For the past fifteen years, I have had these conditions. I am usually able to manage them effectively, but I cannot do this completely on my own. I have come to terms with needing medication to manage said conditions. I don’t like depending on something external to help me internally. But with medication, I feel normally. I am happy. I am sad. I am blissful and morose, passionate and angry, funny and free and sensitive and secure. I feel normal, or at least what I think must be normal for most people.
Without medication, feelings collapse upon me. It’s hard for me to describe, and I find that incredibly frustrating. It is usually easy for me to describe anything and everything with great detail and at great length. It is almost like going from 3D to 2D. An entire dimension flat-lines, making everything else shift to a single plane, all in shades of gray. With Zoloft (anti-depressant) and Buspar (anti-anxiety), I am capable of feeling and expressing a full range of emotion. Without, I exist in a dull, empty, state of being. I am a cardboard cutout of myself. Those words do not describe my condition – they describe me. Even worse, though, is how they define me.
This song is the best expression of depression that I’ve found. Here are some excerpts from the lyrics that I’ve found to be apropos:
How I die when I look at you smilin’
Lovin’ life and all I know is blue
Rainy days and cold stares, broken love affairs
Everything’s beautiful as long as I ain’t there
I guess I wasn’t meant to crack a smile
Who cares, I think I’ll go to sleep for a while nowI’m barely livin’ in my skin
Depression’s my only friend
And I don’t know where I am headed
Trying to forget where I’ve been
And I’m so sick of lyin’
God, please, show me that silver lining
Cause I’ve heard tales and I’m not well
My heads full of hell and this world’s a jail, butAnd it don’t matter and I don’t care
I let my pain into the air
Cause everything good’s over there
And everything here’s hard to bearAnd so they say that life’s a play
And that all the world’s a stage
And for another part I pray
The show ends the same way every day
And my heart carries the pain
Of a brain I can’t explain
Am I insane? Am I insane?And it don’t matter and I don’t care
I let my pain into the air
Cause everything good’s over there
And everything here’s hard to bear“It Don’t Matter” by Rehab, Southern Discomfort album, 10-24-2000
Right now, I am sans medicine and desperately struggling to stay above ground. To not go to the dark place. To retain my sense of hope, patience, optimism, acceptance. To be stronger than I feel. To get out of bed each morning. To sit at the computer. To accomplish something – anything. To not let myself get too hurt, take things too personally, or take on too much blame. Guilt and frustration are the poison that I’m trying to avoid. Everything good becomes something I am doing bad. My blog, for example. As of this morning it had over 85,000 hits. That completely blows my mind. It is my greatest recent accomplishment, and one of the things that I am most proud of in life.
But right now it feels like 85,000 people who I am letting down. I realize that number of hits doesn’t equal number of readers, BTW, but that’s how it feels to me. This amazing thing that I should be so proud of…it feels like evidence of my failure. I know this isn’t logical. I know it isn’t accurate. I can easily track my emotions and perceptions back to formative events from my childhood, chemical imbalances in my brain, and personal issues that I am trying to get over. I know where all of this comes from, but I can’t block the flow. As Christina Yang said once on Grey’s Anatomy:
Being aware of your crap and actually overcoming your crap are two very different things.
So, for now, I am aware of my crap and trying to overcome it. I don’t have my medication, though, and I’m not sure when I will be able to get it. I have to work an average of 30 hours a week to maintain health insurance through the marketing agency that assigns me to freelance positions. With my most recent endeavor done (a full website revamp with both optimized and brand new content – go me!) I have not been able to keep up this average. Cobra health insurance is, per the most recent paperwork I got from them, approximately $438 a month. That doesn’t really mesh well with the whole not being able to find work thing. I’m on unemployment, but the money coming in from that isn’t enough to cover $400+/month for health insurance. If things get worse, though, that might be my only option.
I’ve tried for individual health insurance outside of my employer. Thing is, most of the companies aren’t that keen on covering me. This is a large part of why I’m personally so grateful for the healthcare changes that Obama’s administration have put into effect. My mom has worked for the same HMO since before I was born, so I received comprehensive medical coverage literally from conception through my 26th birthday. The HMO was more than happy to diagnose me with medical conditions, and prescribe medication to treat those conditions. When I applied for coverage through them individually, though, that became a liability.
The rejection letter specifically noted three reasons, counted down here:
3. “Weight/height ratio” (This one I can’t fight with, as I am overweight and not trying to deny it. I will note that I was willing to pay a higher premium to accommodate that my weight may be indicative of more future health problems than a thinner individual might have. Unfortunately they wouldn’t offer me any coverage at any rate, even when I checked the box saying I would be interested in a higher priced plan if I did not qualify for a value priced plan. But I digress…)
2. “History of reproductive health issues” (I presume this is because I truthfully acknowledged on my application that, over 10 years ago, I struggled with irregular, painful periods. No matter that the problem has been managed since then with birth control pills.)
