Medical Care

You know, spending a large portion of my time worrying about only my mental health means that I can often forget about my physical well-being. Well, thanks tot he wonders of insurance (or rather, my insurance company being forced to accept me as a client), I got in to see a non-psychiatrist doctor for the first time since last March yesterday. It was interesting having to fill out all the forms, and I know that without my insurance, I wouldn’t have even gotten in to see the doctor – one other gentleman there was told he needed insurance to be seen by any of the doctors in the office.

To go from not being able to see a doctor, to a doctor’s visit that cost me all of $30 – including vaccination for tetanus, and whooping cough – is a pretty big change. And there didn’t seem to be a whole lot wrong with me, thankfully, at least not at a cursory inspection – my blood pressure could have been lower, but it was still within normal limits. Because I have no thyroid, and am on thyroid replacement medication, the doctor did order tests – a whole battery of them – which I could o at the lab down the hall.

I went over to the lab (having, oddly but helpfully, not eaten beforehand), sat down in the waiting room, and 15 minutes later I was having a ridiculous amount of blood drawn. I mean, really, five vials? I don’t even like seeing enough blood to fill one leave my body. But the woman who took the blood said that for a batch of tests that would normally run around $1000, it only cost me $15. How good is insurance, right? Then I tottered off to my apartment and lunch, my left arm hurting from a tetanus shot and my right one feeling worse the wear for blood loss.

It’s kind of amazing how much I took that kind of thing for granted before; while I was a grad student, I got health care automatically, and never really worried about the cost of doctor’s visits. Now I am keenly aware of how much it would normally cost me without insurance – and how much less it costs me with insurance. It may not be an ideal system, but I am certainly glad that I am now allowed to get insurance, and not bankrupt myself for even the smallest medical expense, simply because I have ongoing conditions beyond my control.

It also makes me feel sorry for the many, many sufferers from mental illness who will never get insurance, and never get the right kind of medical care – either because it is too expensive, or because they are afraid of the stigma that such a condition brings. It’s not right that mental illness is treated so poorly, but I don’t know that that stigma will change anytime soon. I hope that my generally well-written postings here go some length to prove that we aren’t people to be afraid of – we’re just people. 

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Mental Illness in Media

So, when I’m not at work or off doing other things, I tend to watch a lot of Netflix (mostly because I still haven’t bothered to get basic cable hooked up). So, because of this, I see a lot of things – and one of those that seems to be most personally affecting, for me, is how mental illnesses are seen in the media, both TV and movies.

I remember watching House, when he voluntarily (though not by much) admits himself into a mental hospital to receive treatment for Vicodin addiction. I didn’t really think much of it at the time, but now that I do, I really wonder about its depiction. I’ve been in three acute care facilities – two of them relatively involuntarily, as it was either admit voluntarily and have a good chance of getting out soon or be admitted involuntarily and stay longer – and none of them really reflected the view you get in House. Now, I get that many of the patients on the show were exaggerated for dramatic effect, but things were very different in reality.

As another example, take Tony Shalhoub’s titular character on the show Monk. He’s a detective with pretty severe OCD, and is shown as being in treatment, but even over the course of years, he never seems to really improve (as noted in this article on PsychCentral). Now, that’s entirely possible – mental illness treatment can be very hit-or-miss – but it gives the impression that, regardless of treatment, mental illness never gets better. Now, as I’ve noted a number of times, mental illness can’t be cured – the medical profession isn’t, and may never be, there yet – but treatment can help significantly. Look at me – in January of last year, I was trying to kill myself, and now I live on my own, I have a job, and I’ve moved to Texas. And I like my life.

On the more positive side, there is the show Homeland, where one of the main characters has bipolar disorder. Now, I haven’t seen the show myself, so I apologize for being uninformed there, but a friend of mine – one who has bipolar disorder – says that the treatment of bipolar disorder is relatively accurate. There’s even at least one doctor who agrees – Dr. Vasilis Pozios tells Time Magazine that “I think (‘Homeland’) does a lot of things that are not only accurate but are commendable. In terms of accuracy, it shows someone with bipolar disorder who has episodes…Instead of being someone who is (either) happy or sad, which is the lay person’s possible understanding of bipolar disorder, this shows the actual major depressive episodes, the manic episodes and also the psychosis that can happen with bipolar disorder.”

