Friday, May 13, 2016

Celebrating May: Mental Health Awareness Month (Actually maintaining my sanity)

Happy Mental Health Awareness Month!

If you weren’t aware (as I wasn’t until this morning), May is mental health awareness month. 

I actually laughed out loud this morning when I saw the awareness banner across my internet home page.

I laughed, because this morning I popped a pill in my mouth to kick off my first-ever prescribed regimen focused on alleviating the symptoms of anxiety and depression. 

I laughed because I had no issue taking Valium as needed for the panic attacks that have been ever more frequent these past few months, but the moment the doctor suggested I start taking something on a daily basis to help prevent these attacks I… panicked. (An everyday pill?! That means there’s something actually, really wrong with me!)

I laughed because when I left the doctor’s office last night, prescription in hand, I cried because I felt like I lost a battle with myself. 

Almost 10 years ago, on a perfectly normal Monday morning, I woke up in my bed next to my best friend at the time who had slept over the night before. I was a freshman in college, and I had a typical day of classes ahead that didn’t start ‘til noon. Nothing particularly stressful was going on— no tests or papers due, but I jolted out of a deep sleep—heart racing. I was dizzy and couldn’t catch my breath—everything just felt generally horrible, and I had no explanation for it. 

My logical brain knew nothing was wrong, but I could not calm myself. I slipped out of bed, trying not to wake or alarm anyone, poured myself a glass of red wine (an old, dusty bottle I found in a cabinet), and sat in the shower—simultaneously nursing the terrible wine while shielding it from the stream of warm water.
While pulling myself together enough to go to school, I recalled a story a friend told me years earlier about waking up in the middle of the night feeling like someone was sitting on her chest; she called it a panic attack, and I remember being unable to truly empathize. 

It was an unwelcome epiphany. 

Since then, I have found my own ways to deal: some constructive (talking with friends, yoga, working out, deep breathing, staying organized, staying away from caffeine) and some less so. 

There is still a very obvious stigma around mental illness—one that is dissipating, not fast enough. If I was writing this post about a different physical affliction (cancer, a peanut allergy, a broken leg) I probably wouldn’t have gone back and forth about whether or not to post this, and one of you probably would have started a GoFundMe page for me already. 

(Disclaimer: I do not want or need a GoFundMe page. I do not discount the very real suffering of those who are dealing with physical illness, or those who are in need of financial help from others to pay for medical treatment. I’m just saying, you don’t see gofundme/viral levels of concern for mental illnesses very often.

I grew up around a lot of people who did not believe in medicating for mental illness. If you needed pills to cope, you probably also needed a good exorcism. So I’ve been turned off to the idea of taking something pharmaceutical from day one. 

Anyone who knows me is aware that I’m a planner. I like to make plans, write lists, and always stay busy. I feel most calm when I am being as productive as humanly possible. If I’m bored, or not being challenged—if things are disorganized or people indecisive—I get anxious. And sometimes, despite all my careful and meticulous planning, I bite off more than I can chew.Then I get anxious. Some days, for no reason at all, I get anxious. There are days when I give myself a pep talk to get out of bed, and others when I am a hurricane of multi-tasking proportions. 


It was a funny feeling last night sitting across from a doctor describing me as “highly functioning.” I wanted to say, “Tell me something I don’t know. I’m nothing if not highly functioning.” But that would have been rude. He had just met me, and was try to help by piecing together my previous charts.

I’m nothing if not self-aware. If I didn’t tell you how I was feeling, if you didn’t see the nervous flush creeping up my neck or feel my clammy hands, I would seem pretty darn put together most of the time. 

I can honestly say that my anxiety and panic disorders (so many names for things that I have a hard time differentiating) have never kept me from doing what I needed to do—neither my work, nor my grades have really been affected by it, and that’s something I’ve prided myself on. I power through. (Look at you! Keeping it together! Without any pills!

However, there have been too many times when I was short or rude or not as compassionate or empathetic as I would have/could have/ should have been had I not been caught up in my own head. There are arguments that could have been avoided with my husband, my family, my friends—those I love the most who sometimes get the worst of me. 

The past 6 months or so have been rough. I work a full time job, run my wedding business on the side, and started grad school this past September. Though I thrive on a packed schedule, I’d been having a harder time coping with my own racing thoughts and emotions. The balancing act of managing the things I had to do (work, math homework, household chores) and the things I wanted to do (plan events, see my friend, fit in some exercise here and there, enjoy being a married person) became more precarious each day. I was praying for the end of the day, the end of the week, the end of the month, the end of the semester. 

