Death by Insurance Company

We got a new insurance company at the beginning of the year. As a patient who has a mental illness I know full well how hard it is to actually get medications that you need. Maybe I should say, that help. See, there are tons of medications out there for us mentally interesting folks. It takes a long time for some people to get just the right med cocktail. Personally, I spent over five years trying this and that, mixed with this or that. We increased this, lowered that, took this one away, added that. Finally we got the right mix. I feel relatively sane and my brain is a bit less mushy than on previous cocktails.

Along comes the insurance company. “Ummm, sorry Mrs. Crazy but that medication is not on our formulary. You’ll have to find something else.” I try to explain to them how I’ve been on almost every medication and I’ve done a bunch of trial and error (mostly error) and this mix happens to be the only mix I’ve ever been on where I’m not a suicidal mess. “Ummmmm, sorry Mrs. Crazy, I don’t actually give a flying fuck what your quality of life is. You are a nothing, a nobody. You are crazy and we really don’t care if you live or die. You will take X medication or take a flying leap. Heck, take X medication and a flying leap for all I care. You suck.”

That’s not exactly how the conversation went but it was close enough.

See, the medication that works for me is a ridiculous price. It’s somewhere in the range of $500 a month for my mood stabilizer (and that’s the generic) and about $200 a month for my anti depressant (brand name). The generic anti depressant doesn’t work for me and according to a bunch of articles and studies it doesn’t work for a whole lot of people but the insurance companies still insists it does. And me being mentally ill makes me sound paranoid when I say, “it doesn’t work and you are trying to tell me it does.”

About paranoia, I have two things to say. First, it’s no where in my diagnosis that I suffer from it. And second, just because one is paranoid doesn’t mean that people aren’t out to get ‘em.

I talked to my psychiatric nurse about all this and she told me my best bet is to try and fill my prescriptions when it’s time. The pharmacy will deny me and then they will send some paperwork to her. At that time she will then try and fight the insurance company. She told me not to hold out hope she fights insurance companies everyday, for many other patients. She also told me in the mean time they can try different medications. I’m not going through another 5 years of this and that. Honestly, I’d rather take the chances of going crazy.

After my job as a case manager ended I spent a few months on unemployment looking for jobs. I also spent those months marathon running towards a total mental breakdown. I had a friend in a different, bigger city than me and we decided it would be a great time for me to pack up my stuff and move on up. I would go and spend a lot of time at her place applying for jobs and going on interviews. I also spent many an evening drinking, partying and getting rides home from total strangers. Each evening the girls got together to go out I would promise myself that when everyone else decided it was time to go home, I would as well. It never turned out that way. I would stay well past closing in a bar parking lot talking to people who I‘d only *known* for an hour. As the last few cars were pulling out of the parking lot I would ask any of the remaining people if I could catch a ride home with them. I had the address written on a piece of paper in my pocket because I hadn’t committed it to memory yet. I was in a city considered one of the most dangerous cities in Kansas, getting a ride home with strangers to a place that I couldn’t find. Yet somehow I lived to tell about it. I thank mania for that.

At this point in time I hadn’t even been diagnosed but looking back on it there is no other reason in the world I would have such disregard for my own safety. Mania can be the biggest, baddest ego boost ever. I honestly think the reason no one messed with me is because I believed so much in myself that I appeared intimidating to others. Plus, I was fun to be around and most folks probably hoped I would be back out the next night to entertain them again, and usually I was.

During the days I would interview for jobs. Believe it or not I got a few and I turned them down. Inside I knew I was on a train wreck heading for face to face combat with a demon. I knew who she was, I just hadn’t met her yet. I didn’t take any of those jobs because they involved being responsible for helping people and I knew, deep down inside, I was the one who was needing the help.

The only place I really knew that could help me was the place where I used to work as a case manager. My employment there did not end well (another story, another day). I don’t know what the final blow was but one day I walked back into that office and asked for help. I had a huge lump in my throat, I thought it was going to block my air passage and that I would gag and choke and die right there on the waiting room floor. I imagined my old boss smoking a cigar and dancing around in glee reveling in the fact that I had lost my mind.

I also knew the small strange details the folks on the other side of the therapist’s desk didn’t know. I knew I had to dress in a certain way because I knew the intake officer would comment on what I was wearing and how I looked in the intake notes. They would process my live body the way a mortician processes the dead.

I was assigned a Psychologist (talk therapy) and a Psychiatrist (medication) and the diagnosing fun began. I was first diagnosed with major depression and social anxiety. That’s a pretty harmless diagnosis. I came into contact with a few of those idiots that think you should just pull yourself up by the bootstraps but I quickly deleted them from my life. I have always had a hard time with ignorance, especially those who don’t even attempt to educate themselves about something that is affecting someone close to them. But yeah, depression and anxiety, not a bad diagnosis at all.

So, we spent a year talking about my issues, blah, blah, blah. I was still depressed and still found it very hard to leave my house. This was not a success.

