I’ve been experiencing a lot of headaches trying to do basic things like get my brain meds filled in Germany. There are rules like only certain types of general doctors can prescribe anti-depressants or anti-anxiety medications, only certain kinds of doctors can prescribe testosterone, and of course only psychiatrists can prescribe ADHD meds. On top of that the color of the paper prescribed matters, because that’s how the pharmacy can tell if the insurance will cover it or if I have to pay out of pocket. In order to get my meds refilled every month I have to physically go to my doctor’s office, talk to the receptionist, and wait for my doctor to hand me the physical paper I have to physically give to the pharmacy (Apotheke). This is all done in the name of personal privacy (which is something Germany takes extremely seriously *stares in GDPR*) but my god is it exhausting.
My psychiatrist was the only English speaking psychiatrist who was taking new patients (and treats ADHD) that I could find, and unfortunately, she doesn’t take insurance. Which means that I have to pay out of pocket for my Ritalin, Buspar, and Bupropion (the last two cost ~100 euro each without insurance). My current GP was willing and able to fill the Buspar and Bupropion for me but keeps writing the wrong dose and giving me trouble over it. This month my normal dose of Buspar was out of stock so I’ve been taking a half dose because trying to navigate getting another script so I could get my normal dose was more anxiety inducing than making do.
Which is huge. I’ve been doing so much work internal work between writing here for the last 14 years and 6 years of therapy that I can actually manage Peridot, my partner, and myself all getting sick in a country with a language I can’t speak while taking half of my usual dose of anti-anxiety meds without spiraling. When I started Bupropion in 2012 I took it with the intention that I would work on myself, that it was a tool to help myself heal. I pictured the anti-depressants as road maintenance workers with the slow/stop signs, like guards, there to bridge the gap my thoughts kept falling into so I could work on closing it. I’m at the point now where that gap feels less like an abyss and more like a pothole I can step over.
It feels so weird to be saying this because I assumed I would be on bupropion until I died, but, I think I’ve done enough internal work that I don’t need the guards anymore. The neuropathways that immediately lead to horrible depression are harder to reach now. So much of the circumstances, internally and externally that I needed help for have changed. The PMDD is gone with my uterus, my dysphoria is the lowest it has been in my entire life, and I live in a place where I feel safe and I’m not filled with capitalism-induced existential dread (which is a huge fucking privilege I know, and it shouldn’t be. Having it again makes me want to cry tears of relief and sadness that this isn’t universal when it could easily be). When I get anxious, overwhelmed, and depressed now? I know in my bones it will pass and I can (and do, often) take that opportunity to work on whatever the underlying issue is and sit with that part and give myself whatever it is I need in that moment.
Usually? What I need is to be heard and validated. Over the last couple years of therapy, I’ve learned how to be the one who can give that to myself. Last year this was especially pertinent because my emotional support system was (is) an ocean away from me. The only person who could help me in the moment was myself, so I leaned even harder into honing that skill. While I was sick with COVID and doing nothing but playing Dicey Dungeons I had a lot of FEELINGS about it. I was angry that I caught it after being so diligent for so long, I was angry that my experience with the German healthcare system is so hostile it actually felt smarter from a recovery standpoint for me to not seek care, I was worried about how bad it would get and if I would get long COVID…and I worked through all of those on my own, and came out better on the other side.
This isn’t something I would have been able to do without all the work I’ve been doing in therapy, and it isn’t something I would have been able to do years ago when I started taking meds so I could do this work. But now I can. Now I can look into what feels like an abyss and see that it isn’t, I can calm myself down and make myself feel safe again. So I think I might be ready to give the guards a break and see how that goes. I can always take meds again if I need to.
It feels weird (in a good way) to be in this place where I’m not constantly screaming internally. Where I can see that all of the internal work I’ve done with my trauma has actually been healing in ways I can feel but am having trouble describing. I’m at a point I never imagined I could get to when I started writing here trying to process everything I went through as a kid. I won’t say I’ve healed completely from CPTSD because I feel like healing is a constantly ongoing process that is the opposite of linear, but healing is happening. Wounds that were soul deep are not as deep anymore. Getting to this place, where I believe good things and can spot the lies anxiety and depression and trauma try to weave is so intense and exhausting. I have to remember to combat the thoughts that tell me I don’t deserve good things with reminders that I do, actually, and follow that up with actions.
It took 11 years but I finally, truly, deeply, believe good things about myself. The immediate descent into self loathing and blame when something goes wrong is finally gone. It feels great. I wish I could boop 21 year old me on the nose and tell them it all works out, better than they could even dare to hope.