So who cares if I can work 80 hours a week and go to grad school if I can’t just be a nice person most of the time? What good are a bunch of hand written letters and cards to people I care about if I don’t think before I speak and offend them? Why make a million plans to do a million things if the days leading up to them give me a stomach ache?

Sometimes it’s hard to identify your own feelings.
Am I just stressed? Because that’s life and it happens. Or am I anxious?
Am I sad? Because that’s OK too, and normal. Or am I feeling depressed?
Am I organized and tidy? Or am I getting caught up in some kind of compulsive cleaning? 

I personally am most relaxed in a clean house, and I don’t think a person has to be diagnosed with “OCD” to like everything in its own place. However, when I let things like laundry tip me over the edge, it becomes an issue that needs to be addressed. 

I think starting grad school was a turning point for me. It shook up my routine. I met new people, and made some new friends—one in particular who I could relate to when it came to being fully functioning, bad-ass ladies with lots and lots of anxiety. It’s also a setting where the general subject of mental health—or more accurately, stereotypes of mental health issues— cropped up quite a bit—usually in ignorant or negative ways: “I’m going to kill myself if I don’t get a B.” “I’m really OCD about XYZ.” “I guess we know who the crazy one is in this class.” I’m not easily offended, and I’m not the PC police. I’m even guilty of speaking flippantly about mental health issues. (Maybe this is one of those cases where “crazy” people can joke about being crazy, but no one else can? Maybe not. I don’t know what the deal is.

So, back to the beginning. It was a very last second decision for me to go to a psychiatrist last night. I tried therapy with a counselor at the same office last year, but I frankly didn’t feel like I was getting much more out of it than I would venting about things to a close, trusted friend. When I met with this counselor, I was adamant that I did not want to be put on medication, so there was no need to ever schedule an appointment for me to meet with the psychiatrist. She listened to me, asked me a few thought provoking questions, and gave me some general advice. I was willing to keep a diary, and practice deep breathing. Even willing to consider cognitive behavior therapy, but I thought that if I broke down and agreed to try a pill, I was weak or broken—unable to just take a deep breath and “get over it.” 

A little part of me still feels that way, even though I know I’m wrong. I was embarrassed dropping off and picking up my scripts at the CVS last night (one pill for daily use to help keep anxiety and depression at bay, and another for use as-needed when I feel an acute attack coming on.) 

I have a lot of things to do tonight and this weekend. And next week, and next weekend. And all the weeks after that. (I did give myself a break in July and August to enjoy summer. Not too many people want to get married in the hottest months.) I was listing all the reasons I should wait to start these new pills. 

Maybe not today, because what if I don’t like them, and I don’t do a great job at my wedding this weekend? Maybe not Monday, because what if they start my work week off weird?

I was standing over the sink, watching the clock this morning—coming very close to being late for work—going back and forth in my head—to pill, or not to pill. I finally just threw the tiny thing in my mouth, swallowed, and walked out the door before I could regret it. (It was ALMOST JUST LIKE Neo’s red pill/blue pill moment, only… way less cool and without an audience.) 

This all sounds very dramatic, but it felt that way for me for those few minutes. The whole drive into work, I was dwelling on the list of potential side effects associated with this pill—do I feel dizzy? Am I nauseous? Do I have a new rash? Did my head just explode? 

Now here I am 8 hours later, feeling just fine. No dramatic change, no zombie feeling, no euphoria either. I do not regret a thing. I don’t expect to have to be on medication forever, but for now, I’m going to give it a chance and see if it can help me do/feel things that 10 years of “holding it together myself” couldn’t.

I don’t honestly know why I’m writing this post. Maybe it’s to make me feel better about myself. Or gather my thoughts. Maybe it’s so this is all out in the open—and any of you who want to can talk to me about it. Maybe it’s so one single person feeling a little “crazy” and doubting whether or not they should seek professional help reads this and just decides to go for it. 

I also don’t want anyone to hesitate to ask me for help (with anything!), because I have no intention of stopping doing the things and seeing the people I love. 

