Question:
I've been in a serious depression since November. I'm unable to sleep and my nights and days are mixed up. My body feels like it's been beat up by a lead pipe. I'm grieving a loss and I can't seem to move on with my life.
I can't afford therapy even with our health insurance paying part of
it. My part would be $40 per visit.
I know that I need intense therapy which would probably entail at least
one visit a week and that adds up to $160 per month and there just
isn't that much left at the end of the month.
My family doctor is unwilling to prescribe any medication unless I
agree to see a therapist at the same time, and he wnats me back for
medication check at least every 2 weeks. That's another $30 per month,
with the co-pay.
I'm at the point that I'm thinking about suicide every single day. The
pain is unbearable and I just "want out".
I don't know what to do or where to turn.
Answer:
Oh hun - I feel for you. It is a shame to feel tied up by such matters
at a time like this. I wish you all the very best. First off, I would explain the financial situation to youremployer,
doctor and or your HMO (I'm assuming) - there maybe a fund to tap into,
or they may be able to negotiate the co-pay.
Next, check in the phone book under "Mental Health" and "Community
Services". The is undoubtedly a non-profit near you that has a sliding
scale for it's fees. Perhaps your MD would be willing to subscribe with
you in therapy at one of these if you sign releases so there can be
contact with the pdoc.
Whatever you do - don't stop looking, or taking care of yourself. It
may take some time to work out the best situation for you, but you will
find it!
if you cannot sleep at all, that sounds like you have
probably developed clinical depression. You do sound pretty bad to be
honest. Therapy would probably do little for you if you have clinical
depression. You badly need meds. I think it is reprehensible that your
family doctor will not prescribe antidepressants for you without seeing
a therapist first. Most family doctors will write a prescription for
SSRIs like Zoloft or Paxil in a heartbeat after simply talking to a
patient. Most family doctors can diagnose depression by themselves. If
a primary care doctor cannot diagnose a case of depression by
themselves these days, well they are not a good doctor Holly. Is there any chance you could go to another doctor Holly? Are there any
of these 24 hour walk in medical places where you live? Usually those
places dont require insurance and you have to pay yourself. But in your
case it might be worth it if you can pay the initial visit yourself.
Just find one, walk in and tell the doctor you are depressed, cant
sleep, etc. and would like a prescription for an SSRI
antidepressant...Paxil or Zoloft, Celexa. Something like that.
Then after you are on antidepressants a while and you stabilize you can
worry about getting some therapy, getting back on your feet and getting
some insurance.
Another idea Holly. Are there any county or city mental health clinics
where you live? Most places have a government run mental health clinic.
The fees are usually based on sliding scale and are usually very cheap.
There are several mental health clinics where I live. All are run by
the county. Ive not been to one yet because I have health insurance so
I have not had to use them. But if you dont have insurance that is the
place to go a lot of times.
This seems to have become my latest theme...the use of anti-depressants
to treat normal sadness or grief. You are fortunate to have one of the rare doctors that don't prescribe
Prozac like candy. In fact, the growing consensus is that general
practitioners should not even be allowed to prescribe these powerful
mind-altering drugs, only psychiatrists.
I think if you are suffering grief over a death or something like that
then therapy is in order. Anti-depressant drugs are for clinical
depression, which is not the same thing as sadness. Clinical depression
results from a lack of the serotonin transmitter in the brain and the
anti-depressants increase the serotonin level. But normal human sadness
is different. An anti-depressant would probably cause far more problems
than you already have. It might make you feel better for a few weeks
but soon you would start to notice serious side-effects such as weight-
loss, sexual dysfunction, and bizarre behaviors like obsessive/compulsive
disorders.
Most communities have charitable or publically-funded therapy available.
Please consider these options before trying for a quick-fix with Prozac. I thought that you sleep all the time with depression. I didn't know
that you *don't* sleep. I'm awake until I crash after about 24 hours,
and then I sleep maybe 3 or 4 hours, and the cycle starts all over
again.
My doctor told me that my insurance ( Regence Blue Shield PPO )
requires that I see a therapist at the same time he prescribes
medicine. He said that I have to get to the root cause of the
depression. I told him what the root cause *was*, in my opinion. I
guess it's time to get another doctor.
Yes, there's a 24 hr. walk in clinic that's a satellite for a large
hospital about 40 minutes away. I think my insurance will consider it
an emergency. In any case, as you said, the important thing is that I
get medication.
Yes, we have a county clinic near that large hospital, but they don't
take insurance so it would cost me less to go to the walkin clinic with
the copay.
I just kept hoping that this would pass, but it hasn't, and it's
getting worse every day.
I'll try to get into the clinic tonight or tomorrow.
Also, I read your signature file. That same doctor had given me
prednisone awhile back. Please explain why prednisone can cause
depression. I'll try negotiating the copay when I'm able to get
into therapy. That cost is the worst. My insurance has a $15 co-pay.
The doctor had told me that the therapist he recommended charges
$90/hr. I'm thinking now that I won't take his recommendation, either.
Maybe I can negotiate the cost with the therapist.
Meanwhile,if any of you have experienced this sleep problem, how did
you cope with it before the medication started to work? I'm so
exhausted that I'm feeling nauseated, too.
