This is mostly copy pasta from Facebook but I wanted to share with a wider audience some ruminations on mental health and poverty.
Today I went to buy my script for Lamotrigine – my ‘wonder drug’ that has been the main contributor to how well I’ve been the last few months, and acknowledged by crazymeds.us as the ‘best med on the market’ for bipolar 2. I was bemused to find that even with a concession card it came to the same as usual – $49.50 for 56 doses.
Lucky for me I can kick a luxury item from my budget and still be able to eat. But many meds are expensive, and often people taking them are economically vulnerable due to precarious mental health. The gap between ‘functionally crazy’ and not is hardly as large as many think, and a lot of people are unable to access even minimum wage incomes and rely on the state. Bouts of illness or recurring symptoms take people out of the workplace or unable to report to state required appointments for benefits, leading to greater stress.
Financial pressures generate huge psychic weight for even the most neurotypical of people, so the phenomenon of money stress linked to declining mental health linked to money stress and so on, is common and a huge concern for the non-neurotypical community – especially the most vulnerable. Stress is reputed as the biggest trigger for illnesses of all kinds – as a kid rocking dual diagnoses I can give an amen.
In a situation like this, finding your meds aren’t on the PBS (pharmaceutical benefits scheme – an Australian government initiative that lowers some medication prices) can be a stress trigger and a choice between other basic services and your medication.
To Facebook I opened the discussion also of the worrying strategies used by some crazy folk that I know – including me – to manage medication deprivation when poverty (no matter how temporary) strikes.
The phenomenon of ‘playing with your dose’ due to money being short, or going off meds altogether is far too common. My ex partner and I would often go through cycles of withdrawal and recommencement when we couldn’t afford our scripts. Often I would cut my dose by half, splitting it to make it last.
Stopping medications cold leads to withdrawal which can be terrible to navigate and cause huge behaviour swings, decline in cognitive function and warped emotional states. Then you’re flying free in the wind without chemical help that you need, often crashing back in to severe ill health. Starting them again is the same as starting in the first place – side effects that can be ugly and harsh to endure.
Halving a dose or taking it intermittently can have you idling at a paltry half life level of inefficacy so great that you experience symptoms just as if you weren’t medicated at all.
All of this is happening in the presence of mounting financial stress and a knowledge that if you buy your meds you won’t pay your electricity bill or feed your cat. I have been in this situation before. I have fed my cat rather than buy an already subsidised $10 script and subsequently spent weeks back in hell, unable to get through a day without thoughts of self harm and endless tears.
What to do? There must be solutions and perhaps they are out there. There is likely more to this story than I am telling – services lurking that I don’t know about. The breadth of my knowledge thus far extends to see only that those in my community – the crazies – have less chance at financial stability than the neurotypical, and are as a result more fragile in even pursuing their own wellbeing and recovery.
The issue of affording medication is a burning one and a placeholder for wider access issues that crazy folk face. How our community is responding to these areas of critical, practical concern is of interest, and bears further contemplation – and of course, action.