I had government insurance last year, and lost it. It's been a year without meds now. I was doing alright for a while, managed the symptoms through routine and physical activity, but I'm really struggling this month. The catatonic phase lasted for so fucking long I barely even recognized it was starting. But I'm seeing the altars again, the shadow people, social interaction is starting to become unbearably anxious, I feel like the person in my brain watching me fry the egg. The lines going between everything. One of them is watching me.

And this psychosis wave is fucking terrible compared to my last one. When shit started popping off for me, it was this dream like euphoric mania, where I'd see things like tree leaves on a color gradient, or start hearing full songs just start playing out of nowhere. The only way I can describe it is feeling like a main character of a play. Not in the sense that I'm particularly important or unique, more in the way that it felt like whoever was watching wasn't a stalker but like a film director, picking when to play songs. I used to hallucinate friends I hadn't spoken to in years, and would occasionally get to have chats with "them". This all was extremely unhealthy, but at least it was pretty easy to cope with.

It felt infinitely funnier back then. As time has gone on, the thought irregularities have become darker and more disruptive. First episode lasted really long before the mania crash, but this just feels like already being in the mania crash and it only has lower to go

I know I need to be on meds, but I haven't had money or insurance for it. America wants schizophrenic people in psychosis and homeless.

  • happyandhappy [she/her]
    ·
    edit-2
    8 months ago

    https://www.youtube.com/watch?v=9v0BnhvkJZ0 this random spontaneous lecture on psychotic disorders while this dr dude was playing disco elysium actually really helped me w others and myself by learning about the specific mechanics about how psychotic disorders work and the discrete effects of them. its nice to know for instance that the paranoia is simply a matter of the brain not being able to discern what information is relevant and important vs irrelevant and unimportant, and that the crossing of the lines leads to strategic and rational attempts to fill in the blanks. hope you can get something out of it.

    his channel in general is an attempt to democratize access to scientific mental health treatment and might be worth a scroll through.

  • LanyrdSkynrd [comrade/them, any]
    ·
    8 months ago

    I have bipolar and was in a similar spot when I lost a job years ago. Started having symptoms of mania and didn't have a script for my meds or a way to pay for them.

    I went to an emergency room eventually and they were able to get me a dose of my meds immediately, a script for 7 days of meds filled for free through the hospital and got me an appointment with someone who helped me get on Medicaid and a treatment plan.

    I'm not sure if you'll get all that help where you are, but hospitals that get public funding(which is almost all of them) have to treat you if you can't afford it. It's in their interest to help get you on Medicaid so they can get paid.

    I wish you the best, take care of yourself.

  • ReadFanon [any, any]
    ·
    edit-2
    8 months ago

    I'm sorry to hear that you're struggling and that the US healthcare system is so fucked.

    I know that you can get, like, coupons and other discounts via manufacturers in the US by going to the pharma manufacturer's website or something? We don't have that here but there are (frankly, kinda bizarre) discounts and certain low-cost schemes that companies provide for prescription meds for people upon application in the US.

    I would maybe dig around on the internet and consider contacting the particular drug manufacturer on their helpline to explain your situation and to ask if there's any sort of subsidy scheme or discounts available, if you have a preferred medication for managing this.

    Costcos have pharmacies over there, apparently, and you can access the pharmacy without being a member, apparently. I've heard word that often they provide extremely low cost prescriptions compared to most other places so this, along with a manufacturer coupon or subsidy scheme, might help to put meds within your financial reach.

    If this isn't viable or you don't know where to start with meds and you're kind of at a crisis point, where you aren't able to wait to hear back about your application for a subsidy scheme etc., and you need a circuit breaker urgently I would strongly consider a first-generation antihistamine because they will knock you out. Promethazine is immediately the drug that springs to mind here because it's generally an OTC antihistamine but it has antipsychotic effects and it has at least some dopamine antagonism, which should cause a reduction in the "positive" symptoms that you're experiencing, at least theoretically. (Positive as in excess/disturbance of normal function, e.g. mania, and not as in "good" symptoms.) Keep in mind that promethazine is gonna make you feel like you're taking a classic antipsychotic - it'll hit you like a truck so expect to be asleep for at least 8 hours after you take a reasonable dose and expect that groggy antipsychotic hangover feeling when you wake up along with the absence of motivation.

    Do you know anyone who suffers from morning sickness or serious nausea (travel sickness, chemo patients/ex-chemo patients etc.)?

    If you can get your hands on some metoclopramide then this would also be something which I'd be pretty comfortable with taking if I was in your situation and things were pretty urgent.

    I really wish I was more familiar with the US healthcare system and everything around it because it's completely outside of my experience so I can't give you any hot tips on how to navigate the system there.

    Btw I'm not a doctor or anything so if you do get advice from a pharmacist or a doctor then please take their advice over what an unqualified internet stranger has told you.

