I shared this post with a friend and realized it was actually not on my primary blog. I wrote this a few years ago and would like to add a couple of things in light of the current political situation.
There were some good things about the existing health care system, but there were also many issues. I don't think I know a single person who doesn't have multiple stories of unaffordable medications, inability to see specialists in a prompt manner, being blindsided by bills for surgeries and labwork they were convinced were covered by their insurance.
Mental health is perhaps one of the biggest gaps. There is still a broad misunderstanding of what mental illness actually is, and mental patients are frequently dismissed as people with the "bad case of nerves" or "unable to handle stress". Taking a sick day for a sore throat, a broken leg or an appendectomy is acceptable. But taking a mental health day is considered lame and often earns you a bad reputation with managers and co-workers. At the other extremes, there are entire groups of doctors and patients too quick to issue and accept a mental illness diagnosis, where there shouldn't be one.
Most insurance companies only cover ten therapy sessions per year. Anyone requiring ongoing attention of a mental health professional will tell you how laughable and pathetic that number is. It often takes up to five sessions just to establish rapport with your therapist. And what if you need therapy every two weeks? Once you have used up your ten sessions, it's either pay hundreds of dollars out of pocket or endure a multi-month interruption in therapy, which can be a dangerous proposition.
With the constant mergers between the health insurance providers and companies shopping for the cheapest plan possible, a mental patient is at a constant risk of losing his or her therapist due to a change in the network coverage. This actually happened to me - I was very fortunate to find my perfect therapist from the first try (again, both mental health professionals and patients will tell you how rare that is), but I had to give her up after only six months because my employer made a decision to switch to another insurer, who did not cover my therapist. That was eight years ago. I was unable to find a good therapist match ever since.
Having seen this many issues with the mental health aspect of our health care alone, I honestly cannot understand people who say that we did not need a reform and that the system was well enough as it was. What follows is a narrative of the good, the bad, and the weird of being a Borderline.
I always joke that Borderline Personality Disorder (BPD) is a trashcan of mental illnesses. It combines nine symptoms from some of the more prominent mental disorders: a little bit of bi-polar, a little bit of clinical depression, a little bit of social anxiety disorder, a little bit of ADD - but none of the symptoms are pronounced enough for a BPD patient to be diagnosed with any one of those illnesses. So, at some point mental health specialists must have gotten together and decided, "Well, let's just pile them all into this one group and call this weird mental illness symptom combo thingie Borderline Personality Disorder. Doesn't that sound cool?!"
Being a BPD patient (also referred to as "a Borderline") is weird. You get misdiagnosed a lot and sometimes have to go through several therapists and several different medications to figure out what is wrong with you. As with any other mental illness, it's tough to face the fact that you actually have a problem - primarily because the symptoms are so scattered and not always pronounced. One Borderline cannot always relate to another Borderline, because while you have to have 6 pronounced symptoms out of 9 to be diagnosed with any certainty, they don't have to be the same 6 symptoms across the board, so a fellow BPD patient might have the same self-destructive tendencies, but not the social anxiety piece.
BPD is a pain in the neck - primarily because of its unpredictability. You never know, which one of your 6 pronounced symptoms (or umpteen combinations thereof) is going to hit you on any given day and how strongly. You might have a mild mood swing or you might have a full-blown "scared out of your mind" panic attack. (I've had those in my car in the middle of a highway a few times. It wasn't fun.) Or you could have two contradictory symptoms acting up on the same day: like your social anxiety and your fear of being alone. Trust me - you do not want to be there!
I think it was the panic attacks and the self-destructive bouts that made me finally give in and try medication. I resisted the thought for a long time, because I thought taking medication would be a sign of weakness. But honestly? I think it was a lot braver to decide not to be miserable on a weekly basis anymore. The last straw came when I had a panic-induced breakdown in the middle of an aikido class in front of my instructor and all my fellow martial arts students. My doctor (the greatest, most wonderful person ever) put me on Lexapro, which is the mildest are pretty much gone. I still have an occasional breakdown, but they happen once every 3-4 months - not once every week.
Interestingly enough, it was Lexapro effectiveness that made me change jobs about a year and a half after I started medicating. I had this very meticulous, detail-oriented boring job, where I got slammed by my boss for having one digit in my documents out of order. The job was so monotonous, that I couldn't keep my mind focused. I talked to my doctor about it and she suggested that we try shifting to Wellbutrin, which is an ADD drug, to help me stay focused. The problem was - Wellbutrin and Lexapro are mutually exclusive and should not be taken together, so I had to get off Lexapro. That was one of the worst months in my life! Wellbutrin did its job - I managed to stay focused despite the monotonous work I had to do. However, I have lost every positive effect I managed to build up with Lexapro over the previous year and a half. I started having panic attacks again and, worst of all, my self-destructive tendencies also decided to rear their ugly heads. I was so miserable, I cried every morning because I had to go to work and I cried every evening because my work made me even more miserable. Talk about a clear indication that it was time to change jobs! I did change jobs and went back to my trusty Lexapro and to feeling as close to normal as I could ever get.
With some of the uglier portions of BPD under control I am not sure if I would want to get rid of BPD altogether. Not everything about being a Borderline is bad. My mind activity is almost always at top pitch. I can think in 10 different directions at the same time and never lose track of any one of them. In all fairness, having an overactive mind can be troublesome sometimes - it makes one bored quickly when working on only one or two tasks and it's difficult to settle down when it's time to go to sleep. Having several things going at once helps in the former case (I usually have a database of some sort going on, an electronic copy of a book I am reading, a couple of e-mails, a trouble-shoot, and either a blog or one of my own books that I'm working on). I haven't found any cure for the latter - difficulty of shutting down - other than taking half a Melatonin at dinner. I am not fond of pills, but any of the other "getting sleepy" methods just didn't work for me consistently. [I had since stopped using any sleep medications, opting for natural remedies like Lavender and Valerian root.]
On a positive side, my memory is huge - I remember myself since I was 3 years old and I can recount stories from then till now with details and in color. I am lousy with dates and phone numbers and I do need to have a conversation with a person to remember his or her name for good. At the same time storylines, character names, major scenes and descriptions from hundreds of books I've read are not a problem - they are as fresh in my mind today as they were when I first read them.
I do have terrible nightmares, but I also have the most beautiful dreams - 3D, in color, with amazing plot twists. Who needs cable to watch a thrilling spectacle? All I need to do is go to sleep.
My ability to analyze just about anything is really sharp. I work as an analyst (it's actually my job title), but I always joke that I am not an analyst by trade - I am an analyst by birth. My brain is wired for it. I think in tables and databases, when I need to, and arrive at conclusions so fast that I sometimes get frustrated by other people who don't get it (I am working on being more tolerant about it).
When I was in grad school at RIT I had to take a couple of mandatory liberal arts courses to fulfill the credit requirements. I took Social Psychology among other things, where we had to do some analysis of various sets of data from public polls. After I have submitted my first summary, our instructor asked my permission to use my homework as an example of proper analysis in other classes. I found it rather amusing, because it must have ticked off a lot of Psychology majors to be shown how to do public data analysis by a Mechanical Engineer.
Yes, BPD is still an illness - there is nothing I can do about that. But when I think about it, I honestly wouldn't want to give up the always-active brain, the memories, the analytical ability and especially the dreams only to get rid of an occasional day when I feel really, really bad. The black, depressive, self-destructive moments do pass and I am getting better at handling them. So, given I choice, I think I would rather keep on being a Borderline. Wouldn't you?