The Cost of Not Going to Therapy

(And How to Make the Investment in Therapy Worth It)

Let’s talk about the number one reason you haven’t started therapy, or the reason you quit: the cost. "$150 an hour? $175? $250?" You see the numbers, and your brain immediately shuts down. It feels like an impossible luxury, an indulgent expense you could never justify when you have rent to pay, student loans breathing down your neck, and the price of groceries going through the roof.

Therapy, you conclude, is a service for the rich. A privilege you can’t afford.

That logic feels sound. It feels responsible. And it is completely and utterly wrong.

You are meticulously calculating the cost of the therapy session, but you have failed to calculate the astronomical, life-altering cost of not going. Your unmanaged anxiety, your unresolved trauma, your poor communication skills, and your self-sabotaging patterns are already costing you a fortune. They are quietly siphoning money, opportunity, and happiness out of your life every single day.

The question isn't whether you can afford to go to therapy. The question is whether you can afford to keep paying the exorbitant price of not going. It's time to stop thinking like a cheap consumer and start thinking like a savvy investor in the most important asset you will ever own: your own damn mind.

The Hidden Invoices: Calculating the Real Cost of Your Unmanaged Sh*t

Your unaddressed mental health issues are sending you hidden invoices every single month. Let's do a brutally honest audit of what they’re actually costing you.

1. The Career Cost: The "Anxiety Tax" on Your Ambition Think about your career. How has your impostor syndrome, your fear of conflict, or your anxiety held you back?

   1. That salary negotiation you were too scared to initiate? Cost: Potentially tens of thousands of dollars over your lifetime.

   2. That promotion you didn't apply for because you felt you weren't qualified? Cost: Lost income, career trajectory, and compounding retirement savings.

   3. That business idea you never launched because of your fear of failure? Cost: Infinite.

   4. The days you were so paralyzed by anxiety or burnout that your productivity plummeted? Cost: Missed opportunities and a reputation for being unreliable.

      This is the "stagnation tax"—the price you pay for letting your unmanaged mind keep you playing small. As we’ve discussed in posts like Invisible at Work?, your mindset is a direct driver of your professional success. A mind riddled with anxiety is a business running at a perpetual loss.

2. The Relationship Cost: The Price of Disconnection What is the line-item cost of poor communication, unresolved anger, or a crippling fear of intimacy?

   1. The Divorce Invoice: The average cost of a divorce in the U.S. can range from $15,000 to $30,000 in legal fees alone, not to mention the devastating financial impact of splitting assets and maintaining two households. It is the single greatest destroyer of wealth for most people. Learning how to communicate and connect—the core work of couples counseling and individual therapy—is a hell of a lot cheaper.

   2. The Friendship Toll: As we covered in I Don't Need Therapy; I Have Friends, using your friends as an emotional dumping ground leads to burnout and distance. The cost of losing a vital support system because you refused to get professional help is immeasurable.

   3. The Generational Debt: The unaddressed trauma and poor communication patterns you have are often passed down to your children. The cost of perpetuating that cycle is a legacy no one wants.

3. The Health Cost: The "Stress Surcharge" on Your Body Your mind and your body are not separate entities. Unmanaged mental health is a direct assault on your physical health, and it gets expensive.

   1. Chronic Stress: As a mountain of research confirms, chronic stress and the associated hormone, cortisol, are directly linked to some of the most expensive health crises in modern life: cardiovascular disease, type 2 diabetes, and autoimmune disorders.

   2. Unhealthy Coping Mechanisms: How much are you spending on your coping mechanisms? The nightly bottle of wine, the "retail therapy" spending sprees, the DoorDash orders when you’re too emotionally exhausted to cook. These aren’t just habits; they are expensive, ineffective substitutes for actually dealing with the root problem.

When you add it all up, that $150 therapy session doesn’t look like an expense. It looks like a bargain.

The Reframe: From a Frivolous Expense to a High-Yield Investment

Here’s the fundamental mindset shift you need to make.

• An expense is a sunk cost. It’s money you spend on something consumable, and then it’s gone.

