Mental Health is Too Expensive

Our country has a mental health crisis. So many people are diagnosed with one or more mental illnesses; many, many more go undiagnosed.

There is a stigma associated with asking for help with mental health. I’ve recently heard that I “should suck it up and get over myself”, and that I was a “wussie”. Thanks, dude, and I hope you never have to deal with what my mind serves up while unmedicated.

There are a lot of different medications out there, and it’s hard enough to ask for help. Then you go through trials of different drug cocktails and pharmaceutical concoctions and combinations of this, that and the other… And if you’re reasonably lucky, you’ll find something that works.

That’s me, right now. There is no shame in admitting I have a mental illness called depression with a handful of anxiety and a sprinkle of obsessive-compulsive disorder stirred in. I’ve tried several medications, and finally found one that soothes the savage beast in my head.

This stuff ain’t cheap. But, hey, since everyone is supposed to be insured, the insurance companies pick up most of it, right? Right?

Up until September 1, my insurance paid for all but $14 each month. I had no clue what the actual cost was; I never looked. But that was the day my employment changed. Same office, same pay, different company. Their health insurance was only a little more expensive than what I’d had before, but there was something else I had to take into consideration: My doctor wasn’t covered. Well… I could live without that, I’m an adult, but… My kids’ doctor wasn’t covered either. Um, hell no.

I went and found an individual policy that will cost about the same, maybe a little less monthly, when you figure that the company insurance was pre-tax. I can deal with that. Till I went to the pharmacy for my refill today and paid $168. Twelve times what I’ve been paying. And it will cost that until I hit my yearly deductible, which thank God is only $500.

But I started thinking… My mental illness is so minor compared to many. I only have to take one medication. What about those people who have to take multiples? Back when mine cost $14, my eldest child’s cost $60. I cannot imagine what it would cost now!

How can we do this to our fellow citizens? How can we expect the poor – who suffer from stress- and poverty-related depression at a much higher rate – to afford the very medications that keep them functioning members of society?

Medicaid isn’t the answer. I don’t qualify. I can “afford” this medication – for now; I’ll be seeing my doctor soon for a change. Hopefully whatever it is will work.

Thalia and Melpomene

Mental illness is a curse to those living it, and those who love them. It is a hardship in the worst sense; a disease that, although treatable, is lifelong.

You don’t “recover” from mental illness the way you might from, say, chicken pox or the measles – or even a cold. It’s with you, all the time, night and day, everywhere you go.

Some try self-medication, with alcohol, drugs, or even self-harm. Cutting is almost a cliché, now. When I was a teen, no one did things like that.

Some get help, through therapy, prescription medication, or both.

Some have caring people who notice something isn’t right and take action. Others hide the monster inside so well that others never see it.

Billy Joel sang, “Well we all have a face that we hide away forever; and we take them out, and show ourselves, when everyone has gone.” Isn’t that true? Doesn’t everyone have a private side? But for some of us, that private side is dark and lonely.

I’ve battled depression off and on for my entire life. I remember being “the crybaby” in early elementary; the “ugly” girl; and a klutz, on top of it all. I took inordinate pride in my brains – I was smarter than everyone, and I could prove it, because I was younger than anyone else in my class! Then I got glasses, and later, braces. I didn’t have a lot of money like most of the kids who went to school with me.

I became brash and outspoken to hide the shyness and fear, and that got me into trouble more than once. I tried to fit in by smoking, and cutting class (which didn’t happen often as I always felt guilty, thanks to that Catholic school beginning), and eventually by trying marijuana (which didn’t work, for me, thank goodness). I wrote a lot of dark poetry and cried a lot. I found out that I could feel loved and wanted, at least for a while, through sex; but of course I ended up pregnant. In retrospect, I was very blessed to not carry that pregnancy to term.

My parents were very, very worried about me. You see, they did want and love me, their only child. They took me to therapy, but unfortunately the therapist decided to focus on my father’s drinking as the cause of my depression. Perhaps that was a contributing factor, but it was not the cause. Neither was my parents’ separation when I was a toddler. The truth is, it runs in families, and I know for a fact that my maternal grandmother and paternal grandfather both were affected. Some of us are touched to a greater extent, and extenuating circumstances can make things easier or more difficult. I tend to believe that my parents’ unconditional love made mine easier.

I didn’t do cutting, but I did have “fights” with my hair. I had marks all over my arms from hitting my unworthy self with a brush.

I tried Zoloft for the first time as a young adult, and it had zero effect, so I threw it away. I drank a lot; frilly, colorful, sweet drinks, because I couldn’t deal with the taste. Later I “graduated” to shots of tequila. But I never had a rock bottom… I am too much “Type A” personality and I do not like being out of control. I still know that two glasses of wine or one mixed drink is my limit – any more and I cannot and will not stop until I do something stupid (which, for me, in a strangely fortunate way, is usually cracking my knee or elbow and dissolving in tears on the kitchen floor). So, over time, I learned to limit myself. It’s quite literally been years since I was even tipsy, and well over a decade since the last time I was actually drunk.

I tried to quit smoking in my late twenties with the assistance of Wellbutrin. That was a miserable failure, as not only did I not quit smoking, but no one wanted to be around me – not even me. It wasn’t until I was 36 that my anxiety attacks and lashing out got to the point I asked for meds again. My doctor suggested Lexapro, and it was like a light switch. I liked myself again. But I stopped taking it to try to get pregnant through IVF. When the first round didn’t work, I was oddly calm, though needy. The second, resigned; and then, third time being the charm, I went through all the ups and downs of being pregnant, medication-free.

But then, after six weeks of crying every day, multiple times a day, and having rather graphic visions of making a mistake with my newborn, I asked my OB for help. I knew Zoloft and Wellbutrin wouldn’t help, and that Lexapro was great for me. Within a few days I was a completely different person again.

I noticed a couple of months ago that I was starting to go off the rails again, and had gained a lot of weight. My doctor and I talked, and we switched me over to Cymbalta. I haven’t lost any weight, but I like my life better now.

I don’t think I will ever be completely medication-free again. I think off-and-on was a bad choice for me. I like the fact that I am taking a very small dose, and it’s helping so much. I’m okay with this.

Something I had noticed, though, is that my anxiety and depression spikes with stress. The antidepressants help, but they have to be on board already to tame that wild demon inside when it awakens from its slumber.

“I wanna hide the truth, I wanna shelter you; but with the beast inside, there’s nowhere we can hide.” (Imagine Dragons, “Demons”)

In memory of Robin McLaurin Williams, actor and great comedian, 1951-2014