    • LeylaLove [she/her, love/loves]
      hexagon
      ·
      8 months ago

      I'm lucky yet unlucky on this. The meds that actually work for me are surprisingly cheap, Risperidone is only about $3 for a bottle. The issue I've been having is actually getting my scripts renewed, going to doctors visits. There is actually a mental health urgent care in my city that will do free visits, but they're worse than going without. They prescribe insanely high doses to first timers, their SSRI doses are so bad (Know someone who was prescribed 500mg a day of Zoloft to start) that it feels like, separate from me being particularly paranoid, they're experimenting on people. I've heard about so many prescriptions that came from there that I'd call bullshit if my friends didn't show the bottle. They had prescribed me Abilify and Celexa without telling me about akathesia, and wouldn't listen to me for months. It literally turned me into an alcoholic for a bit just so that I could have the luxury of sitting still. It's either deal with actively harmful doctors, or spend hundreds a visit.

      American drug law is bullshit, and doctors here are extremely stupid when it comes to drugs because they don't know what actually gets people high. Promethazine is actually damn near impossible to get in the states because some of the doctors out here are so uneducated on their job that they think it's an opiate. I have Hydroxizine around for my 1st gen anti-histamine, and that's generally been helpful. Maintaining a sleep schedule has been good.

      It's funny you mentioned chemo patients, because the person I know that was on it is also the type of person I really should be around during my episodes. I'm gonna message them. Thank you for taking time to respond, I really appreciate it.

      • ReadFanon [any, any]
        ·
        edit-2
        8 months ago

        Fuck, that's awful.

        It sounds like you really know what you're working with but it's just a fucked situation. I was hoping that there was going to be an easy fix with something simple that you might have overlooked.

        I can't believe that promethazine is hard to get there. So they don't let anyone have it because doctors feel like it might be kinda like an opioid and yet they hand out Oxys like candy on Halloween? I need someone to explain that to me.

        I can literally walk into a pharmacy and buy plenty of promethazine here without a prescription and we are generally much stricter with our drug control than the US is. To have it so close within my reach and yet so far away from where it could be useful is kinda heartbreaking ngl.

        So I've just gone through an exhaustive list of dopamine antagonists while drafting this and there's nothing that stands out as being a viable alternative which you might be able to get OTC. There are no readily accessible options that are herbal or supplements which I would be comfortable recommending because any that might be useful seem to have mixed effects on dopamine in the brain and that's absolutely not worth rolling the dice on, especially given that herbal supplements barely have any research available on them compared to drugs.

        And now after spending 2 hours at this I'm really scraping the bottom of the barrel trying to find something and I'm coming up with obscure herbs used in Traditional Chinese Medicine but trying to find anything conclusive on them is pretty much impossible and none of it is going to be cheap. Plus there's stuff like figuring out extraction methods and trying to find a therapeutic dose without risking permanent damage somewhere while using stuff that doesn't have any degree of purity... this isn't a viable option.

        The option to go to the urgent care centre to get a prescription for an SSRI so that you can take a fraction of a potentially-outrageous dose to try and lower dopamine doesn't sound like it's going to be good for you simply on the psychological level, and then we would be relying on chance to get the right SSRI prescription, and then waiting for it to affect your dopamine levels enough to make a dent and all of that stuff - that's really not a workable option either.

        Might be a bit of a long shot but your friend might know of someone that's doing chemo at the moment who might happen have some spare metoclopramide (or similar anti-nausea meds) laying around?

        Sorry I couldn't come up with any solutions for you. I wish I could offer you more than just solidarity.

        I guess if there's one thing that you can take away from this comment chain it's that you really aren't overlooking any readily-accessible fixes and you've got a good handle on the situation. I know that doesn't address the problem but hopefully it makes a good case against you internalising blame for what sounds like some really shitty circumstances that are beyond your control.

        • FumpyAer [any, comrade/them]
          ·
          edit-2
          8 months ago

          I mean, you could just ship a couple months worth (ideally 3) with a bogus return address if it's that cheap and otc. Desperate times, desperate measures, etc. I'd PayPal or cash app the money if necessary to make it work. Just make sure LeylaLove sends you her address via a secure channel.

          • ReadFanon [any, any]
            ·
            8 months ago

            I'm open to exploring this as an option though I don't know the ins and outs of it so I'd need to put in some groundwork before I'd be comfortable committing to anything but, more to the point, there's a lot of risk on her end as she would be the one receiving what amounts to an i... *am not going to use the word because it leaves a easily traceable footprint but - 🤢🦅 *... package and she would need to expose a lot of personal information through the internet to a complete stranger for this to happen.

            When you're managing schizophrenia without medication and you're experiencing a troubling increase in psychosis and paranoia you need the people who help you to be very careful to not unintentionally aggravate those symptoms.

