The staggering cost of a pre-existing condition
Like 44 million other people in the United States, I have a serious mental illness. In fact, I have a few—bipolar II disorder, post-traumatic stress disorder, anxiety, and depression. Some days, they vie for my attention, but not in a cute way, like in a precocious little shit way. I’ll start my day with deep depression, but then PTSD is like ‘Look! Look at what I can do!’ And when I look, it’s a traumatic memory. Other times, I’ll spend a whole week with one illness. I can’t tell you how many times my anxiety has whisked me away on a couple’s retreat where we spend every waking hour with each other (and with anxiety, every hour is a waking hour). Dealing with a mind that wants to hurt you all the time is exhausting, which is why I take medication.
The side effects can be messy, but they’re nothing compared to what my untreated mind can do. For the 10 or so years I went untreated, my illnesses cost me relationships, jobs, important life milestones, and many other things that are extremely (Mastercard voice) “priceless.”
To me, the $6000 annual cost of treatment (ok that’s with insurance—without it’s more like $145,000) far outweighs the cost of going untreated. Because without meds, my mind would win and I’d be dead. Simple as that.
Here, I run through all of the costs of every medication I’ve ever been on— emotional, physical, financial—over the past five years.
(It’s important to note: I am not a mental health professional. I’m not a professional in any way. I’m just mentally ill, and I’m not even good at being mentally ill, so please don’t take any advice from me. These accounts are purely based on my experience and my experience alone.)
I'd be dead without Latuda, but I'd also be a lot more alert. Now, I don’t want to shit on the Tuda because it literally keeps me sane, but it can dull your mind. Not in a major way. It just sometimes takes me a second to respond, and, oftentimes, that’s not a bad thing. I want to be clear, Latuda doesn’t make you dull or less creative or any bullshit like that, it just levels you out. Maybe I shouldn’t have used the word dull. Ugh. Great start.
Lithium: prevents manic episodes
Whenever my pharmacist hands me this prescription I can feel them thinking, Oh, so you’re crazy crazy. Obviously, they never say it, and their face never indicates it, but I see you, pharmacist, I see you. Most people know what lithium is for—it’s one of those old-school meds. Nirvana even had a song called “Lithium,” the one where the chorus is just “yeah” 14 times, which I feel perfectly captures the essence of the drug. I do well on lithium—except when I take it before bed; then it gives me nightmares. No one is allowed to challenge me on this. I've run my tests. It also makes me want to piss all the time. I'm like a freakin’ tea strainer. I often wake up in the middle of the night to squeeze out a thimble of urine. That said, lithium keeps my mind intact, and I'd keep taking it even if it made me wet my pants in public.
Soon after I started taking citalopram, I began having manic episodes. It tapped into my bipolar disorder and it amplified it real quick. Now, I’m usually an insecure, self-loathing mess, but on citalopram I am a god of gods. It made me feel omniscient, but also irritable and sweaty. My body overheated from mania while my brain overheated from delusions of grandeur. In my mind, I looked like Godfrey Gao, but in reality, I appeared more like Alex Jones.
I don’t remember a lot from this period. I tend to black out during these episodes. I only know these details because I asked my psychiatrist to go through my medical history with me for this article. Apparently, at one point, I told her I had “energy searing through my blood,” which seems very on brand for Alex Jones. Needless to say, I don’t take it anymore.
I call trazodone “Traz” because I’m awful like that. I honestly don’t know if this works for me or not. When you take more than three types of medication a day, it’s hard to figure out what is doing what. I take Traz as a sedative, but it never keeps me down. Honest to god, I think my body is resistant to it. Over the years I’ve built up the boisterous immunity of a wild thoroughbred. Team that with the high-speed thoughts of a cracked-out meerkat, and you have a recipe for disaster … and a very weird animal.
Lorazepam: treats anxiety
I love lorazepam more than I love most people. It’s the only drug that (for a short period of time) can extinguish the fire in my mind. It’s a relief like no other—like putting aloe on a burn or being canceled on at the last minute. It’s addictive. I crave it’s soothing psyche abilities. The thing is, I often mistake soothing relief with being knocked the fuck out, which is pretty dangerous. I also call it “Pam” which is unhealthy and irresponsible, because it makes it sound sort of endearing, like a caring old lady. She’d make me tea, tell me stories, and then knock me the fuck out.
Saphris is the most intense medication I’ve ever taken. I used to take it before bed and I was out like a light in minutes. Then came the dreams. My god. It was like, before, my dreams were in black and white, but on Saphris, they were in this 4-D Technicolor surround sound shit. I remember them to this day, but I’m not going to describe them here because I’m not a monster. However, they did feel a lot like immersive theater in that, at first, you’re like, ‘Ok, not as bad as I thought it was going to be.’ Then you’re like, ‘Alright this is a little much.’ And eventually you’re like, ‘WHY CAN’T I LEAVE? DOES ANYONE WORK HERE OR ARE THEY ALL ACTORS? WTF.’ In “normal” dreams, your body tends to wake you up right before (or right after) something horrifying happens. With Saphris, you’re made to experience your nightmare in full—no breaks—just like immersive theater.
Pretty sure Viibryd never worked for me. I remember taking it and still feeling super depressed (which is different than the medium depression I feel most days). Also, the name is kind of weird, even by medication standards. I kept calling it Vye Bird, so maybe I was given a different drug instead? Maybe I was given Vye Bird, which definitely sounds like a thrush medication aimed at millennial women: Say Vye Vye Birdy to vaginal thrush!
Hydroxyzine: treats anxiety/nausea
Hydroxyzine is like a confident Benadryl. It makes you so drowsy you forget why you had anxiety in the first place. It won’t put you to sleep, but it will turn you into a drunken toddler for a bit.
Propranolol: beta blocker
I take propranolol for heart palpitations. I often take it before I have to go to a place where there will be people and things, or if I think about going to a place where there will be people and things. Does it work? Meh. It depends on the number of people and things.
Cost: $317.26, weight gain
When I think of Abilify, I think of two things: 1) if it weren’t an antipsychotic medication it’d be quite a cute name and 2) weight gain. I'm talking weight gain that doesn’t even have the decency to creep up on you. I gained something like 15 pounds in two weeks. The change was so fast, my mind had a hard time processing it. The weight gain made me more depressed, so I took more Abilify and gained more weight. It was fucking vicious.