Friday, April 10

Finally, the economy affects me

I need to see a doctor. Or an ARNP. Or a psychiatric nurse. Stat.

I have been going off the deep end lately. Emotions are too strong for what they should be. I am starting to feel hopeless. Tim and I both agree that the Lexapro just isn't cutting it.

Last night, after screaming at him for wanting to go to bed at 10:30 -- I just couldn't stand that he was yet again more tired than me... I know that makes no logical sense... I knew it at the time... but I was just so tired and so angry and so over-ridden with emotion -- I wept. And I wept some more.

I had kicked him out of the bedroom to sleep on the couch. And the general disproportion of everything made me realize the last couple days weren't a fluke. I've been having a harder and harder time coping. Yet again.

I had hoped it was a brief interlude from stress. But it's the illness, the depression, asserting itself over and above the medication.

I felt hopeless. And lost. And exhausted from the fight. And ashamed of how much Tim has had to suffer it lately.

And that's when the thought came. Unbidden. Scary. He is a deep sleeper. I could go out to the kitchen and grab a knife and cut my wrists and he probably wouldn't even wake up.

Then I really started to cry.

I don't want to go away. I don't want to die. I certainly don't want to experience the pain of cutting myself. Or the mess of blood when inevitably the attempt failed. (Yes, sadly, cleaning up after my own suicide attempt was a logical argument against it. I guess I'm more of a neatnik than I thought.)

Mostly, though, I didn't want to die. And I didn't want to leave Tim. And I really didn't want to leave Tim all alone.

Yes, it was just a stray thought. It slipped in twice during one weeping session. But even once is a bad sign. Perhaps it was a random iteration of a brain flooded with ideas, like so many monkeys at typewriters aiming for Shakespeare. But I'm not willing to take that chance.

I think even one suicidal thought is one too many, depressive or not. It's not a good sign that it's ever a possibility. I don't care how you explain it away. It's not something that occurs to a person who can manage on his own.

So I called the North Seattle Health Clinic. I was prepared to make an argument for triage so that they could fit me in somewhere. With someone. My own doctor doesn't work on Fridays. (The plan was to start looking for a psychiatric nurse or psychiatrist next week.)

I got this message:

"Due to budget cutbacks, the North Seattle Public Health Clinic is closed Friday, April 10th. We will reopen Monday, April 13th."

So, at last, the economy affects me. Kind of strange that it took a stray, suicidal ideation to do it. But, strangely, it actually makes me feel slightly more connected to everyone. Is that weird? It's probably weird. But, frankly, dear Scarlett, I don't give a damn.

I'm off to try and find someone who will take me. I will probably end up at the doc-in-the-box up just outside the city limits. (Seattle's border is 145th St NE. The clinic is on 147th.) There's a long wait, often. And you'll rarely see the same doctor twice. But I have to get this taken care of. For Tim. For my mom. For me.

I don't want to go anywhere. Literally or figuratively. But I also don't want to struggle through the weekend with these peaks and troughs. It's unbearable. And I don't want to have anymore stray thoughts about hurting myself. Even for the completely isolated, forlorn, hopeless folks, they tend to be terrifying rather than a relief.

I honestly don't know what the doc-in-the-box can do. I'm already on three antidepressants. In the end, I'll probably have to be weaned off some of them. And both Lexapro and Effexor have severe mental repercussions.

But I have to do something. I'm actually proud that I know that. No, scratch that. I'm proud that I feel that. It's a sign that I haven't completely been lost yet to this illness. Because I'm not just staying alive for other people. Last time, it was for my mom. Probably the only time an overactive guilt complex worked in my favor.

This time, I'm doing it for me. Because I plan to have a long, if somewhat tumultuous, life with Tim. And while certainly he and my mom are a factor, I am not ready to abandon my future for present pain.

So I may come back on a fourth antidepressant. As a stop-gap until I can see someone more regularly. Who knows. But I will have done something.

And just so that this also personal-finance relevant: I have to do something before I have to go in-patient. Medicare covers only 190 lifetime days in a facility. and the first 60, I'd be responsible fora $952 deductible. The next 30 days, it's $238/day. Then $476 a day until day 150, at which point, all costs are covered. (This is the same for inpatient hospital care.) Anyone else find it hard to believe that this is the system for folks on disability and retirement -- aka "limited income"?

