The cost of mental health meds

I don’t want to get political here, but I think this blog might be. How does anyone without insurance do this?

I’m temporarily without prescription insurance, and my psych doc phoned in some orders for meds that I don’t need to refill immediately. But I didn’t tell that to CVS, and the pharmacy filled them and sent me a text that the meds are ready for pickup. I looked up the prices on their app. Two that I take are name-brand, not yet available as generics. A 30-day supply of one of them is over $2900, and the other is over $800. That doesn’t include the ~$150 for each generic drug!

I’ll be able to afford my meds once my new insurance kicks in, so I’m not concerned for me. But I truly wonder about this for others – for those with less or on fixed incomes.

I have a couple of friends who don’t have the insurance to help offset the costs of their antidepressants. I’ve seen their tears of frustration as they struggle for mental health and feel defeated, which just adds to depression misery.

What about folks on a fixed income with reduced medical benefits? How are they supposed to pay for their mental health medications if insurance companies remove effective medications from their approved lists?

What about newer medications that are improvements over what’s currently available, but they aren’t the reduced price of a generic drug? Many people are denied access to those improved meds, simply because the cost is out of reach.

What’s the pharmaceutical companies’ responsibility in this? Their research takes years and costs gazillions of dollars to find formulas and get meds approved, but do they recoup those costs on the back of the ill? How should this really work, and be fair? How can we get mental health medicines to the people who need it, in an affordable and timely manner? I don’t have answers, am not pointing fingers to blame. I’m truly asking – how can this be affordable? Is it the PollyAnna in me that wants this to be equal and easy?

Am I Supposed To Write A Book?

In my last post, I mentioned writing a book. And I decided that I don’t need initials after my name to be an expert – particularly since it’s my story. Who knows it better than me, besides God? (“You saw me before I was born. Every day of my life was recorded in your book. Every moment was laid out before a single day had passed.” Psalms‬ ‭139:16‬ ‭NLT‬‬)

Ted first suggested it, many years ago. He said it during several of our therapy sessions. He thinks “I have a book in me.”

While living in Florida, my then-therapist Elizabeth told me that she, too, thinks I should write a book. She said it almost every time she saw me – that I should write it all down. And she’d buy it!

Carol and Anne and Stacy have been encouraging. So has Jane. Even Dad a little. I have support from several friends who think I could do it.

From where will I get my story? I began journaling consistently in March 2008 – right at the beginning of my depression journey. And I wrote lots! Some days I wrote several times throughout the hours, especially when I was in the depths of the darkness. How do I even begin to sort through them? I’ve developed a color-coding system with 3M sticky arrows, to highlight different entries I wrote that might be significant to outlining the book. Now to read through all 17 journals and flag them appropriately!

I also began to write email summaries of my appointments with Ted, often with questions for clarification, and I kept a copy of most of them. I wrote in Docs at work when I didn’t have my journal, so I have those notes. And finally, I joined WordPress to try blogging. Maybe I should print out these things and flag them as well.

I can add to this what I learned when I facilitated the depression support group at my old church. My friend advised when I shared with the attendees, I should simply start with my current situation. “Start with where you are.”

So, is that what I do if I want to write a book? Start with where I am now? Or start with the beginning of the journey? How will it be different from blogging? How do I know to whom I’m writing – who is my audience?

I’d like to write a memoir or devotional of the time of my life when I first experienced depression, up to present-day struggles. To explain to Christian women with depression (there’s my audience) that it’s possible to have hope in Christ in spite of having a mental illness. That I am not my depression – I’m a beloved daughter of the King, and so are they. I want to offer them this hope, as I found it in my journey through the desert of depression.

There are many tools and organizations available to me to help me write this book. A friend of mine just recently published his first book, and he recommended a writing program. Perhaps I’ll use one of those to keep me organized and on-task, and to give me regular feedback in the process. I took a one day writing workshop a few months ago – I need to get the workbook out and finish those exercises. They’ll help me be disciplined, too. Perhaps these tools can give me an idea of the order in which I tell my story.

No matter what, I think I know what my next adventure is. Let the writing begin!

What makes an expert?

I’ve been pondering the word “expert.” What makes someone an expert in an area? Could I be one? Do I need initials after my name to be considered particularly knowledgeable?

Merriam-Webster defines expert as: “having, involving, or displaying special skill or knowledge derived from training or experience.”

If experience is enough, then maybe I’m an expert in depression. I’ve lived with it for 10+ years. I’ve blogged about it for several years; indeed, the focus of my blog is being a Christ-follower who has depression. And I’ve read a lot about the subject, from textbooks to memoirs. I’ve started writing down my own story in a book draft.

Probably because this is an area of struggle for me, I find the topic of depression intriguing. I’m slowly building my personal library of books on the subject. My list of authors on my Book Buddy app who I’ve yet to read is 20+ titles. I regularly read several mental health blogs.

At my most recent appointment, my therapist asked me why I wasn’t a counselor. Funny thing… I’ve thought a lot about that. Way back in my early college years, I thought I wanted to be a psychologist. Then as I got tired of school, I decided getting a PhD was too much work, so I nixed the idea. But I’ve come back around, and am intrigued by her suggestion. I’ve spent the last couple of days researching online Master’s counseling programs.

I want to help people through mental health challenges. I love my role as a facilitator in the Fresh Hope support group. Tuesday night is the highlight of my week, as we meet and talk about what it means to live with a mental illness. I love navigating the discussions and leading the group. As I’ve said before, I feel like this support group is a way for me to give back, from all the help and encouragement I’ve received as I’ve journeyed with depression. It’s an answer to prayer, from when I begged God to not waste my experience in the darkness.

I love families, and family dynamics. I find them fascinating. I’d like to help people build healthy family and marriage relationships.

