Sarah* is, in many ways, just like any other 20-something you’d meet. Her hair is dyed rust red and she is at ease in the casually-torn jeans, graphic tee shirt and well-loved tennis shoes you’d expect from someone from her generation. Yes, she shares so much in common with people her age, but what sets SMH client Sarah apart from many of her peers is that she is a walking, talking testament to the life-changing power of Medicaid Expansion and the Affordable Care Act.
Growing up in a small, rural town, Sarah always felt different. Given that her parents were from different part of the country, the depressed ex-logging community and small town culture didn’t help.
“It was a tough environment to be raised,” Sarah says. “Higher education was severely looked down upon, and we were outsiders because we didn’t have a family history of being loggers.”
Sarah became depressed. Because there were not many mental health resources available in the small town, and because of limited awareness, her parents never considered behavioral health counseling as a real option.
“My parents just didn’t accept ‘mental illness’ as a thing,” she says today.
Though she would see physicians to treat the symptoms of her issues, it didn’t seem to help. In school, nurses seemed to miss that her sadness and struggles were clinical in nature.
“I would call my mom and tell her that I didn’t feel well. She would be like ‘what’s wrong?’ I told her that I was feeling really sad. ‘I’m so sad that my stomach hurts, I just want to come home and lay down.’”
As she grew up, her troubles grew, too. She began failing in school, particularly in mathematics. With a father who worked in the sciences, this only added to the anxiety and depression she felt. Her poor academic performance dimmed her high hopes of attending college. For her, college life would have been a way out of the small town where she was raised, and a way, she thought, to escape her unbearable unhappiness.
Despite growing suspicions about her depression, Sarah pressed on, eventually going to trade school in Vancouver, BC to study animation. Afterward, she moved to Kirkland, Washington, to take a job at a major game development company. In this super-charged and male-dominated environment, things didn’t go well for Sarah, who was ultimately released from the company in 2008.
Sarah experienced high levels of harassment from non-male employees, which impacted her interactions and, according to the company, her attendance. Though she doesn’t go into details about her past, it was clear that that work environment brought back long buried memories and emotions.
“My depression just escalated with my life and, of course, encountering any struggles, especially in a corporate environment… that just didn’t help anything.”
Her depression became more pronounced during the year she worked there and she recalls calling her mother to share, and was curtly informed “to tough it out.”
She now knows that it was her depression and feelings of instability that affected her well-being, recalling that overwhelming feelings of sadness and grief dominated thorough both the rough patches – and the good.
Several years later, a satisfying job and a boyfriend she adored — “an amazing human being,” she says, still left her wanting, and feeling tremendously guilty that she just wasn’t happy.
“I would still have days where I’d have this sick pit in my stomach, where I would be overwhelmingly sad. Even on the good days in my journal,” she says “there were always these random notes like ‘Today was so great! We went out and had a great time! So why am I still so miserable?'”
Her boyfriend, a very sensitive and caring person, was helpless to support her. The depression only got worse, and by 2015, she felt she just had to do something. Increasingly desperate to understand what she was going through and to take control of her spiraling emotions, she turned to SMH.
“I hadn’t wanted to live for about three months,” she recalls. “That was my mental state.”
She was diagnosed with depression, anxiety, and obsessive compulsive disorder. Her therapy consisted of individual talk therapy sessions with a counselor. Though it helped her tremendously, Sarah still felt that she needed additional support, and after careful consideration, saw an SMH psychiatrist.
Though medication is not often the first option, it did work for Sarah. One year later, after exploring a number of medication options, Sarah and Kelly Bliss, her prescriber, finally determined a specific anti-depression medication that worked well for her. It is a topical, powerful and expensive medication that manages her dosage throughout each day. She has been on that medication for approximately a year and has noticed an overwhelming difference in her day to day life.
The Affordable Care Act, which passed into law in 2010, was essential to unlocking her recovery. Without access to the medication to complement her therapy, she believes that her full stability would not have happened. The cost alone for the medication without Medicaid expansion would have been prohibitive.
“The cost of the medication is more than the cost of both of me and my boyfriend’s 90s cars,” she says. “The Kelly Bluebook estimate for both of our cars is less than a monthly supply of (it).”
Access to the medication has certainly pointed her life in a positive direction.
“I feel my life has completely changed,” Sarah now says. “I look at my past journals and sketch books and it’s just odd. It’s like a day and night change. I used to really struggle to eat well, exercise, and complete a single assignment in a typical day-something I’d done a hundred times before. Now, I can study math for an hour, do three assignments, cook dinner, and go for a walk that’s a couple miles long on a daily basis, not just on good days.”
With nearly two years of therapeutic and medication support helping her, Sarah now is blossoming. Though she had previously given up on becoming an astronaut, citing Sally Ride as her inspiration, Sarah has gradually rediscovered a passion for science that she had thought died away long ago in that small town.
This passion for science has fueled an interest in engineering and robotics. She currently takes online courses in Robotics and hopes to learn as much as she can. Sarah, whose love of science is blossoming, frequently sketches out schematics and pre-calculus equations in the notebook she carries around with her everywhere she goes.
“Math, which used to cause me to have panic attacks, is now a fantastic vice for me in that it is not emotional, and a great way to vent my OCD,” she says in reference to escaping from outside stress and anxiety. “For me this is investing in myself. It is me doing something worthwhile.”
*Name changed due to confidentiality.