Stress/sadness is overwhelming and I don't want to do something stupid

[VertexSquared]

I'm going to seek help because I've already signed up for medical insurance -- it'd be a waste not to leverage it.

 

The problem is that I don't know how to seek the *proper* help in an affordable way. Finances are part of my problem.

[hydorclops]

Plan to voice all your concerns as you navigate the mental health care system. Insist on reasonable answers to your questions.

 

Mental health care, as part of the medical care system, relies on evidence based theories and treatments. Physicists may scorn it, but it is scientific. Ask your care givers to explain how and why.

[sunshinegirl]

I think on some level I am afraid of seeking help. I don't want to be told that there is more wrong with me than I realized. Your cancer comment made my heart race -- I have an immense phobia of cancer because it's an uncontrollable thing that can seemingly strike anyone at any time, and I hate not being in control of my fate but I feel resigned to it. I am sorry to hear that you were diagnosed with cancer -- is it something you think will be treatable?

 

I feel like going to get help is going to cost me more than I can afford because the damages are so great. The stress of dealing with all this is crushing to me. I'm not against getting help, but the process of getting help is in itself stressful to me. Who do I talk to? Where do I go? What's a reasonable cost, if any? If I take meds, how do I know they're actually going to help and not cause some nasty side-effect somewhere or harm me down the line?

 

Listen to me on this: the not knowing is much, much worse than knowing what you're facing, in terms of what kind of help you need, how much it will cost, and what the side effects might be.

 

Until I had surgery and we knew exactly what type of cancer I had and whether it had spread, I lived the hell of not knowing if I was going to live or die within the next 5 years. My thoughts ran rampant, through every worst case scenario and nightmare you could imagine. I dreamt about saying goodbye to my husband, about him raising our (future) children alone, about him marrying someone else, about all the things I would never get to do in life. You can imagine the bitter taste in my mouth after finally, finally finding my life partner and then getting sucker punched 3 days before our wedding with the cancer diagnosis.

 

About six weeks later, after surgery, we got the pathology back on my tumor. I breathed a huge sigh of relief - because now at least I knew what I was dealing with, and we could put together a treatment plan. I felt so much more in control of my life again, and I could eliminate those fears that had been based on the much worse situations that I was (thankfully) not having to face myself. (As a side note, my cancer is very treatable and after radiation, I will have a low chance of recurrence though I will be monitored closely for years to come. I am lucky.)

 

You are going crazy with a million what-ifs and worries about how bad everything is and what it will cost...because right now you don't know.

 

The best thing you can do is use your medical insurance to see your doctor and relevant specialists to get a handle on what you need. You don't have to do everything at once; in fact you'll probably need to prioritize and space things out over time. You've lived this long without fixing anything, so presumably your physical health will not be at greater risk by making a longer-term plan to get whatever procedures and treatments you may need, in some priority order. That being said, I would still stay your emotional health needs attention ASAP - it should be a priority (IMO).

 

You're a smart person, Vertex. Use that brain of yours to gather as much information as possible about your medical/psychological needs, and then make a plan. You will have to advocate for yourself, as does anyone who has to interface with the medical community. It's a simple fact of life that no doctor or counselor is going to be perfectly aligned with your needs and concerns - hence, you need to speak up if you think you are not being appropriately treated. That's true of all of us, as I am learning first-hand.

[sunshinegirl]

I'm going to seek help because I've already signed up for medical insurance -- it'd be a waste not to leverage it.

 

The problem is that I don't know how to seek the *proper* help in an affordable way. Finances are part of my problem.

 

Great! Start by seeing your primary care physician. He/she can then help you sort out what additional specialists/help you need. Good luck!

[sweetjasmine]

The stress of dealing with all this is crushing to me. I'm not against getting help, but the process of getting help is in itself stressful to me.

 

Break it down into pieces. You're looking at all of it at the same time and then wondering, "What if it's actually worse than what I'm seeing?" That's enough to cause anxiety in anyone. Take it piece by piece, step by step. Pick something small and relatively easy to start with, like going to the dentist or your GP - something that you know you can do.

 

Who do I talk to? Where do I go? What's a reasonable cost, if any? If I take meds, how do I know they're actually going to help and not cause some nasty side-effect somewhere or harm me down the line?

