21 PM on October 6, 2009

Response by poster: The way I asked the question was wandering, but my goal was one of the following:

1) How can I/is there any way to get mental health treatment while in my current situation? The mental stuff is severely hindering any kind of progress on any other fronts.


2) Is there some place I can go where I can simultaneously start working on all of these problems at the same time?

The closest to the first was The Straightener's answer. It's a very depressing answer but I have to admit it's at least on point. The closest to the second was Cool Papa Bell's answer about joining the Coast Guard.

Up until a few years ago I was a relatively put-together person. Then one thing after another happened and now I'm an anxious, depressed, asocial wreck. I am sure if I could just get a month or two together of some sort of treatment (therapy, medication) then things would start to take off. I have not done anything to myself physically, legally etc to cause any lasting damage. I am not an ex-con or hard drug user. The type of program that MsMolly describes is dedicated to those folks; though I in no way mean to disparage those programs (God knows they do what they can with what little they have), I don't think sleeping on a mat in a halfway house is the way back for me. Similarly with hustling aluminum cans.

It seems very easy to get things started again as far as room, job, friends. It's as straight-forward as explaining to someone with no legs how to finish a marathon: just keep putting one foot in front of the other. For some reason when it comes time to actually do it, I don't. I'm starting to think I can't. I've tried, but it just doesn't seem to work -- I just don't follow through. I worry it will be like every other time I've failed to have friends, open up to people, hold a job without hating it, etc. That's why I think I need to address the mental stuff first or at least simultaneously.

As for Hometownia, there is nothing sinister there. My (limited number of) friends and family that I can depend on are all great in their own ways. No drugs, no abuse. But they either are incapable of understanding the sorts of problems I have, or they just aren't equipped to deal with it. They aren't professionals, just like you all aren't. I have in fact stayed with relatives and it doesn't work, I feel trapped and it makes things worse. As for Hometownia itself, I hate the weather, the high cost of living vs. low quality of life, the fact that you need a car and I don't have one and have a deep hatred of driving. It is not a place I want to settle down, and this means that I can't ever really relax and just live there because I know in the back of my mind that I'm going to leave.

I was really hoping for more Coast Guard-type suggestions. Unfortunately I have medical issues that make the military impossible, along with other adventurous things I'd like to do such as logging, fishing, working on an oil rig, wwoof, etc. I've also considered the Peace Corps, AmeriCorps, Teach for America, even truck driving but for one reason or another none of those seem to fit.

Anyway thanks for the answers so far and I hope this sheds some light on things and gets more targeted answers.
posted by MyMetaAccount at 6:04 PM on October 6, 2009

Here's the U.S. Department of Health Center for Mental Health Services web site. You'll find that many Federal programs, including some aspects of SSI, including major parts of outpatient mental health services delivery, are administered through state and local programs like Medicaid and PATH grant programs, although they are keyed on eligibility and benefits payments from programs like SSI. So, you've generally got to know your local bureaucracy to get help in these programs, and it often means making a number of appointments, filling out a bunch of forms, doing evaluation interviews, and eventually getting eligibility for benefits under these programs, as described previously by The Straightner. I didn't send you down this road, because it generally takes a while for eligibility determinations, and because, in my experience, unassisted young people with ongoing mental issues and employment history problems rarely make it through the screening and intake process alone. You miss some appointments, fail to fill out forms correctly, have transportation problems, and you're often starting all over, in a new case period, in many state bureaucracies. But, if The Straightner's suggestions sound like something you could do, do it.

Without any localization information from you, it's hard to make specific recommendations. You might want to get in touch with the local volunteers in your chapter of NAMI, for pointers to resources in your area. In some communities, faith based organizations are the big, general purpose intake providers of emergency social and mental health services, but your issues don't seem to rise to the level of a true emergency, just yet. You also haven't yet run afoul of the legal system, as far as we know, which is another general purpose entry point to emergency support services for many mentally ill people. The National Collaborative on Workforce and Disability has a whitepaper up on the web that discusses a few pilot programs around the U.S. that are attempting to deliver services to people in your situation. But as even they say
"Insuring that a young person is healthy and ready for work, independent living, and civic engagement is easier said than done. There is no coordinated system that guides youth through the process of becoming productive and self-sufficient members of society and the labor market. Pieces of the system exist, such as Career and Technical Education, transition planning under the Individuals with Disabilities Education Act, and programs available through Vocational Rehabilitation and the Workforce Investment Act. Unfortunately, however, these services are often incomplete and uncoordinated – and therefore ineffective. Youth with educational and career challenges, such as those with mental health needs, too often fall off one of the cliffs between youth and adult systems or get shunted down an arbitrary or inappropriate service tunnel based on considerations dictated by the system rather than the youth’s wants and needs."
Good luck.
posted by paulsc at 8:44 PM on October 6, 2009

Response by poster: paulsc, thanks for the well thought out post and links. I mentioned The Straightener's comment because out of all the comments, it was the only one that addressed the part where I said I was looking for mental health resources before getting to everything else.

