Part of my zeal for rejoining the world of employment — besides wanting to fight racial in justice while getting paid a living wage — was that I could finally afford to go to doctors and dentists again. As soon as my insurance kicked in, I began booking long put off appointments left and right. And I was successful with most. I was able to retain my old OB/GYN, who was still as nice and blunt as ever. I found a primary care physician (or so I thought). And I made a long overdue dental appointment. But what has been, by far, the hardest nut to crack, the thing I needed more than anything, was finding a psychiatrist.
For those who are long time readers, I’ve been living with Bipolar Disorder, Type II since I was diagnosed in 2006. But, like most Bipolar patients, my disease manifested much earlier than that and was chronically misdiagnosed. I’d been sick since about 2000-2001, the years where I found it harder and harder to deal — my early 20s. Because of that, I’ve been on a lot of different medications and there was a point my illness things were pretty bleak.
For about eight years, almost the entirety of my 20s and part of my early 30s, I fought for a life I didn’t really care that much about saving. And as I’ve written many times, my parents’ love for me is what kept me going when I no longer cared to fight for myself.
Since my illness, no matter how stable I may be right now, is a potentially life-threatening one, I take even the most minor things seriously, hearing my father and mother’s voices in the back of my head, “Don’t let yourself get sick.” It took them a long time to understand mental illness, and even of what they can’t comprehend, they do know one thing, I need to be on medication and I need to be monitored and I need to talk about my issues. That I need to not let myself get sick and let the bad old times come back when my mother got insomnia because she was convinced she was going to get the worst call any parent ever wanted to hear.
Even though now I wanted to stay well for myself, not just my family, the bad old times are always just in the back of my mind. I don’t want them to come back. I never want them to come back. My life is too good now.
So, needless to say, finding a good (or just serviceable) psychiatrist was paramount. And yet, even with insurance, it was much harder than I ever anticipated.
Perhaps the listings are just old for my insurer (they require that the doctors update their status themselves), but I spent two months cold calling doctors trying to find one that would prescribe me medication for my Bipolar Disorder. Most of the calls went no where. Soon I was tearfully begging someone, anyone to call me back. I called about 30 different doctors to no success. Most didn’t take my insurance, took my insurance but weren’t taking patients, or just never bothered to call me back no matter how many messages I left. I even had to enlist the ensurer themselves to start cold-calling people to find out if they were still up and running.
Last year, for the first time in a long time, I realized I could not continue to go long periods of time without being medicated. It was too dangerous and it went against my promise to myself back in 2009 to do whatever it took to stay balanced and well. Although I liked my new job, I was struggling every day to wake up on time and focus. I was miserable. But spending my lunch hour calling every number I could find and being turned down for treatment was beyond demoralizing. Sure, I wasn’t in crisis, but what if I had been? It’s not supposed to be this hard.
After two months I FINALLY found a doctor, an older gentleman who seemed to really know what he was talking about … or at least I thought so at the time. He put me back on a medication I once took years ago, but couldn’t remember it having any positive or negative affect — Lamictal. He concluded (correctly) that I’d never had a therapeutic dose of the medication. He also put me on Latuda, an anti-psychotic to help me deal with me chronic, negative thoughts and promised, that when I would see him three weeks from then, that he would finally treat my ADHD, something most of my doctors had refused to touch out of fear the drugs would trigger my hypomania.
I was so happy. Finally, a doctor for my medication management. And he was a smart one too! He really listened to me and my concerns. Like, he told me anxiety medication would not help me with my anxiety. That I needed to go back to talk therapy and get at the root of what was triggering my anxiety in the first place. Medicine could only treat the symptoms in that case, it couldn’t cure it.
So, under his thoughtful guidance, I began taking my medication and almost immediately I saw a difference. I was happier and livelier and felt much more like my “normal” self. I wasn’t too flat, wasn’t too high and wasn’t too low … until I started gradually increasing my dosages as the doctor had recommended. Suddenly I was waking up earlier and earlier, needing less and less sleep. Which, at first was kind of nice, until I started struggling to stay awake during meetings at work. Then came those days, when after taking my higher dosage of Latuda, plus not sleeping, lead to me being so tired by the end of the day I couldn’t think straight. I’d go to bed at 8 or 9 p.m., only to wake up at some crazy hour.
I quickly realized I had a problem even if those around me didn’t. I’d seen all these signs before. Too much energy. Too little focus. Too irritable. Not enough sleep. Sudden urges to black out mid-conversation. I was manic without the high. I haven’t had that wonderful, terrible hypomanic “high” in years. If I was getting that along with all these other annoyances you wouldn’t be reading this post right now because I’d be too happy and too hopped up on my own “brain crack” to care. But since I’m not getting high on my own endorphin supply, I couldn’t ignore that I was clearly heading for some kind of disaster.
So, as instructed, I started reaching out to my doctor. I wanted to tell him about the hyperactivity and how I felt maybe a lower dosage of both Lamictal and Latuda would be enough. I also wanted to talk more about my ADHD and possible options, since I was still struggling at times to stay focused during meetings or at my computer. I kept forgetting deadlines. It wasn’t acceptable. But when I reached out, I received no answer. Then, one day, I called his answering service and got the grim news.
My elderly doctor had a massive heart attack and died.
Death, in and of itself, is sad. But when your mental health is also a matter of life and death, realizing I would have to go through this process all over again was maddening. I could no longer remember the names of the three doctors who FINALLY called me back after I’d found a doctor who would see me. And the doctor my primary care physician suggested wasn’t taking new patients. He suggested a peer, but that doctor didn’t take my insurance, or any insurance for that matter, and wanted me to pay $300 for an initial consultation. I balked. I’d just HAD an initial consultation. How was it my fault my doctor died?
Then my primary care physician, the one who’d promised to manage my prescriptions once I found a proper psychiatrist went ghost on me. First he canceled my afternoon appointment last Tuesday, then a few days later, when I showed up for my rescheduled appointment, I learned he was no longer with the practice. Apparently some “drama” went down. I called him up to say, “What the hell, dude?” and he promised to make it up to me even though it would probably take him a couple weeks to find a new place to practice.
But did I have a couple weeks? My dosage of Lamictal, as my doctor recommended, is now up to 150 mg. I woke up at 1:45 a.m. today and couldn’t fall back asleep. Maybe this was a fluke, but then I thought about it and why, all those years ago when I was on Lamictal I stopped taking it. One of the possible side effects is insomnia. So now what? Do I go back to the lower dosage (probably)? But should I be doing that without a doctor’s supervision? And what happens when my medicine runs out? I don’t have two months worth of medication to get me through however long it takes for me to find another psychiatrist.
As I told my insurer, finding a psychiatrist shouldn’t be this hard. And as frustrating as this is for me, all I could think about was the poor person who was in crisis or on the verge of a crisis who needs, badly, to be treated for their depression, or Bipolar Disorder or any mental illness. When you’re sick, it’s hard to focus on anything, let alone spending a ton of energy just to find a doctor. It shouldn’t be this hard. And yet, it is.