I'm sure Medicaid would help out with some. And that a well-written letter/filled-out application to the institution's financial aid center would help. But frankly I don't need the further workload. Or headache.

Medicare also wants me to pay a $135 deductible for outpatient mental health care. And then it will pay 50% of the fee (the one that Medicare deems fair, anyway). So that's not really ideal, either. But my GP simply isn't enough at this point. And it can take a month to get in to see him. So I will find a psychiatric nurse, who charges significantly less than a psychiatrist, and figure out the money part of it later. Or perhaps over the weekend. I'll need to keep busy then anyway.

Perhaps this all proves my point: It's more exhausting to be sick than to be a normal, full-time worker.

I'll go ahead and post Friday Freebies either later today or on Saturday.

Don't worry, folks, things will get better. And for a change, I'm not just saying that to convince myself or to shoo away the terror I know this talk creates in other people. I actually know (and feel) that this will be dealt with. And it will improve.

That, in itself, is huge.

I'm honestly not sure if it's a good or bad sign that money is a factor in my decisions about my mental health.


Blogger Alane said...

After wanting to LOL! at the statement about cleaning up your own botched suicide attempt ( my thinking tends to go the same way) I want to say Medicare sucks. No wonder there are so many commercials about supplemental medicare plans. Jeez. You also should think of using the suicide hotline number if it gets bad and honestly if the shit gets ugly get yourself the help you need, screw the cost and file BK. In my mind 10:30 is a good time to go to bed but if you aren't tired or you are but can't sleep and are moping around the apartment all night you need help ASAP. I check this blog everyday and am now gonna check several times a day. I am worried.

April 10, 2009 at 5:29 PM

Blogger Abby said...

Okay, well a mere 3.5 hours later I'm back. I did go to Care Plus (aka doc-in-a-box) and got a very nice ARNP.

She listened, expressed worry that I had "a plan" -- horrible how much worse things sound when put in real, psychological parlance -- and suggested in patient treatment. I explained some of our trepidation and that we were hoping to try just an increased med thing until I could see a psychiatric nurse.

She did me one better and essentially put a guy on the case for me. He's going to call on Monday, having checked how much of everything will be covered. If it's not tenable with his company, he has a lot of resources and will find me a place I can go.

Meanwhile, we raised my Effexor back up by 37.5 mg, which my doc had taken me down on a few months ago. And I promised that if even one more suicidal thought flashes into my brain, I will go to the emergency room, cost be damned.

I recognize that we can get out of a lot of the cost because of our bad financial position. More importantly, even if we do have to pay it, we'll pay it back. It'll be slow but it's nothing compared to my health and continued existence.

So Tim and I got some groceries while we waited for my prescription to be filled. We're munching now and will be spending the weekend sorting Magic cards, which will help keep me busy until Monday.

I'm upset that it got this far and is affecting Tim so much. But I keep reminding myself that I wouldn't act this way if I had recurring pneumonia, so I need to just work on getting better.

It's definitely embarrassing to get to this point, that I have to be labeled a potential danger to myself. So I plan to keep that promise about the ER or in-patient treatment. Which I mainly want to avoid because of the aforementioned cost and the complete lack of Internet/people familiar with my energy problems.

But I'll do it if that's what it takes to get better. So don't worry too much. Think of the suicidality as alarming, sure, but also a symptom of the illness and a sign that the meds aren't covering the symptoms as they should. Just like when my MRSA infection got worse, not better, with the antibiotics. I had to go in and get stronger ones. There was a chance I'd have to go to the emergency room if it got worse. I'm trying to think of this depression as just like any illness: no shame or judgment, just a danger to my continued health. I'd have gone to the ER if the MRSA kept getting worse. I'll go to the ER if my depression gets worse.

April 10, 2009 at 6:02 PM

Blogger Alane said...

Thanks for posting back so soon. I will be keeping a watchful eye on you though. I hope the meds help you get through this weekend.

April 10, 2009 at 6:23 PM

Blogger Meg said...

Oh hon, "that sucks" is an understatement. Hang in there and know that you are very loved.