I know I am going to make self-care more of a priority. I’m going to stop telling myself it’s better to be “strong” than to feel sane. I’ll try to take another moment to think before agreeing to do things I maybe don’t want to/ or don’t have time to do. Hopefully, I’ll take an extra second before I open my mouth to say anything. And even if this isn’t the cure all, I’ll still be happy I tried. 

I hope your take away from all of this is to try be easy on others and to extend that same kindness to your own self.

Thursday, August 6, 2015

Scrubs Enlightenment RE: Health Care & Politics

As I’ve mentioned before, I’ve been on a bit of a Scrubs binge on Netflix. 

That show is SO good! Although I enjoyed watching it 10 years ago when it first came on, re-watching it from the beginning has been even better, because I am old and can now relate to more late-twenty-something issues. 

Yes, it’s a fictional comedy, but man, it can hit you right in the feels some times.
Last night, it really made me think.

It was an episode in early Season 8 (with Courtney Cox as a guest star) where JD and Elliott were treating a guy pretending to have MS so that he could get the prescription drugs for his daughter who ACTUALLY has MS, because she didn’t have health insurance. In the end, the doctors were convicted (by their consciences, not the law) and willing to put their careers on the line by knowingly prescribing a healthy patient with MS drugs. Happy Ending. 

This show originally aired before “Obama Care” came onto the scene; this was a fictional portrayal of a very real issue. Statistics show that about 129 million Americans (something like 50% of the US) have what the insurance world calls “pre-existing conditions.” These conditions include, but are not limited to: cancer, diabetes, heart disease, mental illness, arthritis and many, many others. 

This is not to say that half of America is uninsured—in fact about 85% of Americans were insured even before Obama Care came into effect—but it does mean that prior to 2014, insurance plans and insurers were routinely denying coverage and/or treatment to these people or charging them much higher rates to obtain and maintain coverage. 

Superficially, this makes sense. People with conditions that cost money are a bigger risk to companies insuring them, and thus, should be charged more for coverage. People with bad driving histories pay more for car insurance. People who drive expensive cars pay more for car insurance. Duh.

But, then again, we’re comparing apples to oranges. 

Comparing conscious choices: 

·         Which car do I want?
·         Do I want to pay attention to the rules of the road?
·         Do I allow myself to be a distracted driver or a cautious and respectful one?
·         Do I have a lead foot?
·         Do I want to drink and drive? (if so, you’re an asshole) 

With luck of the draw:

·         Does cancer, heart disease, mental illness, etc. run in my family?
·         Does my job put me under a lot of physical or mental stress?
·         Does my body just not want to cooperate with me?

Now before you start arguing with me in your own head (A La John Dorian, MD), I know some of the questions that come up:

·         But what about FAT people?! Can’t they just start living a healthier lifestyle? This would/could reduce so many instances of high blood pressure, heart disease and arthritis. 

·         If your job is so mentally/physically demanding, why not just QUIT and find a new one?!

I reply:

1.    Fat people need health insurance too. Just because they LOOK heavier than you think a healthy person should look, that doesn’t mean they aren’t eating well and exercising. There are people who don’t take care of themselves as well as they should, but there are also people who suffer from OTHER conditions that exacerbate weight issues, such as thyroid and other hormone issues, polycystic ovary syndrome, etc. There are slim people who appear fit, yet eat fast food every day. Genetic luck of the draw. There are also people who work 2 and 3 jobs to support their families and have little time or money to get in the shape society requires of them to be deemed healthy.

I’ll tell you right now that in college, I gained something like 30 pounds. I was not obese, but I was teetering on that fine BMI** line that tells you what your fat person health risks are. Suddenly I had gone from a thin, busy, college student who could eat whatever she wanted whenever she wanted and not gain a pound, to someone who’s metabolism stepped back and was like, I’m gonna let all that pizza catch up to you.

**I don’t hold much stock in the BMI index anyway, but that’s another story.

I have since gotten myself into a healthier lifestyle that includes lots of plant based foods, yoga, and walking, blah blah blah. I lost a lot of the weight and feel better, but I also won’t be turning down the occasional ice cream or bacon cheese burger.

However, had anyone presented me with the choice of putting down my pizza or paying more for health insurance because being overweight was riskier for my provider, I would have punched them in the throat with my fist that wasn’t holding pizza.  

2.    Please, continue to elaborate on how easy it is to find a good paying job these days that offers good benefits. For many people, it’s about sacrifice and survival. They work long hours, sometimes doing grueling or menial work to provide for their families. The end. 

