Depression Army

Marching Out of the Dark

Depression Army is a growing and dynamic international movement that aims to end the stigmatism surrounding mental illness and to serve as a community of support for those undergoing one.

Poor Prognosis: The AHCA and America's Mental Health Care

Art © 2017 Julie Stoller

Art © 2017 Julie Stoller

People who struggle day-to-day with a mental health issue don’t usually spend a lot of time following politics. When the world is closing in, it becomes necessary to shut out all that extraneous noise, push away the distractions and focus single-mindedly on one’s well-being. However, with a new administration comes proposed changes to the American health care system that may make it more difficult for the less wealthy among us to find adequate mental health support.

Difficult as it is to take in all the information, ignorance is not bliss. People who are struggling need to be informed about — and sometimes even stand up for — one’s basic right to decent mental health care.

Mental Health Coverage Under the Affordable Care Act (a.k.a. Obamacare)

On HealthCare.gov, the official site of the Affordable Care Act (ACA), there is a mental health and substance abuse coverage page that clearly states the legal requirements  of all ACA Marketplace health care plans. This includes behavioral health treatment (for example, psychotherapy and counseling), mental and behavioral health inpatient services and substance abuse treatment. Specifics depend upon where you reside and your health plan, but the law states that all ACA plans prohibit spending limits and must cover pre-existing conditions, which includes any mental illness. The ACA also provides “parity protections” for mental health services. This means that it enjoys the same protections as any other kind of health coverage in terms of deductibles, co-payments, out-of-pocket limits, treatment limits and care management.

In fact, there’s an entire government website devoted to mental health, with clear information about how the ACA has improved access to mental health services for many people, regardless of where they live and what type of plan they have. This official source says, “As of 2014, most individual and small group health insurance plans, including plans sold on the Marketplace, are required to cover mental health and substance use disorder services. Medicaid Alternative Benefit Plans also must cover mental health and substance use disorder services. These plans must have coverage of essential health benefits, which include 10 categories of benefits as defined under the health care law. One of those categories is mental health and substance use disorder services.” In the ACA program, mental health care is seen as an essential health benefit.

Despite the improvements to mental health care since the ACA first went into effect in 2014, a study by researchers at NYU’s Langone Medical Center found that mental care access in the U.S. is still inadequate. Nearly one in 10 Americans who had mental health problems in 2014 didn’t have insurance that would allow them access to treatment. For approximately 10.5 percent of people, there were delays in receiving professional mental health treatment due to insufficient coverage, compared to 9.5 percent in 2006. In 2014, 9.5 percent of those suffering with mental health issues couldn’t afford to pay for psychiatric medications, up from 8.7 percent in 2006. 

The AHCA – Just Passed by the House of Representatives

The American Health Care Act, passed by the House of Representatives on May 4, seeks to roll back federal guarantees of mental health coverage and substance abuse treatment, instead leaving it to the discretion of individual states. Under the new plan, states can also opt-out of requiring that insurers cover pre-existing conditions. Other Essential Health Benefits (EHBs) left to the states to provide or not provide include emergency services, hospitalization, maternity and newborn care, rehabilitative services, chronic disease management, pediatric services and prescription drugs. The AHCA, as currently written, allows insurers in states that have opted out of covering EHBs to charge people more for their health insurance if they have pre-existing conditions.

What Do We Stand to Lose?

The ACHA bill leaves critical mental health care treatment and prescription medication coverage for poorer people up in the air. Depending on where you live, there may be state-provided financial assistance for psychiatric evaluations, counseling and potentially life-changing psychiatric drugs—or not. Should this bill go into effect, coverage that you’re currently receiving from your insurer, whether it’s through your employer or through the federal ACA marketplace, might go away. In a worst-case scenario, those families who need certain medical coverage for pre-existing mental health conditions may have to consider moving to a state where insurers will cover them. Unable to get proper care in their community, people with a serious mental illness are increasingly ending up in local jails, a sad development that is straining law enforcement. Mental Health America states that 1.2 million people living with mental illness are in jails and prisons every year. The Sentencing Project study referred to in the article found that six out 10 of those states with the least access to mental health care (Southern states) also have the highest incarceration rates.

