February 17, 2014 by Kate Dore
One of the best depictions of depression that I have ever read was from the hilarious popular web comic and blog, Hyperbole and a Half. Creator, Allie Brosh, shared a couple of detailed posts about her struggle with the illness. You can check them out here and here.
In one particular passage of “Depression Part Two“, she described:
“And that’s the most frustrating thing about depression. It isn’t always something you can fight back against with hope. It isn’t even something — it’s nothing. And you can’t combat nothing. You can’t fill it up. You can’t cover it. It’s just there, pulling the meaning out of everything. That being the case, all the hopeful, proactive solutions start to sound completely insane in contrast to the scope of the problem.
It would be like having a bunch of dead fish, but no one around you will acknowledge that the fish are dead. Instead, they offer to help you look for the fish or try to help you figure out why they disappeared.”
Her second post came after an eighteen month hiatus, but it profoundly connected with many readers. In fact, the site had 1.5 millions views in a single day. I remember feeling deeply appreciative of her very real depiction of living with depression.
I had been quietly suffering from anxiety and depression for about a year. Nashville was patiently creeping into summer and everyone I knew was outside enjoying the beautiful weather. People often lament the challenges of living with mental illness in the winter, but I found it to be much harder in the summer. Winter gives you an excuse for spending more time at home, but summer has a way of making you feel especially isolated, particularly when everyone you know is enjoying patio drinks while you’re at home going to bed early.
It’s difficult to recognize deteriorating mental health right away. It’s not something that can be easily seen or understood, so it can be mistaken for other things at first. Not only was I highly functioning, but I was also very good at hiding that there was anything wrong from family, friends, and co-workers. I blamed my incessant bad mood and lack of energy on stress at work and excessive travel.
I tried exercising more, practicing yoga, and cleaning up my diet. I cut out alcohol and caffeine. I monitored my sleep. While temporary improvements were made, it was clear that my condition was worsening. I was in a constant fog, having memory problems, exhausted, and struggling with the simplest daily tasks. I was overwhelmed with feelings of hopelessness.
To make matters worse, when I finally worked up the courage to seek professional help, I was shocked and saddened to learn that my health insurance plan didn’t include any behavioral health coverage. I learned from our insurance agent that my company had opted out of providing it, and that it wasn’t possible to add it on my own. How could that be possible? I felt helpless and angry.
Despite the cost, I eventually moved forward with getting help. The therapy was expensive ($150 per session), but it was worth the cost. I was prescribed a mild anti-depressant that helped level out my symptoms. Slowly, life started to feel more manageable, but it took several weeks. The dark cloud lifted, my energy returned, and I began to feel more like myself.
I now feel more comfortable sharing my recent experiences with depression and anxiety. It is my hope that being candid like Allie Brosh may encourage someone else to seek help, and at the very least, make them feel less alone.
The National Alliance on Mental illness has found that mental illness affects one in four American adults, however, 60% of adults with mental illness received no treatment within the last year. How is there still a stigma, prejudice, and discrimination associated with these problems? And why do so many of us lack proper coverage to affordably treat mental illness?
One of the benefits of the Affordable Care Act is that mental and behavioral healthcare are now considered essential benefits. While this is a significant reform, unfortunately, my company is exempt from being required to provide this as we have less than fifty employees. However, all plans in the healthcare marketplace include this coverage and parity protections are offered.
“This means that in general, limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services. The kinds of limits covered by the parity protections include:
– Financial, like deductibles, copayments, coinsurance, and out-of-pocket limits
– Treatment, like limits to the number of days or visits covered
– Care management, like being required to get authorization of treatment before getting it”
I’m currently paying ~$200 per month for my employer provided health insurance, so I’m interested in exploring the healthcare marketplace and seeing if I can pay a similar amount for a more comprehensive plan. I’m nervous about taking this step, especially with all of the horror stories I’ve heard, but I think it’s worth exploring.
Readers: Does your health insurance include behavior health coverage? Have you had any experience with healthcare.gov? Can you offer any advice?