Wednesday, February 17, 2010

Part 2: Starting Medication while Struggling with OCD and Insurance


I am fortunate to have a job with health insurance coverage, but "behavioral health" was only grudgingly included in any form, complete with a limited network of therapists, and no psychiatrists. I already had a therapist when I started considering medication, but of the sparse list of psychiatrists in my area, many didn't want to do "medication management" if they couldn't also counsel me in some way, others weren't taking new patients, or didn't return my calls. One called me back and had a 3 month waiting list, but at least was willing to put me on it.

Willingness to take medication was already tenuous for me at best, and the maneuvering required by my OCD and social anxiety was a serious challenge to following through. It's hard to cope with:

1)I really don't want to do this.
2)It's going to take quite a bit of effort to do what I don't want to do.
3)OCD is having a field day with all the uncertainty, cultural debates about overmedication, and an intense fear of trial and error.

The only other psychiatrist I'd ever seen was 7 years previously, a requirement by a previous insurance company that to get any talk therapy I had to see a psychiatrist first. He prefaced his diagnosis of generalized anxiety disorder with "You're not going to like this, but I think you need to consider taking medication." At the time, SSRI's weren't generally being used for anxiety disorders or anything else for that matter, and the drug he suggested was Buspar, which got mediocre reviews.

I felt defensive, hearing in his tone that "psych patients don't want to take their psych meds", that he knew me thoroughly after just 45 minutes, and I was a stereotype. At that point, I didn't drive, and he gave me a referral to a therapist remote from where I lived, and only accessible by car, which seemed like sending me to another country altogether.

OCD as a disorder is very adept at latching onto whatever is at hand, and waylaying you with a grain of truth, just enough truth to make itself plausible, needed, useful. It is wise to be an informed consumer, so I felt justified in compulsively reading about Buspar, to the point of exhaustion. OCD will demand an answer in advance to the question: Will this work for me? The psychiatrist was patronizing, and that sucked, and OCD was more than willing to say "Don't do anything. Just keep obsessing."

Ironically, when I was considering medication 7 years later, I was fixated on getting it from a psychiatrist because I had compulsively researched the topic, and was afraid that my family doctor wouldn't choose the right medication or dose.

Related Posts:
Part 1: OCD and Medication Decisions
Part 3: The Limits of Research in Medication Decisions
Part 4: My First Prescription for SSRI's
Part5: Feeling in the Jaw: Side effects
Part 6: Being on Medication & OCD Weeping
Part 7: Wanting to Get off my Medication
Part 7.5: Built on Sinking Sand: OCD and Health Anxiety

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