The New Health Care Proposal: Here’s What Happens Next

As the House’s AHCA bill moves to the Senate for approval, the Congressional Budget Office(CBO)  has issued their findings on the House’s proposed bill. The CBO estimates that the AHCA will leave 23 million more people without insurance by 2026 than if the ACA were to stay in place. They also discuss the dangers of leaving coverage decisions to the states. A CBO breakdown confirms that a state opting out of covering mental health care and prescription medicines, as well as pre-existing conditions, could cause out-of-pocket expenses to significantly rise for that coverage, leaving many priced out of the healthcare marketplace. The good news is that the U.S. Senate is unlikely to approve the House bill and in fact, they’re writing their own version. The bad news is that there are senators who may not heed the warnings in the CBO report.

What Can You Do?

First, don’t despair! There are many people who are aggressively fighting these radical changes to a healthcare system that, although flawed and in need of fixing, many people rely on. However, if you’re someone who is especially sensitive to mental health issues, it is imperative that you add your own voice to the choir of discontent. Indivisible is a nationwide organization that encourages people to take local action to express their concerns and tell their personal stories. Town Hall Project has an interactive database of town hall meetings by members of congress that constituents can attend. Add yourself to the mailing list of upcoming events in your area. If you’re unable to attend a meeting in person, you can also contact your senators directly to tell them how important mental health care coverage is for you and your family. You can also contact your House Representatives. When your representatives aren’t legislating in Washington, they should be back in their states to meet with their constituents. You can view the senate schedule and house schedule for 2017.

Above all, keep yourself well-armed with information! Important decisions are being made right now that could impact your mental health care and essential support services. If you believe that healthcare is a basic right, and that those living with mental illness should have the same rights as anyone else who suffers from a crippling affliction, Speak Out and Speak Loudly!

Your voice matters, and the voices of millions of sufferers will be heard in the voting booths!


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The Struggles of My "Normal" Life

Why is it that some people seem to have it all, yet still suffer from crippling depression? The answer is different depending on who you talk to. Depression Army invites you to take a look into the life of one such person in this deeply heartfelt account of their life. Perhaps you will even gain some understanding of yourself in the process?

Written by Cassandre

I always knew something was strange about me. Ever since I was a child I was the lonely type, always in my books or thinking instead of going out and making friends.

In fact, I’ve never been very good at making friends because I’ve always felt like an outsider. Eventually I got used to that loneliness. Sometimes it even made me feel kind of good. I kept that feeling of being an outsider inside for a very, very long time. Actually, probably all my life.

I started to wear a mask when I was a kid. I kept it on for so long it became like my face and… well, you can’t remove your face, can you?

Growing up, I went from the calm kid to the weird teenager. When people my age were worried about their dates and their grades, I started living in “another world.” I imagined stories taking place in a faraway land or fantastic stories taking place in our world.

My life was boring. These stories were a way to escape my reality.

I still have them in my mind today. Sometimes I think about writing them down, but it’s very hard to get motivated when you suffer from depression. You don’t feel like doing anything.

Becoming an adult was supposed to be the answer ‘cause an adult can do whatever they want!

Now I realize I’ve been pretty stupid.

When you are a child or a teenager, there are people that care about you. If you are not feeling alright you can always ask for help and even if the first adult won’t help, eventually you’ll find someone.

When you are an adult, you are pretty much alone… 

As I got older, I kept living with those feelings of loneliness and emptiness but it got worse ‘cause now I wasn’t allowed to escape reality anymore. I had obligations to attend to. Soon, I lost self-confidence. I started to suffer from anxiety and I even thought about ending it all.

