The receptionist opens the glass partition and greets me. “I see you already have your water” she points to the Evian bottle I have brought into the office. I thank her for asking and we begin the typical small talk that I’d rather avoid but is necessary. “I just love the fall, don’t you?”
“Oh yeah, it’s wonderful. My favorite time of year, for sure.”
“How was your trip in? Did you come just for this?”
I always feel stupid when she asks that question. No Barbara, I just love driving almost 250 miles west every three months for the hell of it. Maybe I can put more miles on our Ford Focus which still has wind-up windows! Maybe Roy Rogers will be open on the turnpike and I can get a few greasy chicken legs for the drive. Of course, I have come in just for this.
I have been lucky that I have been mostly stable after finding this doctor 17 years ago after bouts with immobilizing Depression, Anxiety, and mood disorders swallowed my life from 18-21. I mention that I have come in for my 20th high school reunion as well, which happened to fall on the same weekend as my pre-planned visit. It seems that I have met the quota of small talk and the conversation winds down as I take my seat in the waiting room.
Every piece of the mental health puzzle feels like a strategic move. When my husband and I relocated east for his job three years ago, the biggest question for me was will I be able to continue seeing the same doctor? It’s not because ObamaCare has made it easier (although as I type this thankfully pre-existing conditions are still covered because of it). The future of “TrumpCare” (man I hate typing that) remains to be seen. I pay $150 out of pocket for each visit because the doctor who saved my life happens to be out of network. But really, $600 plus travel expenses is a small price to pay for getting my life back.
So there is the balance of making and keeping my appointments. On this particular visit, I am not worried. I feel put together. I look as pulled together as I can. My hair is colored an acceptable blonde shade. I’m dressed modestly and my tattoos are mostly covered. But about a year ago when Joico started making all of those fashion hair colors so accessible, I walked in with fire engine red hair and worried that I might look too much like that kid that shot the movie theatre up in Colorado a few years ago. Does that raise red flags? Will my doctor write those things down? I have no idea if he wrote that in my file but I think it’s a possibility.
I taught yoga for the last eight years full-time. It was my front hustle. It was amazing to me that I was good at it. Before the age of thirty I didn’t realize that I had an athletic bone or non-medicated nerve in my body. It turned out that my ever-present anxiety helped me to connect with my students. It certainly fueled my ability to continually show up prepared to teach and I was able to speak to the frenetic pace of life that was the reason so many people seek out their yoga mats because that “sometimes-present-for-them-anxiety” was my baseline. There is always a buzz of anxiety just below the skin for me and I have learned to live right above that line.
Teaching yoga brought new challenges in staying the course for my own mental health. Have you ever told a roomful of long-haired, boho yoga goddesses who you swear are the models from the Free People app that not only do you not eschew caffeine, meat, and gluten, but that you also mostly practice power yoga AND take the “oh-so-not-cool” western meds that you are prescribed by the patriarchy? Yeah, me neither.
Yoga is kind of a dangerous thing for someone with obsessive, hypo-manic tendencies to get swept up in. I have been gifted beautiful little bottles of “aura cleaner”. I have been “cleansed” with an eagle’s feather by a shaman before entering a sweat lodge. I’ve had my chakras “cleansed and aligned”. (Evidently, a lot of cleansing is necessary.) That shit gets in your head. One second you are certain which thoughts you have that are absurd and the next second you’re talking to a highly successful life coach about the validity of making yourself well with sacred seed sounds and about how wearing the color red will help you to feel more grounded. Logic goes right out the window.
The crushing Depressions that follow the hypo-manic episodes are worth it. I always thought that and I still do. They are rare these days but every few years, even with carefully managed care, they still happen. How else can you feel when every cell of your body is on fire with the glow of energy and you are certain that every thought you are thinking is not only brilliant but also transcendent and you haven’t ingested one drop of anything illicit? Actually not even food, come to think of it, because you just haven’t had a moment to even become hungry… well come on, people pay to get this high. People live their entire life not knowing what that feels like and I just get to dwell there because the chemicals in my brain aren’t configured the same as yours.
I lean back in a textured sofa that hits me in the middle of my back and sit up a little taller. My psychiatrist, an older man who has become a little hard of hearing over the years, and who has been seeing me since I was 21 has opened my file and is going down the typical list of questions which he asks me every three months.
“Any headaches, blurred vision?”
“Thoughts of harming yourself or others?”
“Constipation, diarrhea, upset stomach?”
I answer him “No, no, no, of course not, no, nope”. We chat some more and I leave with three months’ worth of prescriptions, an appointment in December, and a growing dread for my 20th high school reunion. In my need to fill the quiet while he writes the scripts, I made small talk about getting older and ask about reunions. My psychiatrist goes to his “every five years” and “has a wonderful time!” “Someone always brings a 1957 Chevy and parks it outside the gymnasium.” Apparently, he’s become friends with a classmate of his who was an “attractive lady who used to model for Kaufmann’s department store.” Jesus Christ, I can’t get out of here fast enough.
It’s a rare day in Baltimore in September. There’s almost no humidity, a breeze in the air, and the sun is shining. I’m going out for a walk and decide to stop and look at fall things I don’t need and drop my new prescriptions off. I’m standing at the counter when a pharmacy tech comes over and I hand her my prescriptions. She looks at the screen and she looks me up and down twice, so quickly that I could have missed it, but I don’t. “I need to talk to the pharmacist. I’ll be right back.”