I’d also like to be an expert in the field of counseling. Of mental health. To have those initials behind my name. So that when I write my book, I’ll be taken seriously.

But returning to the dictionary’s definition, I don’t need those letters. My experience, my research and reading, may be enough.

Maybe I do know what I’m talking about.

Depression at Night

dark darkness loneliness mystery
Photo by Engin Akyurt on Pexels.com

Depression always feels heavier at night. And I just wanna be alone.

I love my husband deeply, but right now, I want to crawl under the covers in a pitch-black bedroom by myself. I’m sorry, honey. No offense intended.

I don’t want to talk to anyone. I want to be alone with my thoughts and my mood. This is not a healthy choice, but it is an overwhelming desire.

Depression has a way of telling me that I’m all alone anyway, and pressuring me to feel it. This disease wants me to ruminate – to think dark thoughts over and over. Or to think no thoughts at all – to let my mind be blank. That’s not easy for me to do normally, but it’s pretty simple in my depressed state.

I would love to huddle in a space where no light gets in. To sit in silence and blackness. To be covered by a blanket of dark. To hear nothing but the echo of no sound. So that I can listen for my heartbeat – a reminder that I’m alive and fighting. Barely. But fighting nonetheless.

I’m drawn to the corner of a room, or the floor of a closet, or in the dark next to a large heavy piece of furniture, such as a dresser or bookshelf. I’d like to just sit there, with my knees pulled up to my chin and my arms wrapped around my legs. I’d be wearing my most comfortable clothes – soft sweats and fluffy socks. My eyes would slowly adjust to the small amount of light filtering in, but I’d be surrounded by the dark. It would be comforting.

Depression often brings its friend, anxiety. A hollowness behind my sternum, an emptiness in my stomach. My long-time therapist recently encouraged me to identify where in my body I’m feeling my emotions, as they are a whole-body experience. So anxiety is in the center of my body.

Depression is on my shoulders, pulling me down and forward. Like a thick pile of blankets would feel – heavy and warm.

Isolation is a very familiar feeling, comforting, enticing. I’ve felt it before, and I long for the peace it brings. But two things I know: it’s not a lasting peace. And I’m not truly alone – Jesus is with me.

The stillness that depression brings invariably turns to negative thinking, to self-accusation, to feelings of hopelessness. My mind goes from no thoughts to condemning thoughts to lonely thoughts.

And the presence of Jesus – the Light of the World – counters the darkness. He longs to comfort me in my isolation, to remind me that He will never leave me, and that nothing – not even the darkness – can separate me from His love.

I could ask the darkness to hide me, and the light around me to become night—but even in darkness I cannot hide from you. To you the night shines as bright as day. Darkness and light are the same to you. Psalm 139:11-12, NLT

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I realize this is a “dark” entry. It’s how I feel as I go to bed at night when I’m in the midst of a depressive episode. I felt this way, too, every day of my worst depression back in 2009.  Fortunately, these feelings don’t last all day long anymore!

Wishful thinking.

“Just pray harder.”

“Why don’t you take a walk in the sunshine?”

“Count your blessings!”

“There are so many who are worse off than you.”

And my mantra: “This, too, shall pass.”

All of these are perhaps well-intentioned, but unhelpful pieces of advice for a depressed person.

I can’t think myself out of depression. Though this time I really tried.

Each day, I answer a mood question, “On a scale of 1-9, how’s your mood?” And when I’m in a healthy mental state, my mood runs at 7 or 8. (9 and 10 are reserved for “extremely good” and “exceptional,” which usually happens when my husband and I are on an adventure or my whole family is together.)

Shortly after Christmas, my mood started running at 7 and 6. Then it dropped down to 6 and 5. Then it was solid days of 5.

I felt like I was handling 5. I didn’t see it as concerning. I was still going to my job, my volunteering. I came home and was tired, but that’s not unusual – it’s the middle of winter, so of course my mood is down a bit.

I started having trouble sleeping – waking at 2am or 3am for a couple of hours, night after night. I wrote it off to being in my mid-50s, that time in my life, etc.

I stopped reading my books, including ones I had been excited to devour. I couldn’t concentrate. And some of the Netflix shows we watched didn’t hold my attention for the entire hour. I’d get up and get a snack: “No, don’t pause it; it’s ok; I’ll be right back.”

I told my friends that I was fighting depression. And I thought I was. But in reality, I wasn’t doing anything but letting it take me further down the tunnel.

I thought it would go away. I thought I would bounce back. For six weeks I let it push me deeper and deeper, but I kept denying it. Or at least minimizing it.

The thing about depression is – my brain is broken during an episode. I don’t think clearly. So I couldn’t see that depression wasn’t going to go away by itself. Even though I know better, I somehow thought that I could will myself out of depression.

I told my husband that if my mood dipped to 3, I would see the psych doc for a med adjustment. And my mood dipped to 4, for several days in a row.

At the same time, I caught a bad head cold, so I continued to “write off” my mood – this time because I wasn’t feeling well.

And then, I tanked. My mood hit 3. I left a message for the doc that I needed to see him.

On our way out of church Sunday, my husband encouraged me to not beat myself up for taking so long to see my psych doc. He reminded me that I gave myself parameters, and I abided by those guidelines: mood = 3 means call for a med check.

I admitted that I am beating myself up a bit. I know better! I know depression doesn’t go away by itself. But he’s right – I did what I said I would do.

I met with the psych doc this morning. He doesn’t want me to plummet (too late), so we’re boosting two of my meds. And because I took my fine sweet time getting in to see him, I’m going to be on these adjusted meds for several months. Hopefully, it won’t take that whole time to begin to feel better.

It is true: “This, too, shall pass.” But not without a helpful push from the doctor.