What our communities carry, and how we can look out for one another, when we have been told to bury it down. September is National Suicide Prevention Month. For a lot of us, this is not an easy subject to bring up at the dinner table or at all. In many Latino households, we were raised to aguantarse, to push through, to keep the taboo things private, and sometimes told that they didn't exist. But silence has a cost, and we are not going to be silent for their sake. This month is a reminder that checking in on each other, and on ourselves, is one of the most protective things we can do. I want to be honest about where I am writing this from. I have never been suicidal. I have lived with depression, and I understand how heavy it can get, how the constant weight of it can start to feel unbearable. That experience is part of why I care about this. When you have felt even the edges of that darkness, you understand why someone might want it to stop. This is written with empathy, not distance. The numbers, and what they actually tell us It is easy to look at the topline data and assume our communities are not affected, along with the comments from our households. In 2022, Hispanic and Latino Americans were about 43% less likely to die by suicide than the U.S. population overall. According to the American Foundation for Suicide Prevention (AFSP), the largest private funder of suicide prevention research, there were 48,824 suicide deaths in the U.S. in 2024, at a rate of 13.7 per 100,000 people. And while suicide rates declined slightly for the non-Hispanic community between 2023 and 2024, they stayed unchanged for the Hispanic population. The longer trend is more concerning. Between 2018 and 2023, CDC data show suicide rates increased among Hispanic and Latino people, even as they decreased among white people. So the risk in our communities is not going down. It is rising. And the deaths are only part of the picture. In 2024, an estimated 14.3 million U.S. adults seriously thought about suicide, 4.6 million made a plan, and 2.2 million attempted. A few figures impacting the Latino community: Young Latinas are especially at risk. In 2023, Hispanic and Latina female high school students were 17% more likely than other U.S. female students to report attempting suicide in the past year. Latino men die at far higher rates. In 2020, the suicide death rate for Hispanic males was 4.4 times the rate for Hispanic women, a gap tied to the pressure to stay silent and self-reliant. Depression is a major driver. Latina women report depression at higher rates than Latino men, and depression is one of the conditions most associated with suicide risk. Why our households hide it Mental illness has long been treated as something to conceal in Latino families. It gets framed as weakness, as drama, as something you pray away or simply do not talk about. That stigma is not just cultural habit. It is reinforced by real barriers to getting help. The care gap is stark. In 2023, Hispanic adults were 60% less likely to have received mental health treatment than non-Hispanic white adults. In 2024, Hispanic and Latino adults were 28% less likely than U.S. adults overall to have received treatment in the past year. The problem is not that our communities struggle less. It is that we are far less likely to get help. The reasons stack on top of each other: language barriers and a shortage of Spanish-speaking providers, lack of health insurance, the cost of care, and a deep mistrust of institutions. When help does get sought, research shows Latinos are more likely to turn to religion, a primary care doctor, or a community organization than to a mental health professional. Immigrant families and the first generation Immigration adds its own layer. There is a well-documented pattern researchers call the immigrant paradox: foreign-born Latinos often have fewer mental health disorders than their U.S.-born children. As families become more acculturated, mental health can actually decline, as later generations navigate discrimination, loss of cultural identity, and the strain of living between two worlds. This shows up in suicide risk directly. Among Latino, Asian American, Pacific Islander, and Black youth, those born in the U.S. have a higher risk of suicidal thoughts and behaviors than first-generation immigrants. In other words, the pressure our parents carried does not disappear. It changes shape and lands on us. For mixed-status and undocumented families, the stress compounds. Everyday tasks like finding work, housing, and medical care carry uncertainty and risk. Fear of deportation keeps people from seeking care or from being fully honest about what they are going through. Family separation leaves lasting trauma, especially in children. These are not small stressors. They are chronic, and they wear people down. This crosses cultures This is not only a Latino story. The same forces of stigma, access, and