• An investment is the allocation of a resource with the expectation of a future return.

Therapy is not an expense. Therapy is the single highest-return investment you can make in your entire life. The skills you acquire—emotional regulation, boundary setting, clear communication, cognitive reframing—don’t just solve one problem. They are a fundamental upgrade to your personal operating system. They pay dividends in every future salary negotiation, every difficult conversation with your partner, every stressful situation you face, and every parenting challenge you navigate, for the rest of your life.

As we explored in Therapy: Gym for Your Mind, this is about performance enhancement, not just damage control. You are investing in an asset that can never be taken away from you: a well-managed mind.

How to Make the Investment Worth It: A Strategic Spending Guide

Okay, you’re convinced it’s a good investment. But you still have to come up with the cash. Here’s how you approach it strategically to get the best possible ROI.

1. Don't Waste Money on a Bad Fit: The fastest way to waste money on therapy is to stick with a therapist who isn’t right for you. As we detailed in How to Interview Your Therapist, you must take control of the hiring process. A few hours spent vetting candidates is better than six months and thousands of dollars spent with the wrong one.

2. Leverage Your Insurance (If You Can) Navigating insurance is a nightmare, but it can be the key to affordability.

   • The Action: Call the mental health/behavioral health number on the back of your insurance card. Do not just look at their website. Ask them these specific questions:

     • "What is my in-network deductible and copay for outpatient mental health visits?"

     • "What are my out-of-network benefits? What percentage do you reimburse, and what is the process for submitting claims?" (Many people don’t realize they may be able to get partial reimbursement for therapists who don't directly take their insurance).

3. Explore High-Quality, Lower-Cost Options: If insurance isn't an option, you are not out of luck.

   • Open Path Psychotherapy Collective: This is a non-profit nationwide network of therapists who provide in-person and online therapy for a one-time membership fee at a steeply reduced rate (typically $40-$70 per session for individuals).

   • University Clinics: If you live near a university with a graduate program in psychology or social work, they often have community clinics where you can receive high-quality, supervised therapy from doctoral students for a very low cost. In Arizona, the University of Phoenix offers free counseling in-person in Phoenix and via telehealth.

   • Sliding-Scale Practices: Many private practices and therapists set aside a certain number of slots for clients who require a reduced fee based on their income. It never hurts to ask a therapist you like, "Do you have any sliding-scale availability?"

   • Try an Intern: As part of the practical experience for their graduate programs, most student counselors are required to do an internship at a community mental health center or private practice. Many practices offer these interns' services at dramatically reduced rates, while providing top-notch and well-supervised care.

4. Maximize Every Single Session: To get the best return on your investment, you have to be an active participant. As we covered in Therapy 'Doesn't Work?', show up with a clear goal, do the work between sessions, and be radically honest. Squeeze every drop of value out of every hour you pay for.

The narrative that you can't afford therapy is a comfortable lie that keeps you stuck. The truth is, you are already paying a heavy price for not going.

Look at the real invoices from your career, your relationships, and your health. Then decide which cost is higher. Investing in your mental health is the ultimate act of taking radical responsibility for your life. It is the most strategic, high-leverage decision you can make for your future. It's time to stop paying the anxiety tax and start investing in your own peace of mind.

References:

• American Psychological Association. (2021). Stress in America™: One Year Later, A New Wave of Pandemic Health Concerns. apa.org.

• Schoenbaum, M., et al. (2016). The costs of depression and the benefits of treatment in a US managed care plan. The Journal of clinical psychiatry, 77(6), 726-733.

• Gottman, J. M., & Levenson, R. W. (2000). The timing of divorce: Predicting when a couple will divorce over a 14-year period. Journal of Marriage and Family, 62(3), 737-745. (Gottman's work repeatedly demonstrates the high cost of failed communication).

• Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016). Scaling-up treatment of depression and anxiety: a global return on investment analysis. The Lancet Psychiatry, 3(5), 415-424.

• McConnell, S. (2018). The behavioral economics of health and health care. Routledge.