When I was a sophomore in college, I learned that my mother had terminal cancer. This news threw me into a downward, depressive spiral. Months later, my friends finally convinced me to get help at the college’s health center. A combination of really good friends, counseling, and medication helped me pull through.
Unfortunately, that’s not the end of the story. Even 4 years later, I still feel the after-effects of that period, not just in my head but also in my wallet. You see, antidepressants are pretty important to getting and staying well. And most doctors prescribe name-brand anti-depressants, the expensive ones.
So if you don’t have insurance, you’re in a bad place. And having depression can lead to losing your job (thus no insurance) and having a hard time finding one after you’ve been through therapy, if you can afford it (again, no insurance).
Few people realize the extent of these effects. I didn’t until I was in the middle of it. If you’re really lucky and have a suitable personality and work hard at it, you can probably pull through to a time where you need neither counseling nor antidepressants. It may take years. I aim to get there some day. But when I spiraled down, it threw a switch in my brain, one that I’m still trying to flip back.
I’ve gotten to the point where I don’t need to see a regular counselor. It’s good. Mr. Micah is the son of a psychologist and good at talking me through my occasional bad days. If it’s really bad, I can call my mother-in-law, not for an official session but for a little help. That saves us some money.
Unfortunately, I have not been able to move off the medication yet. My dose was cut in half, which worked fine. I tend to cut that in half too (the lowest dose prescribed) and it works pretty well. But if I go without it? Bad things happen, I can’t maintain the emotional stability I need to do even normal things.
I worry that if I go off them, I won’t be able to work. This job is new, I’m in a temp-to-hire process, and my situation can be a bit stressful. They could let me go whenever they wanted. Now, they said that they want to keep me, but I know they can change their minds.
So in this situation, I have no guaranteed insurance (my husband’s job doesn’t offer it) and not enough stability to be able to go off my meds. Unfortunately this means paying the full price. As I said, I cut them in half, and since the 5mg dose costs about the same as the 10mg, I “only” spend $45/month on them by buying 1 month of 10mg and cutting them to last for 2 months.
The financial effects for me are at least $45/month, combined with not getting as good a dose as I could. They also include periodic doctors visits and could include therapy.
This is a problem. But I think the cost, anyway, has a comparatively simple solution.
Right now, lots of doctors are prescribing brand-name antidepressants to their patients. Yet there are plenty of generic types out there, a variety which means that they could fit the different peoples’ needs. Many are simply older versions of the name brand (which was probably only reformulated because the formula was going to be public property). They can cost as little as $4-30 per month (some do cost more, unfortunately, but still less than regular ones). That would fit most peoples’ budgets just fine.
But doctors don’t like to switch you off one that’s working. I hope their only concern is for your health and not upsetting your equilibrium. New medications increase suicide risk. I’m sure pharmaceutical companies don’t have such laudable motives.
I wish that my doctor had started me on a generic antidepressant. I’m still trying to get switched. If you’re depressed, if you ever become depressed, or if you’re caring for a depressed person, see if you can get them on generics right away. It’ll save a lot of money in the long run. It’ll make them less likely to spend time figuring out how to afford their medication. It’ll probably work just as well (and with several different types to try, you have good odds of finding one that works).
It’s too late for me to get that good start. We’ve laid out hundreds of dollars for my medications. It doesn’t have to happen to you. Talk with your doctor about generics. If they’re not right for you, at least you tried.
Note: Mrs. Micah is not a health professional, just as she’s not a finance professional. Please talk to your doctor before taking any medications.
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I never knew how depression affects your life, including financially. I think that you and your husband are doing well and I hope that your new job goes well. Thanks for sharing your experience.
My thoughts are with you as well!
Hope the job goes fantastic.. I really loved reading the story because now I know a bit more about you.. 🙂
I use generics for all my prescriptions too – I never ask for the brand name if I can get it on the cheap..
Hugs, my dear.
I feel for you. I’ve been doing the Paxil thing for eight years now, and I know exactly what you mean by not being able to afford the drug, or the doctor visit to have a meds consult without insurance.
I’ve been in the temp-to-hire spot many a time as well as being self-employed by both my husband and myself, and even when we’ve been able to get insurance the premiums are outrageous and the coverage nil.
Here’s what I’ve learned along the way if it’s of any help to you at all.
1. You are the patient, and therefore the client for your doctor. Use that and stand up for yourself in your appointments. If you want a generic version of your drug and it’s available out there, don’t leave the office without it.