This one is my favorite:
1. “Medical conditions and the use of medications to treat said medical conditions”. (I can’t even deal with this. They’re the ones that diagnosed me with any medical conditions and prescribed-advised-required! said medications to treat said medical conditions, but now it’s their number one reason for rejecting me.)
Alright, so, with the usual health insurance options not panning out for me, I’ve been pursuing other options. This has happened to me before. It was a few years ago, when I turned 27 and aged out of eligibility on my mom’s work coverage health insurance. I (foolishly) thought I would be able to get individual coverage through them, so I didn’t sign up for work insurance during the last eligibility period. When I was rejected by every health insurance option I could find, I started to look into county resources. I did not want to do this and didn’t feel like it was fair. I wasn’t completely poor, and I wasn’t homeless, and I wasn’t suffering from the really bad mental health issues like schizophrenia or bi-polar disorder. I felt like other people needed – and maybe even deserved – help more than I did. But I also couldn’t find help anywhere else, and I couldn’t go on without it.
My middle ground positioning has made this process ridiculously difficult. I have somehow managed to be right along the edge of exclusion for nearly every option that I found, then and now. I was too old to be on my mom’s coverage, and too old to be covered by anything that helped uninsured kids and teenagers in California. Those made sense to me. Then I realized I was too young for many other options, as seniors are (thankfully) eligible for several Medi-Cal, Medicaid, etc, forms of assistance. If I had been pregnant or the mother of a small child, I could have qualified for WIC. If I had been a veteran, the government could have helped me (but I don’t think veterans get the mental health care they deserve, overall – more on that in a future post). If I had been homeless or had a lower income I could have gotten assistance through the county. If I had a higher income I could have paid out-of-pocket. Other programs specifically help minorities, immigrants, those without college degrees, those on welfare, etc, etc, etc.
I am glad that those options exist for those people. The vast majority of middle-income, American born, employed full-time, mostly healthy but somewhat chubby white girls with depression and anxiety probably don’t need help like I did. I guess I’m trying to say that my particular demographic isn’t, on average, in need of as much social assistance as some others. But I was. I am. And I don’t know what to do.
Last time I ended up going to the County Mental Health Services walk-in treatment center. I was scared of being there, and struck with an irrational fear that I would be institutionalized and taken away. Instead, I peed in a cup, explained that I’ve been stable on the same medication for 10+ years, and told the doctor about my supportive family and friends. He gave me my prescription, I filled it at Rite-Aid, and I was on my way. A bill came later, and I paid the few hundred dollars due for a single office visit. It was hard to get the money together, but it’s much easier to pay $300 one time than it is to pay it every month, no?
Now we’re up to present day. I’m out of medication, out of refills, out of insurance providers to be rejected from (again). I called all of the resources I could find, hoping that one would be a good fit. I spoke with the East County hospital, and they advised me to come to their walk in clinic. Unfortunately, they went on to explain that they only accepted new patients three days a week. On Tuesdays they took two new patients, and then three on Thursdays, and three on Fridays. No more. You are expected to show up before 8 am, and warned that you should allow one to five hours. Patients are not selected on a first come, first served basis. They are helped in order of need, much like a hospital ER. This is great for people who need help ASAP for major psychological problems. It is not great for me.
I am not suicidal. I am not considering harming myself or anyone else. I am not seeing things or hearing voices that aren’t actually there. I am cogent and non-delusional. These are all wonderful things, don’t get me wrong, but they’re also keeping me low on the priority list for medical assistance. The screening nurse told me to anticipate several weeks of showing up each day, waiting all day, but not being seen. I’m currently sharing a car with my mom, trying to find employment, and struggling to even make it out of bed each morning. The idea of basically taking a part-time job waiting at the county health clinic is more than I can handle.
I need medication now. I am not at the bad point, but I am desperately fighting the pull. I can not – and will not – exaggerate my symptoms for the sake of prompt service. I wouldn’t feel right about receiving help before someone who needed it more. I used to work at a suicide hotline, and beyond that, I’m generally not an asshole. Despite my being in a rough point, I still have more resources available to me than many others. Also, I’m completely terrified of being committed. But my main point is that I’m not going to fuck around with this because it really isn’t a game to be won. Everyone playing is just trying to hang in there until it’s their turn.
