My Privilege Keeps Me Alive

I recently experienced a bipolar episode. As the character Quentin Coldwater from “The Magicians” puts it, sometimes my mind just breaks. It started gradually: I found myself arguing excessively on Facebook, which then spilled over into real-life confrontations. A sense of unavoidable despair took hold, accompanied by paralyzing anxiety. When the thought of using an entire bottle of pills began to seem more appealing than following the prescribed dosage, I reached out to my partner and psychiatrist, desperately seeking an appointment that same day. Clearly, I was in urgent need of mental health support.

My partner spoke to me, pretending he was in between classes. He continued the conversation until we reached our home. He understood that if he mentioned he was leaving his job as a teacher, I would resist. He wanted to keep me engaged in dialogue, steering me away from that bottle of pills. What transpired afterwards was only possible due to a significant amount of privilege.

Access to Mental Health Care Requires Privilege

The fact that my partner could leave work was a privilege in itself. He has wonderful colleagues who are aware of my mental health struggles. They’ve allowed him to leave before, such as skipping his last free period to accompany me to a psychiatrist’s appointment just a few blocks from his school. More than once, they have encouraged him to leave early during my breakdowns. They recognize that my partner has a wife who requires mental health care. That’s a clear example of privilege.

That afternoon, he stayed home with our children — another privilege: he could take time off work. As I drove to my psychiatrist’s office, I was relieved to know that she is the best in our state, having previously led our state’s Board of Psychiatry. Given my multiple comorbid conditions, I needed someone with significant expertise. However, my mental health care does not come cheap. My psychiatrist does not accept insurance, meaning we pay out of pocket at over $150 for each half-hour session.

That’s $150 I hadn’t anticipated needing when I woke up that morning. Add another $10 for new medication. While that may not seem like much, we already spend over $100 (even with insurance) on my psychiatric medications each month.

The privilege continued as my partner took several days off work. Although he wasn’t penalized for this absence, he had already exhausted his paid sick days, resulting in a smaller paycheck. We managed it, though, because my mental health care is paramount. I couldn’t have stayed home alone, especially during a pandemic when none of our friends could visit.

I had a partner who could leave work and take time off; a psychiatrist who could accommodate me immediately; money to pay for that psychiatrist; funds for my new medication; and someone to oversee our children’s education while I focused on my well-being. Moreover, my own employers were understanding when I needed a week off without previous notice. My access to mental health care exemplifies privilege.

I’m Grateful for My Insurance

The Affordable Care Act, commonly known as Obamacare, mandates mental health parity, ensuring that insurance must provide equal coverage for mental health services, including prescriptions. Some of my medications are particularly costly; for instance, my ADHD medication—which has no generic alternative—costs nearly fifty dollars each month.

However, simply having insurance is a privilege in America. According to the Kaiser Family Foundation, the number of uninsured individuals rose from 2018 to 2019 to approximately 28.9 million, not accounting for the uninsured elderly. That’s nearly ten percent of the population. I’m fortunate that my insurance provides decent prescription drug coverage; I dread to imagine the costs of my mental health care without it, as most of my medications have only a $9 copay.

My Partner Took Time Off Work

Statistics regarding how many employers would allow their employees to leave due to their spouse’s mental health crisis are scarce, but the numbers are likely low. My partner works in a white-collar job, where it’s more common to receive the understanding we needed. He wasn’t dismissed for taking time off; his employer was supportive.

We were able to manage the reduction in his salary. It wasn’t easy, but we adapted. Losing a significant portion of one income—or cutting our overall monthly earnings by around 5%—was something we hadn’t planned for. But we prioritized my mental health care.

Mental Health Care Is Absolutely Essential

Without treatment, I might not be here today.

I could sugarcoat it, but the reality is that I live with bipolar II disorder, anxiety, depression, and ADHD. According to Medscape, 25-50% of individuals with bipolar disorder will attempt suicide in their lifetime, with 11% succeeding. Over time, my condition carries a high mortality risk.

Research shows that low income is a significant risk factor for suicide, but it’s not merely a matter of “poor people are stressed, so they die by suicide.” The poorer you are, the less likely you are to have insurance, access quality mental health care, or benefit from a supportive network that can take time off when it’s needed.

I recovered. I’m doing well and back to work. But my breakdown could have had a vastly different outcome without my privilege. My privilege provides not only a safety net but also access to quality care.

My privilege keeps me alive. Unfortunately, too many others cannot make the same claim.

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Summary:

This article explores the author’s experience with a bipolar episode and the privileges that enabled her to seek necessary mental health care. It emphasizes the importance of access to quality mental health services and how societal and economic factors play a crucial role in one’s ability to receive care. The author reflects on her gratitude for her supportive partner, insurance coverage, and the understanding of her employers, highlighting the stark reality that many individuals lack such privileges.