disparity show up across minority communities, often in even sharper form. Native communities carry the heaviest burden. Non-Hispanic American Indian and Alaska Native people have consistently had the highest suicide rates of any group in the U.S. Rates are rising among Black Americans. Like Latino communities, Black Americans saw suicide rates increase between 2018 and 2023. The steepest recent climb is among Pacific Islanders. The suicide rate for Native Hawaiian and Pacific Islander males nearly doubled between 2018 and 2023. The through line is the same everywhere: where stigma is high and access is low, people suffer in silence and are less likely to survive it. Prevention works, and it is not complicated Here is the hopeful part. Suicide is preventable, and the things that help are within reach. AFSP, which was founded in 1987 by survivors of suicide loss and researchers, puts it simply: connection makes a difference. Getting help early is the single most important protective factor. Depression and anxiety are treatable. Therapy works. Medication works for many people. And connection itself is protective. What actually reduces risk: Treatment and early intervention. The sooner someone talks to a professional, the better the outcome. You do not have to be in crisis to reach out. Culturally rooted, bilingual care. Care that speaks your language and understands your background makes people far more likely to stay in it. Community and belonging. Our cultural values of familismo and confianza, family and trust, are protective when we let them include mental health. Reducing access to means and knowing the warning signs. Withdrawal, giving things away, sudden calm after a low period, talking about being a burden. Take these seriously. How to actually be there for someone A lot of people stay quiet because they are afraid of saying the wrong thing. Here is the truth: you do not need the perfect words, and you do not have to bring up suicide to help someone. Caring by simply being present is what matters most. Some ways to reach out: Just show up. Sit with them when they are not feeling good. You do not have to fix anything or even talk about it. Your presence tells them they are not alone. Ask simple, real questions. How are you, really? I have noticed you have seemed off, and I am here. Then listen without rushing to solve it. Do not minimize. Skip you have so much to live for or others have it worse. Try that sounds really heavy, and I am glad you told me. Offer something concrete. Bring food. Go on a walk. Sit and watch a movie. Small, steady gestures carry weight. Keep checking in. One text is good. A pattern of texts is better. Consistency says you matter to me, over and over. If you are worried they are in danger, ask directly and stay with them. Asking someone if they are thinking about suicide does not plant the idea. It gives them permission to be honest, and it helps them connect to support. If you are the one carrying it If you are reading this and you are the one who is struggling, you are not weak. You are not a burden. What you are feeling is real, and it can get better with support. Reaching out is not failure. It is one of the bravest and hardest things a person can do. Resources If you or someone you love is struggling, help is available, and much of it is free and confidential. You do not need insurance or a diagnosis to reach out. National 988 Suicide and Crisis Lifeline: Call or text 988, 24/7. For Spanish, call 988 and press 2, or text AYUDA to 988. Crisis Text Line: Text TALK to 741741 (or AYUDA al 741741 en español). American Foundation for Suicide Prevention: afsp.org offers resources for those at risk, survivors of suicide loss, and anyone supporting a loved one. NAMI HelpLine: Call 1-800-950-6264, or text 62640, for information and referrals (not a crisis line). Trevor Project (LGBTQ+ youth): Call 1-866-488-7386, or text START to 678-678, 24/7. Los Angeles County LA County Dept. of Mental Health Help Line: 1-800-854-7771, 24/7, in more than a dozen languages, for crisis support, screening, and referrals to services. Didi Hirsch Suicide Prevention Center: 1-877-727-4747, 24/7 crisis support (LA and Orange Counties). 211 LA County: Dial 2-1-1 for referrals to health, housing, and social services. Riverside and San Bernardino Counties (Inland Empire) Inland SoCal Crisis and Suicide Helpline: 951-686-HELP (4357), 24/7, free and confidential, bilingual, serving Riverside and San Bernardino Counties. Riverside County CARES Line: Call for screening and referrals to mental health and substance use services in English and Spanish. Riverside County also runs 24/7 Mental Health Urgent Care with no appointment needed, regardless of insurance or ability to pay. San Bernardino County Behavioral Health Access Unit: 1-888-743-1478, 24/7 crisis referrals. Crisis Walk-In Centers provide urgent mental health care to county residents. 