2. Ask for samples. Explain to the doctor that you don’t have insurance and are on a budget and that this is difficult for you to afford. Point out it adds to your stress level and that anything they could do to help you with it you would be grateful for. Those samples are in the cabinet for them to hand out by the drug reps. If you can’t have a generic, might they have some samples?
3. Consider doubling your dose with your doctor. Depending on your comfort level with your meds, and how astute you are at monitoring your body and brain in the light of the depression and the meds, you could lie and tell them you need a 20 mg dose. Then, splitting that pill? You’ve gotten your actual dosage and shaved some money off the price at the same time. Obviously ideal if you’re able to score a generic version.
4. Costco Pharmacy. What costs me $5 a pill at Walgreen’s is $23 for 30 pills. I swear by them. Swear. You might be able to shop them over the phone to see if your particular prescription will save you money if you aren’t already a member.
5. If you aren’t getting the results you want with your doctor, move on. I said it at the beginning and I’ll finish with it too.. you have to be your own patient advocate and insist your physician treat you and your needs independently of their bottom line. I just left a new doctor after moving away that tried to extort me for two visits to get my annual pap and have a meds consult at the same time. Ridiculous. I don’t have insurance at this point and that’s just unacceptable to me. They say it’s because they’re all specialists. I say it’s because they see a way to double bill.
My heart goes out to you. My husband wants me to blog on this same thing because I’m kicking bootie and taking names in my war on this depression and evil anti-depressant saga. Light at the end of the tunnel? I cold turkey quit taking a 30 mg dose of Paxil six weeks ago. For the very first time it didn’t put me into the corner in a fetal position crying my eyes out unable to face another minute. Granted, I’m scared to death some moments, but I’m able to start talking my way out of them and putting myself in a better space. It doesn’t eliminate the ickies, but somewhere along the line I’ve found a way to manage them.
Take Care… Jen
Yup – when the jungle is inside and outside (depression versus med costs, insurance) it gets rougher. I envy you having a spouse that will stay with you and was listening when they read the part about “better or worse, sickness and health”. At the final psychiatrist consult after my separation, I was told that there are “some people who just can’t deal with a partners’ disability and your wife just happens to be one of those people”. She was in the room. At that time I was on 1800mg. Trileptal and 90 mg Celexa daily. Just to cope. Since then I am using 30mg Lithium, 900mg. Trileptal. Progress in my book. Plus the divorce was final in June, and I’m doing MUCH better. My aim is to get down as low as possible on meds and still be able to enjoy life. I have faith. Best of luck in you struggle – you can make it if you really want.
Thank you everyone for the kind wishes.
@ Jen. I’m planning to double my dose next time I go to see the doctor if they won’t give me generics. Because then I really will be dealing with a lot of stress and everything else. The 5mg I’m on now work, but not quite as well as 10. I hope to ease into them eventually.
@ transformedia. Fortunately (?), Mr. Micah has had major depressive disorder for years now. I knew about it when we first started going out. So in learning to handle his own disorder (and with help from his mom) he learned the skills to help me manage mine.
And once I came clean with myself about my depression I was able to apply some of the techniques I used to help him. And for some reason, we don’t have too much trouble with both of us being depressed because it’s not so bad that we can’t take care of each other. I know a lot of other people probably wouldn’t have been able to handle the disorder, you’re quite right! I feel blessed.
You mentioned that your depression started when you found out about your mother’s terminal cancer, but never mentioned the outcome. I assume she is no longer with you. My condolences on your loss.
Actually, Andrew, after some drastic surgery and a lot of medication, she’s still with us but also still terminal. Her primary cancer is inoperable. They’ve been able to slow it down and currently estimate that she may have 3 years left. This fits with before when they said 1 to 7 most likely. We appreciate each day and month more that we get her. She’s a plucky little fighter.
Hugs to you.
This is the kind of post that is so real, so heartfelt and so necessary. It helps others who don’t suffer the illness to understand those who do. By sharing your story, you’re doing a major public service!
I’m glad your mom is still with you, and that you have such supportive in-laws. Family can be your best support system!
Sara
Huge huge hugs for you and Mr. Micah. Been there, done that, seen it happen right before my eyes. It’s FAN-FREAKIN’-TASTIC. Bought the DVD and watch it every week.
Titrating medication is difficult, but definitely look into moving your prescriptions around to Target and CVS. Sometimes there are coupon incentives to bring your prescription to a new pharmacy. I’ve seen them for as much as $25, which would probably help.
