4-11-17

Dear Diary,

It’s been five days since my appointment and while I’m still not letting myself feel the emotions from that day, I have been taking action in other ways. For instance, I am getting referrals for hospital therapists and for a PHP program back at home. I am working on the appointment for the neuropsychiatric evaluation and getting my medications in line. For once I am willing to open up completely to a therapist to get the help I need and deserve. I am putting it all out there, in the hopes that I will get results. What happens if I don’t? Well I have some morbid ideas about that but hopefully I won’t have to deal with that.

The PHP program I am trying to get into is at a private institution which already screened me out for a psychiatrist and a therapist at their institution. This hurt me hard and had me seething at the current mental health system. I believed they didn’t want a patient as complicated as me in order to keep their numbers high, I thought they just didn’t want to deal with me and couldn’t help me. If this well-regarded mental health facility can’t help me, then who could? I felt rejected and defeated, and all as a result of the wording they used. “We don’t have any doctors willing to take you on as a patient.” As a mental health facility, I expected more. They are dealing with fragile patients and their families and hearing this felt like a kick in the gut. They referred me to a place I had already tried. I was devastated and about ready to throw in the towel.

It seems that whenever I am ready to give up, something good happens to keep me going. It’s like some cruel joke the universe has planned for me, but that’s a little egocentric and probably not true (although sometimes a good “woe is me” attitude is necessary to get through life events). I am about at the end of my rope once again. After being diagnosed with BPD and realizing that everything I am taking is the correct treatment, my hope is dwindling. I’m not sure I can take being rejected from this PHP program even though the chances are great that I will be based on past experience. The last time I needed to get into IOP, I had to go to the ED before they would see me, otherwise it would take months to even have an intake appointment. I am beyond baffled by the mental health system and shocked that in 2017 it still exists this way.

Mentally ill patients are second class citizens and it will be that way until politicians realize the necessity for social programs and subsidies. I don’t know, I hate politics. I just need something to change.

When I called the insurance about covering a partial program, the first question I was asked was “are you suicidal?” and I stumbled over my words. I thought, if I say no they may not cover the program, but if I say yes they may call the cops on me. Now, in hindsight, they wouldn’t have called the cops on me but that is such a loaded question and I was offended that I was asked that when simply implying about my coverage (or my parent’s coverage; when I get kicked off my parent’s coverage I am going to be in real trouble, but that’s a post for another day). I reiterated that I just wanted to know about coverage level, yet he persistently asked me questions like “you just had treatment, why do you need it again?” or “what is your current diagnosis and why is this medically necessary?” and I was pissed. I am not supposed to be the one explaining why this is medically necessary, how can anyone determine what is medically necessary and when? I finally told him that if he is trying to determine medical necessity that he should talk to my doctor and I just want to know what it will cost. Finally I got an answer, but I was furious. The stigma is alive and well and I see it around every corner.

Now I sit and wait once again for my fate to be delivered to me with “accepted” or “rejected”.

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Eight Years Later

Eight years have gone by since my first depressive episode in 2009. It’s hard for me to believe that eight years ago I was beginning this journey and even harder to imagine that young girl going through hell. I want to give her a hug and tell her that things will get better, but I can’t. And that hurts me to my core in a way words can’t explain. I feel for this terrified teenager and I am so grateful that I didn’t know at the time that eight years later I would still be deeply suffering.

I write this after five major depressive episodes. I write this after returning home from urgent care where they removed the sutures from my latest act of self-injury. I write this after four psychiatrists, six therapists, a traumatizing psych ward stay, and extensive outpatient treatment programs. After repeated trial and failure of the long list of antidepressants, after being given hope and having the hope tragically ripped away from me each time. I write this from a place of deep, pure hopelessness.

Six months ago I identified as depressed and anxious. Now, I’m not so sure. My mood swings are unbearable. I am cycling at a rate I have never cycled before. Cutting one night and waking up the next morning disgusted at the visible sign of my pain because I now feel on top of the world. One night I plan my suicide, I schedule the date and acquire the means with which to complete the act. The next night I am out with friends, plans that I myself initiated (very out of character) because I was euphoric and wanted to share it with the world. The painful awareness I have of these mood swings penetrates every moment of my life without exception.

In hindsight these mood swings aren’t new, what’s new is the rapid cycling and dramatic uncertainty about the following day. This is not a way I can live my life. I thought the depressive episodes were bad, and they were (still are), but this adds a layer of complexity to the issue that I cannot cope with. At first I believed the swings to be a result of hormones, a sort of severe PMS (PMDD as it is formally known). This was always something I struggled with and the reason I initially began birth control. I went to the gynecologist who humored me by ordering blood tests. But we both know the mood swings do not align with changes in my hormones, the changes just exacerbate it (in my non-medical opinion). My horrible current psychiatrist told me, in the five minutes she had for me, that likely my primary diagnosis is incorrect and began me on lamictal, my first big-time mood stabilizer. She so kindly gave me instructions to increase the dose rather quickly, resulting in horrible health anxiety and an eventual rash. Against medical advice, I continued to take the lamictal believing it to be my only hope as I am not willing to take a drug that will cause weight gain. I halved my dose and the rash subsided. All my hope is on this drug, all my hope rests on one doctor’s appointment and finally it is getting close.

I have this idea in my head that is admittedly wrong that this appointment will change everything. That getting an answer about what is wrong with me will somehow change my life. In reality, nothing will change. Sure, the label may change, but what matters won’t. When it comes down to it, I will still be chronically ill. I still will have repeated major depressive episodes that seemingly get worse each time. I will still experience periods of intense pain when I believe my only option is ending it all. The weight of my fate is still carried on my shoulders to class and to work and back again to my apartment. The weight sits on my chest as I lay in bed through insomnia contemplating my pathetic, painful existence. It is bearing on my soul so much that I don’t know how much longer I can take it. I have shifted this weight to rest on this appointment and I don’t know what hurts worse: carrying the weight day in and day out or the realization that I can’t fight off my fate much longer.