I second that, I would suggest move to a larger city and get a job and therapist there (looks like the OP is from Germany, which I would personally prefer to US).
And regarding to life goals, wife and kids in particular, although I have decided not to have a family, so take my advice with a grain of salt, but I think there are many single mothers out there who would appreciate a stable and solid partner with 2nd income.
One thing to note is that while Germany is much better if you need social services, it's much easier to move between classes in the US. It's very hard to move up in German society without the right social circles which are also much more exclusive than in the US or London.
That said, while therapy is one thing(and very hard to find someone that actually helps you out of your misery instead of reinforcing it), I'd maybe suggest creating a fixed schedule. Some basic cardio sports at a fixed time and day once a week(if that is too much once every two weeks). Ideally a group practice that gives some social pressure. It's much harder to get out a tough spot when you're alone. Maybe a beginner Capoeira class. No real requirement to socially engage if you don't want to, but warms your heart nonetheless.
And maybe one usergroup of some sort once a month. No need to engage with people. Worst case, you just listen to some talks and get free Pizza.
One thing that's very important in Germany when getting help is to never EVER say that you have suicidal thoughts. The moment you do that you slide into a bracket out of the social system that you can never get out of on your own. Any doctor or psychologist may now force you to take medication or put you in the asylum whenever they chose.
>>One thing that's very important in Germany when getting help is to never EVER say that you have suicidal thoughts. The moment you do that you slide into a bracket out of the social system that you can never get out of on your own. Any doctor or psychologist may now force you to take medication or put you in the asylum whenever they chose.
That is terrifying. Those medications are mediocre in the long-term. If you have a problem with a side-effect and they deem it trivial, you may be forced to take a medicine for life. Some of the alternative approaches to medicine are proving far superior for moderate level depressions (which can still be suicidal ideation).
It's as terrifying as it is wrong. Nobody ever forces you to take meds or being put into an "asylum". ESPECIALLY in Germany. I have no idea where this idea comes from but it is not true at all
Disclaimer: I have two very close friends and one relative who struggled with suicidal thoughts. None of them were put on meds against their will, or put into an "asylum". There was staionary therapy though, sometimes multiple ones, but not against their will
It's shocking that people write that kind of misinformation and it is upvoted so highly at the same time. The threshold to be forcibly put into a closed psychiatry ward is enormously high.
Is therapy better in Germany? I live in Hamburg and the waiting list is more than a year for therapy. I was under the impression that it is somewhat faster in the US
When I lived in the UK they wouldn’t offer me even a waiting list
Go private if you can afford it. NHS therapy in the U.K. is basically impossible to get for most people, but there are many, many good professional therapists charging £40-£60/hour. Once a week or fortnight, it’s worth it.
Unfortunately I live in Germany now where private therapists are far more expensive than that. More like 100 to 200 an hour. When I eventually return to the UK I won’t bother with the NHS again
As I posted above, German public insurance is required to cover therapy if your GP prescribes it. So you can get private therapy covered if public therapists are too busy to take you.
The process is roughly like this:
* GP prescribes therapy.
* You call seven public therapists who are busy and note their information and when you called. There's a specific form for this.
* You find a private therapist that satisfies certain conditions (e.g. degree granted in Germany) that is a good fit for you, and your public insurance is obligated to pay for your care.
You can find therapist from other countries if you are comfortable speaking with them in english through video call. It may not provide the same experience but it might be better than the alternative which is no help.
I would check out eastern europe or Asia. They will cost around $15-25/hour.
Yes, you can easily find a meeting for the same week (maybe same day) in the US. The downside is the better ones are picky about taking insurance (i.e. you might have to pay 40% yourself and then submit the bill to your insurance company to get reimbursed the 60%) because most insurance companies pay really low rates for mental health. From what I've heard Aetna is the best.
Having worked in Germany's healthcare system, specifically in Hamburg, I can only see one trajectory. Worse. The policymakers are deeply corrupt and doing everything they can to squeeze more money out of patients.
You can book therapists online next week in the US, but they're not cheap.
> The policymakers are deeply corrupt and doing everything they can to squeeze more money out of patients.
The problem is more related to the problem of „fixed budgets“. Every health practitioner in Germany’s public health system receives a fixed quota of money per quarter. In regions with few doctors and therapists this means practitioners would operate on a loss if they accept too many patients. That’s why you wait forever for a doctor if you got bad luck.
It’s an effect similar to the case a private good is regulated to have a maximum price. This way politicians create a shortage of that good. You can have a public system where everybody is forced to have insurance (or receives welfare if one cannot afford it) but where healthcare prices are allowed to float more freely. But German policy makers rarely understand basic economics (or don’t care) — but they are acting on good intentions.
