So, I haven’t made any secret about having what many would call “mental health struggles.” I don’t find this something to be ashamed or embarrassed about — if I had diabetes, I wouldn’t be embarrassed by using insulin. If I don’t have enough serotonin or dopamine, I’m not embarrassed by supplementing those, either.
Most medicine is pretty much fixing malfunctioning levels of various horrible meat fluids, whether they’re in the blood, pancreas, liver, or brain. The human body is a soggy box of horrors.

(Really, though, I’m not super fond of the euphemism “mental health struggles” either. I came out with funky brain stuff, and I’ll likely die with funky brain stuff regardless of how much therapy, medication, yoga, supplements, special diets, et cetera that I use. Rises and falls in this aren’t because I’m not struggling hard enough, or I’m losing some kind of struggle. Them’s just the breaks, you know?)

Anybutts, I’ve been using a very common SSRI for years to help blunt the worst of it, and it’s helped. The only trouble is, since it’s widely available in a generic form, I’ve been getting those generics. This isn’t a big deal, usually, except for every couple of months when I go to refill my medication.

Generics are generic because they can be produced by companies other than the brand owner, usually for a fraction of the price. This means that pharmacies can fill their generics from whichever manufacturer is currently cheapest (or at least not straight-up out of stock). As a result, if you use a common generic medication on an ongoing basis, you’re likely to get meds from a number of different manufacturers over time.

“But J., what’s the big deal? It’s all the same, right?”
Helas, it is not. Generics have to be bioequivalent to brand-name medications, but that’s it. The inactive ingredients (the stuff that actually dictates how fast the medication breaks down, and how quickly or how well your particular body absorbs it, et cetera) do not. This means there’s also no objective “best” generic, because everyone’s personal biochemistry reacts to these inactive ingredients in different ways. You wouldn’t want to give someone with celiac disease a pill that used wheat starch as a binding agent, for example.

This generally isn’t a big deal for most medical conditions, but it can be a very big deal for drugs to treat or mitigate mental illness. For example, my last bottle of pills came from Camber, whereas the one before was from Aurobindo. I had Lupin before that. Every time I get a refill from a different manufacturer, I have to go through an adjustment period. Sometimes, it’s easy. Sometimes, it’s not. Sometimes, it involves resigning myself to having terrible stomach pains, increased panic, or dangerous ideation for months and hoping I’ll get a different manufacturer on the next go-round. It’s not fun. It’s not helpful. It’s not safe.
For some reason, I hit a heavy, long, difficult period of what I call The Ennui shortly after I started taking Camber’s pills. This happens sometimes.

But this is going on seemingly forever. Flatness. Anhedonia. Withdrawing from life. Nothing seems to move the needle even a little bit. It’s not as if the medication isn’t doing anything — if that were the case, I’d be curled up terror-breathing with tetany. But whatever it is doing is Weird and Bad.

“But J., pills are unnatural anyway! Our ancestors didn’t have pharmaceuticals! Just do what they did!”
They fucking died, Sharon.
That’s what they did.

So, not exactly wishing to go the ancestral approach just yet, I call my doctor. No problem. This happens. It’s a thing. Generics are not all equivalent, and there isn’t really a way to go, “Hey, this manufacturer’s meds suck for me, and I need the ones from this one.” All you can do is get them from the actual brand name, consistently, so you don’t have to readjust every time you refill. Once you know how the brand name medication works for you, you can have some consistency. So, my doctor filled out a new prescription and designated it “brand medically necessary.”

And my health insurance (through United) doesn’t want to cover it.

This isn’t my first brush with this sort of thing. When I was diagnosed with pseudotumor cerebri (intracranial hypertension), I was referred to a neuro-ophthalmology specialist — someone who specializes entirely in the connection between the brain and eyesight, who’d know better than anyone what was going on.
And Blue Cross wouldn’t cover it, so I didn’t get to go. Would I have saved more of my vision had I been able to? Would I still have developed Charles Bonnet syndrome? I guess we’ll never know!

At this point, I’m not sure what else to do. A significant part of me is very close to calling United and saying, “Look, I understand. The brand name is way more expensive. However, in light of recent events… you sure, bro?”

If you’re in a similar position, you probably get it. A friend of mine who has experienced in the medical field recommended a service called SingleCare that’s a) highly rated, and b) able to help discount prescriptions and find the pharmacies with the lowest prices. They even help with brand name medication. Even with their help, the specific medication I need is still priced well out of my price range, but they can be a lifesaver for a huge number of other people.