211 / Inland SoCal United Way: Dial 2-1-1 for local resource referrals across the Inland Empire. Finding a therapist Getting into therapy can feel like the hardest step, so I have pulled together a list of therapists and mental health resources for LA County and the Riverside and San Bernardino area right here on the Educated Chola blog. It includes options for how to actually get started, whether you have insurance, Medi-Cal, or are paying out of pocket. Head to the page to find a provider near you. This September, checking in on each other is an act of amistad. Sanar en comunidad. We take care of our own by making space for the hard conversations, and sometimes just by sitting beside someone in the quiet. You are not alone. Sources American Foundation for Suicide Prevention (AFSP), Suicide Statistics, afsp.org/suicide-statistics (2024 data). U.S. Centers for Disease Control and Prevention (CDC), Suicide Data and Statistics; MMWR, Differences in Suicide Rates by Race and Ethnicity, 2018-2023. HHS Office of Minority Health, Mental and Behavioral Health - Hispanics/Latinos. Substance Abuse and Mental Health Services Administration (SAMHSA), 2024 National Survey on Drug Use and Health. NAMI, Hispanic/Latinx Immigrants and First-Generation Americans; scoping review on acculturation and suicide risk in minoritized youth (NCBI, PMC10366293). LA County Department of Mental Health; Riverside University Health System - Behavioral Health; San Bernardino County Department of Behavioral Health; Inland SoCal United Way.

This is me walking/ standing by leasing office of my apartment complex (see IG Reel). That's it. That's the whole video. No workout, no rush, just a normal walk in some workout clothes and by only having had walked there for a minute or two, and then waiting another minute - I'm dripping. Sweat running down my face like I just finished a class at the gym. It's been brutal out here; highs of 105 to 107 degrees, the kind of heat that makes the air feel thick, its humid, but also dry and even accounting for that, something about how much I've been sweating lately hasn't felt normal. It felt like too much, too fast, for a walk that short. I'm almost a month into taking Zoloft (sertraline) I think?, and its Hot AF! Okay, so is it the heat or is it the meds? Probably both, feeding off each other. But the research backs up what I suspected; SSRIs like Zoloft genuinely do mess with how your body sweats, independent of the weather. Antidepressant-induced sweating is common enough that it has its own name in the medical literature: drug-induced hyperhidrosis. The numbers from Zoloft's own FDA prescribing information: the actual data from the clinical trials used to get it approved, pooled across more than 5,000 patients, show hyperhidrosis in 7% of people on sertraline versus 3% on placebo, and nausea in 26% versus 12% on placebo. So both of these are real, measurable, more-than-double-placebo effects, not just a coincidence of a hot summer. So since I’ve been on SSRI’s or a version of them every summer since, I’ve been aware of this type of excess sweating. I've been on Prozac and Lexapro before, and this one, Zoloft, feels like it's made me sweat so much more than either of those did. The good thing is that it turns out that's not just in my head. A 2017 meta-analysis published in the journal Depression and Anxiety (Beyer et al.) specifically found that sertraline and paroxetine carry a higher risk of hyperhidrosis compared to other antidepressants like fluvoxamine and bupropion, and that a medication's affinity for the dopamine transporter is correlated with higher sweating risk. Nobody fully understands the exact mechanism, it's often described as "likely idiopathic," which is doctor-speak for "we see it happen, we're not 100% sure why", but the leading theory is that SSRIs interfere with the hypothalamus, which is the part of your brain that regulates body temperature and tells your sweat glands what to do. Why the heat makes it so much worse Kinda scarily, SSRIs and other antidepressants can actually impair your body's ability to regulate temperature at all, not just make you sweat more. That can look like hyperhidrosis (too much sweat) in some people, but in others it can flip to the opposite — not being able to sweat enough to cool down, which is even more dangerous in extreme heat. Healthline notes that this thermoregulation disruption can let core body temperature climb dangerously high, and combined with 105+ degree days, that raises real risk for heat exhaustion and heatstroke — not just discomfort. This is how I've been feeling. All I want to do is lay down. I'm drinking more water than normal, and I've had to seriously up my electrolyte intake because I can tell I'm sweating them out faster than I can replace them with water alone. I’ve had other health issues, that I think have happened as a result that are too TMI to share, but just use your imagination. If you're