I did a lot of research over the past year or two to better understand all of this. Most recently, this past winter when it was finally my turn to take on the task of figuring out what was the best insurance to purchase for my husband and I and what could we afford. 

Curious about the hot button topic that is “Obama Care”, I scoured for as much information I could find, on both liberal and conservative sides (trying to see different points of views and find pros and cons) as well as any sites that CLAIMED to be fact finders and truth checkers. 

Obviously, it sounds good to say that the Affordable Care Act (ACA) could potentially positively affect half of our countries population. As I mentioned earlier, about 85% of Americans currently have health insurance. Out of the remaining 15%, most conservative sites say that only about 1 million of them would truly be turned away because of a pre-existing condition if they were to try to acquire health insurance. 

I cite that “low ball” number (although liberals would say this number is much higher), because I know that seems insignificant. Personally, thinking that ONE MILLION PEOPLE in the most developed country in the world CAN’T GET MEDICAL HELP without the possibility of going bankrupt seems like a REALLY BIG DEAL. More significant. 

Concerning the rest of the already-insured people, if they contracted on of these aforementioned health conditions while they had coverage, they would get treated. However, if they lost coverage for some reason (loss of a job, divorce, etc.) and then had to try to get NEW insurance—TA DA—they now have a pre-existing condition.

The ACA also did away with Lifetime Benefit Caps. Many of us have never had to pay attention to these caps, because we’re fortunate enough not to get sick with some of the nastier, more expensive diseases out there, but it basically means, although you’re paying for an insurance plan and you are covered, the insurance company will only pay up to a set amount of money for LIFE. In many cases, this means if your treatments reach this max dollar amount, you are no longer covered and the rest of your treatment bills fall on you. 

This is how so many cancer patients end up having to decide if they can afford some of the newest or best treatments. This is why insured citizens still end up under mountains of debt— dealing with that stress on top of a debilitating illness. 

Even for people who don’t have cancer, but suffer from other chronic illnesses, the insurance co-pays alone can hurt. $15 per visit (for good plans) weekly or biweekly adds up. It’s like a whole new bill! 

Maybe, with serious reform, our health care system will stop allowing the pharmaceutical industry to reap OBSCENE amounts of profit from sick people—cancer patients in particular. Perhaps, if cancer stopped being such a cash cow for doctors and drug producers, it might actually incentivize a cure. 

This is one of my favorite John Oliver segments about big pharma:

And THIS is a disgusting story about a doctor who lied to his patients so that he could send them for cancer treatment in order to make more money off of them:

I’m sure this doctor is not the first or last to pull this sickening stunt. When the opportunity for doctors to profit from prescribing unnecessary treatment ceases to exist, then perhaps they will stop pandering to pharmaceutical reps, insurance companies, and lobbyists and focus on what’s best for their patients

For a country with so much (power, knowledge, wealth), it seems we can be seriously lacking in compassion, common sense, and moral compass.

The USA currently ranks 37th in the World Health Organization’s list of the World’s Health Systems:

USA can’t chant WE’RE NUMBER ONE about this. 

Even if these stats are not 100% accurate (bias is unavoidable and there are A LOT of factors to consider), we don’t even make the TOP 10. 

Here’s another list comparing the US to 11 similar countries:

We’re dead last. Shouldn’t be surprising, but it also costs the most here for some of the worst care among the top developed countries. 

If you want to drive fast in your big, fancy car—it’s on you if your insurance costs are through the roof. Take the bus; ride a bike; get a Prius! Those are all of your choices

No one chooses to get cancer. Don’t blame cigarettes or bad eating habits. 
 Yes—they’re not great for you. But I know too many healthy people who eat right, work out, never smoke and STILL get sick to let that argument stand in the way of reform. I don’t know why this stuff happens, and I probably never will, but it sucks. 

I have been fortunate to have health insurance for as much of my life as I remember. Before the full ACA mandatory enrollment period came up, I was in college and health care was the last thing on my mind. I didn’t even realize that the reason I was still able to mooch off of my mom’s health insurance for so long was because the ACA required plans and issuers that offered dependent coverage in their plans to make that coverage available until the dependent (child. me) reached the age of 26. 

