What Depression Is Actually Costing You (And Why We Never Calculate It)
January 7, 2026
The Real Cost of 'Too Expensive'
She sat across from me and said what I hear at least once a week: "I just can't afford TMS. It's too expensive."
I get it. The number feels big.
But then I asked her to walk me through the last three years. I meant the actual experience of living with treatment-resistant depression.
Six different antidepressants. Each one requiring 8-12 weeks to "see if it works." Do the math on that, over a year of her life spent waiting. Most didn't work. A couple made things worse.
Two years of therapy. Twice a week. Good therapy, actually. She understood her childhood, her patterns, her triggers. But understanding why you're depressed doesn't fix the neural pathways that aren't firing.
EMDR. Acupuncture. Functional medicine panels. A $6,000 wellness retreat in Costa Rica that gave her five peaceful days before the fog rolled back in.
We started adding it up. Rough numbers. Medication copays. Therapy sessions. The retreat. Time off work. The promotion she didn't pursue because she couldn't trust herself to show up consistently.
Somewhere around $30,000.
And she was still depressed.
"So the real question isn't whether you can afford treatment. It's how much longer you can afford to stay exactly where you are."
She cried.
Here's What Nobody Tells You About Cost
We're excellent at calculating upfront prices. We're terrible at calculating what it costs to do nothing.
I'm not just talking about money. I'm talking about the stuff that actually keeps you up at 3am when everyone's asleep and you're alone with your thoughts.
The cost of missing your daughter's volleyball tournament because you couldn't pull yourself out of bed.
The cost of being physically present in your marriage but emotionally checked out—until your spouse stops trying to reach you.
The cost of brain fog so thick at work that you're making mistakes you never would have made three years ago. And you know it. And you're terrified someone else will notice.
And you tell yourself it's fine, you're an introvert, you need space. But actually? You're just too exhausted to pretend you're okay.
That's the real expense.
Most people with treatment-resistant depression have tried everything. Multiple medications. Years of therapy. Lifestyle changes. Supplements. Meditation. Everything their doctors told them to do.
And they're still not better.
Not because they didn't try hard enough.
Not because they're "broken."
But because they've been undertreated.
Depression isn't always just a chemical imbalance you can medicate away. Often, it's a problem of neural connectivity.
Specific brain regions become underactive. Think of it like a highway where half the lanes are permanently closed. Traffic backs up. Everything slows down. You can't get where you need to go no matter how hard you try.
Medications try to work around this by flooding your system with neurotransmitters. Sometimes it helps. Often it doesn't. And even when it does, you're managing symptoms, not fixing the underlying circuit problem.
Transcranial Magnetic Stimulation (TMS) works differently. It doesn't medicate around the problem. It reactivates those dormant neural pathways. It's like re-opening the closed lanes so traffic can flow the way it's supposed to.
The research is clear. FDA-approved since 2008. This is established neuroscience that just isn't widely offered yet.
Because yes, TMS is an investment. I won't pretend it isn't.
Traditional TMS protocols require 30-40 sessions over 6-8 weeks. Daily appointments. Major time commitment. That's one of the barriers that kept effective treatment out of reach for busy professionals, parents, and anyone who couldn't take two months out of their life.
That's why we developed a different approach. Same science. Same total dose. One day instead of two months.
But here's the part that matters more than the protocol:
We don't think about treatment as a single transaction. We think about it as a year-long partnership.
Because here's what patients actually need—and what traditional mental health care almost never provides:
Not just the treatment itself, but ongoing support. Access to your doctor. Follow-up care. Someone who knows your story and checks in when things shift.
That's not how psychiatry works anymore. It's 15-minute med checks with a provider who barely remembers your name.
That's not healthcare. That's gatekeeping.
Let me ask you this:
What would it be worth to wake up in the morning without dread about the day ahead?
To be fully present when your kid tells you about their day—not forcing interest through the fog, but genuinely there?
To walk into a work meeting and trust your brain to perform the way you know it can?
To look in the mirror and recognize the person staring back at you?
To feel sharp again. Clear. Like yourself.
Not "less depressed." Not "managing." Actually alive.
One of my patients said it perfectly:
"I didn't even realize how much I'd lost until it came back."
That's what breaks my heart.
Not that depression is common, we know it is. Not that it's hard to treat.
What breaks my heart is how long people suffer when effective treatment exists. Right now. Today.
Here's the truth: Five years from now, you're going to look back on this moment. Either you'll think: "I'm so glad I finally did something different." Or you'll think: "I wish I hadn't waited so long."
The most expensive decision isn't investing in treatment that actually works. It's choosing to stay depressed for another year. Another five years. Another decade. That's a cost none of us can afford.
If you've tried everything and nothing's worked, you have every reason to be skeptical. I would be too. But skepticism shouldn't keep you stuck. You don't have to make any decisions right now. You don't have to commit to anything.
Just ask yourself this one question: How much longer am I willing to live like this?
What will the next five years look like if nothing changes?
Or what could they look like if you finally addressed the neural pathways that aren't working?
If this landed with you, share it with someone who needs to read it.
Your sister who keeps saying she's fine when you both know she's not.
Your friend who's been on medication after medication for years.
The colleague who shows up every day but you can tell is barely holding it together.
Sometimes people need permission to hope again. This is that permission.
Meet the Author
Dr. Georgine Nanos, MD, MPH
Founder of Kind Health Group