April 10, 2009 at 7:48 PM

Anonymous Anonymous said...

Oh, lovey. Take care of you. If you need to talk, hop on yahoo. I'm up all night tonight.

April 11, 2009 at 12:19 AM

Blogger Shtinkykat said...

Suicidal thoughts, no matter how fleeting, are so dangerous. A friend of mine committed suicide over the New Year's holiday and I witnessed the devastation of the survivors. I'm so relieved to hear that you are actively seeking help. Please keep in mind that there are people in the blogosphere who also want to see you healthy and alive. :-D It is troubling that the healthcare system we have in place for the disabled and retirees require significant personal outlay to receive long term health treatments. I'll be praying for you during this holiday weekend. Take care.

April 11, 2009 at 4:56 AM

Blogger Alane said...

Good Morning! I hope you got through the night okay. Sorry I wasn't back last night. It is kinda tough since I am on the East Coast. I am working today but will be checking back in tonight when I get home. 7:30 my time.
Take care.

April 11, 2009 at 8:06 AM

Blogger Abby said...


I'm sorry to hear about your recent loss. Certainly, I have no desire to hurt those around me. More importantly, perhaps, as Tim points out, I'm simply too stubborn to give up. And I'm vaguely sure he'd pull an Orpheus even if I did. Only with a happier outcome.


I appreciate the thought. There are, I think, no real good words of sympathy for depressive pain. I ended up talking to a friend last night who's checking into rehab. After years of acknowledging his alcoholism without any real interest in dealing with it. Words are so difficult in any such situation because all the cliches that rise to mind are genearlly filled with awful subtext. So I guess I'm saying I appreciate the kind words.


I will probably be online later tonight. I will try to log in and say hello.


Thank you for checking in. Any and all support is always very touching in tough times.

April 11, 2009 at 2:02 PM

Blogger Alane said...

After helping me out with that post the other night I owe ya. :) Never forget you are much more than any illness.
Anytime you want to talk let me know here and I will give you my personal email and phone # if you want to talk to somebody with a funny accent. :p

April 11, 2009 at 4:55 PM

Blogger Mrs. Modern Tightwad said...

I'm very glad you decided that your continued health and well-being ranks higher than debt. From personal experience I can say you're right, it is scary when you look back and realize there was a plan, some sort of intent; although at least it means you're there to look back. I am also very glad that you found someone who's going to follow-up and make sure you're okay.

You are definitely cared about, and we will keep you in all of our good thoughts. If you need anything, if any of us can help with anything, please let us know.

April 11, 2009 at 10:04 PM

Blogger Shevy said...

I've been offline due to the beginning of Passover and I come back to catch up on everybody's posts and there's so much major stuff going on all over it's just mind-blowing.

I'm so sorry to hear that your depression is getting worse. As long as it's kind of "under control" it's not okay but it's just the status quo and you manage the things you normally do. When it starts to get worse it's kind of like everything starts circling the drain.

One don't have the energy or the focus to do certain things. Stuff starts to get away from one and that makes one feel worse. It becomes apparent that changes need to be made but changes, hard at the best of times, seem impossible when one is struggling to move through molasses up to the neck. (This paragraph sounds dumb with "one" all over it but it sounded worse to me when it said "you", almost accusatory or something. It could just as easily say "I" and "me". Right now either the English language or my competency in it sucks.)

It's so much easier to curl up in bed and reread favorite books or play some mindless computer game or watch every single episode of Buffy on DVD than it is to take a positive action. I'm proud of you for taking action and being brave enough to tell us all about it.

I had my own meltdown as I came down to the wire with all the cleaning and preparations combined with a couple of really tough conversations with my Eldest Daughter. I made it through to the other side though because the intense time-dependent stress ended when Passover started. Then things just revert to the status quo. What you've been going through is so much more difficult to deal with and doesn't suddenly ease up.

Good luck with finding new solutions.

Remember that, even though we don't "really" know you (whatever *that* means), there are a lot of us bloggers out here who do care about you.

April 12, 2009 at 12:03 AM

Blogger said...

Your article scared me, caused concern, and some reflection.

I've just recently visited your site and I really enjoy your articles and insight. We blog about the same things mostly PF and I understand your point of view.