 

Approach it like an assignment. Get a list of GPs that accept your insurance. Ask a GP for referrals and do your own research. Call offices, ask about costs, and compare them. As for meds, you might have to try a few before you find something that works for you. Ask about side-effects, but don't fixate on them. Express your concerns if your therapist suggests seeing a psychiatrist for a prescription and decide from there.

 

I'm tired of living this way and I want help, but how can I trust anyone is going to help me with my best interests in mind? Everyone ALWAYS lets me down. "Trust me" on this, "I'm an expert" at that, "I am doing this for your own good" over here. None of it ever seems to ring true, from my perspective. It feels like nobody really knows what they're doing and nobody really cares unless they have something to lose, themselves. I don't want to be "just another patient" if something goes wrong somewhere. I don't want to get iced out as the result of an inexorable stoicism that a doctor must uphold in order to maintain an equilibrium of performance and sanity.

 

Yes, I'm aware that my world view is likely heavily biased by PTSD and depression and anxiety. I recognize this -- but I also know that I'm intelligent and not going to buy into complete BS. It feels like I simply can't trust anyone to do anything anymore unless I do it myself.

 

This is something I would bring up right away with a therapist once you find one who you think might be helpful. Trust is important. You already understand, intellectually, that your perception is warped by your depression and anxiety, so you should keep in mind that it also affects your ability to detect BS. As you said, you're kind of scared and overwhelmed by the idea of getting professional help, so just understand that you're going to want to dismiss a lot of things as BS because it's easier to do that than face your anxieties.

[VertexSquared]

Listen to me on this: the not knowing is much, much worse than knowing what you're facing, in terms of what kind of help you need, how much it will cost, and what the side effects might be.

 

Until I had surgery and we knew exactly what type of cancer I had and whether it had spread, I lived the hell of not knowing if I was going to live or die within the next 5 years. My thoughts ran rampant, through every worst case scenario and nightmare you could imagine. I dreamt about saying goodbye to my husband, about him raising our (future) children alone, about him marrying someone else, about all the things I would never get to do in life. You can imagine the bitter taste in my mouth after finally, finally finding my life partner and then getting sucker punched 3 days before our wedding with the cancer diagnosis.

 

About six weeks later, after surgery, we got the pathology back on my tumor. I breathed a huge sigh of relief - because now at least I knew what I was dealing with, and we could put together a treatment plan. I felt so much more in control of my life again, and I could eliminate those fears that had been based on the much worse situations that I was (thankfully) not having to face myself. (As a side note, my cancer is very treatable and after radiation, I will have a low chance of recurrence though I will be monitored closely for years to come. I am lucky.)

 

You are going crazy with a million what-ifs and worries about how bad everything is and what it will cost...because right now you don't know.

 

The best thing you can do is use your medical insurance to see your doctor and relevant specialists to get a handle on what you need. You don't have to do everything at once; in fact you'll probably need to prioritize and space things out over time. You've lived this long without fixing anything, so presumably your physical health will not be at greater risk by making a longer-term plan to get whatever procedures and treatments you may need, in some priority order. That being said, I would still stay your emotional health needs attention ASAP - it should be a priority (IMO).

 

You're a smart person, Vertex. Use that brain of yours to gather as much information as possible about your medical/psychological needs, and then make a plan. You will have to advocate for yourself, as does anyone who has to interface with the medical community. It's a simple fact of life that no doctor or counselor is going to be perfectly aligned with your needs and concerns - hence, you need to speak up if you think you are not being appropriately treated. That's true of all of us, as I am learning first-hand.

 

Thank you for this post. It makes me feel reassured.

 

As an aside though, congratulations on your wedding!

[VertexSquared]

Break it down into pieces. You're looking at all of it at the same time and then wondering, "What if it's actually worse than what I'm seeing?" That's enough to cause anxiety in anyone. Take it piece by piece, step by step. Pick something small and relatively easy to start with, like going to the dentist or your GP - something that you know you can do.

 

I think this is a good point. Sometimes I feel like everything is coming down at me all at once, and I'm not sure how to modularize it. I think if I can chip away the easy stuff first, I can then work on the more difficult things. The worry is that something will go wrong at each stage. Even at the dentist, if I am getting my teeth cleaned or something I worry that the dentist will slip and cut my gums or break/knock out a tooth or something, especially if it's plaque/tartar removal or something.

