At the end of 2021, I paid $720 for the privilege of a psychiatrist telling me I have Obsessive Compulsive Disorder. This was a huge relief, particularly as the same compulsive, overthinking tendencies that led to the diagnosis had also convinced me that I was making it up. The psychiatrist pointed out this was exactly why I should accept his professional opinion and suggested I try a high dose of a common antidepressant I’d not tried before. It had been found to have anti-obsessive effects and, in his opinion, was a good option for me. After two and a half years of therapy, going sober, meditating twice a day and regularly exercising, it was the only thing I hadn’t yet tried.
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This is not normally the way it goes. When people are having serious mental health struggles and seeking support, medication is often the first and only port of call. But I was one of the lucky ones — this psychiatry session with someone new was a “luxury” I could now afford, as my parents had been funding the other therapy I’d needed since 2019.
A lot can be (and has been) said about the benefits of seeking mental health treatment, particularly therapy. But the fact that in-person treatment is so often inaccessible and unaffordable doesn’t seem to often factor into proclamations that people should “just go”. The ugly truth is that the best way to access meaningful support is generally to pay for it. Medicare support is limited. To access support you must be referred by your GP who will assess what, if anything, is the best course of treatment for you. That can include a prescription and a referral to a waiting list. For depression and anxiety there can be long, debilitating waits.
One in three psychologists in Australia are unable to see new clients and over 88% of psychologists have seen an increase in demand for services since the pandemic. 73.5% of psychologists in Australian metropolitan areas have a waiting list — and these are only expected to get worse.
Without treatment, as anyone who’s experienced a mental health crisis can tell you, the descent into a breakdown is precipitous. Though my OCD first showed signs in February of 2019, I didn’t seek any help until June that year. By then I couldn’t function without the looming fear of a panic attack and was in a constant state of debilitating terror. It was destabilising my relationship, jeopardising my career, and making day-to-day life unbearable. I couldn’t afford to not deal with it. The problem was I was making $53,000 a year (and would do so until 2022) and I was spending around 60% of my salary on rent and bills alone. When I called my work health insurance they told me they couldn’t help because this was a “pre-existing condition” (I had dealt with anorexia and depression in my early twenties). In June that year I went to my GP who prescribed me an antidepressant that had previously worked for me and put me on the Talking Therapies waiting list. That medication didn’t work, so I went through the withdrawal mid summer before trying another one. That did nothing for me either. I stayed at that GP and that address until June 2021 and never heard back about the waiting list.
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When I began therapy that year, paid for by my parents, I was lucky to find a therapist who really understood me from the first session. That, again, is a privilege. If we hadn’t clicked I would have had the luxury of trialling sessions with other therapists until I found the one that worked. This is another important and expensive part of finding mental health support that is particularly difficult for marginalised people – if you are disabled or dealing with intergenerational trauma or navigating your gender, it’s crucial to have support of someone who will actually support you rather than denying or exacerbating your struggles, and that is far from a given.
Because talking therapy is harder to come by, antidepressants, an option I came back to after exhausting every other avenue, become a first port of call. While my experience with my current medication has been life-changing, I do not attribute that to the medication alone. After trying two other different medications and giving them up in 2019, I had done the work to understand where my OCD was stemming from and how to quell spikes in anxiety. I was managing it and doing a good performance of being mentally well, but the panic was always lurking at the back of my mind. The medication let me remember what it felt like to live without the fear that any thought could trigger a relapse. It was a circuit breaker that solidified all the other work I’d done, rather than the solution itself.
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Antidepressants are fundamental to the Australia's mental health support system, with one in eight Australians prescribed antidepressants. Trial and error in finding the right one for you is not unique either: different people respond differently to medications. They can even stop working, a horrible experience jovially named “pooping out”. Going through withdrawal is part of finding the right treatment, not just the process of ending it. But guidance through withdrawal, like everything else, is hard to access. Paying for a psychiatrist to handhold you through that process is yet another luxury. And they work best when used as part of a wider course of treatment, not the only option.
People find it difficult to “admit” when they have benefitted from the “bank of mum and dad”, as it’s known. I find this to be insidious. Masking the fact that you have to be extremely lucky to have this support glosses over the fact you must be wealthy (either personally or generationally) to deal with a mental health crisis. It’s how you end up with campaigns that focus primarily on destigmatising mental ill health and a focus on platitudes over providing options for people to actually “talk to someone”.
Money gives you the opportunity to actually treat the condition rather than being given one solution and hoping it’s the one that works best. It allows you the space to invest in your long term wellbeing. I will always be grateful for that. But I do not “deserve” this more than anyone else. I can be a silly, spiteful person but I would not wish the agony of OCD on anyone. And yet, because of the current system, the way I found is often the only option.
If you or anyone you know is experiencing mental illness, please contact Lifeline (131 114) or Beyond Blue (1300 22 4636). Support is available 24/7.
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