I hear the baby crying at the other end of the car in shotgun screams pausing only for breath as the train races underground, popping ears and causing discomfort for all but for none so much as this infant whose tiny head must feel as though it is being crushed in a vise grip like a nut in a little handheld nutcracker, the kind that so handily cracks crab shells and lobster claws so someone can pick and pull the white meat from within. The pressure mounts and the shrieks continue and I sit on my hands to actively resist clapping them over my ears and crying for the crying to stop because it’s so unbearable to hear such expressions of pain from a creature so small and unspoiled knowing that not so long from now the pain that causes such tears will come from the pressure within and not without. Everyone’s ears pop and everyone feels discomfort but no one’s physical pain rivals that caused by the internal invisible hand which cracks their bones and picks and pulls the heart meat from within, daring us all to cry in shotgun screams that we cannot allow ourselves to cry. Mummy and Dad try to soothe Baby who wants none of it and continues his gulps and yells and no one on the train can look at him for we all know that in his every tear and sobbing breath is a little of ourselves, a little of the wrenching ache we suppress because we’ve grown and spoiled like an old quart of milk left in a hollow log in a clearing in the woods that none will approach except the bearer of the hand that scraped our guts and left us there to spoil. And so we bury our heads in papers and books and turn up the volume and close our eyes, turning away from the little pan of new milk at the other end of the car with the fresh cream rising and threatening to spill as the train rattles along, because unlike Baby we know our destination approaches rapidly and there is nothing we can do to save the milk that will inevitably spill and spoil.
You know what irks me? We talk so much about how if a person is feeling depressed or anxious or whatnot, they should “seek help,” but honestly, that’s so much easier said than done when you really think about it. Working up to actually asking for help is hard enough, but then actually getting help is beyond difficult, and when you find help, it’s often not that helpful.
For instance: I had to stop seeing my therapist a year ago because she was out of my insurance network and I couldn’t afford to keep seeing her. I had to find a new psychiatrist because I moved to New York. I asked for references from a number of people but none of them were in my network or they weren’t accepting new patients. So, I looked up several on my insurance provider’s website. I spent an afternoon calling about 10 psychiatrists and 10 psychologists/therapists and got an appointment with one. ONE.
So, I went to see the psychologist/therapist two weeks later (that was the earliest intake appointment I could get). Turns out she worked out of her weird apartment in Park Slope, had lots of cats, and wanted to blame all my problems on being adopted. No thanks.
I finally got an appointment with a psychiatrist. I met him in his weird apartment in Gramercy. His walls looked like the doctor’s wall in Garden State – covered with certificates and diplomas, except there wasn’t one on the ceiling. He was an old obese Jewish man who didn’t move from his armchair once – he kept everything in reach of either his arms or cane – and after talking to me for 20 minutes, he simply wrote me scripts for everything I claimed to be currently taking in the doses I requested. (I didn’t lie.) This was a year and a half ago and he has refused to meet with me since.
Last December, I lost my health care coverage and elected COBRA for a while, paying a massive amount of dollars to be able to keep not seeing this psychiatrist and have him renew whatever I asked him to. When I got a new job and new insurance, I discovered my new plan only covered half my required dose for one of my medications, and out of pocket, the other half would cost me upwards of $400 a month. After a lot of calls to the jerk psychiatrist, my pharmacy, and my insurance company, I got it waived and can get my medicine. The pharmacists know me by name and face now and it’s a wonder they don’t hate me.
This is what “getting help” looks like. I still haven’t been able to find a new therapist because pretty much anyone in network isn’t accepting new patients and just generally, it isn’t easy to find someone you like and trust. Even when you find someone, unless your insurance plan has some kind of mental health parity rider that allows for an unlimited number of outpatient visits, you can only go get diagnosed and then have maybe 6 follow-up appointments. SIX. I just made an appointment with a new psychiatrist and hope he is able to get me on a medication that doesn’t make me so lethargic I want to sleep 14 hours a day, and something I can afford, and something that doesn’t make me physically ill, but I damn sure hope he can do it in six visits or less.
The reason I’m doing this at all is because I don’t feel like my current medication is helping me as much as it might – I have a lot of truly terrible days where I feel very unstable and incapable of functioning. But, I don’t experience suicidal ideation ever, and so, I can’t exactly call a crisis lifeline or check myself into a hospital or anything because I’m not about to harm myself. And what do I tell my employers? “Sorry, I need to come in late because I’m in the fetal position crying in the dark and feel like I can’t physically move without the world crashing around me”? That doesn’t exactly fly.
I’m okay, though. I always end up being okay. Not great, ever, but okay. But what about all the people who aren’t? What about all the people who don’t get the level of help they need before they reach the point of crisis? What about the people who can’t afford the help they need, can’t find the help they need, even when they have the courage to ask for it, and end up needing that lifeline or that hospital visit?
Suicide prevention and mental healthcare aren’t only about providing help in crisis situations or medication to those affected who are approaching the end of their ropes. It’s about providing affordable, personal care and support to individuals. I don’t know what the solution is, but I know we have to find one.