Nightmares and Preexisting Conditions


Fifteen years ago, I had a nervous breakdown. Rooted in depression and anxiety, breakdowns shift one’s perspective from bad dream to nightmare and wasn’t my first, or my last. I was thirty feet up a ladder working on a house and sobbing so hard, I could barely climb down.

I was 27 and had been struggling with depression, anxiety, PTSD and suicidal thoughts for at least fifteen years. Living in Jackson, WY, I was working two or three jobs, and could not afford health insurance.

After chain smoking six or eight cigarettes, I mellowing out, researched, and found a community mental health clinic with a sliding scale fee. Do you know how hard it is to look and ask for help when one is deep in a emotional hole? Thankfully, a friend was there.

At twenty dollars a visit, I could afford twice a month. Since then, I have been in and out of therapy, always paying cash. Therapy is expensive and until the ACA (Obamacare) I could not consistently afford therapy or insurance.

I didn’t know what I was struggling with until an official diagnosis few years later, so just worried I was crazy. If I had had a primary care physician, my mental health issues could have been spotted and DEALT with earlier. This thought sometimes angers me, sometimes saddens me.

Without proper interventions and healthcare I am fortunate I have not commit suicide. The two (give or take) students I help find counseling each term might be dead. There definitely would be no Josephine (my daughter).

Death: The Ultimate Preexisting Condition

Death is an emergency that cannot be treated in a hospital.

Lately, for obvious reasons, I’ve been thinking about preexisting conditions and the comments last month by the senator from Idaho.

He said, “Nobody has ever died because they didn’t have access to healthcare.” Later, when criticized, he clarified, “Emergency rooms and hospitals have to treat you whether you can pay or not.”

His comments smack of the privilege of someone who is healthy and has always had access to healthcare. His comments are shortsighted and insulting.

Twenty-five years of untreated depression, anxiety, and PTSD have probably shaved a decade off my life. It was only three years ago that I went on medication. We were on Medicare (Obamacare or the ACA) because we were making a combined $15-20K a year.

Not all health issues need an emergency room visit. Some are unseen but need to be treated or they will result in death or disability.

Hypertension, obesity, high cholesterol, vision problems, cysts, moles, cavities, torn ligaments, treating these are easily put off if a person does not have insurance. These issues shorten life expectancy and are a drag on our communities and economies.

But, more importantly, they destroy a person’s quality of life, impacting income, nutrition, and hope for the future. Combine this with being poor, and you become twisted in constant stress and worry. Despite the smiles, stress and worry are your only experience, always vibrating around you.

Even though I was diagnosed over thirteen years ago, the reason I avoided medication wasn’t just lack of access; I was afraid of going on the record for a preexisting condition. I paid cash for all my therapy appointments and avoided any official record of my mental illness. There was (and still is) terrible stigma against those who struggle with mental illness.


These days I write openly about my struggle for two reasons. First, there is no going back. If Trumpcare passes, the stigmas (in the form of increased premiums and possible stopping my medication because of cost) I faced in the healthcare industry will return.

Second, nobody “subsidizes” my health. My health allows my economic output and community involvement. This MORE than makes up for any insignificant shifting of tax money my way for my health.

I drive an economical Subaru and don’t complain about the extra cost of highway repairs because of giant trucks, RVs, or studded snow tires. I fly every two or three years and don’t complain about the excess carbon pumped into the air for the business travelers. I use a stainless steel reusable to go cup for coffee and don’t complain about paying for the trash created by everybody else’s cardboard cups.

This illness cost me jobs and relationships. This illness cost me stability and good decision making skills. This illness has cost me.

Pay It Forward

Mother and baby on the Oregon coast, the three rocks of Three Arches Wildlife Refuge in the distance.

I’m 42 now, and I’ve only had THREE good years in my life: the last three, the ones I’ve been on medication. And, this emotional stability is PAYING OFF huge for my career and marriage.

All the other years of my life (39 to be exact) have been mired in a pit toilet.

Even though life is great, I still have nightmares once or twice a week. Occasionally, my wife will wake me because I am yelling and screaming.

However, the biggest nightmare is when I think about the years shaved off my life because of my depression, when I think about dying and leaving my wife and child behind.

My father, a Viet Nam vet, died at 48 from lung cancer. But, I know what really killed him, the same things that plague me: depression, anxiety, PTSD. 48 is only six years away for me. That’s scary.

Would my depression and anxiety have grown so severe if I gotten help sooner?

Who else has suffered because they did not have access to health insurance?

We all know someone. Not everybody can speak up. We need to do that for them until they have the strength.