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In the Expensive Bay Area, Artists Navigate Unique Mental Health Challenges

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A music studio viewed from above. A man sits in a chair with a guitar and looks up.
The Housewarmers’ bandleader Ian Santillano says that the Bay Area’s high cost of living can exacerbate the unique pressures musicians face by virtue of their profession. (Courtesy of Ian Santillano)

“As a musician, it can be difficult to navigate a community stricken with mental health concerns,” says Sean Emmett Thompson, a 26-year-old singer and guitarist who lives in San Francisco.

Grueling tour schedules, financial ups and downs, performance anxiety, fear of failure—musicians face unique job pressures that can make them more prone to mental illness. A 2019 survey of nearly 1,500 independent musicians conducted by music distributor Record Union found that 73 percent of respondents struggled with anxiety and depression, and 33 percent grappled with panic attacks. Furthermore, a 2016 University of Westminster survey of 2,211 U.K. musicians found that respondents were three times more likely than the general population to become depressed.

While composing and playing music can be therapeutic, trying to turn that into a full-time career can be an occupational hazard. Performing music puts an artist’s talent on display, and while this is one way to garner fans, it makes artists vulnerable to the praise and rejection of others.

There are also issues of fair compensation: as one University of Westminster survey respondent shared, “A doctor doesn’t perform surgery for ‘exposure.’” Artists disclosed that poor pay, impostor syndrome and toxic working conditions had damaged their mental health.

These challenges are especially pronounced in the Bay Area, where high living costs make it nearly impossible for local artists to pursue their passion full time. And in a competitive industry, being pulled away from one’s art can cause feelings of insecurity and doubt to surface. Ian Santillano, a 23-year-old Bay Area musician and leader of the band The Housewarmers, says not having enough time to work on music can rattle his confidence.


“I get anxious, because I wonder if I am doing enough and if I’m truly a musician,” he says. At those times, impostor syndrome can set in—a dreadful feeling that’s amplified when Santillano scrolls through fellow artists’ Instagram feeds.

Thompson has faced similar struggles. “When I first moved to San Francisco, I could barely make ends meet,” he says. Like many artists, Thompson teaches music lessons and takes on side projects, but overworking can make it tricky to find a work-life balance. “I’ve had difficulty saying ‘no’ to projects for fear of losing out on an opportunity, which only creates more stress,” says the artist.

In the past, those stressors caused Thompson to become anxious and depressed, “When you’re distracted by other work responsibilities, composing music is hard,” he shares. Not being able to create new music feeds impostor syndrome, which can leave Thompson feeling aimless and inadequate. Despite those challenges, he’s never seen a mental health professional. “Once I’m financially stable, I hope to address my mental health needs in therapy,” Thompson adds.

Sean Thompson (center). (Courtesy of the artist)

While many artists battle with mental illness, the latest survey results suggest that only 40 percent of suffering musicians received mental health care, while over 50 percent turned to alcohol and drugs to numb their pain, which isn’t uncommon for people with mental illness.

“I couldn’t see the wonder in the world,” recalls Oliver Blank, 37, a Bay Area artist and composer. Last year, Blank’s long-term relationship ended, and his intense grief caused his creative drive to dwindle.

At that time, Blank was working on his podcast The One Who Got Away, which intimately depicts the lingering grief that travels with loss. For the podcast, Blank invited people from all over the world to call a phone number and leave a message for a lost loved one, or forgotten romance, answering just one question: “What would you say to the one who got away?”

Hearing other people’s grief-stricken stories amplified Blank’s suffering, which only intensified his sadness. “I didn’t want to die or to hurt myself, but I wanted to go to sleep for a very long time,” the artist explains.

Concerned friends encouraged Blank to talk to a therapist. He reached out for professional help, but initially, no one reached back. “The biggest issue was finding a therapist who would return my call,” says Blank.

For many people, navigating the mental healthcare system can be puzzling. Firstly, even with health coverage, high-deductible insurance plans require people to pay upfront for medical expenses, including psychotherapy, which can be costly. In the Bay Area, the economic boost brought on by the tech boom has driven up the cost of rent, food and psychotherapy. As a result, therapy can cost anywhere between 140 and 300 dollars per session.

More affordable options are available, but finding the right type of help isn’t always straight forward. Websites like Better Help and Talkspace offer counseling online. While convenient, talking to a therapist online may not be ideal for people with acute mental health symptoms, such as panic attacks, thoughts of self-harm and severe depression.

For those seeking in-person mental health care, the non-profit organization Open Path Psychotherapy Collective provides affordable counseling services, and its fees range from 30 to 60 dollars per session. According to the website, over 300 therapists in the Bay Area provide mental health services through the Open Path network.

Psychotherapy training clinics staffed by graduate students and recent graduates also provide accessible care. For instance, in San Francisco, Center for Somatic Psychotherapy (CSP) offers sliding-scale psychotherapy services seven days a week, and therapy is provided by graduate students and recent graduates from the California Institute of Integral Studies (CIIS).

In addition to offering traditional talk therapy, CSP therapists promote self-awareness and stress reduction by helping clients connect with the mind, body and spirit, says Steuart Gold, the CSP clinic director. “Somatic therapy encourages accessing the wisdom of the body and creates conditions where one’s creative self can live its fullest expression,” he explains. With this focus, Gold says musicians and artists often benefit from somatic psychotherapy.

Even though it took many phone calls, Blank eventually found a therapist. “My therapist diagnosed me with depression and told me I was experiencing suicidal ideation,” he shares. Receiving a diagnosis helped Blank understand the nature of his pain, which aided in the healing process. “I immediately felt relief,” he shares.


For now, Santillano and Thompson find emotional support by talking to their peers. Still, Thompson hopes to speak to a therapist in the near future, “I believe therapy can help me pinpoint things that I haven’t been able to put together for myself,” he says.

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