            If I was feeling a lot of paranoia that was becoming more difficult to manage and my reality was getting very wobbly at the edges and an anonymous person suddenly reached out to me via social media offering me the assistance that I'm a bit desperate for in exchange for me doxing myself to them and agreeing to do something i... 🤢🦅, personally that would aggravate my paranoia like nobody's business and it's not fair to put someone in that situation.

            I have worked in the mental health sector so please don't take this as me criticising you or anything, I know that lots of people don't have the experience that I do but I just wanted to explain what I'm prioritising and why that is the case. I'm not some cold-hearted monster who wants to stand by when people are suffering nor am I the "Sending thoughts and prayers, bye now!" type of person but if I did send aid then I have to consider the risk of turning a situation that at present is barely manageable and deteriorating into something which is an outright emergency that the aid would be completely insufficient to address by the time that it arrives (assuming it doesn't happen to get intercepted along the way.)

            When you're on the edge of a proper mental health crisis you need the people around you to be very risk-averse and you need them to understand that how something is done is at least as important as what actually gets done. If you screw up on the how part then you probably lose your chance at reaching the outcome that you're aiming for.

            • FumpyAer [any, comrade/them]
              ·
              edit-2
              8 months ago

              Well, I gave 3 other possible things to try. Hopefully, one of them works! But as far as I know, you can't be prosecuted for something showing up on your doorstep from the mail. After all, there would be no proof you asked for or solicited it, even if it was an "illegal" or restricted drug.

              • ReadFanon [any, any]
                ·
                8 months ago

                I hear what you're saying but it's really important that we come at this from a place of deep empathy.

                I'm sure there must have been a situation in your life where you were totally convinced that something pretty terrible was going to happen - maybe that a partner was going to dump you, you were going to get fired from work, someone was going to blame you and you wouldn't be able to prove your innocence, you were informed that someone close to you was involved in an accident and has been rushed to the hospital but nobody can provide any more info, that sort of thing - and those feelings built up inside you until you basically knew that it was all over and nothing would change that fact. You might have even felt physically sick with worry and avoided doing things like checking messages or answering your phone. People might have even tried to convince you that you're getting worked up over nothing and that everything would be fine although it wouldn't have made any difference to how you felt at the time. But then eventually it turned out that you were completely wrong and it all just blew over like nothing ever happened.

                So if you take that experience and dial it up to 11, that's kind of like how schizophrenic paranoia would feel. But on top of that you're also hallucinating and you're seeing disturbing things like shadow people who are watching you and there's probably more stuff that you do not feel comfortable or safe to tell others about.

                Now, with all that in mind, you get approached by a person who has something you need. And all they are asking from you is a bit of your personal information and for you to agree to certain things. You don't know who this person is. You don't really know how secure your communication is. But you really need it so you decide to agree to it. And now you have to wait for a week or two and you have no idea what will happen next or what could go wrong at any point.

                How much does this situation impact on your psychological state? Does the fact that you probably shouldn't be liable for prosecution really change what you're experiencing?

                Keep in mind that in the situation I invited you to recall from your past, you had a resolution to the experience of worry or dread because you discovered that you were operating under a misapprehension.

                What is it going to be like for you if don't ever get a resolution to this hypothetical situation? How does that impact on your life for the foreseeable future?

                How does that impact your ability to communicate with others, to engage with the world, and to function?

                How long does this hang over your head for?

                Please try to remember what I said in my comment above - if you aren't focused on how something is done in these types of situations then you're likely going to lose your chance at achieving your outcome.

                When paramedics attend an emergency mental health call, their objective is to get the person into the ambulance and to the hospital so they can be treated and stabilised, right? So why don't the paramedics just send in cops to kick down the person's door and slap them in cuffs before dragging them off and throwing them in the back of the ambulance?

                Because if you're dealing with a person who is on the edge of a proper mental health crisis, the how is at least as important as what actually gets done.

                In this case, you have successfully got the patient into the ambulance and now they can be transported to hospital and now you can achieve your outcome of treatment and stabilisation.

                Have you made it more or less likely that the patient is going to comply with treatment though?

                How has your approach affected your ability to achieve your goal of stabilising the patient - are you closer to it or are you actually much further away from it than you were when you began?

                • FumpyAer [any, comrade/them]
                  ·
                  edit-2
                  8 months ago

                  I can definitely see how waiting two weeks for a semi-illegal package could be very, very bad for somebody with a paranoia-causing illness. I shouldn't have suggested it in this case. I definitely don't want to unintentionally steer her away from attempting to get medical care. From what I've seen so far though, she is pretty solidly invested in doing so or at least in finding ways to cope.

                  In most other circumstances, sending cheap lifesaving drugs internationally is based and not actually dangerous aside from initially sharing contact details, especially if it is not a scheduled controled substance, as is the case here; I want to make that clear.