[elaina]

Hello Vertex,

 

I'm sorry for what you're going through. You're not alone.

 

Frisky is right. Medicine can really help. Also, I've heard that sometimes it's good to "fake it till you make it". I guess that gets a person's mind off of the hurt they are experiencing and puts it on something else. For me when I'm sad or when I'm not, it really helps to be involved in the community and helping others. If I focus on negative things, it just brings me down, but if I focus on helping others, that helps a lot, because it is fulfilling to see others doing well, you know?

 

Hope you feel better soon, and please know what you're going through is a part of life, but you can overcome it!

 

Sweet Jasmine, that's great advice! (Just read what you wrote too)

Edited December 14, 2010 by elaina

[eerie_reverie]

I know you don't like me V, because I've been nasty to you, but for what's it's worth, I've been in the same place as you with the medical stuff. I know it's stressful, but most of the stress is in not knowing.

 

 

When I started working, it had been about 10 years since I'd gotten a dental checkup or a physical. I was afraid I would go to the doctor and be told I have cancer and multiple STD's. I was afraid the dentist would find all my teeth had rotted away past repair. I was so scared about the condition of my health, I literally felt like my body was decaying. Having a high deductible insurance plan, I was also concerned about finances.

 

Eventually, I made an appointment with a GP, and it turned out, I was pretty healthy. The decay I felt was mostly all in my head. The GP did find a tumor, but it was benign (~$400 to confirm this). She also suggested I get some cancerous-looking moles removed and biopsied (~$100).

 

I did have a mouth full of cavities, but nothing as bad as imagined. (~$300).

 

A year later, I am also seeing a psychiatrist, and have recently started taking some meds for ADD which so far seem promising. I feel so much better knowing I'm not a ****-show anymore, physically or emotionally, which, believe me, I was just a few years ago.

 

You should research your benefits. If you have an HMO, going to a doctor will likely only cost you the co-pay.

 

Even with a high-deductible PPO plan like mine, your company has likely contributed some money to your health savings account, and if your costs go above your deductible in a given year, you are probably 100% covered.

 

If you have a high deduc PPO, and you think you are going to exceed the deductible, it might make sense to start using your benefits next year, and just go crazy.

 

Before you reach the deductible, your insurance company likely covers a certain percentage of each procedue according to a pre-determined fee schedule, and "preventive medicine" is likely 100% covered (checkup, bloodwork, etc).

 

If you are concerned about saving money, I woudl be upfront with the specialists so they don't prescribe unnecessarily expensive tests when a cheaper one would suffice. There is nothing wrong with knowing the costs of your health care. It doens't have to be a black box, you can choose to be an informed consumed.

 

Many companies also provide some mental health benefits, so I woudl also check into that. For example, I get 6 free visits to a shrink every year.

[sweetjasmine]

The worry is that something will go wrong at each stage. Even at the dentist, if I am getting my teeth cleaned or something I worry that the dentist will slip and cut my gums or break/knock out a tooth or something, especially if it's plaque/tartar removal or something.

 

Or you could trip over something tomorrow, fall flat on your face, and chip your tooth. But that doesn't prevent you from leaving the apartment and going to work, anyway.

 

A cleaning is about as basic as you can get. It's difficult to screw that up if you're a licensed professional who has been in practice for a while. I don't think it's even possible for a dentist to break or knock out a tooth during a routine cleaning unless that tooth is already dangling and ready to fall off on its own.

 

I hate going to the dentist, and the sensation of having a tooth drilled makes my muscles tense up even though I don't feel all that anxious, mentally. It's unpleasant, but you have to learn how to trust a professional who's doing his job.

 

As for the money, my family dentist has always been perfectly okay with setting up an informal monthly payment plan. My family never had dental insurance, so when one of us went and needed work done, my parents would then get monthly bills in the mail to slowly pay it off. Not everyone works that way, and in my experience, doctors are less likely to be that flexible, but it's another thing worth considering/asking about.

[VertexSquared]

This is the plan I am currently using as of Jan 2011

 

http://www.aetna.com/about-aetna-insurance/public-policy-perspectives/consumer-directed-health-care.html

 

Any insights?

 

$1100 deductible, $3k out of pocket maximum, coverage level of 80% after deductible for in-network.

