My Privilege Keeps Me Alive

Parenting

Recently, I experienced a challenging episode related to my bipolar disorder. As Quentin Coldwater says in “The Magicians,” sometimes my mind just breaks. It began subtly: my arguments on Facebook escalated, and soon I found myself in heated discussions in real life. A sense of impending doom enveloped me, accompanied by overwhelming anxiety. When the thought of taking my medication as an entire bottle became more appealing than following the prescribed dosage, I reached out to my partner and my psychiatrist, desperately requesting an appointment that same day. It was clear to me that I needed immediate mental health support.

My partner spoke with me on the phone, pretending to be between classes. He continued to chat until he reached our driveway, knowing I would resist if he mentioned he was leaving his job as a public school teacher. He wanted to keep me engaged in conversation rather than letting my thoughts drift toward that bottle of pills. What transpired afterward was only possible due to a significant amount of privilege and financial resources.

Access to Mental Health Care is a Privilege

The very fact that my partner could step away from work was a privilege in itself. He has supportive colleagues who are aware of my mental health challenges. They’ve allowed him to leave before—such as when he skipped a class to accompany me to my psychiatrist’s office, just a few blocks away from his school. More than once, they’ve encouraged him to leave early when I was in crisis. They understand that my partner has a spouse who requires mental health care.

That’s a significant privilege.

On that particular afternoon, he stayed home with our children while I drove to my psychiatrist’s office. She is the best in our state; in fact, she used to oversee the state’s Board of Psychiatry. Given my multiple overlapping conditions, I require someone with extensive experience. However, my mental health care does not come cheap. My psychiatrist does not accept insurance, and while I can submit claims later, they won’t cover the expenses. We pay out of pocket at over $150 for a half-hour session, which is my typical appointment length.

That’s $150 I hadn’t anticipated when I woke up that morning. Adding another $10 for new medication doesn’t seem like much, but we already spend over $100 a month (with insurance) on my psychiatric medications.

The privilege continued. My partner took several days off work. While he wasn’t penalized for his absence, he wasn’t paid since he had already exhausted his sick leave. This left us with a smaller paycheck. We managed, knowing how crucial my mental health care is. I couldn’t have been home alone, especially during a pandemic when none of our friends could assist me.

I had: a partner who could leave work and take time off; a psychiatrist who could accommodate me immediately; the financial means to pay for my psychiatrist; funds for new medication; and someone (my partner) to oversee our children’s education while I focused on my well-being. Additionally, my employers did not penalize me when I required a week off with no prior notice. My mental health care exemplified privilege.

Grateful for Insurance

The Affordable Care Act, also known as Obamacare, mandates mental health parity, ensuring that insurance offers equal coverage for mental health services, including prescriptions. Some of my medications are more costly than others; for instance, the ADHD medication I need doesn’t have a generic alternative and costs nearly fifty dollars monthly.

However, even having insurance is a privilege in the United States. According to the Kaiser Family Foundation, the number of uninsured individuals rose to 28.9 million from 2018 to 2019, excluding uninsured seniors. That’s about ten percent of the population. I’m fortunate that my insurance provides decent prescription drug coverage. I can’t fathom the financial burden my mental health care would impose without this coverage, as most of my medications only require a $9 copay.

My Partner Took Time Off Work

There are no clear statistics on how many employers would permit their employees to leave for a spouse experiencing a mental health crisis, but I suspect the numbers are not high. My partner works in a white-collar position, which often affords us the consideration we needed. Furthermore, he wasn’t dismissed for needing time off, as his employer was supportive.

We managed the reduction in his paycheck. It wasn’t easy, but we coped. Losing half of our primary earner’s income or reducing our total monthly earnings by about five percent was unplanned and unforeseen. Yet, we made it work because my mental health care is too vital to ignore.

The Importance of Mental Health Care

Without treatment, I wouldn’t be here today.

I could try to soften the reality, but I have bipolar disorder II, along with anxiety, depression, and ADHD. Medscape reports that 25-50% of individuals diagnosed with bipolar disorder attempt suicide at some point in their lives, with 11% succeeding. Over time, my condition carries a high mortality risk.

Research shows that low income is a significant risk factor for suicide. It’s not simply that “poor people are stressed, so they die by suicide.” The less wealth you have, the less likely you are to be insured, to access quality mental health care, or to have a support system able to take time off work when necessary.

I recovered. I’m doing well and am back at work. However, my breakdown would have had an entirely different outcome without my privilege. It serves as both a safety net and a pathway to quality care in the first place.

My privilege sustains me, but far too many others cannot say the same.

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In summary, my recent mental health episode highlighted the immense privilege I have in accessing care. This experience has reinforced the importance of mental health treatment and the disparities that exist for those without similar support systems and financial resources.