What Happens When Your Insurance Company Won’t Cover the Medications Needed for Your Mental Health
In the last year, I have made so many positive strides in my ongoing fight to get in front of my mental illness and to be in a healthier place. I not only have begun finally opening up, writing and talking about my struggles with depression, anxiety and p.t.s.d., I have begun therapy at a wonderful facility that uses a multi-pronged treatment plan to combat mental illness, involving not only traditional treatments such as therapy and medication management but also incorporating unconventional tools such as yoga, meditation and art into the mix to help people heal mind, body and soul. Perhaps the greatest stride forward I have made, however, happened thanks to a genetic test my new doctors gave me that identified a genetic mutation I possessed that has been the linchpin blocking all previous attempts at medication and treatment. Due to this genetic mutation, my liver is incapable of metabolizing folic acid, a simple b vitamin used by the brain to help transport the chemicals needed to help moderate my moods and depression. It is a fairly simple fix because there is an already broken-down version of folic acid on the market, a synthetic version that can help my brain to function properly – something it has never been able to do on it’s own, due to my genetic mutation. However, the simple yet life-changing fix has been completely derailed by my insurance company, CDPHP, that refuses to cover it.
My doctor had been providing me with samples of the broken-down folic acid, also known as l-methylfolate or by the prescription name Deplin, for the last seven months. While it is in no way a panacea that would make my mental illness disappear, it made a world of a difference. I had more clarity, was able to focus better and function more. I was able to fight back tears and move forward, face fears and be productive in ways I previously never imagined possible. I found myself able to genuinely smile and experience happiness. Despite the fact that I was going through one of the rockiest times in my life, I had real hope. It was the beginning of a new life, a new world for me.
Yet despite how much of a breakthrough I had achieved on many levels thanks to this medication, CDPHP continues to refuse to cover it, deeming it unnecessary. My doctor had a drawer full of samples to keep me going while we began our fight for coverage. I had been filing appeals, reaching out for help, fighting with every ounce of energy and courage that I could muster, completely due to the Deplin helping my antidepressants and anti-anxiety medications get where they were needed in my brain, something they could never do on their own because I had always been medication resistant due to my genetic mutation.
…And then the samples ran out.
…And my internal appeal for coverage by CDPHP was denied.
It has been a week since I have had any Deplin in my system. Where I was previously up before seven in the morning every day, up for breakfast and ready to start my day, I can’t seem to pull myself up out of bed again. Today, it was almost eleven before I even got out of bed. Less than twenty minutes later, I was back in bed, wrapped in my blanket, wondering why I was even bothering. Each day, it becomes increasingly harder to do anything at all.
Even the simplest conflicts feel unbearable again. I find myself panicking and breaking down into tears over even the smallest bumps in the road. Where previously I was convinced that I could somehow figure things out and find a way, I don’t feel like I can deal with anything right now. I’m afraid to go out, to leave my room, because I have no control over my emotions or my tears anymore. My mind is racing again, I cannot focus, I cannot sleep, I have no desire to eat, no desire to do anything. I feel like I’m in a constant panic, one word away from breaking down into tears again.
It is like I had entered a Renaissance, a beautiful world full of progress and hope, only to be kicked back into the darkness of the stone age.
I have an external appeal yet to file with the state but I don’t know if I can do it. I don’t know if I have the strength. My mind keeps asking me why bother? Everything feels hopeless. The battle feels lost. All I want to do is climb back in bed and cry. That other world, that one where I was smiling, where I felt hopeful, feels like another world, another life, just a dream. I’m terrified I’ll never find my way back to that person again. Sitting out in public, typing this out, I cannot stop the tears from flowing, cannot find my way back to the person I was even a week ago when I believed that things were going to be okay, when I believed in hope.
This story began with Fighting for My Mental Health on 1/13/17.
Republished on The Mighty on 5/11/17.