on an SSRI during a heatwave like this one, electrolytes, are not just a good idea, it's basically necessary — your body is working overtime to cool itself and losing salt and minerals along with all that water. If any of this sounds like you, talk to your doctor about it, especially with heat like this. There are real medical options — things like adjusting dosage, switching medications, or even a low-dose add-on medication to specifically manage the sweating — so you don't have to just white-knuckle it through summer. For me, I’ve decided that I will continue to take the Zoloft, just like I did the Prozac and the Lexapro before they crapped out on me. Yes, this blows, and yes I feel like poo. But my brain has never felt so much less like poo, than when I’ve taken my medication and I am not willing to trade that over this side effect. I’m sure if I had side effects that were intolerable I would reconsider but i’ll take the sweat for now. The other stuff nobody warns you about Sweating aside, a month in, I've been paying attention to everything else this medication is doing, and some of it lines up exactly with what the research says. The nausea — I had it hard for the first two weeks, and then it just kind of disappeared. That goes with what the FDA trial data above (26% vs. 12% on placebo), and clinically, nausea is consistently described as the single most common early Zoloft side effect, one that tends to fade within the first one to two weeks as your body adjusts. Honestly, it's one of the only side effects from any medication that's ever really gotten to me, and I still love this medication, so make of that what you will. The jaw and mouth clenching — this one's tricky for me to fully judge because I already clench my jaw regardless of medication, so I can't say for sure how much is the Zoloft versus how much is just me. It is documented, but the evidence is thin on it: the main source I found on sertraline specifically is a single case report in the Journal of Medical Case Reports, meaning it's one patient, not a large study, which found that sertraline was the most frequently flagged antidepressant for jaw clenching in a global drug-safety database, even though older research had suggested it was less associated with this than other SSRIs. So treat this one as "documented but not settled." The working theory is that boosting serotonin can indirectly suppress dopamine activity in a way that shows up as involuntary jaw movement. Again, for myself I do clench my jaw, but then again I take other medications that I know are also potentially not helping the situation, sooo we don’t know. Next. The vivid dreams — not wild, not scary, just vivid. Like actual conversations I can remember in detail, the kind where I could tell you what was said the next day like it really happened. That's textbook SSRI behavior. A 2001 sleep-lab study published in the Journal of Sleep Research (Pace-Schott et al.) found that SSRIs actually suppress how often people recall dreams, but when a dream does get remembered, it comes back more subjectively vivid and intense than dreams on no medication. That lines up almost exactly with what you're describing; not more dreams, just sharper ones. The mechanism is thought to be REM sleep suppression: SSRIs delay REM sleep, so when it finally happens it lands closer to when you wake up, which is when dreams are freshest and easiest to remember in detail. The crying thing — this is the one I find most interesting about myself right now. I can still cry, I'm not numb, but it feels more controlled than it used to, less like it's taking over me. That's a mild version of something called emotional blunting, and it's actually really common. A 2023 double-blind, placebo-controlled study out of Cambridge and Copenhagen, published in Neuropsychopharmacology (Langley et al.), found that healthy volunteers on escitalopram (a close cousin of sertraline) became less responsive to both positive and negative feedback after three weeks, and Cambridge's own research summary puts the real-world rate at 40–60% of people on SSRIs experiencing some degree of blunting. The theory isn't that the medication numbs you exactly, but that it dampens how strongly your brain responds to emotional ups and downs — both the good and the bad hit a little softer. For me, at this stage, that's actually felt more like relief than loss. Where I'm at Almost a month in, and between the sweating, the nausea that came and went, the jaw thing I can't fully separate from my own habits, the vivid dreams, and crying a little more on my own terms, it's a lot to hold at once. But I can genuinely feel like it's working, and that matters more to me than any of the rest of it. I feel calm, stable, and I feel like my anxiety, which anxiety is supposed to be a part of everyone, is at that ‘normal’ version I should have, then I will take it. If you're on an SSRI this summer and you've been