 

I have no idea how this stuff works, to be honest. I have to pay for insurance and then spend $1100 plus copayments before they start covering stuff... but even then, only 80% of it. This is what makes my stomach lurch. There's no way I can spend that much even if I had problems adding up to those amounts.

 

Stuff like this makes me want to just give up. With my rent payments and student loans and retardedly high NYC costs... and, soon, rising MTA costs, I just can't afford this crap. I suspect I was better off NOT getting insurance.

Edited December 14, 2010 by VertexSquared

[sb129]

You have some serious trust issues mate!

 

I am a dentist, and trust me we are generally caring people with a high level of skill. We train for years to get to be able to practice. Most people are scared because they don't feel as if they are in control of what is happening to them, but a good dentist who listens to you will be able to tell you what they are doing as they do it, and if they have an intra oral camera they can show you on a screen what is happening in your mouth.

 

Word of mouth is as good as anything to find a dentist. Ask around- people talk, and if they have seen someone who is gentle and caring, thats a good recommendation.

 

Female dentists can be more empathetic and gentle, and if you are worried about someones experience, dentists in their 30s and 40s are generally the most qualified and up to date with the latest research.

 

As the others said- you can't control everything, and looking at the big picture is going to stress you out. Break it down into little manageable pieces, and take it from there.

 

Baby steps in the right direction are still going in the right direction.

[VertexSquared]

Please tell me I am not wasting my money.

 

I bought into the Consumer Directed Health Plan and a Comprehensive Dental Plan, which, altogether, costs about $940 per year before taxes.

 

If I am understanding this correctly, it means that on top of this $940 *just to enroll*, I have to pay up to $1100 out of my own pocket before the plan starts covering 80% of the costs after that.

 

So in other words, this plan seems to only be worth it unless getting my teeth cleaned/my health checked etc costs far more than $2000+ to me had I *not* bought into insurance?

[sb129]

I can't help you with that sorry, I am not in the US and the system there is totally different to what I am used to.

[eerie_reverie]

This is the plan I am currently using as of Jan 2011

 

http://www.aetna.com/about-aetna-insurance/public-policy-perspectives/consumer-directed-health-care.html

 

Any insights?

 

$1100 deductible, $3k out of pocket maximum, coverage level of 80% after deductible for in-network.

 

I have no idea how this stuff works, to be honest. I have to pay for insurance and then spend $1100 plus copayments before they start covering stuff... but even then, only 80% of it. This is what makes my stomach lurch. There's no way I can spend that much even if I had problems adding up to those amounts.

 

Stuff like this makes me want to just give up. With my rent payments and student loans and retardedly high NYC costs... and, soon, rising MTA costs, I just can't afford this crap. I suspect I was better off NOT getting insurance.

 

That is pretty much the same plan I have, and I am really happy with it.

 

First of all, preventative care is completely covered, so it would cost you NOTHING to get a physical, blood work, etc, probably a few hundred bucks worth of diagnostic procedures, etc. So, you have NO EXCUSE for not getting that done.

 

Secondly, I am guessing you have a health savings account in addition to this plan, to which you have been making payroll contributions, which are not taxed. I am guessing your employer also contributed to this account at the start of the year, so you have some money which you are SUPPOSED to use on health care saved up. You should figure out how much you have.

 

You are responsible for the first $1100 (but probably really the second $600 or so, since your company probably contributed to your HSA) then your insurance covers 80% until you have spent more than $3000, at which point they cover 100%.

 

Having insurance also means you also have access to a network, which has contracted with hospitals and doctors for discounts. So, you/ your insurance are goign to be charged for every procedure according to a fee schedule, which you can inquire about, and which is not arbitrary.

 

Re: the bold part, for an Ivy grad, you sure sound dumb sometimes. The point of INSURANCE is not to cover all your medical expenses as the American public tends to believe, but to financially protect you against catastrophic events. If you got into a car crash without insurance, you'd be financially fvked for life (as opposed to down 3G).

[VertexSquared]

Re: the bold part, for an Ivy grad, you sure sound dumb sometimes. The point of INSURANCE is not to cover all your medical expenses as the American public tends to believe, but to financially protect you against catastrophic events. If you got into a car crash without insurance, you'd be financially fvked for life (as opposed to down 3G).