                  I hope that Leyla finds a way to access the meds she wants and needs as soon as possible.

                  I actually have a relative with paranoid schizophrenia and I should have known better.

        • LeylaLove [she/her, love/loves]
          hexagon
          ·
          8 months ago

          I appreciate it. It's very much a situation where solidarity seems to be the only thing attainable.

          To answer your question on promethazine and oxys, doctors in America are a lot different after the massive egg on their face that was allowing the opiate craze to happen. They're adjusted for this by underperscribing anything even slightly controlled. Promethazine obviously isn't an opiate, but people on opiates like it because of the ever famous codeine/promethazine cough syrup. Every doctor you see about meds assumes that you're trying to get drugs to get high. So unless you're paying a lot for your doctor, SSRIs and anti-psychotics are pretty much the only thing doctors will prescribe now.

          • ReadFanon [any, any]
            ·
            8 months ago

            Yeah, it seems like a real mess and the overcorrection is going to have its own blowback sooner or later.

            On the other side of the dopamine dysregulation landscape, there's that chronic shortage of ADHD meds in the US which gets exacerbated more and more each year because the rates of diagnosis and prescribing are increasing and yet the DEA hasn't adjusted the amount of stimulant meds available to be in line with the medical establishment, which is now causing a major shortage of Vyvanse globally due to some quirks in capitalism that I'll spare you the boring details of.

            It's a big mess 😖

            • LeylaLove [she/her, love/loves]
              hexagon
              ·
              8 months ago

              Oh I know all about that, my girlfriend has an adderall prescription. What makes it even more annoying is that making amphetamines is only marginally harder to make than hard liquor. Anybody with an internet connection can make enough meth to last them for months. Or buy 2 scripts worth of meth for $20. This also coincides with some medicaid changes, where medicaid will not pay for your controlled substances (amphetamines, painkillers, benzos, ect.) but will track how much you spend on them throughout the year. So now people who are prescribed amphetamine are liable to lose state healthcare because they have money for their amphetamine. Anything controlled is slowly becoming unattainable, through a mix of shortages, overcorrection from the opiate epidemic, and by fucking with people's insurance. Everything I just listed is a feature, not a bug. They want us to be criminals.

              Pretty much every drug issue in America is completely manufactured by the state. I have no direct proof of this, but the fentanyl crysis in the states is obviously being ran by feds. If the fentanyl was coming from another country, why does America have BY FAR the highest amount of fent deaths? Forcing more neurodiverse people to get their medication off the streets leads to more people getting things laced with fent, more death. It's a silent extermination campaign against neurodivergent people. I only expect the shortage to get worse as the ghouls at the DEA realize they can get away with more.

              • ReadFanon [any, any]
                ·
                8 months ago

                For real.

                I'm going to speak a bit vaguely so I'm not putting out too much information but the region I am in has an anomalously low ADHD diagnosis rate due to a big player's influence and their skepticism towards ADHD. You can probably guess what the stats are like for illicit amphetamine usage in the same region.

                Like if you take a demographic of people who are predisposed to addiction, who are especially prone to addiction when they aren't appropriately medicated, and who happen to feel a whole lot more normal when they take stimulants and then you put an effective blockade on them accessing appropriate medication... it doesn't take a PhD to figure out what happens next.

      • FumpyAer [any, comrade/them]
        ·
        edit-2
        8 months ago

        It could be worth the time to try this shitty free mental health place again and be very insistent (beg if you must) that X drug at X dose worked really well for you before. If they prescribe you something else, just don't fill the script. Then all you've lost is an afternoon and no money. Bring the empty pill bottle if you still have one, or your prescription record from the pharmacy. You can download it from most US ones.

        My other advice would be to get a social worker. They can help you cut through red tape.

        In my state if you get kicked off of medicaid you have 90 days to call them and get back onto it and it's actually not super difficult. And my state had to be dragged kicking and screaming into medicaid expansion.

        Or if they agree to it, ReadFanon could mail you their otc version of the drug with a bogus return address. I would pay for it via PayPal or cash app if it's expensive to ship. Send them your address through a secure channel if you do this.

        Solidarity, I'm so sorry this is so hard when it should be easy.

  • the_itsb [she/her, comrade/them]
    ·
    8 months ago

    This sounds really hard. I admire the humor and perseverance you've used to get this far, and I hope things get easier.

    Are there any addiction clinics around you? Usually the income cutoff for their help isn't much better than the cutoff for government help, but sometimes they are more flexible. The place I go for my ADHD meds markets itself as an addiction clinic for opiates and has a wider income range they help than other offices in the area. Their clinicians are psychiatric nurse practitioners who can prescribe controlled substances, though, which means they work just fine for my needs.