Asking for samples works, but if you don’t have insurance and if you are going to a university hospital for services, you might try asking them if you can get a discount on your prescription by having it filled at the in-house hospital pharmacy. My old roommate was a nurse at UMAB in Baltimore and that particular hospital has $5 prescriptions for low-income patients, even non-generics. One of my doctors there would always stamp my prescriptions for me because I was scraping by on a fluctuating income at that time. It was a godsend.
Totally ironic because the cost of depression just makes one more depressed. Viscious circle.
i feel your pain!
when i was first diagnosed with depression back in 1999(i lost my father to colon cancer when i was 16 and my mother to lung cancer when i was 18)i was put on prozac which worked really well. unfortunately, i lost my job and no longer had insurance so couldn’t afford to renew my prescription. i eventually had to go back on meds(without insurance) and the prozac didn’t work the second time. i spent the next few years on and off different meds until i finally found one that worked, wellbutrin xl. i’ve been taking it since jan 2004 and it has really helped changed my life, but the cost has steadily increased from $99.00 a month up to 160.00 a month at one point. i’m paying 143.00 right now. there are generics for wellbutrin available but not the 24 hour release kind. i’ve tried taking the generic one (it’s twice a day) but feel like i’m on a roller coaster as the meds process. fortunately, i have a job with insurance again and enrollment is in a few months.
talk to your doctor and ask for the generic. if he won’t prescribe it to you and doesn’t have a good reason, find a doctor that will. ultimately, your health is in your hands and it is your responsibility to do what is right for you. you didn’t mention what you were taking but by the dosages i’m assuming it’s lexapro. if it is, i’m pretty sure they came out with a generic last year.
good luck with the meds and the job and let me know how it turns out for you.
Thanks for this very personal post, I am sure your honest advice will help many.
I agree that generics are a god send, especially with antidepressants. However, there is one more thing to remember. Shop around for your prescriptions. I take generic Prozac and for months I was going to CVS and paying $90 for a month’s supply. Then as I was reading a site one day I decided to see if I could get it cheaper. Well guess what, Target will fill my prescription for $4. I never even thought to shop around, but boy was I glad that I did. It’s one less thing to worry about when you already have too much shit to deal with.
Wow. Thanks, Andy! I’ll call the Target near us and see what they offer. Dang. Thanks!
The Monster has greeted me at wake-up last 2 days….lots going on – my Mom is hospitalized for ‘tests’. She is 84 and has stomach and bowel complaints, ( has survived radical mastectomy ) , got word last night that I need Cancer surgery of my own, am on disability, lost out on two jobs in the last month ( I free-lance). Etc., Etc. As a man, revealing weakness and sadness/depression is a hard one. Yet, sometimes there is nothing else for it but to get up, get busy, do my day. It takes strength and balance.
I was lucky in that when I went on antidepressants for a while in ’03 and ’04, first there was an awesome state mental health program that let me get my meds free, and then later I was pregnant and could get on Medicaid. It would have been better if I could have been helped out of my bad life situation instead, but never mind.
If you ever do an update for the subject matter of this post, please share with the folks out there that unless the rules have significantly changed since I got out of the Army, anyone who has retired from the military *should* be entitled to go get their prescriptions filled at a military healthcare facility’s pharmacy (i.e., military clinic, military hospital, etc.) for free. You take your civilian doctor’s prescription in to whoever has the DEERS computer (usually medical records), have them check your name and SSN in the system and they stamp your prescription and send you over to the pharmacy. Be sure to call ahead and make sure the policy is still in effect, but it was in the mid-90s.
I was a medical records clerk when I was in. A retiree came up one day and asked me if it was true he could get his civilian-prescribed meds for free. I told him it was and explained to him how to do it. He just stared, dumbfounded. “I have been spending X amount of money per month for these prescriptions and had NO IDEA I had this benefit.” I felt so bad for him. But the good news was that he found out before he’d gotten any farther into the hole.
Talk to your doctor. See if he’d be willing to switch it to a prescription. Also talk to the pharmacist. Sometimes, doctors write the script for the name-brand but you can have it filled as generic. Also are you seeing a PCP or a psychiatrist? If you’re not happy with the depression stuff but everything else you don’t have to change your doc, but can just see a psychiatrist about it and they will be more likely to understand your concerns about cost. See if there’s a local mental health clinic in your area, you might also qualify for assistance in affording those medications. Good luck!
.-= Shakela´s last blog ..The costs of overmaintanence =-.
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