Managing Money and Mental Wellness

by Mackenzie Stewart 

The hardest part about being low-income is the lack of access. Things like affordable housing, childcare, and, of course, healthcare are simply not in the budget. While a statement like, “Consult your doctor before trying xzy” may be well-intentioned, for someone like me, that simple direction wasn’t an option for a long time because of my income. 

Labeled and Low Income

I was diagnosed bipolar when I was 24. I’ve managed it with insurance and without. I’ve had to spend weeks shuffling paperwork back and forth only to be told I don’t qualify for coverage or my premiums are still more than I can afford. Coupling that with outrageous co-pay or cash prices for appointments and medication, treatment for mental illness is a straight-up luxury for a lot of people. 

Fluctuations in mental well-being is normal.

We all experience highs and lows in life. Situational anxiety and depression are totally normal. An emergency trip to the dentist is stressful. Starting a new job is stressful. All of these for a neurotypical person are taxing yet manageable, even with stress. Those of us that aren’t neurotypical or that have mental illness are literally not wired to respond that way. An already triggering event can kick off massive depressive or manic episodes when coupled with a lack of money to correct these situations. Trust me. I have lived it too many times. 

Mackenzie’s time in Hawaii was filled with ups, downs, and mental and financial hurdles.

Impact of Housing and Living Expenses on Mental Health

I have a distinct memory of this from my time living in Hawaii while uninsured and low-income. The house we were renting a room in was put up for sale, so we had to start looking for a new place to live. Hawaii, having one of the highest costs of living in the country, made our apartment search straight up traumatizing. Neither I nor my partner were making great money. We had less than 30 days to come up with deposits and rent. 

After a week of applying to places, Hawaii’s lack of affordable housing (especially because the housing market is mostly private owners, meaning they can add stipulations that remove many from qualifying and it’s legal) meant we would probably be living out of our van. It was a miracle we found a somewhat affordable place last minute, but that’s not the case for everyone. That all took its toll mentally. I dropped into a massive depression because I lacked access to therapists, and I couldn’t afford the $200 or $300 per session fees without insurance. I couldn’t afford to keep up with my medication because it was $100 for one month. Especially not when I needed to try and save for moving. 

Long-Term Impact of Financially Traumatic Events

That one experience still affects me today. I went through a period of hoarding money and being scared to spend anything. I’m afraid to rent a home in case it sells and we have to move suddenly. I’m afraid to switch jobs and lose my health insurance. I see vans while I’m driving and my first thought is how comfortable it would be to live in. And not because of cute van life aesthetics. I have more of these “quirks” and finally learned they have a name. Poverty trauma. 

Money Habits, Normal and Abnormal Reactions to Abnormal Situations

Some of you might scrape every little bit of toothpaste, shampoo, dish soap, etc. because you don’t want to waste anything. I know I’m extremely aware of food waste and others are also to the point of developing eating disorders or overbuying things like canned goods because we’re worried about where our next meal is coming from.  

How many of you put off things like doctor’s appointments because you don’t want to know if you have something expensive? It could be frugality, but it could also be something deeper. It looks different for everyone, but at the root of it, it’s the lack of financial stability that keeps us waiting for the other shoe to drop.

Mental illness rewires our brains to perceive certain events in a way that may or may not be true. Without access to consistent therapy or medication, we never get the chance to rewrite those stories even after the event has long passed. It’s been four years since I left Hawaii, and I still carry those financial traumas with me. This is why access to mental health services is so important as well as getting your money right.

Managing Money Better Improved my Mental Wellness

Working on my finances brought me a lot of “Ah-ha!” moments in regards to my mental health. The biggest one being my sense of security. Knowing I can cover an unexpected emergency, consistently pay my bills, and afford necessities removed stressors that can be roadblocks in treating my mental illness. It is extremely difficult to try to recover from a manic episode when you know you can’t afford a therapist, let alone groceries. We are forced to see treatment as a luxury when we know it’s a necessity. It’s frustrating and makes it harder and harder to get progress. 

In my years of experience managing money and mental illness, I learned some tricks to help with the lack of money and access to care that I share with everyone because I never want someone to feel as isolated and scared as I did. 

1) Local universities that have psychology programs usually have sliding scale clinics open to the public.

I’ve used this and currently, my father does too. Without insurance, I was paying $10 a session. Talking with someone half your age might sound weird, but they are professionals, and they have a whole team of licensed therapists to help review and suggest treatments.

2) Price shop for medications.

Medication is expensive. Currently, I’m on Lamotrigine that without insurance would be around $500 for a one-month supply. The expletives I have for this are unending. However, even without insurance, I can get a 90 day supply from Walmart for $10. Yes really. Places like Walmart and Costco offer low-cost meds and you can find lists for them on their website. You don’t need a Costco membership either. Apps like HoneyBee Health and GoodRX find coupons for all kinds of medications as well.  

3) Look for sliding scale clinics in your area.

These will base your co-pay on your income. Some clinics may even offer multiple practices in one. This means having a primary doctor, psychologist, gynecologist, etc. all in the same building, which makes scheduling and charting a lot easier. 

Your financial situation doesn’t dictate how good of a person you are. It can, however, dictate how good you feel. Whether it’s about being able to go to therapy or having money to eat consistently, money and mental health go hand in hand. They both can make the other better or worse. These tips and tricks are nice, but they should not be the only accessible option low-income folks have to address mental health.


Mackenzie Stewart launched her site Life at 23k to fill a void for the people who can’t afford to invest or start an emergency fund. She wants to find and give financial advice that the underemployed minimum wage worker can use – not just those making great salaries with marketable degrees already.

You can find her on Instagram, Twitter and Facebook.

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