A LOT of my friends took advantage of that new insurance requirement without even realizing how helpful it was! I stayed under my mom’s insurance until I got married (4 months before my 26th birthday) and that was a lifesaver. Often, with family insurance plans, it doesn’t cost any more if you’ve got one or 5 dependents on the plan. So, I was saving my own money by not having to buy insurance so soon after college, and my mom wasn’t financially affected by me staying on her plan (since I’m the oldest of 4 kids who were all still on it). It was funny to hear a lot of my very conservative friends rail against “Obama Care” while they were lucky enough to be reaping its early benefits. 

I’m not saying the Affordable Care Act is perfect, but it really is a step in the right direction—even if you think everything proposed sucks—it’s a conversation starter and an acknowledgement that our system is in need of serious improvement. 

I’m aware that this is not news. It wasn’t news to me last night…but for some reason, it was never in the forefront of my brain—most likely because I had insurance for most of my awareness years. (Although before I remember understanding co-pays and coverage, I know we did go through a time where we were at the mercy of charity care organizations and Medicaid. My mom got a job working for the county, which opened up a door for good health benefit options. Many people aren’t that fortunate, and while some would call it a blessing, my mom still works really hard for a modest salary, because of the health insurance benefit.) 

I don’t know why Scrubs was the final straw or why it hit me so hard. The light bulb went off, and I laid awake for much of the night thinking how horrible it must be for the people who have to find “illegal” ways to get the medical care and drugs they need because insurance won’t help them. How could health care and quality of life not be a basic human right in a country like ours? I thought about hard-working people I know who have to buy their antibiotics from Canada, because they don’t have insurance and can’t afford to go to the doctor. 

Change seems to be so difficult in our country. So many bureaucratic hoops to jump through. And almost ALL of the officials, politicians, lobbyists, presidents, and CEOs in power are privileged and wealthy. You can’t even get to hire levels of government without millions of dollars to spend on a campaign behind you. All this money, and yet there are citizens who can’t get quality health care. 

Here are some articles that give you an idea of what the average congress-person’s benefits and salary package looks like. And yes—they all have the option to obtain federal insurance.

Scrubs made me realize that this situation can be as serious and ridiculous as it comes across on screen. 

It also got me thinking about how infinitesimal I am. Although sometimes I get discouraged thinking that my vote has to get through a political swamp of money and power and lobbyists to matter, I still have to do it. This is the first step to having an opinion and hoping to effect change. Vote. Vote. Vote.

And for heaven’s sake. BE INFORMED. And I don’t mean turn on your one favorite news channel every day or share some stupid bumper stickers on social media. 

I have made it my mission to cast a completely thoughtful and thoroughly informed vote for the upcoming Presidential election. I appreciate any advice on quality news sources or political forums. I am determined to learn about every single candidate and weigh the options as well as the outcomes that could accompany them. 

Although I work in government, I’m not nearly as politically savvy as I could or should be. I had to Google the pros and cons of free vs. fair trade and research off-shore drilling. I swing back and forth on some issues, because sometimes I feel like I could be a VERY liberal Republican or a conservative Democrat. (Don’t get me started on the ridiculousness of the 2 parties in general or the fact that everyone on social media seems to LOOOOOVE the independents, and yet they never get voted in.) 

Growing up, almost everyone I associated with voted for the same party. It was not even a question. It almost seemed like it didn’t matter WHO was running, as long as you check the right box. My first few voting experiences followed suit. Then I got really cynical and stopped voting for a bit altogether. 

Whoever you vote for, please do so with conviction. Not because your friends or parents or pastor or media tell you to vote that way. 

This year, I’ve decided to vote for the candidate who is serious about addressing the health care system, equality for women, and the environment. I decided that right now they are most important issues to me (and in my opinion, very important for everyone living here in our country and, in regards to the environment, on earth).

I Googled “Quizzes to help you figure out who to vote for” at one point, and took a few. My results surprised me because they were all very similar to each other and contrary to my prior voting habits. 

With so many candidates right now, it helps to get a better understanding of who’s who. 

If you’re interested, this one was my favorite, and seemed to be one of the most in depth and easiest to use (best website set up):

Although I really dislike Fox news and laugh at the thought that some people consider Megan Kelly to be a trusted news source, I will be watching the Republican debate tonight. If anything, it will be a conversation starter for the rest of the week with friends and coworkers, and conversations (if respectful) can often lead to new perspectives.