I nod and try to keep my composure. I’ve let my guard down. I walked over in a tank top and leggings. I pull at the straps of my tank and realize that my chest piece and sleeves are showing. I haven’t taken the usual precautions to throw a jacket over my outfit. She thinks I look slutty and manic and crazy.
She whispers to the pharmacist and I try to play it so cool. He looks over at me and continues to watch while she whispers. My heart is beating fast and I have to remind myself that I’m not actually doing anything illicit. There is no joy and certainly no power in handing over prescriptions for a benzodiazepine and a mood stabilizer. I try not to fidget while the pharmacist strides over.
He doesn’t say hello. He doesn’t smile. He has spiky hair and wears a silver crucifix around his neck. Without looking up, he asks “When is the last time that you saw your doctor?”
“Last Thursday. The date is on the prescription. Is there a problem?”
“You know this is an out of state prescription.”
My head spins. Of course, I know that. This has never been a problem. He has my prescription card. Doesn’t my husband’s job give me validity? In my head, I know I’m leaning on my privilege but I don’t know what else to do. Mental illness is embarrassing. It’s still stigmatized. He thinks I’m crazy. He doesn’t want to give medicine to my tattooed, dirtbag ass. What the hell am I going to do?
“Yes, my psychiatrist is in Pennsylvania and we have lived in Maryland for 3 years. I have never had a problem. Is there a problem now?”
“No, it’s just that we can lose our licenses. We can be audited…” He sighs.
“You can be audited for filling a legit prescription for a patient? I don’t understand. My lifelong psychiatrist lives in another state. What would you have me do?”
The pharmacy is next to a Pizza Hut Express. I can smell the cheese and bread continuing to cook underneath the heat lamps. A line of my neighbors has formed behind me. I don’t recognize anyone but I’m also not making eye contact with any of them, either.
I’m using every yoga technique I know. Full ujjayi breathing in and out through my nose, feel the discomfort and sit with it, don’t run away. This medicine helps keep me stable. This medicine combined with my yoga practice and my writing is part of my wellness plan. The boho goddesses would call me dependent. They’d think I was weak for relying on the patriarchy. Maybe I am.
“No, it’s like, fine I guess. I can make a note that you’re a special case and I can fill it for you.”
“Special case? How am I a special case? But what about next month and the month after that? What was the red flag? If I would’ve come in here in a suit would you have asked me all of this? Why would I feel comfortable coming in here anymore? I feel shamed by you in my neighborhood store, in front of all of the techs, and the people behind me in line. I’m sure you can imagine that bringing prescriptions in for medication for mental illness is already uncomfortable. This visit has validated every one of my worst fears. Couldn’t you have just called my doctor if there was a question?”
“Ma’am, I didn’t want it to get that far, I guess.”
“That far?! That’s what he’s there for! I’d welcome you to call him!”
You know that stereotype about the manic-pixie dream girls? Like most characters Drew Barrymore played in the late nineties? Like most characters Angelina Jolie played in the late nineties? I’ve never been those girls. I don’t convince people to do things because I’m so whimsical and fun crazy. I’m not the sexy and fun kind of crazy. I’m the “it’s in my genes, obsess all night about the dead bodies in a plane crash a mile from my house when I was a kid, paralyzed with fear so I’ll just hang out in last night’s pajamas all day kind of crazy.” If I was the sexy kind of crazy then I would just swagger and flirt my way through this whole ordeal.
“I don’t think you understand. Now that we’ve cleared this up, I’m willing to fill these.”
“You’re willing to fill these? Do you police prescriptions or provide care? I just don’t understand what the red flag was. Was it because they’re out of state or because of what I look like, or what?”
“No, of course not. Not technically. It’s just… It’s just, we have to be careful about how often and who we fill these prescription for, you know? Our licenses…”
He won’t give me his last name. I’m left with his first name and last initial. In my hot embarrassment, I look around for the typical school day photos of the pharmacists mounted on the walls of the pharmacy and I don’t see any. While glancing up from the screen with all of my private information on it, he tells me that he doesn’t have to give me any identifying information. He hands me a business card with a number that reaches the phone behind him and tells me to call tomorrow to talk to his supervisor. I take my prescriptions back and walk back out into the sun. You know, truthfully, the high school reunion wasn’t that bad. I don’t know that I’d ever go to another but I’d advise anyone to at least go to one and make an appearance. It’s cathartic and silly and a little like visiting yourself 20 years ago.
It’s not even about me. It’s not about this shaming experience that was ultimately embarrassing and resolvable. It’s about the culture around all of the conversations that we’re still not having surrounding mental health care. I’m lucky, I have a support system in place, and I’ve become strong enough to know that I can leave a situation like that, find a different pharmacist, and then follow up to advocate on my behalf. Many people receiving treatment for a mental health issue do not have the luxury of living in that space. It’s up to those of us who can speak clearly and loudly of our own experiences to share our stories and to let people in positions of power know that their power does not come unchecked. We begin to advocate for those without a voice when we stand for ourselves.
And listen, I don’t want to be the woman who’s always writing about mental illness. I’ve got stories about teaching yoga at noon on a Tuesday to a man in a yellow thong, I watched a pretty well-known yoga teacher have a meltdown when a coffee shop was out of almond milk, and you wouldn’t believe the passive aggressive bullshit that people believe they can get away with when they end an email with “Namaste” but those stories are put on hold when I turn into the ”may I speak to your supervisor” woman, I want a full-gluten, cow-cheese covered pizza, and I’m out of anxiety medicine.