Life can be a blessing and at times wonderful, and at other times terrible. Life is a journey. There are really, really, rough parts and great parts.

I often imagine my journey as whitewater rafting trip. While I'm in the rough parts I know that further down the river it gets better. When things get better I try to slow down and enjoy them.

I wish you the best, please, please, hang in there and paddle like mad! There's a calm part of the river just a little further down stream. sp:)

April 12, 2009 at 5:12 AM

Blogger Alane said...

Happy Holiday ( and all that other PC crap!) Hope you had a good night and got some sleep.

April 12, 2009 at 9:12 AM

Blogger Abby said...

Mrs. MT,

Thanks for your thoughts/concern. I agree, the important part is being around to look back.

In the book I'm reading (Kill the Damn Dog) the author notes that it's less likely after the first bout that depressives will become suicidal or at least try to kill themselves. It's assumed (and this is what I thought, too) that it's because they have more experience and can better know/feel that this pain will come to an end. So there's more reason to stick around. Thanks for keeping me in your thoughts.


You're absolutely right -- at the time when we most need to change, change is the hardest to effect. Which leads to further self-recrimination and that leads nowhere fast.

I'm sorry to hear that you had some troubles of your own, including discussions with your eldest daughter. I think holidays are wonderful in that they bring family together, but they are also problematic in that, well, they bring family together. I hope your Seder (and Passover as a whole) went well. It sounds like things worked themselves out, to the extent that they ever do over short periods of time.


Thank you for reading! And for your concern. I was a tad scared myself, truth be told. Which is perhaps a good sign. It's when such thoughts don't cause concern that it's particularly problematic.

That said, I am certainly going to be sure to take care of myself. I have a life that, while difficult (white water as you pointed out) is also full of blessings. My ever-patient husband being one of them. He must have asked me six times yesterday how I was doing, what I was thinking, etc. Even if I didn't want to stick around for myself (and I do), I just don't think I could leave him.

I am, as you say, paddling like crazy. The added Effexor is helping to balance out my mood for now. And I spent most of yesterday organizing Tim's cards by set, then alphabetizing. I still have two big stacks and a couple small ones to go. But most of his Type II cards (those still playable in mainstream tournaments) are organized. It's nice to get something that is visually productive. I can look at the box, with all the dividers and think: Aha, I did that. I'm effecting change.

Thanks again to everyone who is reading and taking an interest in my life and this blog. I have to say there is certainly a slightly egocentric part of me that is flattered by people logging in to read my words. I guess that's good motivation for me to stick around, as well.

April 12, 2009 at 9:14 AM

Blogger Alane said...

Glad to see your new post. I hope things went well today. Have you gotten any appointments?

April 13, 2009 at 4:19 PM

Blogger Revanche said...

Hey there, I wasn't able to comment before but I did want to check in and see how you were doing.

Is it weird that I sort of wondered how you knew you'd botch the attempt? Or was that part of the thinking process? I have trouble separating the rational from depressive thoughts, sometimes, possibly due to being so dang practical sometimes.

Hope you're feeling better, sending warm wishes your way.

April 13, 2009 at 5:18 PM

Blogger Abby said...


Pain can interfere with one's ability to cut deeply enough. Plus, there would have been every chance Tim would have woken up during the process and rushed me off to the hospital. Hence my assumption.


The one clinic wouldn't take me without Medicaid. So I've put in some calls to a couple of clinics and am waiting for calls back. One has to screen me. The other is a private psychiatrist, actually, so I'm hoping I'll hear from her tomorrow.

April 13, 2009 at 5:49 PM

Blogger Alane said...

Alright maybe it is my Jersey Girl attitude but I would tell the clinics to go f... themselves and get myself to one of the local teaching hospitals and really make a pest of myself. Is it really that hard to get help when you need it? That just burns my a.. Now I am pissed.

April 13, 2009 at 6:33 PM

Blogger Shevy said...

Did you read Mrs Micah's post titled "Why I'm Glad I Didn't Kill Myself?" referring back to a time when she was suicidal?

Remodelling This Life linked to it or I probably wouldn't have seen it.

You are so not alone.

April 13, 2009 at 9:30 PM


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