How the Military Health Care System Failed Me

A warning to our readers: This piece deals with serious and disturbing discussions of self-harm. We encourage you to read this story as an act of empathy-building, and please be gentle with yourself.

In November 2018, I lay in bed, sobbing with my hand over my mouth so I wouldn’t scare my family, as I Googled “painless suicide methods.”

I felt despair, fear, shame, but also bewilderment and shock that my mental illness had gotten this bad. Three years before, I had been a healthy college graduate with mild anxiety. I had assumed it would be treatable. After all, I thought, I had good healthcare. My dad had been in the army for more than 25 years. As his dependent, I was entitled to receive military health insurance, known as TriCare, until I turned 26. But for many, this benefit comes at a heavy price. It did for me. 

The way the military healthcare system works is strange and confusing. Wait times are interminable and the infrastructure is out-of-date. There’s also an inadequate number of providers. If you want to go to a civilian provider instead, going “on the outside,” as they call it, you have to pay a hefty copay, which rules this out as an option for most people affiliated with the military, including me.

Thus, when I began to experience anxiety shortly after leaving college, I made an appointment at my local military medical center—a one-stop shop where service members and their descendants can see general practitioners and their specialists all under the same roof (not great for privacy, incidentally; I once ran into my boss there).

The department I would be going to was called, tellingly, “Behavioral Health.” I couldn’t make an appointment over the phone, let alone online, so I went in person. They assigned me a psychiatrist, Dr. A. 

The medical center ignored my multiple written requests to switch psychiatrists.

From the start, my experience with her was concerning. She only ever had appointments available at 6 am. I had come in complaining of anxiety. She told me that since I looked tired, moved slowly, and looked at the floor a lot, I must be severely depressed. It did not occur to her that this could be because of the time of the appointment.

She prescribed me a selective serotonin reuptake inhibitor (SSRI), Zoloft. I later learned that this was one of the worst things she could have done. SSRIs are antidepressants, but they can sometimes make anxiety worse if given alone. 

She never did give me anything for the anxiety. She never asked about it at all, in fact. When I finally had the presence of mind to bring it up, she insisted there were no drugs available to treat Generalized Anxiety Disorder (aside from benzodiazepines, a class of drugs including Ativan and Xanax, which are dangerous and largely being phased out). In fact, there is an entire non-benzo class of depression medications currently in use, called serotonin and norepinephrine reuptake inhibitors, or SNRIs.

Not surprisingly, my mental health immediately took a nosedive. The racing thoughts that had been at the edges of my brain began to consume me. I couldn’t sleep or eat. I was constantly nauseous. As a result of this, I quickly became depressed, as well. Anxiety leading to depression is a common occurrence. 

I thought that the reason the meds weren’t working was that there must be something wrong with my brain. Maybe I just had bad genes. I figured the doctor knew what she was doing. 

But I kept trying, ignoring her insensitivity and rudeness, until one day, a particularly outrageous and hurtful comment she made finally pushed me over the edge. Crying in the elevator on the way down to the first floor, I knew I could never see her again. 

So, I stopped making appointments, and the Zoloft stopped, too. My anxiety eased a little. But the depression began to spiral out of control. Soon, it had consumed me. I went months without experiencing happiness or hope. The only emotions I could feel were fear, anger, shame, and regret.  

There are, unfortunately, Dr. As everywhere. Her presence, in itself, would not be a damning indictment of the military healthcare system in particular. The problem is how the medical center handled the situation. They ignored my multiple written requests to switch psychiatrists.

I continued to get worse. Finally one night I realized, with frightening clarity, that I could not go on living like this.

I called the counselor I was seeing at the time, the best one I’ve ever had (who, not surprisingly, was from “the outside”—I’d been paying the $60 weekly appointment entirely on my own, even though it was a financial burden). I told her how I’d begun to think frequently and specifically about killing myself. She told me to go to the ER. I took the extra 15 minutes to drive to the one at the military medical center, so I wouldn’t get charged extra.

I said “I’m at risk of suicide” to the receptionist on duty, as quietly as possible, and burst into tears. 

The hospital saw me relatively quickly, although they didn’t exactly drop everything.

It was one of the worst nights of my life. I was terrified they wouldn’t be able to help me. I had exhausted every other possible option. The worst part was that I had to lay it all out on paper. I had to do the thing people are often penalized for in the hiring process — this incident is still on my medical record, after all. But nothing less than telling them there was an immediate risk of me killing myself would make them take action. 

Luckily, an informed, compassionate nurse and doctor said the things I needed to hear that night. They assured me that there was nothing wrong with me, the way I’d been treated was wrong, and my depression and anxiety were absolutely treatable. I was assigned to a new psychiatrist within an hour.

I was staggered. It had been that simple! But it hadn’t been easy. Why had it taken this? 

I also learned that night that I was not the first patient who had wound up in the ER complaining about Dr. A. She had a reputation. As far as I know, though, she’s still working there. She certainly never faced any consequences for what she did to me.

The psychiatrist, who was competent, saw me the next day. I wondered why this had taken so long if the other psychiatrists had openings in their books the whole time. She adjusted my medication and I stabilized. I still didn’t feel great, but I wasn’t suicidal anymore.

Shortly afterward, I aged out of TriCare. Dealing with the civilian healthcare system felt like a vacation. Nobody should have to pay hundreds of dollars a month for health insurance, but it was still a better experience overall than what I’d been dealing with before.

I got to pick my own psychiatrist this time. The difference in quality of care was shocking. I felt like he actually cared about me as a human being, an experience I hadn’t had with any provider in the military system, except the two in the ER. After just a couple of appointments, he diagnosed me with ADHD, which should have been glaringly obvious from the start (he said I was the worst case he’d ever seen). Being put on Ritalin immediately began to ease the racing thoughts that had been torturing me throughout this whole ordeal.

At our second appointment, I mentioned the anxiety to him. It was then that he asked the million-dollar question, the question Dr. A had never asked: “Which is bothering you more — the depression or the anxiety?” 

The anxiety, I told him.

If Dr. A had asked me that from the start, none of this would ever have happened. 

My new psychiatrist put me on an SNRI and within a week I began to feel like myself again. With the anxiety clearing up, my depression swiftly went into remission, too. I’ve been on the mend ever since. I wasn’t depressed because there was something wrong with me. I was depressed because the people I trusted to help me, the entire system, failed me. I am haunted by the thought of how many people could easily have saved me from a disease that nearly killed me at the age of 25, and just didn’t bother. I hold the military healthcare system directly responsible for the fact that I nearly died.