feeling like you're sweating for no reason, or like the heat is hitting you harder than everyone around you, it's not just you and it's not just in your head, but also you have my empathy since I'm down for the count too. It's a real, documented thing, and it's worth a real conversation with your doctor — especially while it's still triple digits out here. I I promise it's just me walking to the mailbox and coming back looking like I ran a mile. This post shares my personal experience and general research and is not medical advice. If you're on an SSRI and struggling with side effects, especially heat-related ones, talk to your prescriber before making any changes. Sources Primary sources — FDA data and peer-reviewed studies: Zoloft (sertraline) FDA prescribing information — official clinical trial data, the strongest source in this post Beyer C, Cappetta K, Johnson JA, Bloch MH. Meta-analysis: Risk of hyperhidrosis with second-generation antidepressants. Depression and Anxiety, 2017. Pace-Schott EF, et al. SSRI treatment suppresses dream recall frequency but increases subjective dream intensity in normal subjects. Journal of Sleep Research, 2001. Langley C, et al. Chronic escitalopram in healthy volunteers has specific effects on reinforcement sensitivity. Neuropsychopharmacology, 2023. Case report: sertraline-induced bruxism — Journal of Medical Case Reports (peer-reviewed, but a single-patient case report, the weakest form of clinical evidence) Context and plain-language explainers — medically reviewed health sites, useful for background but not primary evidence: Scientists explain emotional 'blunting' caused by common antidepressants — University of Cambridge Antidepressants and Heat Intolerance — Healthline Managing psychotropic-induced hyperhidrosis — MDedge (a clinical news outlet for physicians, reporting on the Beyer study above) Consequence of Taking Antidepressants: Excessive Sweating — International Hyperhidrosis Society Zoloft (Sertraline) Side Effects to Expect in the First Week — Choosing Therapy SSRI Side Effects: Dealing with Vivid Dreams — Sleep.com

Real talk on finding a therapist who actually gets you: plus a bilingual guide to affordable online therapy, a la culturally relevant. Okay so this has happened to me more than once. And no; they didn't really leave me. I know that. But it always feels like it when I really like one. If you've ever gotten that email or that "I'm transitioning out of this practice" talk from a therapist you finally clicked with, you already know the specific little heartbreak I'm talking about. You did the work. You got comfortable. You said the hard stuff out loud. And now you have to start over with a stranger? Ugh. So let's talk about it, what to do now, how I search for a therapist, and the actual research I did this time around (with prices), because my deductible is not cute and maybe yours isn't either. First, let me take you back I had my first therapist when I came back from UC Santa Cruz. I basically dropped out, okay, withdrew, let's be technical, but hey, I still had a 3.5 GPA, so yay. Depressed but still did good. That was me. High Functioning Anxiety because that's how I do things. I was clearly not in a good state. I'd lost some weight and wasn't really eating, and when I did, it was mostly fruit just to stay alive. My lovely roommate at the time, Meagan, this little white girl from San Diego, would take me to the dining hall with her so we could go eat together. She was, and is, the best. We're not in contact anymore; things just drift apart. But I will never forget her. My first-ever roommate. Together we were the SoCal girls, totally different from each other, but we took care of each other. Anyway, I got back to LA after that and immediately started researching what I had to do to get back into the university system, all while still depressed. I enrolled at ELAC,[1] the local community college, and got into the EOPS program,[2] which helped me with financial aid and other resources. I'm pretty sure they're the ones who pointed me toward the therapist's office. I honestly can't fully recall but either way, I started seeing a therapist there. She was this little old Asian lady. I don't think she really understood me. But back in 2007–2008, when I was still scared of medication, the moment I heard her suggest it, I was suddenly "cured". I got my motivation right back, worked my way up, and eventually got into UCSD. (And yes, it was "free." I'm sure the government or the college was footing the bill somehow, but I wasn't paying out of pocket.) I'm laughing about it now, but honestly, that fear-based "motivation" was just survival mode. Whatever it took to keep moving. The one thing I've always asked for From then on, I kept going to therapy. My providers have mostly been white, and here's the one thing I have always requested: at least a woman. This applies to my medical providers too. Mind you, I didn't get to choose as a kid; my childhood doctor was a man, because that's what was available locally on Medi-Cal. But as an adult? It is so odd to me to have a male therapist. There isn't an ounce of me that wants to talk to a man about my issues, at least not a cis-gender straight man, let's be clear. Anything outside of that, I'm probably open to. But not that. And over the years, my list got longer and more specific. Now I also look for a therapist who understands: The first-gen experience: being the child of immigrants, carrying things our parents may not have had the language for.