How my untreated bipolar disorder led to a $45,000 medical bill

“We need to start discussing dentures.”

I had 19 teeth at the time. One tooth—my only molar—had grown an abscess dangerously close to entering my bloodstream and going septic. I had ignored it for over two and a half years. Finally, I couldn’t ignore the problem anymore because now it could kill me.

Doubled over with my face in my hands, I was overcome with a wave of grief. My fiancé sat beside me, asking the questions that wouldn’t come out of my mouth. “How much will it cost? When does this need to be done? What causes a healthy young woman to lose her teeth at 23 years old?”

It wasn’t an easy question, but I already knew the answer.

My untreated Bipolar II disorder consumed my life.

Mental illness manifests differently for everyone, and I culled mine internally. Many days I fought to move out of bed, let alone comb my hair or brush my teeth. I drank soda like water to calm my nerves. This caused a lifetime of neglect to my body, and it had finally shown up to haunt me.

“Tomorrow, I’ll do a better job brushing. Tomorrow, I’ll start eating better. Tomorrow, I’ll take care of myself.” It was easy to lie to myself. Mental illness can’t be cured by time, only managed, but I had just done a terrible job of managing mine. While I carried a diagnosis and considered myself to be a mental health advocate, I quietly shirked treatment for years. My teeth were the collateral.

The infected tooth was pulled immediately to prevent further infection, but it left behind a glaring problem. With the only molar out of my mouth, I had no teeth left with which to chew. My remaining 18 teeth were severely decayed, and the question became, what happens now?

The dentist mapped out an extensive game-plan for my mouth. The salvageable teeth would be repaired in order to create a foundation for a piece called a partial denture. The replica looked like a retainer with pink plastic gums and mounds of teeth on either side. It was mobile and would snap into my mouth to replace the missing teeth on the bottom.

The teeth on the top would likely be extracted to make room for denture implants, also known as an All-On-Four. The price tag added up to a whopping $45,000.

Hearing that number struck me hard. It was double my yearly income, double the cost of my car, and enough for a down payment on a house. I bristled over logistics. Despite insurance, family, and resources that would help me, the astronomical cost made the guilt I felt undeniable. I wanted to flee the office and forget the plan entirely.

Despite my inner battle, my family, friends, and work surrounded me with love. Their support showed me the error in my thinking. I was immeasurably lucky to have the help and resources that I’d been given. I took a deep breath and questioned what made me feel so ashamed. Being transparent about my mental health had always helped me find my people—were my teeth really any different?

The burst of encouragement led me down a path of research and showed me I was not alone. According to data from the Behavioral Risk Factor Surveillance System, a study conducted on U.S. adults showed that patients with depression were 20-30% more likely to lose all of their teeth than patients who didn’t suffer with the condition. Additionally, bipolar patients in the manic phase who overzealously brushed or flossed were faced with dental abrasions and gum lacerations. The popular consensus of every study I read was that untreated mental health conditions caused significant dental damage down the line.

While these facts were eye-opening, I still had work to do on my own.

The only way to combat the toll mental health takes on your body is to show up for yourself consistently.

Connecting the dots, it was abundantly clear that in addition to my dentist, I needed to schedule regular visits with my psychologist and psychiatrist to keep myself healthy. I found community in support groups online and in videos from fellow young survivors, like YouTuber Destiny Nicole. I just had to trust myself to commit.

Mental health and dental resources may seem like a luxury for only those who can afford it, but government grants and taxpayer-funded clinics are set up around the country for this reason. No matter your socioeconomic background, you deserve to get the help and love you need. There are people who can help. Above everything else, it’s important to remember you are never alone.