That being said: There was a time I needed to see a therapist (after getting through a divorce) and didn’t have any trouble finding a therapist around the corner within two weeks. Five hours were covered by public health care provider immediately, then the therapist had to write a proposal and another doctor had to sanction it as others described. The proposal was smoothly granted.
It's actually not just because of that and it's not as simple as "it's just because of fixed budgets". The fundamental problem just like with most places there is in fact corruption(there is a lot to talk about here actually), and a decades long misunderstanding of basic economics. I.e. until 2019, which is when I finally gave up on it, most people in leadership for decades fundamentally disagree that it's unsustainable that the budget is not balanced. I.e. the money that comes into KV's from insurance and the money that is being paid to doctors is not balanced.
First of all the fixed budget don't apply for everything, there are budgeting hierarchies. Radiology for example is not limited at all. First radiologists get paid whichever amount they want.
Second, when migrants flooded the healthcare system the following happened:
- The political leadership of Germany had a meeting with the political leadership of the healthcare system
- Due to the lack of technical competence on the side of the political leadership of the healthcare system they threw the migrants into a special accounting bucket. I think it was 4, but I don't fully remember
- The accounting bucket was chosen mainly because the custom made accounting system had been built over decade and most of the knowledge about it is either retired or dead and no political leader wants to invest in changing it, because nobody wants to be responsible if there is a problem with doctor payouts for one quarter during a migration.
- The leadership of the KVs were too scared to touch their own accounting system and as a result searched for an accounting bracket to dump migrants in.
- The only two states that were competent enough to build their own that is easy to change were Schleswig-Holstein and Bavaria.
- The migrants are outside of fixed budgets due to the special status are in, meaning that if a German retiree goes to the doctor the second time at the end of the month the doctor is not paid, but if an asylum seeker goes 10 times the doctor gets paid in full 10 ten times. It creates an imbalance in who certain doctors would like to treat.
During one of the sessions with the policymakers in Hamburg the leadership openly said that they would like it to be more like the dentist situation, where only basic care is covered and the rest is paid in private.
You have to understand that German retirement money can be as low as 40% of your last working salary, which is extremely low for most people and it's the lowest of all of western Europe. Although I imagine that after this whole evaporating European wealth for Ukraine the situation might end up looking even worse in other places of Europe.
The whole situation is completely avoided, but the political leadership has been systematically blocking attempts at solving the technical challenges. They have inherited a system that was built for a completely different demographic of Germany decades ago and have refused to reform it, because they are extremely scared that they would lose the support of the doctors that elect them.
I think the US has a stronger therapy culture. It reminds me of how in the US pain relief medicine is much more common, while in Germany a lot of people won’t even take paracetamol
Oh yeah definitely. In online US circles it often seems like almost every other person utilized therapy at some point, in Germany it’s pretty taboo, i.e. therapy is for the mentally ill. There are various euphemisms for totally-not-therapy therapy (e.g. coaching or supervision) in German because if you say you did or do therapy you instantly go in the loony bin.
That last bit probably applies to most countries, not just Germany. Though keep in mind that’s a judicial process triggered by doctors and enforced by police, most people killed by police are in that “bracket” and nobody gives a flying fuck about it.
Sorry, but the last bit is complete and utter bollocks. Never, ever don't mention this. Please delete this dangerous misinformation that might keep people from looking for help in times of need.
Parent appears to be giving a practical suggestion on how to literally survive in a society. If it is true that it flags you, then why would you qualify it as misinformation? For the record, I have almost no knowledge of how Germany healthcare works in that regard.
There is no flagging. Who should flag you, and where? I know quite some people that were in these situations, no one experienced any such consequences.
I mean I don't know why people keep saying it's too late to have kids if you're 43. You could have a 20 year old by age 65, which is the time you could retire and have them move out after they get a job.
Not sure why you've been downvoted. This is absolutely true.
I would however be careful equating having kids to being successful in life. At best, they can be a joy to have. At worst, they can be little sources of chaos and stress that you can pass your own worst traits to.
You could carefully choose an egg donor and a sperm donor who don't exhibit your bad traits. And then pay for someone else to raise the child. Dodge nature and nurture
Regarding the last point, that's shooting pretty low imo. Definitely a range of women out there between 25-35 who might be a catch, you just don't want to be desperate first.
And regarding to life goals, wife and kids in particular, although I have decided not to have a family, so take my advice with a grain of salt, but I think there are many single mothers out there who would appreciate a stable and solid partner with 2nd income.