(tw suicidality)

Hi CareFirst Representative,

My name is Wiley. I’m twenty five, and I live in Washington DC. I have a mother and five brothers and sisters. I work as a bookkeeper and in my spare time I volunteer at my local animal shelter, watch cooking shows, garden, and go to Washington Nationals games. I have a condition called PMDD (Pre-Menstrual Depressive Disorder). This is not a well known condition–it’s been in the DSM since the seventies, but many doctors I’ve seen haven’t heard of it. Let me tell you a little bit about it.

I got my period when I was eleven. A few months later I tried to kill myself by smashing my head into a wall until my brain shut off. I didn’t know what was wrong, and as a young kid, I didn’t have the maturity to deal with the sudden influx of “bad thoughts.”

See, when I’m having a PMDD episode, my brain sends me messages. It shuts off its pleasure centers, so nothing feels good anymore. Then it sends me hateful messages. “You’ve done nothing you can be proud of.” “Your friends will abandon you the second you’re not fun or interesting anymore.” “This will never get better.”

It took me years to realize that these spells of overwhelming despair were connected to my period. When I talked to my doctors about it, they diagnosed me with PMDD, and prescribed me birth control to treat it. I take birth control continuously–no placebo pills–with the goal of eliminating my period. This is where you come in.

When I went to the pharmacy the last time to pick up my medication, I was told that I wasn’t due for a refill for a week. I quickly corrected the pharmacy staff, assuring them that I’m on continuous birth control, and they should look up my prescription. They did, but they were unable to release the medication to me unless I paid out of pocket because you, my insurance, refused to pay for my birth control the way it was prescribed.

It’s not the cost, CareFirst, although frankly $60 is a little bit much to be paying every month for a medication that should absolutely be covered. It’s that you’ve decided not to cover the medicine that I take for a chronic, life-threatening condition. Would you deny a diabetic insulin? What about chemo to a cancer patient? No? Then why are you refusing to pay for medicine that keeps me from killing myself?

I can only assume the message didn’t get through to you. I need these pills every three weeks or I suffer. This morning my girlfriend got upset with me because I hadn’t said a single kind word or smiled at her all morning. And I’ve been like that for a week. I almost called into work sick today because I couldn’t stop crying. I’ve thought “I have no future” three times this morning alone.

When I take my medicine, like other sick people, I get better. When I don’t take my medicine, I remain ill.

You need to be covering my treatment, CareFirst. It’s unacceptable that you’re denying a sick person the treatment that keeps them well.


A Concerned Citizen