I’ve been doing quite well lately, overall. For the most part, ever since boosting my Wellbutrin back at the end of February, I’ve had my concentration back, I’ve been able to work (in a limited way), and most importantly, I’ve reconnected with hope.
Yes, I’ve had some challenges trying to work on attachment issues with E, and sometimes that’s been painful. But they haven’t derailed me. They haven’t sent me back to bed. Furthermore, they haven’t been constant. Some of the time, especially lately, I’ve felt like we do understand each other and are able to have honest and meaningful conversations.
I wonder if you can imagine how amazing and unusual and… joyful it is to feel consistently good for weeks on end. I smile at myself in the mirror. I think about things I want to do (just the fact that I want to do something!), this week and longer term. I make plans. Friends I talk to on the phone tell me there’s a different energy in my voice.
So there was a little twist in the plot this week, due in part to my own misunderstanding and in part to the harshly profit-focused state of the U.S. health insurance industry. Since I no longer work for a big company but instead work as a free-lance consultant, I have to purchase my own insurance. On the one hand, I am lucky I can do this, because before the ACA (“Obamacare”) went into effect in 2014, someone with severe depression would not even be able to buy insurance. (Severe depression being seen not something you need medical care for but rather as a disqualifying pre-existing medical condition.)
On the other hand, that insurance costs me $888 per month. After that, I still have co-pays to see my primary care doctor and my therapist and psychiatric nurse, and if I need to see a specialist or have any lab or other tests, I have to pay the first $1500 in expenses myself. Also, if I see a chiropractor or nutritionist (which I do), I have to pay for all of that myself. In other words, the insurance is expensive and while definitely helpful, also has its limitations.
So maybe I could be forgiven for thinking that the $888 would pay all my insurance expenses. Maybe you could understand that I somehow overlooked the additional $37 per month that I am supposed to pay for my dental coverage. I somehow thought the $888 was the total for the medical and dental insurance together, so on the first of each month, I transferred $888 over to my health insurance company.
In January, I got a notice my insurance was discontinued for non-payment. I called them, saying, “I paid you; I can see the payment on my bank statement.” The person I talked to agreed and corrected my account so I had insurance. Same thing in February. When the same thing happened in March, I asked, “What’s going on, that every month you kick me off insurance?” The agent on the phone didn’t know and said she would look into it. A week later, she told me it was because of the unpaid dental. That was the first I knew of it. I never got a monthly bill or anything.
So I paid the delinquent dental fees, but the insurance company ended my insurance anyway, and retroactively to the end of February. I found this out not by a notification via email or a letter, but when I went to the pharmacy to refill my Wellbutrin. “Your insurance has lapsed,” the pharmacist told me.
Fortunately, I had a couple of days of medication left, so I started calling the insurance company every day. Every day. The agents were nice and put in a request for me to be reinstated. They even requested that the decision be expedited, because I needed my meds. But then I’d call the next day, and nothing. And the next day, nothing.
Inevitably, I reached the point where I didn’t have enough Wellbutrin to come up with a full dose. Oh well, I thought. It’s only the Wellbutrin, not the Effexor, which is truly my crazy-making medication. And I have a partial dose. I should be fine for one more day anyway.
I am astonished at how little time it took on a reduced doses–only half a day–for things to crumble. In the morning, I was working. In the afternoon, I stared at the computer screen but couldn’t think. The gears in my brain stalled out. I ended up crawling in bed. The mean voices in my head started up again, telling me I was stupid, lazy, disgusting, ugly… the usual litany. It was as if someone had turned a light off., leaving the world dark and cold.
I had just enough energy to remember what E and I have covered in therapy about a thousand times:
- I should be kind to myself (ugh but why? I’m so weak, back here again…)
- When it’s hard to help myself, it’s okay to reach to others
- My husband is a safe person, and it’s okay to tell him how I feel and let him help me
- Despite the painful mess around texting with E, she has said that she wants me to reach for her when I’m feeling really bad, when I’m thinking of harming myself
I had doubts about all those things, but I made a conscious decision that I would trust they were true. I had to wait for my husband to get home from work, but when he did, I told him how I was feeling. (Of course, he could see it for himself–I was back in bed, looking miserable.) We talked and decided he’d go to the pharmacy and just buy me a few more days worth of the medication without any insurance.
Then I emailed (did not text, feeling text-phobic, I think) E and told her how I was feeling and just asked for some encouragement. But I also admitted:
The desire to punish myself for letting this get messed up is big. I think maybe that would help me feel less out of control. I also feel like eating a bunch of tortilla chips and otherwise violating my diet. Self sabotage as coping strategy–brilliant.
If I am only okay when I swallow chemicals, who am I when I am okay? Am I myself? Or am I chemically altered someone? If it takes so little to have me let go and slide into exhaustion, indecision and lethargy, maybe those things are who I truly am? It is confusing.
She wrote back later that evening, addressing the existential doubts.
I think it’s helpful to that that it’s not the chemicals per se that your system needs so mach as a stability of the chemical mix. Interrupting that stability is really hard on your system. The chemicals don’t make you “yourself.” Please rise above those thoughts and see the larger picture. Who you “truly” are is a woman struggling to find a a new equilibrium with fewer unnecessary chemicals in your system.
Who you have thought you were, for much of your life, is not who I believe you truly are. You are not defective, broken, and in need of fixing. You are a woman who deserves love, respect and attention. You are a woman with clarity, conviction and investment in your own well-being. You are capable to being kind and supportive towards yourself, and this is SO much easier when the chemicals in your body are stable. When the chemistry shifts, it upsets your sense of balance.
… I have been watching the joy of your new sense of balance and stability recently. I have enjoyed seeing you begin to trust that this could possibly be a new normal. I’m so frustrated by the forces that mess with your solid grounding. It will be important to prioritize actions that keep a steady ground under you. I’m so sorry this got messed up. And… this to shall pass.
It was sweet to receive her response, even if it was mostly on the level of thinking rather than feeling.
But what helped me more was listening again to a song she had sent me some weeks ago. I actually find the song kind of corny and, I don’t know, unsubtle, I suppose. (Don’t ask me why that should matter, given that I sometimes have great fondness for songs from Disney cartoons.) Anyway, I listened to the song again, and what stuck with me were the lines about things passing through. Thoughts pass through you, but they are not you. You are the one emotions pass through.
I found those ideas very comforting. I’m not the ugly, stupid, disgusting self my scolding thoughts like to say I am, when my body chemistry is unbalanced. I’m not lazy. I’m not perpetually and inevitably self-hating. I’m a woman who has stormy thoughts and emotions sometimes. I’m the one the storm is passing through.