 

It's not "dumb" because *I've never gone to the doctor before and therefore I have no clue how it works*. I understand quite well how insurance overall functions. The problem is whether or not I can actually afford the stuff. I don't want to be protected against catastrophic events (yet) because I've gotten good at avoiding those my whole life. I want any pre-existing crap to be taken care of as top priority. I really can't afford to pay out the nose for this stuff. If this insurance plan + all relevant costs are going to exceed the costs of what I would pay otherwise for what I am after, then it's a huge waste of money.

[eerie_reverie]

Please tell me I am not wasting my money.

 

I bought into the Consumer Directed Health Plan and a Comprehensive Dental Plan, which, altogether, costs about $940 per year before taxes.

 

If I am understanding this correctly, it means that on top of this $940 *just to enroll*, I have to pay up to $1100 out of my own pocket before the plan starts covering 80% of the costs after that.

 

So in other words, this plan seems to only be worth it unless getting my teeth cleaned/my health checked etc costs far more than $2000+ to me had I *not* bought into insurance?

 

The $940 for medical and dental sounds reasonable to me.

 

Remember, the MAIN point of insurance is to protect you against LARGE losses, not to pay your teeth cleaning bill.

 

If you needed heart surgery, or gave birth to premature twins, that would cost the insurance company hundreds of thousands of dollars. That is where your premium is coming from. You are paying for protection against large, unlikely losses, that would devastate you financially.

 

I am positive that your dental plan also covers preventative care, such as biannual cleanings.

 

(Insurance companies love for their insureds to use preventative care, because it saves them on big bills later.)

[VertexSquared]

The $940 for medical and dental sounds reasonable to me.

 

Remember, the MAIN point of insurance is to protect you against LARGE losses, not to pay your teeth cleaning bill.

 

If you needed heart surgery, or gave birth to premature twins, that would cost the insurance company hundreds of thousands of dollars. That is where your premium is coming from. You are paying for protection against large, unlikely losses, that would devastate you financially.

 

I am positive that your dental plan also covers preventative care, such as biannual cleanings.

 

(Insurance companies love for their insureds to use preventative care, because it saves them on big bills later.)

 

Right, but again, I'm not really concerned about the low-probability high-impact events. Maybe I am biased because I grew up with a lot of pain. But I feel like it's not worth wasting thousands over. I'd rather just pay for checkups. I want my teeth cleaned/stuff removed/any other issues resolved, and I want my blood/cholesterol/whatever else checked that normally gets performed. I just want to know my overall state of health and how to fix/improve it from this point forward.

[eerie_reverie]

It's not "dumb" because *I've never gone to the doctor before and therefore I have no clue how it works*. I understand quite well how insurance overall functions. The problem is whether or not I can actually afford the stuff. I don't want to be protected against catastrophic events (yet) because I've gotten good at avoiding those my whole life. I want any pre-existing crap to be taken care of as top priority. I really can't afford to pay out the nose for this stuff. If this insurance plan + all relevant costs are going to exceed the costs of what I would pay otherwise for what I am after, then it's a huge waste of money.

 

That is like saying, I have a zero percent chance of falling down the stairs, because I haven't fallen down yet.

 

IMO it is irresponsible not to have insurance, more so if you are educated and make above a certain income.

 

Yes, it's expensive, and thanks to the health reform act, costs are only going to rise, but think about all the stress you have from your loans. How are you going to feel if in addition to that, you owed $500,000 for medical expenses due to an accident??

[eerie_reverie]

Anyway, if you don't care about protection against huge losses, then yes, of course you are wasting your money.

 

But I would hope that by our age you are more responsible than that.

[NYCGirly]

Please tell me I am not wasting my money.

 

I bought into the Consumer Directed Health Plan and a Comprehensive Dental Plan, which, altogether, costs about $940 per year before taxes.

 

If I am understanding this correctly, it means that on top of this $940 *just to enroll*, I have to pay up to $1100 out of my own pocket before the plan starts covering 80% of the costs after that.

 

So in other words, this plan seems to only be worth it unless getting my teeth cleaned/my health checked etc costs far more than $2000+ to me had I *not* bought into insurance?

