Let's chat about insurance and mental health in 🌟America🌟
Hi, folks, it's been a while. I think I probably stopped Tumblr blogging right around the time I was hospitalized in December of 2025. I'm not going to check right now. I was (am, really) in a perpetual state of overwhelm due to some medication fuckery that I'm tired of keeping to myself. Sorry, it's long and talks about a lot of meds.
So when I was hospitalized in December, I was on the following meds cocktail:
Lamictal 400mg - a mood stabilizer we added to treat my bipolar.
Wellbutrin 450mg - an anti-depressant we added to treat my bipolar.
Adderall 20mg - a stimulant that treats ADHD.
BuSpar 5mg - an anti-anxiety and anti-depressant med added to treat my bipolar.
Vraylar 6mg - an anti-psychotic that is the cornerstone med of my regimen, which treats my bipolar.
Atenolol 25mg - an anti-anxiety med that works similarly to propranolol by regulating heart rate. I actually take this regularly for tachycardia more than anxiety.
Medical marijuana - to suppress PTSD nightmares.
At the time, I had been diagnosed with ADHD, bipolar type 2, generalized anxiety disorder, and PTSD.
You might look at that meds list and say, "Holy smokes! There are so many meds!! Overmedication!!!" and trust me, I know.
Each of these medications treated one part of the complex problem that is my mental health. Part of the problem was that the Northwest Arkansas area has a severe psychiatrist shortage and I spent a year and a half on a wait list until a slot opened up with the University of Arkansas Medical School (UAMS) Psychiatry Research Institute. My PCP was excellent and acknowledged that there were limitations to her expertise that included psychiatric med management, but she didn't leave me high and dry while I languished on a wait list. We learned together. Her practice closed its doors right after my psychiatrist started treating me.
So by the time my psychiatrist started seeing me, I was pretty certain I was going to be in for a rough winter. Winter is always hard for me, always a time when my mood dives into hibernation (if I'm lucky) or active torment (if I'm unlucky). This year, I could feel it coming on like a wave.
I finally had a breakdown mid-December and knew I was going to do something drastic if I didn't get help. So I called my psychiatrist and she fit me in for an emergency appointment. She talked me through the process of admitting, doing the research into where my insurance would let me go and coaching my anxious wife (who struggles with mental health as well) as to what she needed to do.
And... well. In hindsight, it wasn't a good experience. I met with a doctor there who assured me he supported the gays (UNCOMFY) before brusquely informing me that adderall, wellbutrin, and marijuana were not good meds for bipolar, therefore I would be off them. I tried to articulate my total discomfort with this treatment plan. I had been considering for a long time that maybe my bipolar type 2 might instead be severe treatment resistant depression. I didn't feel comfortable articulating that here, though, because I sensed he would brush my concerns aside. But I did tell him that I hadn't found that to be the case for me and could I please at least keep the marijuana, because it was the only thing that kept me from having the nightmares that come with PTSD otherwise.
He praised me for self-advocating and told me no. I wanted to be well, right? Therefore I needed to do what he said.
I left the meeting having cried and feeling totally unheard (as well as kicking myself for not advocating harder for my needs).
My medications at the time of discharge were:
Atenolol 50mg - the tachycardia med.
Oxcarbazepine 1,200mg - a mood stabilizer for bipolar 2.
Vraylar 6mg - still the cornerstone med.
A much more manageable set, and my mood was good. But my energy was so poor and my cognition so degraded that I couldn't function. In addition, I started having nightmares, so I informed my psychiatrist that I would be restarting my medical marijuana use. And, from there, we swapped Topamax 50mg (kind of a weird one - works on GABA) in instead of Oxcarbazepine. Then swapped it back out when it became clear that my mood was lifting since spring was coming on, and the med was literally making me into a potato.
I still felt off, but I knew from experience that as the sun comes out more, I become more able to function, so I chalked it up to that. I just needed to be patient.
My psychiatrist sprung into action and was only able to get them to approve Caplyta 21mg - a similar anti-psychotic to Vraylar but newer, more expensive, and never tested for me.
To be clear, this was a disaster in multiple ways:
They didn't sort out my coverage until I had been out of the Vraylar for over a week.
They didn't cross-taper me.
They started me on the lowest possible dose of Caplyta, from the highest possible dosage of Vraylar.
They did this while my psychiatrist was set to go on vacation soon.
"I was pissed," my psychiatrist told me at our appointment yesterday. "I told them you had been on it for five years, but they wouldn't listen."
I went into a complete tailspin. I have never felt as bad as I felt coming cold off of Vraylar. As much as I love that med and it has relatively painlessly changed my life, when you have to come off of it in this way, it REALLY messes with you. I walked around in a constant state of Something Bad Is Going To Happen for basically three weeks. The first week, my natural cheer saw me through. This was okay. I could use my tools and redirect my attention.
But every day saw me spiral further and further away from the light, and the fears got bigger, and my ability to cope got smaller and smaller.
So, yeah, you see where this is headed, right?
I was hospitalized again on April 9th, 2026.
This time, it went much, much better. My insurance paid for a facility that allowed us time outside in a yard every day, plus Dialectical Behavioral Therapy concepts I found truly useful. The doctor listened to my concerns about my diagnosis, and I'm now diagnosed with ADHD, depression, generalized anxiety, and PTSD. My meds are:
Vraylar 6mg - and I'm so happy I have it again. The withdrawal anxiety has almost completely stopped.
Wellbutrin 150mg - which is helping me connect with my creativity again.
Atenolol 50mg - still keeping the ticker going smooth. ;)
Depakote 500mg - a mood stabilizer that works on GABA.
Medical marijuana - still helping with the ol' PTSD.
I get a little bit stronger every day. I'm hopeful that soon I will feel more myself. It takes a while to ramp up, so I have a rational basis.
So - Lessons Were Learned
Doctors: Don't treat the label. Treat the person. The doctor who heard to my concerns, took my viewpoint into account, and listened to my recommendations is the one who got me on the path to wellness. Instead of looking at me and seeing "bipolar patient who doesn't know what she's talking about," he saw, "mentally ill person who knows what medications have worked for them in the past."
Patients: Persist. You will probably have to try a few medications or go through a few doctors, or both, before you find your ideal regimen. And even then, it's not going to work forever. Expect to advocate for yourself, even when it's uncomfortable. It's your body. You have a right to answers about it.
Insurers: Listen to doctors and patients. I mean... I doubt you'll listen, but wouldn't it be nice?
And if you got to the end of this, and you got something out of it, even if it's just "holy shit that's a lot of meds," that's, uh. Fair. 😂🫣
Please comment. I do really love talking with people in the comments. And thank you for reading.