The psychological burden comes from the endless harassment and attempted scamming from the lenders. They don't just accept your IDR and let you quietly pay $60/mo forever. It's 20 years of endless threatening calls, "urgent notices," surprise debits that must be fought. They'll delay or outright "lose" your annual recertification paperwork every year, reverting you to to some outrageously high "default" plan.

Plus the threat that a hostile administration might come in and change who qualifies for IDR at any point, which just happened and is causing a massive spike in defaults.