I Made It Through 2020
*Trigger warning for suicidal ideation
November of 2020 was the first time in my life I have ever experienced suicidal thoughts. Not because I wanted to die. Not because I was giving up on living, but because it felt like the only thing I hadn’t tried to escape my PTSD.
Because I have a support system and I chose to lean on it, I am alive today. I called my closest friends and asked them to spend the night with me during a pandemic because I was afraid of what I might do to myself while everyone else was sleeping. I told them about what I saw when I closed my eyes and how terrified I was that it might become my reality. I talked to my doctor about the benefits and drawbacks of mental health medication. I called my insurance provider and asked for a psychiatric evaluation.
I would like to think I did everything right, and yet, it took over two months to get an appointment with an in-network psychiatrist. Ten weeks to get help for someone teetering on the precipice of self-harm.
That woke me up.
I am not the first to say that my mental health took a hit last year. I rediscovered lows in 2020 that haven’t troubled me in 10 years, mostly due to constant isolation, financial fear, grief, uncertainty, and the stress of living under an administration fighting every day to take my human rights away. But I am still privileged. I can afford mental health services, even without insurance, if I had to. I have my family and friends to fall back on when a crisis hits. I’m a white woman living in one of the largest cities in the world. It would be hard for me to slip through the cracks that so many others did this past year.
It’s too soon to tell if suicide rates have risen due to this pandemic. Still, national suicide rates have been steadily rising for the past ten years, and treatment and prevention of suicide became infinitely more complicated last year.
Mental health services have changed drastically as a result of COVID-19. On one side of the spectrum, telehealth and virtual therapeutic modalities multiplied and soared to heights no one expected we’d ever need. On the other end, we’ve seen mental health services disrupted and all but abandoned in 93% of countries worldwide as critical funding goes towards fighting the coronavirus outbreak, according to the World Health Organization.
Even without a pandemic, good mental health services can be cost-prohibitive for most people, whether or not they have insurance. Given the rise in anxiety, depression, and prolonged grief disorders nationwide, as reported by the Washington Post, we are in desperate need of a massive overhaul of our attitudes and resources going towards mental illness and fast.
I hate to say it, but I don’t think COVID-19 isn’t going anywhere anytime soon. It could be another year before we have enough people vaccinated against the virus and vaccines developed for all its possible strains to make lifting pandemic restrictions feasible. Although it’s a new year, very little has changed for social distancing, self-quarantine orders, stay-at-home orders, or travel restrictions. How many more people will find themselves in an emotional crisis before we begin to change our already broken healthcare system?
I have struggled with depression, panic attacks, disordered eating, and anxiety since I was a child. I have PTSD from grief and emotional abuse and sexual assault — and I just spent a year, isolated, inside, with little to no physical contact with my loved ones, with dwindling income and encroaching tides of hopelessness and purposelessness threatening to drown me daily.
I got it in my head sometime this fall that medication was my way out of these constant lows that I was experiencing. So when the first psychiatric provider my insurance recommended canceled on me because his internet server crashed, I panicked. I forgot everything else at my disposal because I was so desperate to solve my emotional state. I even contacted my previous therapist to see if he could recommend a psychiatrist that could see me within a week.
This was his response:
“No medicine would relieve depression symptoms that quickly. So in order to feel some relief in the next few days, I’d suggest a few things. The fundamentals are key. Eat in a balanced way. Exercise. Sleep. Connect with some people.”
He knew that I could take care of myself if I just remembered how to; if I could just crawl out of my own hopelessness long enough to remember that my moods were not wholly dependent on my brain chemistry.
Not everyone is so lucky. It is not a given in this country to have access to a “balanced diet,” time or motivation to exercise, or a network of compassionate ears to hear us. Sometimes, the only thing that will shine a flashlight on someone’s darkest hour is the knowledge that they’re probably feeling this way because their neurotransmitters are out of balance, and there are medical means to rebalance them.
When I finally got a virtual appointment with a psychiatrist, we spoke for about 45 minutes. She prescribed me a low dose of the drug, Lexapro, a Selective Serotonin Reuptake Inhibitor, or SSRI. She warned me that it could take up to a month for me to feel the drug’s effects and that it may take some time to figure out the right “cocktail” for me. With my insurance coverage, the total cost of the visit plus medication was about $70.
Thankfully, I have not experienced suicidal ideation since November 2020. Even while I was waiting for medication, I had the support of my primary care physician, a trauma therapist, and a life coach. I was never alone, no matter how isolated I felt. I even got to spend the holidays with my Mom and keep both of us safe throughout my visit.
I do not believe that mental health medication is the answer for everyone. I do believe that now, perhaps more than ever before, we need easy access to medical professionals who can help us explore the many options available, from talk therapy to Somatic Experiencing to ketamine and micro-dosing psychedelics. We need affordable mental health coverage in our most basic insurance plans. We need more qualified, well-paid, and open-minded professionals who take insurance filling these gaps in our healthcare system, and we need an insurance market that supports them.
In the meantime, do what you can for your friends, your family, your neighbors, and your online community. Remind each other that it’s normal to be feeling off right now and that it’s OK to talk about it. If there’s anything we can do for each other in 2021, let’s normalize asking for help when we need it. I don’t think I could have made it through 2020 if I hadn’t.
As always, I’m here for you, and I promise to do my best to hear you if you reach out to me.