Mental illness needs better representation in the media; when there are mass shootings and people immediately pounce on a description of mental illness as a reason, it just stigmatizes those of us who have mental illnesses, and it frightens people who may have mental problems into not looking for treatment. Going without treatment can be catastrophic, even for people with relatively mild diagnoses, and people shouldn’t be being punished for something they literally can’t help having. So I wish the media would try to represent mental illness in a more responsible way.

Cracked Wisdom

Well, not a lot has occurred since my last post, but I have found some interesting things I would like to share. First, like the post name implies, is another link to the website Cracked; today I saw that they posted an article on things people get wrong when talking or thinking about mental illness, and I thought it would be an appropriate thing to repost here: 5 Things Everyone Gets Wrong About Mental Illness. I read through it, and it hit a lot of chords with me, because of how much it reflects things I have seen and experienced, so I suggest checking it out.

Sometimes I wonder if I spend too much of my time thinking about mental illness; it can sometimes seem like the only thing I talk about (outside of my blog, that is – that’s the whole point of this blog, so talking about it here is expected). It’s a little odd; time I used to spend talking about or playing video games or RPGs is now mostly time that I spend thinking about, reading about, or talking about psychiatric disorders, mental illness, and other things of the sort.

Anyway, this all feels heavy to me, so I apologize to anyone who is morally opposed to Budweiser, but I think their Super Bowl commercial is cute, and I challenge you not to watch it and smile, or say ‘awww…’:

Life Support

I have found that one of the most important things in treatment – at least for me – is the existence of a healthy support system. In my case, that consists of my friends, my family, my therapist, and any doctors involved – as well as, currently, my co-workers. To a certain extent, a support system has to be nearby. I know that while I was living in St. Louis, my closest friends weren’t nearby, and so while I could talk to them on the phone, I rarely got to see them face-to-face. That was a big pat of my feeling disconnected.

Living in Houston, I have friends who are close by – several of them live in the same apartment complex with me, in fact. We can see each other on a regular basis. That doesn’t make my other friends any less important to me; I still talk to them often. But having people I can see and get together with makes me feel like I am part of the community here, in a way I never really felt in St. Louis. So, while I don’t get to see my family as often as I did when I lived with them, I still talk to them, and I got to see them over Christmas.

It’s important for me to be a part of the support systems of others, too. I know that I’m a friend for Calla, and I view that as a privilege; I view being a part of all my friends’ support systems as a privilege, actually, I just don’t tell them that nearly enough. I also can’t really mention them by name here, which makes it a little tricky. Being part of a community is a big deal, for all of us, since we are social creatures – and many of my friends here in Houston came here from elsewhere, and we have shared experiences which bring us together.

It’s not just friends, though. Having my therapist and psychiatrist is also a big part of things. I can talk to both of them about issues that don’t really come up in everyday conversations with my friends – not that my friends can’t handle them, but talking about variations in medication schedule isn’t exactly a thrilling conversation topic, you know? Also, the support I get from my therapist is different than the support I get from my friends. It’s hard to explain, but both kinds are helpful.

Friends, family, doctors, co-workers, support groups – they’re all important to me in my continuing life. I don’t know that I need all of them, all the time, but I do not that the support system I have formed here has helped me to get where I am now. Which is a far, far better place than I was a little over a year ago. My health isn’t totally due to that – the things I learned in treatment and my medication also play big roles – but the support system is a necessary part.

The Wonders of Insurance

So, through some program – I imagine the Affordable Care Act, but knowing Texas, it could be something else – I was able to get insurance. This is a big deal for me; with several pre-existing conditions, I was persona non grata to insurance companies for the last half of last year. This meant my medications – of which I’m on 4, which is a relatively small number compared to some folks I know – cost a lot; with even one non-generic medication, it cost me in the neighborhood of $500 a month. Doctor’s visits were right out.

So, I got insurance at the beginning of this month. I went to go pick up my medications after seeing my psychiatrist on Tuesday, and you know what they ended up costing me? $18. That’s so different it isn’t even funny. Now, granted, my insurance plan is not cheap, but it’s still cheaper than medication costs without insurance. Plus, I get to go see a doctor in a week or so, and it won’t cost me an arm and a leg.

That’s part of the cost of mental illness. It’s an illness that never goes away, and was a reason for insurance companies to deny us treatment. The only reason I had insurance before is because I got it through my school, so I had to be allowed in. It’s a monetary cost, true, but it’s still a cost – I’m lucky to have had the ability to pay for a place like Menninger. There are a lot of people with serious mental issues who can’t afford that kind of treatment – or any treatment, really. People who never get diagnosed, who end up roaming, homeless and scared, because they can’t function mentally. People understand a missing arm or leg, but a missing part of your mind – that’s much hard to conceptualize.

