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Every so often in America, an angry white man shoots a bunch of other white people[1], and we engage in a brief national conversation about our mental health care system. As far as I can tell, the Newtown shootings have provoked the longest national conversation about mental health care in recent memory, and it’s mostly died down now, a couple of months after the attack. It’s possible that Adam Lanza, whose violence was directed primarily toward women and children, was mentally ill. It’s possible that he was sane, but angry. Regardless, I am appalled that the only time we seem to discuss mental illness is when we’d like to rationalize a horrendous crime.

This is an important conversation that we, as a nation, are not having. Around 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.[2] Most of these people are no danger to anyone but themselves.[3] Most of us are no danger to anyone but ourselves.

I was born in 1988 in a small Catholic hospital in New Brunswick, New Jersey. My mother was a middle-aged lawyer; my father was a zoning officer for nearby Bernards Township. They divorced when I was very young—I have no memory of them as a couple. The divorce was extremely contentious, and the custody battle raged on for over ten years. My mother, my primary caretaker as a child, suffers from severe depression and an untreated anxiety disorder. My father remarried when I was a toddler, to a woman who had difficulty concealing her dislike of me. My stepmother subjected me, and later some of my siblings, to years of regular violent outbursts.

I can’t remember ever not being depressed.

My mother puts great stock in therapy, so I began therapy as a very young child. My first psychiatrist had a dog that ate tissues, and a highly unethical habit of fabricating allegations of sexual abuse against the fathers of the children in her care. She was court-mandated, yet we were required to pay out of pocket for her sessions. My second counselor, Marty, gave me the absolute creeps, even as a six year old. I had to see him on Wednesdays, and I reliably got psychosomatic stomachaches every Wednesday afternoon. I begged my parents to let me stop seeing him. He was also court-mandated, and again we paid out of pocket.  A few years later, I began seeing another psychiatrist, Dr. M, who administered me the anti-anxiety medication Paxil. Paxil is currently not approved for patients younger than 18 because of the increased risk of suicidality[4]. I was on Paxil for 2 years. My visits were only partially covered, and we had to pay a co-pay for the medication. While I was seeing Dr. M, I was also seeing a therapist, Dr. Roz, who insisted on family therapy. My parents hated each other, and couldn’t agree on anything. Once, my stepmother was invited to come to a session, and she punched my mother. I started getting stomachaches before Dr. Roz appointments, too. Dr. Roz was in-network, so we paid a smaller fee to see her, which, I’m sure, was one of the reasons we stuck it out with her although she was poorly suited to our needs.

In middle school my grades, which had never been good, slipped even further into the toilet. My mother, at her wits’ end, had me evaluated by a neurodevelopmental pediatrician. She diagnosed me with my learning disorder cocktail. My evaluation session was paid out of pocket. I began taking Concerta. It didn’t help me focus, and the crash when the medication wore off was profound[5].

The first truly helpful therapist I ever had came into my life during my sophomore year of high school. I came out to my mother at 14, and she asked me if I’d like to “talk to somebody about it.” I didn’t really need to talk about being gay—I’ve never been particularly conflicted about my sexuality—but there were about a million other good reasons for me to be in therapy. Dr. G was out of network, so we paid out of pocket for each visit.

When I got to college I fell apart. This is apparently common—people whose childhoods were war zones stay strong until they escape, and then all hell breaks loose. I gleefully sabotaged myself at every opportunity during my first year of college, and when my boyfriend dumped me at the beginning of the summer, I fell into the worst depression I have ever experienced. Eventually after spending all day on the phone, calling provider after provider, I made an appointment with mental health professional number nine. She prescribed me Cymbalta, which was partially covered by my insurance. Cymbalta worked for a few months, and I felt good, so I stopped taking it. I was back at school, and no one was supervising my care. After a few mediocre months, I crashed again, and began seeing a college therapist, who I saw for exactly eight appointments—as many as my college health plan allowed me at no cost. She referred me to a psychiatrist (not free), who prescribed me Cymbalta, again, since it worked the first time. It didn’t work this time, and I had trouble paying the substantial co-pay for the refills. I didn’t improve. Somehow, I survived the rest of college and moved to DC.

To be continued…

[1] White dudes shoot fucking everyone, but the media only seems to care when it’s other white people.

[2] Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.

[3] People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime (Appleby, et al., 2001). People with severe mental illnesses, schizophrenia, bipolar disorder or psychosis, are 2 ½ times more likely to be attacked, raped or mugged than the general population (Hiday, et al.,1999).

[5] When I rolled for the first time, I was warned that coming down would send me spiraling into depression. Pssht. NOTHING is worse than coming down off Concerta, and I handled that shit at 13.