Down the Rabbit Hole

Today I have health insurance. There’s a sentence I haven’t been able to say for the last three years. I recently convinced my employer to purchase health insurance for me and to say that I feel relieved would be the mother of all understatements. For three years my access to health care has been minimal. Routine tests and check-ups I once took for granted have not been possible and perhaps most notably, my chronic depression has gone untreated.


A couple of years ago, during a particularly difficult time, I scraped together enough money for one visit to a therapist I had seen previously. We had a frank discussion about the dangers of leaving chronic depression untreated. She described my baseline of depression as something that would not go away without treatment. Period. But she was more concerned about major depressive episodes left unchecked. She described it as my depression going through periods of relapse and remission, but progressing with each cycle. In other words, every time I went down that rabbit hole, I went a little deeper and came up just a little short of the top when I climbed back up. She advised me to begin taking anti-depressants, which had worked well for me in the past, and never stop once I found a medication and a dose that worked well. I didn't disagree, but when you’re uninsured and on a limited budget, that’s easier said than done.

Unfortunately, even when I found medication I could afford, without health insurance there was never room in my budget for the doctor’s visits necessary to monitor it and keep the prescription current. And when I tried to find low-cost options, I could never quite make it through the requisite maze of programs not accepting patients, calls not returned and waiting lists. I would set out with the best of intentions, but lose steam, my nerve and sadly, hope before ever finding the help I needed. The devil is in the details and those details are kryptonite for those who suffer from depression.

But today I have health insurance and not a moment too soon because I’ve fallen down the rabbit hole again and I really, really want to get the hell out of here. Quite frankly, it sucks down here.

Armed with my shiny, new health insurance, I visited a psychiatrist a couple of weeks ago to begin the process of finding a medication to help me out of this place and keep me from coming back. Side effects of these drugs can be incredibly difficult and often appear right away, so I took a deep breath and steeled myself before I began the medication she prescribed. As if on cue, two hours later my heart began to race, my anxiety increased, I shook uncontrollably, lost my appetite entirely and felt horribly nauseous. As it’s not my first time at this particular rodeo, I knew I should give it ten days to see if the side effects would abate, so I put my head down and rode it out. Frankly, I find it to be an inexcusable flaw in these drugs that side effects present immediately and with the force of a ton of bricks, yet the positive effects take weeks to notice at all and even then, build slowly over time.

It took all ten days—ten seriously crappy days—but nearly all the side effects have subsided now. My appetite hasn’t quite returned, but I’m no longer nauseous and most things have stopped tasting terrible. It’s a world gone mad (or perhaps brain chemicals gone mad) when I find red wine repellent.  That god that's over and I’m back to “just” a deep depression complete with confusion that makes me wonder if I’m crazy and anxiety that too often rises to full-blown panic attacks. But with any luck, relief is a mere three to seven weeks away. (Thank you Forest Pharmaceuticals.)

I’m what’s known as a high-functioning depressive. I keep up appearances, do what’s expected of me. The casual observer would never know the shit-storm that’s going on inside my head. The luxury of a breakdown is something I simply can’t afford, and let’s face it, who among us can? The perfect piano recital dress isn’t going to find itself, and 30 elementary school kids aren’t going to produce a yearbook on their own, and, and, and. We all have so many “ands.” Keeping up appearances is exhausting, however, and the relationships on which I most I depend can suffer as a result. I consider those closest to me a safe place to stop pretending to have it all together, to cry or hide, or not talk and have that be OK. But while I’m reveling in the relief of letting my facade slip, those closest to me can feel neglected or even rejected. It’s a seemingly impossible dynamic, but one I feel powerless to change.

Because down in this rabbit hole things are strange, painful and confusing. I feel like I’m shrinking down here, literally folding in on myself. It’s as if I’ve pulled in all my exposed parts and I’m holding all of “me” close for protection. This is how I’ve always done it. It’s a skill, really. A skill born out of necessity from years without treatment, as a teenager because I didn't understand what I was dealing with and as an adult when I’ve been unable to afford what I need. It’s the only way I've ever found to live down here. I fold myself up, grit my teeth, clinch my fists and focus intently on the details of simply getting through my day and caring for my children. I’m afraid, though, that once I’ve folded myself up really tight and small, I must seem unreachable. I’m still here, though. I'm right here.

But if it seems that a piece of me is missing—that there’s somehow less of me right now—it might be because I’ve given that piece of me to Ben and Lucy for the time being, so that they know they’re safe, protected and loved. Or maybe I’ve folded that piece deep inside myself for extra strength. I hope to climb back out of this rabbit hole soon. To grow back to my regular size. When I do, I may be a little worse for wear, but I’m sure those who love me won’t mind a few new battle scars… any more than I mind theirs.

And if you’re down in a rabbit hole of your own, fold up as tight as you need to—I’ll still know you’re there. And hold on tight to you. You’re stronger than you realize. We all are.