The Price of Mental Stability

Trigger Warning: Medical imagery

The price of my mental stability is $250 a month.

It can be hard to put a price on things like this, but my case is clear. It’s the difference in costs between two medications that achieve the same purpose for the same physical illness I developed seven years ago. Both treat the symptoms in similar ways, but there’s one huge difference that means I can’t take the cheaper clinical alternative.

I was given the original medication along with a packet of blue paper. I can still remember how many sheets there were, straining the staple as I flipped through them. These were no ordinary instructions. These were restrictions on what I could eat - no leafy greens, and I’m a vegetarian. I had to take the medicine at the same exact time every day and not eat for an hour before or half an hour after. I had to get blood draws to even know how much to take, and the doctor would tell me what to do each day. There was also a list of how to know when things went wrong, and all the tiny little conditions that meant to go to the ER immediately, or else.

Instructions like these are probably meant to cause some kind of comfort to patients - if you follow these rules, you won’t get sick again. But for me, it took on a whole other meaning.

Thanks to my OCD, I tend to see all the possibilities of things. Sometimes, this can be a good thing, helping me to find the good in a negative situation. But here, all I could see was this huge list of rules that had to be done completely right. What if I took the pill at 5:01 instead of 5:00? What if I forgot any of the rules? What if I ate a potato chip before dinner? And what if that chip then somehow ruined the blood value for the dose I was supposed to take, and I took too much and bled or too little and died?

And that was just the aspect of things I could control - I also might have symptoms that terrified me because of my obsessive relationship with my digestive system for no reason at all, and all the sticking to the packet in the world couldn’t keep me safe if I had something like that. All it took was one memory of the horrifying taste of blood for me to become completely, utterly terrified.

When I started the medication, it was a daily ordeal. Not only did I have to keep the rules, but because my numbers were never consistent, daily blood draws became a part of my life. I had to enter an environment I was terrified of every day, and be in pain and fear every afternoon until the doctor would call me and tell me my dose. Then that would feed into the fear that I was cutting the tiny pills wrong, and what if I had half of one instead of a third, and did the little dust on the pill-cutter count?

The blood draws thinned as time went on, but the fear and obsessions lingered. I begged for an alternative, and when I heard about a new drug that was in FDA testing, I told my doctor to call me the minute it was approved for use.

Eleven months after I got that blue packet, I was finally able to take a pill with no restrictions. No blood draws, no counting, no timing. This pill was, medically, the less safe option. It didn’t even have an antidote at the time, which meant that paramedics couldn’t do much of anything if I was bleeding too much for any reason. But I gladly made that trade, so that the life I lived could be the life I loved from before any of this happened.

The new drug has no generic version, and won’t for years. It’s very expensive, even with insurance and the manufacturer’s discount card. The other option costs a pittance, if that. But there’s nothing I can do.

I know myself well enough to know that I can’t do something that regimented. I know this lesson in many ways, like when I’m trying to lose weight, I know to not count calories. I know to not fall into traps like these because of how hard it is to claw my way out. And so, I pay.

I pay the $250 not because I want to be difficult or don’t respect the money I earn, but because I prefer living my life without having to fight every single second for a shred of happiness. I know what that feels like, thanks to a prolonged mental health crisis where I dealt with the trauma of this illness and its recovery years after I left the hospital.

I pay the $250 because I don’t know how to tell an insurance company that yes, there are technically other options, but even the thought of going back on the first medicine made me start to cry and wonder if I had the strength to make it.

I pay the $250 because after experiencing a crisis like that, I’d gladly give my entire bank account to avoid having to deal with unending panic attacks and flashbacks and depression that sucked away everything good about my life.

I sometimes wonder about the people who can’t afford to pay the $250, or however much it might be for them. I wonder if they find ways to get used to the pain over time, or if they simply fall deeper into despair. I hope for their sake and mine that one day, mental health will be a valid reason to switch from one medication to another, especially in cases like mine where I was able to find research that 1 in 3 people facing my illness would also face a mental health crisis within the following two years.

To me, this is a reflection of the secrecy and shame around mental health. It’s not easy to use my OCD as a reason to make one choice over another, especially after I’ve been conditioned to believe that doing anything based on OCD is wrong. It’s not easy to explain things to doctors and pharmacists and insurance companies. It’s not easy spending the money that I could be saving for my future.

But for me, it’s no choice at all. I need to advocate for myself, to do what I know is right for me. I need to be able to eat salads at 5:00 and keep my blood in my veins where it belongs. I need to not be in a hospital environment that breeds flashbacks. And that means I need to pay this price for no reason other than the chemical production of my mind, so that I have a real chance to be happy and healthy.

And isn’t that what any medicine is ultimately for?

Ellie, a writer new to the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.