I was diagnosed with major depression 18 years ago this month, and in the time since then I’ve seen 2 good shrinks, 4 lousy ones, and 1 so-so nurse. I have been hospitalized twice, and the second time, a little over three years ago they tacked on Borderline Personality Disorder. Oh, and somewhere between the first diagnosis and then, I got stamped with Alcohol Dependence. The only reason I still bother with seeing ANYONE in the mental healthcare system is because I HAVE TO. My primary diagnosis is “Major Depression, Severe, Recurrent” which means that I can fumble along for a few months but will eventually slide into a massive sadness that makes me contemplate killing myself. Oh, and I have a history of cutting. So if I want to avoid the deep fathoms of depression, I have to stay medicated. I still struggle daily with depression, and sometimes I feel the blackness pulling at me but I mostly manage to keep from sinking into complete abjection.
I’ve encountered some real assholes along the way. One of the times when I was without mental health coverage, I went to the county mental health clinic. At the time, I had not been diagnosed with a substance abuse problem, so I told them I was depressed. The button pusher who was taking my info angrily tore into the form she had been typing when she decided it was the wrong form after asking me questions about my drinking. This is how I was first dually “diagnosed,” by a rude typist in a state-run clinic while in the midst of an episode of major depression. I was promptly enrolled in M-F substance abuse counseling; I went once, discovered that it was a huge joke (room of criminals pretending they wanted to get clean), and never went back. When I went back three months later for my appt. with the psychiatrist (who was also an unfeeling jerk), it was to discover my appt. had been cancelled because I didn’t attend the classes. No one bothered to call me.
Another time, when I THOUGHT I had mental healthcare coverage (I did have insurance, but discovered it didn’t include mental), I was being charged $185 for five minutes of “psychotherapy.” After having made arrangements over the phone to pay a lesser fee, imagine my shock when I was rudely demanded to pay more upon arriving for my next appointment. Even my friend who had driven me, because at the time I was suffering from anxiety, was angry on my behalf.
The second psychiatrist I ever saw (this was years before the two event mentioned above) was a creepy old dude in an office without a receptionist. He almost caused me to have a nervous breakdown by continuing to increase my Zoloft dosage. As I have discovered through much trial and error, I am REALLY SENSITIVE to antidepressants and most of them make me WORSE instead of better. When you are seeing a crap-assed doctor who doesn’t listen when you are describing severe panic attacks and insists that the medicine can’t be causing it, and then tells you to stop taking it for three days and then start again, it can be very hazardous for your health. If I had not had the common sense to realize that YES, it was the medicine making me worse and never going back to that doctor, who knows what would have happened to me. I discovered some years later that this man had a reputation as a script-writer (i.e. a doctor people go to when they just want a prescription with few questions asked).
So here’s my latest dilemma. I am currently going to another state-run clinic, which is not as horrible as the first one, but has caused me a great deal of frustration. For the first two years I went there, individual counseling was never offered. They wanted me to go to a dually-diagnosed group, which I would agree to do but never managed to get to. What I am about to say is going to sound really snotty. I’m pretty sure I don’t have much in common with most of the other patients in that clinic. The few times I have been in group therapy before have NOT been helpful. Sitting next to a ranting schizophrenic or a manic bi-polar person isn’t helpful. And I’ve tried A.A. in the past and that line of self-flagellation isn’t for me. I did go to one group earlier this year, which turned out to be me, a really nice young student-in-charge, and young adult of moderate mental capacity who hadn’t bothered to take her meds that day. During my last “treatment plan” (about six months ago), I yet again expressed an interest in individual counseling, and was told I would be put on a list.
And so this is what I have actually gotten from the last three years. I have never seen a psychiatrist. I see a nurse about every three months for fifteen minutes. One time this year, after being irritated at my lack of progress she said, “I just don’t think you’re going to be one of my success stories.” I think she felt a little bad about that after I burst into tears about five minutes later. She has offered to get me in to see someone who could help with job placement and another person who could help me with setting goals. Neither of these things have happened. I had also been paying out of pocket for quite some time before I was made aware that I could be using a prescription assistance program through the clinic. I have since discovered that that is a joke as well, since I saw one person who called in my prescriptions, but NO ONE actually calls me to let me know they have arrived. It took me five trips to the clinic to actually be given meds because no one was ever there who was allowed to dispense them.
I blew off my last appt. with the nurse because I didn’t feel like being chewed out. When I emailed the chick who is supposed to reorder my medicine, she informed me she didn’t have a prescription for me. NEVER MIND that the programs I enrolled in earlier this year are for a full year’s worth of meds, and I have only ordered ONE 3-month supply. She said I had to make an appt. to have another worthless treatment plan, then make one to see a “doctor” i.e. the nurse before she could do anything for me. So I am going to run out of meds in the interum; if you’re interested in knowing what that’s going to be like, just Google “Pristiq withdrawal.” I realized a week ago that I could reorder the other medicine myself (Lamictal, which is used as a mood stabilizer) so I did. I still have to go to the damn clinic to pick it up, so I am waiting another week before I start calling/stopping by to see if it has arrived.
I realize that I am complicating things by not acquiesing and just going to group therapy, and by missing appointments and waiting too long to order meds. After this summer’s ridiculousness of trying to pick up my meds, I never want to go back into that place but I don’t have a choice. I don’t have a job so this is my only option.
I did have good mental healthcare once. It was through my school. I saw a psychologist once a week and a psychiatrist bi-weekly in addition to attending a group. I honestly believe that if I still have that kind of treatment I would be in a much better place mentally. I need to “suck it up” and drop in the office tomorrow to see if there is any way around this impending medicine free Christmas. I really don’t want to spend it in the mental hospital.