[3] The immigrant experience: my parents went through, not necessarily to have lived it, but to at least be able to reference and understand it.[4] The dynamics of a Latino household: or honestly any culturally rooted household. So much of it overlaps with Asian communities, or even Italian families, because of that shared Catholic upbringing and those same family qualities.[5] And while it's not always necessary, I think I just get lucky, they often end up speaking Spanish too. Why you need a list (Yes, YOU!) Here's what I wish someone had told me at the start: make a list of what you want in a provider. I never had this all written down when I first started. I figured it out the hard way, over years. I do this for my medical providers too: I request women, I read their backgrounds, what they practice, their family life, how they work. I just want to make sure what they're about sits right with me. Aim for a good provider, not just whoever's available. Like a male Ob/Gyn, heck no. No, thanks! Not for me. And I've been lucky in that. I haven't had to switch many of my providers or therapists. But I've had one or two I did switch, and that brings me to the other reason you might leave a provider (besides them leaving the practice): Sometimes they just... suck. I say this with love, but it's true. And this is exactly why I believe those of us who are people of color or anyone who carries a sense of a culture that's complex, need to have a list of what we want and actually request it. I remind myself all the time: the worst thing they can say, if it's the insurance, is NO. For any thing really, all that can be said is no. That's it. No is survivable. Ask anyway. The psychiatrist I left (and why) Let me tell you about the one I switched, because it's a good example of leaving for the right reason. I went in with an open mind, assuming this older white woman would know what she was doing. And at first, it was great. My Lexapro wasn't working as well anymore, so we needed something else. We landed on Wellbutrin. Now, funny thing I learned afterward, Wellbutrin isn't typically the go-to for people with anxiety.[6] But it worked fine for me. Still, I told her: hey, I feel like there's just this lingering anxiety. So she also gave me Buspar to take "as needed" when the anxiety hit. But here's the thing, for me, anxiety isn't an as-needed thing. It's just... there. It doesn't wait around for some big moment to show up. It's there in the background all day. So she increased my dose. And here's what I didn't know then but know now: different side effects can show up at different doses.[7] This turned out to be the first time I ever had a really bad reaction. From that Monday to Friday, I developed full-blown depression. By Thursday I decided to stop taking it entirely. It was that bad. When I finally met with her again, all she said was: "Okay, just take the Buspar as needed." And I just did not feel heard. Because, why would I take something multiple times a day if the anxiety is there all the time? It didn't make sense to me. Turns out my confusion was completely valid: Buspar (buspirone) genuinely isn't an as-needed medication. It has to be taken consistently, on a schedule, and it takes weeks of regular dosing to even start working, it does nothing for anxiety in the moment.[8] So my gut instinct of this doesn't make sense, was right the whole time. So I left. I felt some guilt, but I had to remind myself: this happens, and it's okay. And to be clear, I didn't leave because I had a bad side effect. I left because I didn't feel heard. Maybe another white woman provider could help me in the future, sure. But if I can, I'll reach for a culturally competent Latina woman first. That's that. Okay, now the actual research (with prices!) So here's where I'm at now. My deductible for Kaiser is so high that I'd probably meet it eventually just from paying for these therapy sessions, but it's not a normal little copay. It's $150 per session, not the $30 you hear "normal" people talk about. Sooooo. Since my therapist is leaving, I took it as an opportunity to research other platforms: including BetterHelp, which I'd actually used before and loved my therapist on. Unlike a lot of people's experiences, I had a great one. Again, it all depends on how and what you search for. So here's a bilingual guide