Being Home and Being Mental

I used to think about killing myself every day, sometimes more than once a day.  You might think that would make a person seek mental help.  In my case, you’d be wrong.  I grew up as a pretty smart kid (in the IQ sense) in a little town (in the 2-hours-off-the-highway sense), and I didn’t really believe in mental health professionals.  Neither did my dad, to my knowledge.  I’m guessing that some things would have been a lot easier for me if I had believed; certainly, the 20 years of bleak high-grade depression would have been much shorter and less debilitating.

While working away, I tried, for the second, third and fourth times in my life, to get help for my issues.  I went to a counsellor with my workplace’s Employee Assistance Program contractor, but did not go back a second time because she had looked at her watch an hour into our session after having said nothing to me.  My employer switched EAP providers, so after a while I tried a phone counsellor with the new guys.  They gave me someone in Kitchener, BC rather than Kitchener, ON, and the person I spoke to was, at best, flaky, so I again stopped after one session.  Finally, after having had cancer, gotten a family doctor for that, and then having had to cancel a trip I’d been very much looking forward to because of a particularly black period, I asked my new doctor to send me to a psychiatrist.

Let me skip forward for a second.  I moved home in January of 2013.  The first thing I did was look for a family doctor, and by a stroke of luck I found someone in between raindrops, during one of those flashes of availability that happens when an established doctor opens, ever-so-briefly, for new patients.  I asked immediately for a referral to a psychiatrist.  Perhaps a month or so later I received a form letter stating that I was on a wait list for an appointment, and I could expect someone to contact me in six months or so.

Seven months prior, I had seen a psychiatrist within a month of my original referral.  I was diagnosed immediately with clinical depression and put on a pill called Pristiq, an in-patent relative of Effexor.  I researched a few things about the drug, but in the meantime I felt profound relief, even exhilaration to know that the things I had believed – that I was simply lazy, unworthy, ugly in body and mind – might not be entirely true.  That there might be reason to believe I could handle my thoughts with the help of a once-a-day pill.  The first week I was high; the next couple of months I was emotionally stronger than I had ever been.

Once that first shock wore off, I found myself cycling lower again, and so I spoke again to my psychiatrist, with whom I had been having a regular appointment, and we decided to increase my dosage.  The drug continued to work its magic.  If I skip a day, I am told, it drops to half effectiveness; after two, I may as well never have taken it at all.  Even if I take it after supper instead of at midday, I can sometimes feel those old feelings nibbling at the edges of my mind.

In the present, I have just called the psychiatrist to whom I was referred.  I had suicidal thoughts recently, the reasons for which I won’t go into.  It doesn’t happen much anymore, but I am living with a woman, and I am very much in love with her, and so my condition has ramifications that require me to be rather more urgent about seeking treatment.  Yet six or eight months have gone by, depending on how you count, and I am only just able to make that appointment, and on the letter that I received on July 18th it said:

“If for any reason you are unable to make this appointment, you will not be offered a new appointment without another referral.  Upon receipt of your new referral you will be placed at the end of the wait list.

If I do not hear from you within two weeks from the date listed above, I will assume that you are no longer interested in our service and your name will be removed from our waiting list.”

This is the reality of “being mental” in Newfoundland: even after you overcome the skepticism that comes naturally in an insular, rural culture, even after you mount the heights that are your own self-doubts and depressive symptoms, you must climb the mountain of our healthcare system to receive care.  The smallest misstep can knock you tumbling back down the mountain, and you will have to summon your resolve – that precious commodity that comes so hard to a person with depression – to again attempt the summit.

If you are lucky – and I must make this clear, here I speak of myself, for I am a lucky one – that will lead to a treatment that works.  The sad fact is that not everyone responds to medication.  But how many fewer get the chance to learn if they will respond when our system provides so poorly?

I got my appointment.  And I have a prescription, and I have a doctor who can refill it, and I am grateful.  But I have a rather stark awareness, now, of how slight a thing it would have been to miss this, the best moment of my life.  I was suicidal, to be sure.  I failed to seek treatment when I needed to do so.  But I got lucky.  I went somewhere that was not Newfoundland, somewhere where I could try several options in reasonably quick succession and thus where I could ease myself into a chemically-dependent happiness.

I guess my point is this: I made it, but I can’t imagine how I would have made it if I’d had to do it after I moved home.  The last time I lived in St. John’s for any length of time I found myself standing on a cliff contemplating climbing over a waist-height wooden rail; some time after that I found myself sitting on a dock at 2 in the morning wondering if I could slip under the water and disappear.

I was sick, and I needed help, and I’m not the only one in that situation.  I worry for the ones that are here and not getting what they need, especially now that I see the system at work.