So, last Friday I went back to the emergency walk-in clinic. Their website outlined exactly what was available the last time I had been there. Their phone number was an automated system providing directions. I arrived and went through the security process, which involves relinquishing your purse, phone, keys, and pocket contents before entering. I was prepared to sit amongst those that could not find help anywhere else. I won’t lie – some of those people scare me. Maybe because they are the future that I’m most afraid of. They are bearing scars from slit wrists and yelling at invisible enemies and detoxing from hardcore drugs. The worst part, though, was the team of med school students brought through the lobby. I understand that they were learning from hands on experience, but it is really uncomfortable and upsetting to be discussed like a zoo animal without any acknowledgement that you are a real person. A sentient being who can hear what is being said, and see that people are writing down notes but refusing to make eye contact. Or, even worse, openly staring at the more obviously troubled among us. I was one of many trying to sink into our chairs to avoid notice.
Anyway, I was prepared for all of that, but the facility is different now. It’s an emergency clinic. Apparently my needs didn’t qualify as an emergency, because after the prerequisite peeing in a cup and waiting for an hour and talking to a doctor for another half hour, I was told that they didn’t do routine medication refills. Since I did not qualify as having a psychiatric emergency, they could not prescribe my medication. The doctor said they weren’t allowed to, because the county was trying to encourage patients to take advantage of resources in their neighborhoods and communities. That sucked, but they gave me a list of clinics to go through, and apologized profusely for their misleading website. Just find a clinic near your house, they said, and go there.
There were two East County resources on the list. The first was the one I had already been in contact with, so I called the second one. I explained my general circumstances and the receptionist said I had to come in for an evaluation before they could explain what options (if any) were available to me. So I drove from Point Loma to El Cajon, and spent two hours in the waiting room there. I did have pleasure of a 70-year-old man’s wedding proposal to entertain me, though. He announced to the entire office that he was looking for a wife, and he already had four girlfriends. But he just found out that one of them had a boyfriend, so he was letting her go and as such had a space open. I graciously declined, but who knows, I may have missed out on an awesome opportunity there. :)
When I’m finally called in to speak with a doctor, she looks over all of my paperwork, asks me the same questions they always ask, and takes notes as I tell my story. I know they have to do these routine diagnostic questions, but they drive me fucking nuts. Example: How does your depression make you feel? What I say: It makes me feel easily overwhelmed, completely unmotivated, and as though I have nothing of value to offer anyone or anything. What I want to say: My depression makes me feel fucking depressed, what do you think? And to answer your next question, my anxiety makes me feel – wait for it! – anxious. Who would have thought?
These are nice people, trying to help others, often for a shitty paycheck and no appreciation. So I am not rude to them. But in my head I am SO OVER IT. Especially because these appointments are all ending the same way – with someone informing me that they can’t help me. It’s always for a reason that was included on my intake forms, so I truly don’t know why I end up having to spend hours at each place. This last one, for example, put me through the rounds before telling me that I wasn’t in their eligible zip code. Nevermind that I told them my home address when I called for information. Nevermind that it’s the first fucking thing you see below my name on my forms. Nevermind that they totally wasted time that I need to spend at a location that CAN help me.
As it turns out, the only place that I can go is the goddamn walk-in T-Th-F East County clinic. I’m looking into other options today – sliding scale clinics or finding a part-time job just for the benefits or just paying out-of-pocket, if I can find a psychiatrist that I can afford. The most frustrating part is that I know exactly what I need. I do not need a new diagnosis, a new prescription, or just more time doing talk therapy. I need 200-300 mg of Zoloft and 20-40 mg of Buspar everyday. This has been my same prescription for over a decade. It varies only as much as my menstrual cycle – I take extra pills (per my doctor’s prescription – and that of every other doctor that has written me a prescription) the week before and the week of my period. I have dutifully tracked every symptom, every side effect, every measurable aspect that proves the efficacy of my treatment plan. Perhaps some of it is the placebo effect. Perhaps I have decided that these drugs help me, and therefore they do. Every way I look at it, though, leads to same result:
I need these medications. I don’t know how to get them. I’m trying to stay okay. I’m trying to stay me. So, friends and family, readers and (as my mom calls you) “blog hitters”, please be patient with me. And please know how much I truly value and appreciate you. I could not – would not – survive these conditions without you. It is the little things that you do that save me from myself. That help me to save myself. Finally, please know that there is so much more that I am trying to do. I want to be the daughter, sister, friend, blogger, that you all deserve. I’m trying to treat everyone as well as they have treated me. I’m trying to be there for you, even when I can’t be there for me.
Because these relationships are what define me. When I feel like I am defined by nothing more than those two words….Corina is depressed…Corina is anxious…my connections to you are what pull me through. I combat those titles by remembering that Corina is a daughter…a sister…an aunt (perhaps not biologically, but I sure do love my BFF’s little boy enough to qualify, in my opinion)…a granddaughter…a friend…and a writer. For right now, those definitions, those truly essential, elemental parts of me, are the only thing strong enough to keep the depression and anxiety at bay.