to what's out there. Please still do your own research in case any info has changed: I'll do my best to keep it updated. But if you're like me and either can't afford it with insurance, or don't have insurance at all, here's what I found: 💗 What I found, platform by platform Rula — This is where my therapist is heading. It's $150 per session right now as self-pay. The pricing supposedly drops eventually, but I couldn't swing that initial intake session or the first several sessions it would take to get there. Not for me right now. Open Path Collective — Seems great! I did a search and the filters are good, the price is decent (one-time $65 membership, then roughly $40–70 a session). But personally, I didn't spot a provider I felt would be a great match for me, and I didn't see that many Latino options. Still worth a look for you. Sentio Counseling Center — I got excited on their site, then got sad: there's a waiting list that opens up in a few months. Amazing sliding-scale option (as low as $15), just not available to me right this second. BetterHelp — Where I've decided to go back to. My same therapist was still assigned and still active (!), and it's $120 a month for 2 video sessions, so about $60 a session, which works great for me affordability-wise. They have other options too (4-session plans and more) also at good prices. Talkspace — Different in that its packages include the ability to text your therapist. So if you've ever thought "I wish I could just message them" and you have an ongoing issue that might call for that, it could be a great fit. Pricing isn't awful: around $73/week for messaging, and about $115/week for video + messaging + workshops. Brightside — I did their assessment. Without insurance, it came out to $229/month for my anxiety, therapy only. That plan includes a personalized treatment plan, 1:1 video sessions, interactive lessons and practice, anytime messaging, and progress tracking. The one monthly subscription fee includes 4 therapy sessions. (With insurance, you're responsible for your copay/coinsurance/deductible and insurance covers the rest.) Therapy for Latinx & Latinx Therapy (directories) — I looked through both and found amazing therapists. Unfortunately, the cheapest ones without insurance were around $100. If I had affordable insurance, I would 1,000% reach out to any of them, that cultural awareness is everything. And here's a tip: they might be in your network when you look them up, so start here in case they take your insurance. And filter! Grow Therapy — Also loved it. Loved the providers, culturally competent, and I appreciated the cash-vs-insurance option. I think I found one as low as $75, which honestly isn't bad. But for now, I'm sticking with the therapist I found through BetterHelp, since she's Latina and affordable for me. 📄 Want the full side-by-side comparison? I put together a bilingual guide with every platform, out-of-pocket vs. insurance pricing, and the pros and cons of each. Here's a PDF guide, with these comparisons. Hope it helps! The takeaway Your therapist leaving isn't the end of the world, even if it feels like it in the moment. And sometimes you're the one who leaves, because you didn't feel heard, that's okay too. Either way, you get through it. So make your list. Figure out what you actually need in a provider and ask for it, out loud, every time. The worst they can say (if it's the insurance) is no, and no just means you keep looking. You deserve someone who gets you! Your culture, your language, where you come from, all of it. That isn't too much to ask for. That's just wanting to be understood, which honestly, shouldn't be that much to ask. 🌶️ Speaking of owning it... This blog is tied to our carefully-thought-out (and new to y'all!) "LOCA" papel picado sticker/print! 💐 Because let's be honest! Who hasn't been called a LOCA? Especially if you're on here reading this. 😉 We're taking the word back and wearing it proud, papel-picado style. 👉 Check out the shop / click here to grab your own LOCA sticker and own your LOCA-ness. With your Salud Mental in mind. 💗 — Educated Chola 📚 Notes & Sources The following back up the medical points mentioned above. This blog is a personal account, not medical advice — always talk to a licensed provider about your own treatment. Platform prices are current as of 2026, based on my own research, and subject to change — confirm directly with each platform before booking. 1. ELAC is East Los Angeles College, a public community college in Monterey Park serving the East LA area — one of the largest community colleges in California and part of the Los Angeles Community College District (LACCD). Community colleges like ELAC are a common (and affordable) re-entry point for students transferring into the UC and CSU systems. 