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Devon Pritchard had spent four years as a Cincinnati firefighter before the depression became something he could no longer outrun on a treadmill or drown at a craft brewery. The 33-year-old had failed sertraline, escitalopram, duloxetine, and a six-month trial of bupropion that gave him insomnia. His psychiatrist at the University of Cincinnati Medical Center … Read more
Dr. Priya Reddy was an emergency medicine resident at a Boston teaching hospital, two years out from board certification, when her panic attacks crossed a line. She had managed them through medical school with therapy and a low-dose SSRI. The night a charge nurse found her hyperventilating in the supply closet during a mass-casualty drill, … Read more
Eleanor, a 62-year-old retired schoolteacher from Asheville, North Carolina, had been in the geriatric psychiatry unit for nine days with a diagnosis of severe major depression. She would not eat. She would not speak. She lay in the same position for hours, her right arm raised slightly off the mattress as if she had been … Read more
A Real Day in an Intensive Outpatient Program People hear the words “intensive outpatient program” and picture something between rehab and weekly therapy without a clear sense of what actually happens during the program day. The vagueness keeps many patients from accepting a step-up referral when their mental health care needs more than standard outpatient can deliver. … Read more
Priya was a software product manager in Seattle, two years into a job she once loved and now resented, when her therapist suggested she try a guided walk on Bainbridge Island. She protested politely. She had hiked plenty. The therapist clarified that this was different. It was a three-hour walk that covered less than half … Read more
Rebecca from Minneapolis came in for her annual physical in late February with a complaint that had become routine. She was tired all winter, irritable in ways she did not recognize as herself, sleeping ten hours and waking up unrefreshed, and her mood was creeping toward what she would have called depression in another context. … Read more
Sergeant First Class Daniel had served three deployments in Afghanistan with the Tenth Mountain Division when he came home to Watertown, New York, with a diagnosis of post-traumatic stress disorder, a marriage on the brink, and the kind of insomnia that turns three in the morning into a familiar enemy. After eighteen months of trauma-focused … Read more
Brian had eighty-seven days clean when he walked out of a Seattle outpatient program with a discharge folder under his arm and a Tuesday afternoon that suddenly stretched ahead of him with no scheduled groups, no morning check-ins, and no counselor down the hall. The folder included a list of AA meetings, a phone number … Read more
The Largest Insurer of Mental Health Care You Probably Forgot When Americans talk about insurance for mental health care, the conversation usually orbits commercial plans. Employer health benefits. ACA marketplace coverage. Networks like UnitedHealthcare therapists, Aetna, Cigna, and Blue Cross Blue Shield. Almost forgotten in that conversation is the country’s largest single source of mental health funding: … Read more
Daniel was thirty-six, a software architect in Minneapolis, when his marriage cracked open and he finally walked into a therapist’s office. He had not cried since he was eleven. He could not say why a slammed cupboard door made his chest seize. He had a successful career, two children he loved, and a private life … Read more