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Counting the Cost: Mental Health and Money

Wait a minute (or fifty), don’t people see a psychologist for issues like anxiety and anorexia? Depression and difficulty sleeping?  Relational problems and recovery from addiction? Sleep disturbance and stress?

What does money have to do with mental health?  As it turns out—a lot.  Money is emotional currency.  It serves as a canvas on which personality, emotion, and behavior are splashed. Thinking about money can crowd out sleep.  It can serve as a rope for relational tug-of-war. Tragically for some, the stress of their financial lives becomes a dangerous noose around their neck.

Erratic, expensive behaviors can be a direct or indirect symptom of some psychological diagnoses. 

  • Bipolar Disorder – When I am assessing for mania –  a class of behaviors common among people who suffer from Bipolar I or Bipolar II –  I specifically ask about examples of erratic spending habits and sprees of high-risk taking financial behaviors.  Psychological concerns can lead to significant impairment in judgment and decision-making.  When the regions of our brain that we call upon for reflective thinking are offline, manic mental money messes can happen fast.
  • Depression – An individual struggling with severe depressive symptoms may exhibit difficulty dragging him or herself out of bed  in the morning.  If you can’t muster the energy to walk out your door in the morning, it is difficult to get to work.  Usually, if you aren’t going to work, eventually an employer stops depositing dollars into your bank account on a regular basis. 
  • Eating Disorders –Individuals who struggle with Bulimia and Binge Eating Disorders are often truly living an existence of torture.  Frequently, individuals struggling with these diagnoses are regularly compelled to eat amounts of food in one sitting that far exceed what may be usually expected for one person at a particular time.  It’s more than a third bowl of Haagen-Daaz.  Some sufferers tearfully report to me during a 24-hour food recall the amount of food that would fill half of a large shopping cart.  Have you checked out lately?  This adds up fast. Suddenly, a sufferer has a sour stomach and panicked mind not only because of their full belly but also due the rapid rate at which he or she is emptying their bank account – literally – into their toilet bowl.
  • Alcohol and Substance Abuse – Going to work high or hung over?  It typically doesn’t bode well for a performance report.  Alcohol – even the stuff from the box – is not “cheap” when consumed in high volume.  Elicit substances are often a premium ticket and can come at exorbitant cost.  Addiction is insidious.  It demands obedience due born out of deep desperation.  It is one the most powerful, tragic forces of nature I have witnessed.  Addiction will drive people to prioritize liquid or pill over life. They may prioritize their spending on a substance above any number of needs required for basic survival:  food, shelter, clothing. In the throes of addiction someone can be willing to bankrupt and abandon relationships with family in pursuit of the next fix.

Financial stress itself can serve to activate and amplify certain psychological symptoms. The concept of “financial anxiety” has been trending recently.  While not a formal diagnosis, the focus in the current zeitgeist on the panicked psychology of  money and mind speaks to something significant:  we are living in a financially worried world.

It is not brand new information that financial fear can reach and rip deep into one’s psyche.  Rumination about former money regrets.  Fear about how to stay financially alive and afloat in the present.   Uncertainty about economic or employment future.  These are real, weighty money concerns that mentally bury many. 

When our brains perceive threat – real or imagined – they set into motion a system of responses designed to keep us alive and kicking.  Sometimes the level of financial anxiety someone holds is amplified by a cognitive thinking pattern coined “catastrophizing” – imagining, fearing, and bracing for “The Worst.”  There are other cases where the anxiety response is, in a sense, grounded in one’s economic reality.  It can be unsafe to have a foundation for the meeting of basic needs – food, shelter, clothing, -threatened by job loss or economic downturn.  Regardless of how reality-based a perceived threat may be, a state of financial panic can trigger fight, flight, or freeze reactions that do not serve a bottom line or overall sense of well-being.

What does money have to do with mental health?  As it turns out, everything. Understanding the complex interplay between currency and clinical concerns can help provide valuable insight for mental health and financial services professionals alike.  Recognizing how psychological concerns commonly play out in a person’s pocketbook can help shed valuable light on a client’s current circumstances.   In psychology and finance, there is shared language of calculating risk.  Unchecked mental health concerns must be accounted for in this equation.


June 23, 2020

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