One day, I was waiting for my train to go home. Suddenly, I found myself walking towards the rails. When I realized what I was doing, I stopped. But, when I got home and my boyfriend asked me about my day, I just smiled and said, “Fine.” That was the only time I “attempted” something. 

Hear me out. I’ve never wanted to kill myself. I’m too scared about the pain and what’s waiting for me after. But, I started to feel like if I died from an accident or something, it wouldn’t be that bad.

I know what some of you are thinking. “Why didn’t you ask for help back then?”

I did.

Some years ago, I went and asked for help. But, it seems I was “too young” and not unfortunate enough.

I started to suffer from paralysis of the right leg. Every time I was on my way to work, it would stop working. I saw 3 or 4 different doctors, did a lot of tests; all negative. My leg was perfectly fine.

“You just want sick leave.” I was told.

I was 20 at the time and when I talk about it today, doctors say it was burn out. It did not exist back then. It was just me being “a spoiled, lazy brat” looking for attention.

A little brat with bruises on her arms and almost no skin left on her fingers. (It’s called dermatillomania and I’ve been doing it ever since I was a child. It calms me.) But, nothing to worry about.

I know you may be asking, “Wait, the girl was harming herself and removing her skin and no one saw it?!”

Well, maybe they did see it but what could they do?

Talk to me? Give me pills? Get me in a rehab center?

You need to know something. When you’ve suffered from this for such a long time, you sadly start getting used to it. It becomes a part of you and people start seeing it as a part of you too. I was drowning, but to the people around me I was just pessimistic and had a bad temper. In a way, I let them believe that was true.

Why? I honestly still don’t know.

In November of 2016 I was diagnosed with depression.

The pain was so far gone that I decided to attempt to ask for help again. I started treatment (my doctor doesn’t really care, she just gives me pills) and a psychoanalysis because I felt I needed to go deeper than just psychotherapy.

Just so you know, my life has always been “normal.”

Thank God I’ve never experienced trauma like abuses or accidents. Aside from a weird family, I had a normal childhood. I say weird family because my parents never really loved each other, and my mom was a depressed alcoholic.

I didn’t really have good relations with my dad until some years ago. It was mostly because I was influenced by my mom and I try to avoid her as much as possible ‘cause she makes me feel so bad. I struggle not to drown from watching her kill herself slowly with alcohol. I can’t do anything and thus it makes me feel so bad and so powerless. It’s not an excuse, of course, but maybe it affected me in a way.

My psychoanalysis was... pretty hard. We talked about a lot of things like my childhood of course but also about my present life too. I could not remember a day, even as a child, when I didn’t feel empty and out of place. I realized that I’ve been like this ever since I could remember. It impacted me a lot because I hadn’t thought about it that way before. I mean, when each day is a battle, you can’t waste energy thinking about the day before. It’s counterproductive.

Why was I feeling that bad?

I had a job, money, an apartment, a companion who loves me and 3 adorable cats (who don’t love me, of course. They’re cats).

The guilt. The guilt of having what others did not and still being unhappy was driving me mad!

I wasn’t starving! I wasn’t living in a country at war! I wasn’t sick! Why wasn’t I happy for God’s sake?!

The answer was so simple…

I was unhappy because I was living in a world I could not understand.

Remember when I told you about the worlds I invented when I was younger? Things were not perfect in those worlds, of course. I know you can’t make a story about a perfect situation, but things were more normal to me. If someone needed help, they would get it, and the people that helped them knew that they would get that help back in return. No need to ask.

Wars would be resolved not with weapons but with words. People would work for a common goal instead of personal benefit.

I kept asking, “Why are there wars?”

“Why are we letting people starve when we destroy so much food every year?”

“Why is everyone, including me, so selfish?”

I remember what my psychoanalyst said then. He removed his glasses, smiled sadly and said, “You are very intelligent.”

That’s when I understood.

I was not unhappy because of external causes, but because of myself. I was living in a world I did not understand. A world where I could not be myself. A world so… illogical.

