Throughout the blurry state of being continuously sedated, I wandered through the pale, cold halls of the hospitals, the bus rides to and from weekly case management and therapy appointments, still not cured of my “ailments.” From the ages of 14-19, I was continuously over-medicated as treatment providers were allowed very little time with me, often berating my inability to conform to complete sedation or relaxation with notes of stigmatization and crude humor. The medications that were prescribed to me during this time, which I had noted down and can remember, were as follows:

Prozac
Zoloft
Lamictal
Topamax
Saphris
Seroquel
Abilify
Zyprexa
Risperdal
Geodon
Restoril
Rozerem
Lunesta
Neurontin
Buspirone
Prazin
Trazadone
Wellbutrin
Cymbalta
Sonata
Effexor
Lithium

When none of these medications worked to cure my relentless anxiety, depression, and fleeting states of mood disorientation, the psychiatrist recommended electroshock therapy for me at age 19. Luckily, another psychiatrist stepped in to review my case and finally noted that the ongoing trauma I had endured during my lifetime was the reason why the treatments were not working. As that psychiatrist had stated to me, “Medications cannot cure trauma. We understand now.”

With the current state of the mental healthcare system in The United States, practitioners continue to be ruled by third-party for-profit insurance companies and the regulations they set for standards of care

With the current state of the mental healthcare system in The United States, practitioners continue to be ruled by third-party for-profit insurance companies and the regulations they set for standards of care. Reckless and motivated by a push to “save money,” cutting costs often costs lives. This healthcare model of immediately diagnosing and pushing medications forces patients to not only lose hope in ever “feeling better” but also creates a stigma that something must be fundamentally wrong with them for medications not to be working effectively. The pattern of this type of treatment establishes the attempt to seek out help and is re-traumatizing, stigmatizing, and dangerous for the patient.

Whether it be an inpatient program, an outpatient program, a therapist, a psychiatrist, or a case manager, all need to bill their hours to an insurance company. These insurance companies regulate what medications are prescribed and what treatment can be given based on the individual’s insurance. The reasoning behind billings to insurance companies is to get reimbursements for their hours – this is how therapists, psychiatrists, and organizations get paid.

I worked for a mental health organization funded by the State of Michigan, which had a grant position paid by insurance companies to “reduce the cost” of homeless and chronically ill patients on Medicaid (even State-funded programs have private insurance companies intertwined in them). This program not only dehumanized individuals to a monetary standing, but it also caused many to be forced to have procedures and treatments done when they did not have a solid foundation of shelter, food, and support needed to be able to benefit from treatment properly. The clients of mine here were sedated on a multitude of medications, none helping the root cause of their situations or inner turmoil. Here, I was playing a direct role, seemingly parallel to the exact harm that the therapists and psychiatrists had done to me. Here, I gained a haunting and gruesome consciousness that there was nothing I could do to truly provide adequate care with the current state of the mental healthcare system.

Money Dominates American Healthcare

The current state of mental healthcare in The United States is not separated from the physical healthcare system. It is a system run solely on the financial gain of large organizations instead of a person-centered approach. As trauma-informed as any practitioner can be, the underlying force they respond to is currently insurance companies. This both stalls healing and is a primary source of overmedication and misdiagnoses.

The rush to diagnose an individual can be seen on many levels. One of the primary diagnoses that are recognized and validated by insurance companies for mental health practitioners is “Bipolar Disorder(s), Mood Disorder, Unspecified.” A multitude of overlapping diagnoses can appear with Bipolar Disorder, Mood Disorders, and Complex PTSD, including, but not limited to:

Mood instability
Aggressive Behavior
Insomnia
Periods of high-energy
Periods of low-energy
Depression
Anxiety
Unstable inter-relational patterns

This practice leads directly to misdiagnosis, overmedication, and a lost sense of identity if the individual is relying on the healthcare provider to make progress in their healing journey

While it is true that CPTSD often overlaps with other mental health co-occurring disorders and morbidities, the push for “bipolar disorder” to be diagnosed instead of a trauma disorder can directly correlate to the insurance companies having a specific mandate on what medications can be provided for this disorder, based on what insurance the individual has. According to this healthcare model, there is now a “Care Plan” for the practitioner, money for the insurance companies, and reimbursement for the provider. On the other hand, if one is to be diagnosed with a trauma disorder, they may continue to be seen by the practitioner (depending on whether the insurance approves the visits). Still, there is currently no pharmaceutical medication that can be used to “treat” trauma. This means that a misdiagnosis not only guarantees more money for the insurance companies but also more money for the pharmaceutical companies and a higher reimbursement rate for providers.

This practice leads directly to misdiagnosis, overmedication, and a lost sense of identity if the individual is relying on the healthcare provider to make progress in their healing journey. Medications used to treat Bipolar Disorder, such as antipsychotics and mood stabilizers, can create long-term chaos within the human body as they affect not only one’s neurological pathways but one’s internal organs as well, shortening one’s life span by up to 20 years, creating an array of side effects, and never fully resolving the issues at hand due to the trauma that has been ignored, and instead replace with medication.

It can be challenging to advocate for oneself during periods of intense vulnerability, such as asking for help. However, it is essential to note that if a therapist is immediately diagnosing and advocating for medication on the first or second visit, this therapist may not be suitable for creating a person-centered, trauma-focused approach to care. During this period of healthcare in the United States being ruled by for-profit companies, we must educate one another on the dangers of misdiagnosis and overmedication.

The Hope for Change

Taking action to separate insurance companies from state and federal-funded programs such as Medicaid and Medicare may only be possible if there is a collaborative motion to restrict insurance participation in influencing medical decisions for providers

I had the benefit of a Physician Assistant helping me to get off of medications. She gave me a bracelet that read “freed up” and was soon fired afterward. It took many attempts to find practitioners who were there to hold space for me, to give comfort and care instead of giving me a diagnosis immediately to medicate me. When I was a child, I was told that I would never be able to live off of drugs and that I wouldn’t be able to function. Here I am years later, having not only lived alone off of drugs but have thrived off of medications, traveling to study abroad for two and a half years. 

Taking action to separate insurance companies from state and federal-funded programs such as Medicaid and Medicare may only be possible if there is a collaborative motion to restrict insurance participation in influencing medical decisions for providers. A reallocation of taxpayer money can do this to serve social services further. In the meantime, we must advocate for ourselves to be treated with dignity in healing from trauma, seeking out safe social connections, allowing ourselves to express ourselves, to feel safe taking time for ourselves to heal in an environment such as The United States where work-life balance is not yet a reality, and practicing the art of mindfulness. These actions include but are not limited to acknowledging when one is being misdiagnosed, not allowing providers to over-medicate us, and taking note of when a provider is working for monetary gain instead of the betterment of your health.

Photo by Giorgio Trovato on Unsplash

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Emily Larson

Emily is a Certified Peer Support Specialist, Recovery Mentor, and Community Healthcare Worker. Her studies in The United States and Switzerland focused on Alcohol and Addiction Counseling, Social Services, Literature, and Psychology. Emily has been an advocate for mental health awareness and education for over a decade as a patient and professional of the mental health system in The United States. Having grown up with a deep passion for the written word, Emily has cultivated her writing through years of education, blogging, poetry, and other literary works to create, educate, and share the honor (alongside horrors) of the human experience.