2. EOPS stands for Extended Opportunity Programs and Services — a state-funded program offered at all California community colleges. It's designed to help low-income and educationally disadvantaged students enroll, stay enrolled, and transfer, by providing "over and above" support: academic, career, and personal counseling, priority registration, book vouchers, tutoring, transfer assistance, and transfer application fee waivers, among other resources. Students who are single parents receiving public assistance can also access the linked CARE (Cooperative Agencies Resources for Education) program. Eligibility generally requires California residency (or AB540/Dream Act status), full-time enrollment, qualifying for the California College Promise Grant, and meeting an educational-disadvantage criterion such as being a first-generation college student. The personal-counseling piece is very likely how I got connected to therapy back then. Sources: California Community Colleges Chancellor's Office; icangotocollege.com; LACC EOPS. 3. On the first-gen experience and mental health: Research backs up how real this weight is. A systematic review of 62 studies found that first-generation college students experience heightened anxiety, depression, and stress — especially when the demands of school conflict with the interdependent, family-first values they were raised with (Journal of American College Health, 2025). A large national study using Healthy Minds data (192,202 students) found that even when first-gen students have the same level of symptoms as their peers, they use mental health services at significantly lower rates — pointing to real barriers like stigma, cost, and access (Kim et al., Journal of First-generation Student Success, 2023). Researchers also describe "family achievement guilt" — the specific guilt of moving beyond where your family started — as something first-gen students carry disproportionately. 4. On the immigrant/second-gen experience: The concept researchers use here is acculturative stress — the strain of navigating between your family's home culture and the culture you're growing up in. Meta-analytic research has linked acculturative stress to both depression and anxiety, and studies of the children of immigrants specifically connect it to depressive symptoms, self-esteem, and family dynamics (see the Children of Immigrants Longitudinal Study analyses, Journal of International Migration and Integration, 2024). A 2025 qualitative study focused directly on the intersection of first-year, first-generation, and second-generation immigrant identities, finding these overlapping identities compound mental-health challenges (Horne & Chukwuere, Healthcare, 2025). 5. On Latino household dynamics — and why they overlap with other cultures: The cultural value researchers most often study here is familismo (familism) — placing the family unit and its priorities above the individual. A systematic review found familismo generally acts as a protective factor against depression, suicide, and internalizing symptoms — a source of resilience (Valdivieso-Mora et al., Frontiers in Psychology, 2016). But it's complex: the same closeness can also produce parentification (kids taking on adult family roles) and guilt, which are linked to distress. And your instinct that it overlaps with Asian and Italian/Catholic families is well-founded — researchers frame these as interdependent or collectivist cultural orientations, a category that spans many immigrant and religious communities, not Latinos alone. That's exactly why a therapist doesn't have to be from your specific culture to "get it" — but they do need to understand interdependent family systems. Sources: Frontiers in Psychology (2016); Salud America; Journal of Child and Family Studies (2022). 6. Wellbutrin (bupropion) is FDA-approved primarily for depression, seasonal affective disorder, and smoking cessation — it is not typically a first-line treatment for anxiety, and some people experience increased anxiety as a side effect, especially early on or after a dose increase. That said, newer research is more mixed: a large comparative study found bupropion reduced anxiety about as well as SSRIs, so some providers do prescribe it when depression and anxiety occur together. Sources: Neuro Wellness Spa; Acibadem Health Library; Talkiatry; Medical News Today. 7. The likelihood of anxiety as a bupropion side effect increases at higher doses — patients on the maximum dose report anxiety more often than those on lower doses — which is why clinicians often start low and titrate slowly. Sources: Elevate Psychiatry; Ubie Health; Interborough. 8. Buspirone (Buspar) is not an "as-needed" medication. It must be taken consistently, usually 2–3 times a day, and typically requires 2–4 weeks (sometimes up to 4–6) of regular dosing before it works. It is not effective for acute anxiety or panic in the moment — unlike fast-acting medications. Missing doses reduces its effectiveness. Sources: Drugs.com; DrOracle; Ubie Health; Blossom Health; Philadelphia Integrative Psychiatry.