We played around with different anti depressants. I wasn’t finding much relief with any of them. I think it was the fifth one we tried and after only a few hours I was cured!!!!! It felt magical. I was elated. This was my wonder drug and I no longer needed therapy. I was totally motivated to get things done. I decided I would write a book on mental illness. I was sure that I was the only person in the world who held the secrets to recovery. I needed to let others know they didn’t have to sit back and let the depression rule their lives.

I wanted newness. I wanted to cleanse my surroundings. I was free and I wanted rid of all old, stuffy, stuck energy. I began to clean, furiously clean. I dusted, polished and organized everything. I went to my friends houses to dust, polish and organize for them. I had to share this renewed energy with those I loved. I started to write in journals. I went to the art supply store and bought hundreds of dollars worth of painting supplies. Even though I had never shown an interest in being an artist I was convinced me and my oil painted stick figures could run circles around Salvador Dali. Please.

In fact no one could touch me in all my greatness. I didn’t need sleep so I could do the work of two people. I could be a writer and a painter. I could and I would.

I didn’t need the shrinks anymore. I was done and I planned on telling them this.

Things really didn’t go as planned when I arrived at the Doctors office. As I’ve already stated in a previous entry I was told I was bipolar and I refused to believe it because I had that darn degree in Psychology and had been a case manager. I was immune. Talk about ignorant, or delusional.

I was livid when I learned I was to be taken off this new wonder drug and put on something that was going to bring me “down a bit, level me out.” What? I couldn’t understand what the hell these people wanted from me. We had worked for over a year to lift me up and once I got there they wanted to bring me back down? What kind of psychobabble, nonsense, bullshit is that?

It was then I was introduced to Lithium. Some people have some crazy, romanticized idea about Lithium, especially people my age, people who were in that *generational angst/no one knows how we feel* period when Nirvanna exploded onto the scene. Ohhhh, Lithium, ohhhhhh, it must be such a cool drug if Kurt Cobain sings about it. I know for some Lithium has been a life saver, for me, it was the beginning of hell.

I often refer to myself as manic depressive or bipolar. I’m not awfully fond of bipolar because it sounds like bisexual polar bears and well, that’s not me, not that there‘s anything wrong with that though, heh. It also gives off the impression that there are two of me and that’s not it either. It’s not multiple personality disorder. I remember on date number three when I told my, now husband, that I was bipolar he said, “So, that’s like you have two personalities?” I was shocked he asked that, shocked he didn’t know what it meant. But then again I held a Psychology degree, worked in the mental health field and was exposed to mental illness, and those who knew about it, on a daily basis.

So, manic depression it is. Self explanatory, sometimes manic, sometimes depressed and sometimes both at the same time. That’s me.





I remember my junior year in college I was taking a class called Abnormal Psychology. On the first day the professor told us that as we learn about these illnesses we may sometimes find ourselves relating a bit with one or more of them. He told us that in no way should we diagnose ourselves, that all people have a few different quirky behaviors here and there and just because it’s mentioned in the Abnormal Psychology class or book doesn’t mean we have it. DO NOT DX YOURSELF! Big, loud, direct orders.

So when it came time to study manic depression (it had not yet been changed to bipolar) I felt a close relationship to it. For the first time in my life I thought, “Holy shit, that’s why I am the way I am.” I leaned over to my friend and I said in a whisper, “this is me.” She leaned back to me and sternly said, “Remember, do not diagnose yourself.” I let it go. I forgot about that moment for years until I was sitting in the Psychiatrists office and she said, “I think you have bipolar.” Of course my first reaction was, “I can’t be bipolar, I am a case manager.” She smiled and said it didn’t matter.

On my drive home I remembered that moment in college years ago when I had thought I was manic depressive.

I’d had other times where I believed my mental health was suspect. After graduation I got a job as a case manager in a partial hospitalization program. It was a day program for severe and persistently mentally ill adults. I remember being a “newbie” that fresh faced kid out of college who was there to change the world. I remember some of the clients looking at me like I was just some kid on step one of the professional psychiatric ladder and I wouldn’t be there in another year so why bother getting to know me. This really bugged me. I wasn’t in it for the money (there was none), I wasn’t in it to move up. I was there because I cared. I was there because the thought of people being unhappy made me sick to my stomach. I thought if I could change that then my life would have meaning.

I was in charge of a couple of groups/classes. One day we were sitting around trying to plan a fun event for the whole day program to enjoy. It was like party planning class. I was so excited and I had all these ideas of what we could celebrate and how we could decorate the place. I looked around at the faces of despair and sadness. I saw people who didn’t want to plan a party because they felt they had nothing to celebrate.

That day I put down the scissors and set aside the glue and I asked them if they'd mind talking about their illness with me. I asked them to treat me like a blank slate. I asked them to take away any preconceived ideas they had about me because I was young or had a degree. I asked them to teach me about them and the illness that they had. I wanted to know what it felt like, how it affected them. I needed to understand.

That was the day I realized I didn’t learn shit in college. No amount of reading some bloody Abnormal Psychology book did me any good.

I also learned another thing that day…we were a lot alike.