I wasn't really happy with it though -- it's massive overkill. I was sort of envisioning getting a prescription and a referral for a few rounds of therapy, to start, to help get everything else going, without making a big deal out of all of it (i.e. walk-in), and without paying big money for it or scouring the web or navigating a bureaucracy. Not to make this political but I hate the American healthcare system and I hope the Canadian and UK members of this site appreciate what they have. Anyway it looks like that sort of help is not realistically available to me right now.

Also, late 20s is well out of the range of youth programs, at least from what I could see in those links.
posted by MyMetaAccount at 9:32 PM on October 6, 2009

Response by poster: "...out of all the comments, it was the only one that addressed the part where I said I was looking for mental health resources before getting to everything else."

I admit I did not actually say this is something I was looking for in my original question. I don't blame anyone for not reading my mind. If nothing else, this is all helping me realize for myself what I'm looking for.
posted by MyMetaAccount at 9:38 PM on October 6, 2009

it's massive overkill. I was sort of envisioning getting a prescription and a referral for a few rounds of therapy, to start, to help get everything else going, without making a big deal out of all of it (i.e. walk-in), and without paying big money for it

Okay then, how about just paying for a therapist? It's not "big money" if you have the funds to stay in a hotel. Why not stay in a cheaper place and use the savings to go pay for therapy?

E.g., $40/night hotel = $1200 / month
An average rent-a-room-in-a-house situation ~ $600
$600 savings

Even at $80 a session, you could go nearly twice per week. If you look for something sliding scale, you can find something even cheaper than that. Would that be enough "to help get everything else going?"
posted by salvia at 11:42 PM on October 6, 2009

"... I was sort of envisioning getting a prescription and a referral for a few rounds of therapy, to start, to help get everything else going, without making a big deal out of all of it (i.e. walk-in), and without paying big money for it or scouring the web or navigating a bureaucracy. ..."

IANAD, but I do care for my brother, who is a disabled schizophrenic man. As a layman, I'm all for people getting direct help from treating psychologists and/or psychiatrists, and you might just want to look in your local phone book for community mental health resources, clinics, or any local hospitals with mental health services, and try making an appointment to see a social worker or staff psychologist or psychiatrist. You could even approach local psychologists or psychiatrists in private practice directly, and see if any will provide you with initial diagnosis and care on a sliding scale, as salvia suggests.

Psych meds, however, may be another matter. It can take time for them to work, and sometimes, you have to go through several iterations, to find the best drug in a family of choices, and to get the right dosages. Many psych meds have significant side effects, and if you are honest with a prescriber about your stability in terms of living situation, lack of a job, lack of social contacts and related matters, few responsible doctors are going to want to try to medicate you on an outpatient basis. In your circumstances, if your condition is going to respond to medication, most psychologists/psychiatrists are going to want to go through the initial diagnosis and medication phases in a more controlled clinical setting, to be sure you don't have adverse reactions, and are likely to follow a medication schedule closely, in your regular life, on your own. Treating psychologists and psychiatrists are also always on the lookout for people trying to get prescriptions for drugs that they can then sell or barter on the street, so that's another big impediment to your idea of "a chat and meds, to go."

Next, many psych meds are comparatively expensive, particularly newer meds that are still on patent. So, in the event you do have a condition or conditions for which medications would be helpful, it's still useless for doctors to get you on those medications, if you won't be able to afford them, or have a means of getting them and the supervisory medical attention for on-going medication management that you'll need.

Start with NAMI, or the Yellow Pages, and try to find whatever community mental health resources are doing the basic intake and screening functions in your community. Get an appointment, and go. But don't be surprised if they don't see your plan for a few visits and a prescription as realistic about helping you. Try following any advice you get closely, instead of trying to get people who might help you, to only act in the ways you want them to act, based on your own ideas.

Any help you do get may come in very different forms from those you initially imagine. But as you say, you gotta start somewhere, soon.
posted by paulsc at 12:18 AM on October 7, 2009

You're right, we're not mind readers. I think many of us took your situation to be much more serious than it actually is (not to belittle your issues). Salvia is is right about the rent costs. Its even cheaper if you have 1-2 roommates, which in your financial situation you should absolutely do.

As someone who was looking for the exact same kind of "pause button" on life, the only other thing I will say on the matter is this...

I saw people, they didn't help. I got prescriptions, and they didn't help either, in fact they caused other issues that made me take myself off them. I ultimately prevailed over my issues by deep self-reflection and analysis, and the realization that, at the end of the day you can get all the treatment you want in the form of talking or pills, but they are just tools to help you. Ultimately, you are the only one who can "cure" yourself and it takes a massive amount of willpower and some time, but it can most certainly be done.

I went from being a complete wreck socially and performance-wise because I had crippling Social Anxiety Disorder to someone who began excelling at work, has recently struck out on a new business venture on my own (that requires me doing a LOT of relationship based selling), has a girlfriend of three years who I've lived with for two, and enough confidence to walk into any social situation. In fact, I'm frequently described as being very outgoing and social which I always chuckle at since I'm a total introvert.

I say this not to brag, just to show what can be done. Best of luck--and yes, you are that strong.
posted by Elminster24 at 10:23 PM on October 7, 2009

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