Anyway, rant over. With luck, I’ll be able to get this sorted out. Otherwise, I guess I’m hanging on and desperately hoping that we’re back to Lupin or Aurobindo next time around.

The election’s over. I don’t really have much to say. Other people who are far more eloquent have said everything that I possibly could.

This post from Waging Nonviolence has been very helpful to my friends and me, and I highly encourage you to read it as well. I’m not going to reiterate the excellent points that it makes, but I did want to add to the list:

1. Find people you trust, and see what skills you have between you.

Many people (women, people of color, and LGBT people) are taking this opportunity to examine and pare down their spending habits. Most major corporations and big box stores are owned by the exact demographics that will either benefit or have the luxury of remaining passive. Divest from them — literally and figuratively.

Gather a group of trusted people and see what you have to offer each other. How can your community build resilience and foster independence? What can you do to lessen your dependence on purchased goods?

Now’s also a good time to focus on reskilling.

2. Grow an edible plant.

This probably seems a bit out of left field, but it ties into number 1. Grow an edible plant. Even if you’re in an apartment. Even if all you have is a tiny windowsill under a basement window. Stick a basil in it. Shove some parsley in there. Grow something that you can eat.

Will this change the political and capitalist landscape? No, but it is a way to increase your confidence and feelings of independence. It’s one less thing you’ll have to buy in the future. It’s something you can propagate and trade with others. It’s something you can eat, at a time when the US is experiencing a resurgence of fucking scurvy because of grocery price-gouging.

It’s also worthwhile to learn to identify local edible plants, especially if you live in an urban environment. Spruce tips are a good source of vitamin C, as is purslane. These are both pretty easy to find/identify (even in a city) and beat the hell out of getting scurvy.

3. Make a big pot of something.

A lot of us don’t have much energy right now. If you have a recipe for a big pot of something that you can eat for a week (khichdi, goulash, slumgullion, stew, rice and beans, something) now’s a good time to make it. If you don’t have the energy to cook every day, it’s something you can go back to. Hell, most of these foods are ones you can make from scraps and odds and ends of things.

(Yesterday, I made a big pot of vegetable soup using a handful of lentils, some cabbage, and a broth I made from vegetable peels and end bits.)

This is another way to help boost feelings of independence and combat helplessness. You can feed yourself for days, maybe even off of things you wouldn’t have much use for otherwise — broccoli stems, onion ends, a can of beans, etc.

A big pot of something is also a good way to gather the people you trust. Invite them over. Have a potluck. Grieve, if you need to, but focus on what you can do for each other going forward.

4. Pick three causes.

It sounds like a lot, but it doesn’t have to be. Pick one local, one national, and one global cause that matter to you. If you can’t do much else, give money. If they need supplies, either give supplies or ask around and gather them from others. If they need volunteers, give your time. If you can’t do any of that, post about them and solicit help from those who can.

Get involved in mutual aid in a way that doesn’t spread you too thin. No single person can support every good cause that comes their way. It’s possible to care about them all, but time, money, and energy are finite resources. Even if you don’t feel like you’re able to make a difference, remember the story of the star-thrower.

5. Skip the bracelets and pins.

Look, safety pins and blue bracelets might make people feel good, but their stated intention was to show others that the wearer is a “safe” person.

There’s only one problem with that: “Safe person” is not a title you can give yourself. If it was, it’d defeat the purpose of having that title at all. If anything, performative gestures have the opposite effect because they cast doubt on whether the wearer is listening to the valid concerns that threatened groups have.

Anyone can wear a safety pin or a blue bracelet. It’s a purely performative gesture, and nobody asked for it. The people who would ostensibly benefit from it don’t want it. It’s also been criticized as a way for the wearer to say “#NotAllWhite/Straight/etc. People.”

It’s easy for gestures like these to be co-opted by predators, and they take agency away from the people they’re trying to help. Women, people of color, religious minorities, and LGBT people can decide for themselves when someone is a “safe person.”

Some people have raised the argument that these visible gestures would make dangerous people uncomfortable, so they’re worth wearing for that reason. The problem here is that that doesn’t work. In the past, they invited mockery. Dangerous people didn’t feel threatened, and other people didn’t feel safe. These gestures only benefit the wearer.

Anyway, that’s all that I have to say for now. Grieve, but don’t stay grieving. Assemble a trusted community. Build resilience. Support the women in your life who’ve chosen the 4B (or 5B-7B) movement. Do things that will foster independence.