So, even though it isn’t an ideal solution, I am certainly glad the Affordable Care Act was passed. It gave me the chance to finally go see a doctor again, and to even think about possible emergency care without bankruptcy. I get the chance to be able to keep my medication going, without wondering if they will drive my financial future.

Compared to that, some headaches are a pretty small price to pay. Those are just a side effect of regularizing my medication schedule, though. Life is going pretty well right now, so I am glad for insurance, and for what I have.

Postscript: Nobody had anythign to say about the Sad Dog diary? Man, you people are stone cold. The first time I watched that I laughed until I almost puked.

Today’s Update, Brought to You By…

I feel like I should have more to say right now, but there’s not a whole lot going through my head right now – at least, not of importance. I think over the last couple days, I’ve managed to kind of course correct; I think that I was having some issues with medication functioning properly, and it was probably because I missed a day and then had a week or two of taking it at irregular times. IT’s interesting to see how much that kind of things can affect how you act.

Things like that are the times it is really driven home for me that depression is a disease. It’s not just a mental construct, because there’s not really anything in my life that I have to feel bad about right now. There is something actually wrong with the chemistry in my brain, and affecting that too much can really make my behavior erratic. While learning to control certain behaviors and manage others is an important part of my treatment, the medication is just as important – without that, I could know all the CBT and DBT in the world – but without the energy or motivation to practice the things they teach, I would be the same as if I had no knowledge of them at all.

This time of year in general seems to be kind of a downer for a lot of people. Several of my friends are having rough times, and some just seem to feel more overwhelmed than normal. Some of the people I talk to regularly seem to have dropped off the map, but I hope that’s a temporary situation. Right now, that I’m feeling a bit more in control, I’m really reading through this Star Wars: Edge of the Empire Beginner’s set and thinking about finding a small group to play through it with.

So, I think things are back on track, and while I know there are things I can’t change, there are also things I can, and knowing the difference between them is important.

Family Connection

So, after my last entry, I signed up for a course through the National Education Alliance for Borderline Personality Disorder called Family Connections. Basically, it is a class for relatives, friends, and loved ones of people with BPD. Today was the first class, and it was pretty interesting.

I’ve been to support groups before; they aren’t new to me. I go to one for my step-down group, and I try to get over to DBSA when I’m not working on that night. But the support groups I’ve been a part of were for the people who had mental disorders. I knew there were groups for family and friends before, but hadn’t ever been part of one. But after having gone, I can see how helpful they can end up being for those supporting people with psychological issues.

For BPD, while there were a lot of stories about children, spouses, and friends, they all had some things in common; at times it seemed like we were quoting out of the DSM criteria for Borderline Personality Disorder. There was a lot of frustration, a lot of wondering what we could do to try and help our loved ones – not fix them, because that’s not something we can do. Like I remember learning in treatment, we can’t change other people, only ourselves; trying to change others is just a recipe for disaster.

Seeing as how it was our first session, much of the time was taken up telling short versions of our stories and reasons for being there. But at the end, we did get to cover some things, and I think, most importantly, we covered some very good advice for those supporting people with BPD. First, as support personnel (shorthand for family, friends, or loved ones), we should always try to take the things our loved ones say in the most benign way possible. A lot of the time, what they are saying isn’t about us; it’s a reflection of what’s going on in their heads. Taking things too personally just ends up in a messy situation. Second, there isn’t one absolute truth; while a loved one might, in a moment of anger, says he or she hates you, we know that in the long run they love us – the hatred being voiced may be true at that second, but not overall. Third, we are all doing the best we can in the moment; never assume that our loved ones are trying to scare us off, drive us away, or manipulate us – they’re just trying to deal with life the best way they know how. If we can help them with that, then we should do so. Finally, we can always do better. Nobody’s perfect, and every time we interact with our loved ones is a chance to do things better than we have before.

There’s a lot of things I hope to learn at this class, and I hope that my own experience with mental illness can help the people there who haven’t had the exposure to treatment that I have. I know that there are tons of things I can learn from them, because they have had so much more experience with BPD, and had to deal with it for much longer. I also hope that what I learn from this class can help me to be a better friend – and possibly more – for Calla, and others I know with BPD.