I could not fit in because I refused, when I was a child, to get in line, to do what others told me just because they said so. Children always ask about everything. They always ask you “why” when you say something. My problem was I never stopped asking why. As I grew older, my why’s became more complex. It was to the point I could not find answers anymore. The more I asked myself questions, the less I understood the world I was living in.

It was like being in the middle of a crowd, watching people walking around you without a second thought. But, instead of walking alongside them, I kept wondering, “Where? Why?”

I needed to understand. But, in the end, is there really anything to understand?

I remember a sentence from an old movie I saw recently called Unbreakable. In the movie, one of the characters says, “You know what the scariest thing is? To not know your place in this world. To not know why you're here. That's... that's just an awful feeling.”

There is a reason why this movie became my favorite. It’s all about living in a world without knowing who you are and where you are going.

I wish I could travel, go to other countries, discover new lands, meet people, learn from them, help them in their daily lives as they would help me in mine. But… it’s just not possible. Not today. Not in the world I live in.

In this world, I have to get up every day just to do a boring job to get the money I’ll spend on my rent, my groceries, and “entertainment” to help me forget because things are not as simple as I always thought they should be. I feel like in my world I’m nothing. No one. I’m here and tomorrow I’ll be gone. Someone else will take my place and I won’t have done anything with my life.

I’m expendable.

Of course, I’m not the only one. Some people eventually get tired of their life as just another puppet. They say, “No more.” and just do what they really want, become who they really are.

I admire and envy them. I could do the same but I’m scared. Scared about the consequences that could occur. I could fail or get hurt. Eventually I could even die.

So instead, I choose the easiest way. I’m like the frog from that story, the one that slowly boils to death without noticing it. Except the frog is aware, and turned the heater on herself.

Like I said earlier, my story is not extraordinary. It can even sound boring or just like whining. But, I can’t believe I’m the only one feeling this way.

I’m not unique.

I know that somewhere there is someone like me with a “perfect life” that is slowly sinking and feeling guilty about it. I just want to tell that person, “You are not alone. If you are not the scared type, don’t get into the boiler.”

My name is Cassandre. It’s not my real name. It’s the one I chose, the one I am, and I hope my story brought you some comfort.


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Artist Spotlight: Natalie Bookchin—My Meds

Written by Ashley Jannasch

Working primarily with video installations, American artist Natalie Bookchin explores the boundary between the individual and society, private and public. Her video, My Meds is a compilation of YouTube videos featuring various individuals listing the medications they are taking. This work includes over 50 separate YouTube videos in a grid-like layout; clips from the videos play simultaneously in clusters when an identical phrase or drug is mentioned.

The beauty of My Meds, beyond its casual, open take on mental illness, is the sense of community Bookchin creates. She finds similarities in personal, diary-esque videos and “matches” them into a larger jigsaw puzzle of similar situations. By using this volume of individual videos, the work is highlighting the commonplaceness of these experiences. Though no two situations are identical, there will always be a community of others with similar circumstances—no one is ever truly alone.

This sense of community could be helpful for those feeling isolated by their illness, especially due to the fact that they may be taking medications too. Due to obvious societal stigma, few people are open to talking about their medications, let alone specifically what they are taking. The vloggers seem to be trying to combat this stigma on their own, but Bookchin’s compilation could (and should) be reassuring to anyone embarrassed by their medications.

The video ends with some of the vloggers briefly stating that their medications have improved how they are feeling—specifically that they are “feeling much better.” By hearing this from real people, rather than doctors or television commercials, this may also reassure those who are doubtful that medications could ever work or are frustrated by the lack of immediate results.

We hope this video will help others feel more confident in their own experiences, or at the very least, feel less alone.

Depression Army encourages everyone to find treatments that work for them. This particular work, however, happens to deal with medications.

Created in 2015 by a group of people dedicated to ending the stigma on mental illness