 

Hmm this sounds like pretty standard coverage. My deductible is only $500 but my plan costs about $1500 per year before taxes so it works out to the same thing really. Only difference is I have 100% coverage after my deductible. So if I were you I would probably talk to your health insurance provider to see if you can possibly up your monthly payments a bit so you get 100% coverage and a lower deductible.

[eerie_reverie]

Anyway, given all the info, my advice is:

 

1. Ask around about a good GP and dentist that are in your network. Perhaps ask your coworkers, as they are likely in the same network.

 

2. Schedule a physical and a cleaning, as those are free under your plan.

 

3. Figure out what your actual "pre-existing" conditions are.

 

4. Figure out if you have an HSA account, how much money is in it, and if it rolls over. (Ask your HR, or check the HSA Bank website, I believe that is the big one). Figure out if you have any mental health benefits.

 

5. Treat your conditions.

[sunshinegirl]

I have come to think of insurance as one of those necessary evils in life. You'd better believe I was happy as a clam to have had my health insurance policy in place when cancer struck. I barely needed it (health insurance) for years - maybe having an annual exam, but that's about it - and I grumbled about it for sure. (My annual premium was well over $3500 because I own my business - no employer to cover a portion of it.) Then I had a climbing injury, about a year ago, that required months of physical therapy...an MRI...and discussion of surgery for a torn labrum. Wouldn't have wanted to pay for all of that out of pocket. Then of course, the cancer. Genetic testing for cancer genes alone would have cost us nearly $4000 out of pocket, but my insurance paid for it.

 

I know you know this intellectually, and I am truly not trying to scare you, but sh*t can unexpectedly happen, and the day may well come when you are thankful to have your $1100 deductible policy in place.

 

If your financial situation is that bad, you might want to consider moving out of Manhattan, as others have suggested? Even saving a few hundred a month will add up over a year. In the meantime, I hope you take advantage of all of the free preventive care benefits you have. Spookie's post above is a good step-by-step guide.

Edited December 15, 2010 by sunshinegirl

[VertexSquared]

That is like saying, I have a zero percent chance of falling down the stairs, because I haven't fallen down yet.

 

IMO it is irresponsible not to have insurance, more so if you are educated and make above a certain income.

 

Yes, it's expensive, and thanks to the health reform act, costs are only going to rise, but think about all the stress you have from your loans. How are you going to feel if in addition to that, you owed $500,000 for medical expenses due to an accident??

 

I understand that marginal probability is largely, well, marginal. But it's a risk I'm willing to take because I know how I live, and I know that life is going to be much harder if I am wasting money on insurance I am almost certain I will never use. I'm not willing to go into huge debts over small probabilities. The chance of me getting into an accident is practically non-existent. I spend so much time at work, and I don't drive.

 

Besides, like I said, I already bought the insurance. I am just kicking myself because I know it'll almost certainly be a waste. That's another $1000 I can't use when things are already really tight. AND MTA is raising their rates.

Edited December 15, 2010 by VertexSquared

[VertexSquared]

I have come to think of insurance as one of those necessary evils in life. You'd better believe I was happy as a clam to have had my health insurance policy in place when cancer struck. I barely needed it (health insurance) for years - maybe having an annual exam, but that's about it - and I grumbled about it for sure. (My annual premium was well over $3500 because I own my business - no employer to cover a portion of it.) Then I had a climbing injury, about a year ago, that required months of physical therapy...an MRI...and discussion of surgery for a torn labrum. Wouldn't have wanted to pay for all of that out of pocket. Then of course, the cancer. Genetic testing for cancer genes alone would have cost us nearly $4000 out of pocket, but my insurance paid for it.

 

I know you know this intellectually, and I am truly not trying to scare you, but sh*t can unexpectedly happen, and the day may well come when you are thankful to have your $1100 deductible policy in place.

 

If your financial situation is that bad, you might want to consider moving out of Manhattan, as others have suggested? Even saving a few hundred a month will add up over a year. In the meantime, I hope you take advantage of all of the free preventive care benefits you have. Spookie's post above is a good step-by-step guide.

 

Yeah, but see, that insurance came into play because you were climbing to begin with. Your life was naturally "riskier" by this metric. I don't do anything that would result in physical injury like this. My free time is spent at the computer or with my girlfriend or with friends -- and we largely chill in the city.

 

And yes I am already planning on moving out on Manhattan, certainly -- but I can't do it until August, when my lease expires.