It Happened To Me Contest Entry: I Was Denied Birth Control Because I Have Depression

I shivered on the table as she, this total stranger who was about to examine my vagina, condemned and disparaged my most private battle. I was already laid bare, literally, making me feel enormously vulnerable and awkward.
Publish date:
February 5, 2013
depression, birth control, IHTM, ihtm contest, ihtm raw

[If you like this IHTM contest entry, comment to that effect below and that will help the writer win big money. Feel free to critique below too, so we can weigh that in our decision -- Jane]

By Bailey Delevan

I needed a renewal for my birth control prescription, so I went in for a checkup at my normal gynecologist. I filled out the paperwork honestly, even though most of it was a total bore and totally irrelevant.

I believe in telling doctors the truth; they’re here to treat you wisely, so they need accurate information. Professional doctors don’t judge you, so telling the truth shouldn’t matter anyway. We’re a team, communicating openly in order to improve my health, which is our shared goal. Right?

Once in the appointment, the doctor began looking through my paperwork and questioning me. She asked about my smoking habits, unsurprisingly, but then politely moved on. I breathed a sigh of relief.

“Uh oh,” she said. “I see you have depression?”

“Yes,” I agreed staidly. “A long history of it.”

She put her pen down and swiveled her chair towards me. “Do you ever think about hurting yourself?”

Flustered, I hemmed and hawed for a minute. “Uh, sometimes,” I finally managed.

“Why?” she asked, staring at me rather pointedly.

You’re not my psychologist, I thought grumpily.

“Long history there, too,” I muttered, embarrassed.

As a teenager, I fought a long battle with self-injury. However, between counseling, growing up, and making a more stable life for myself, I’ve managed to throw away my razor blades.

But it still crosses my mind, even if I don’t give in. It’s embarrassing and frustrating, and I don’t enjoy talking about it. Plus, I’m pretty sure having a rough adolescence doesn’t disqualify you from having birth control. (Otherwise, we’re all screwed.)

I tried to explain, but stumbled over my words for a minute. “Sorry,” I said. “I didn’t expect to talk about this stuff here.”

“It’s an annual exam,” she pointed out.

“But only for my, you know, lady business!” I protested, pointing unnecessarily toward my crotch.

“I’m a doctor,” she announced primly. “If I see on your chart that you have depression, then I have to ask you these things.”

Then why has this never happened before? I wondered. I usually have to beg doctors to take my depression seriously.

“Do you ever think about killing yourself?” She continued.

“I don’t know!” I felt even more flustered, so I fell back on my doctor-patient principle: I told the truth. “Sometimes the thought crosses my mind,” I admitted. “But I would never actually do it.”

The addendum didn’t matter. The doctor went into full-powered savior-and-critic mode, giving me a long scolding. I shivered on the table as she, this total stranger who was about to examine my vagina, condemned and disparaged my most private battle. I was already laid bare, literally, making me feel enormously vulnerable and awkward.

As I sat there half-naked and half-listening (as that was all I could take in), a few tears slid down my face.

I readily promised not to kill myself, since, as I had already explained, I would never actually do it. I’ve struggled with depression, and other health problems, for years; so, yes, sometimes -- for a brief moment -- I think, “Maybe it would be nice to just leave this all behind.”

But after that brief moment, I remind myself of all the things I’m living for, and then I keep on living for them. It doesn’t mean I carry around a vial of hemlock. And it really doesn’t mean I should be yelled at.

Distinguishing between dangerously suicidal and averagely depressed might not be easy for a gynecologist. But that’s why I would prefer to direct such conversations towards an expert! I was already seeing my primary doctor for my depression, as I explained to her: I’m working on it, and also I’m fine.

“You still need to see a therapist,” she concluded, closing her folder of notes and records. “Let me get you some pamphlets.”

I waited while she left the room. When she returned, she handed me some papers. “Here you go,” she said. “Also, I cannot give you a prescription for birth control.”

“What!” I cried, surprised at the sudden change of topic. “Why?”

“Well, I think you need to get control of your depression first,” she explained. “I have limited prescription privileges, and I don’t feel comfortable prescribing you the pill right now.”

“I am being treated for my depression,” I told her again. “And I still really need birth control. And I’m already on the pill, I just need a renewal.”

“Well, the answer is no,” she concluded.

“Depression isn’t even a contraindication of birth control!” I exclaimed. “This particular pill helps my depression, since it regulates my hormones and eliminates PMDD. If I stop taking Yaz, then I will feel worse.”

In this area, we were on her home turf. Side effects of birth control: maybe something a gynecologist should know. The National Institutes of Health reports that women with PMDD (a severe form of PMS) are more likely to have suicidal thoughts. Yaz is specifically formulated to reduce PMDD symptoms.

For me, Yaz has been a lifesaver, maybe literally. I wouldn’t commit suicide, but the idea had its heyday when PMDD turned everything black and terrifying. Yaz opened the blinds, letting the sunlight pour in, revealing that the monster in the corner was actually the shadow of a fuzzy sweater.

“Please,” I begged. “I need it. Desperately.”

“Well, I can’t give it to you,” she replied.

I racked my brain for solutions. “Could I possibly talk to a doctor who has broader privileges, and maybe she can help us?”

“No doctors are here right now,” she said. “Just us nurse practitioners.” (Oh.)

“Could I call tomorrow and talk to a doctor? Or can I come back tomorrow? What can I do?”

“We can’t help you,” she said. “Go to Planned Parenthood.”

Now I was offended. What kind of business sends its loyal customers away? Especially after they paid!

“I came here,” I said. “I paid for this appointment -- out of pocket, because I don’t even have insurance. I’ve been saving up just to get my prescription renewed. I don’t have any more money to go anywhere else!” I tried not to hyperventilate.

“A history of depression has been in my paperwork for years,” I ranted. “When I made this appointment, I said I just wanted a renewal for my prescription -- which this health center originally gave me. They said OK, and so I paid the $145. You can’t tell me, after I paid for a prescription-renewal appointment, that I can’t have my prescription renewed!” I was mad.

“I’m sorry,” she said, and she left the room.

I walked out alone, holding back tears, and asked the receptionist to make another appointment. Fortunately, she was kind and helpful. As I explained, I tried to sound like a calm and reasonable person -- not a fucked-up mess who, apparently, didn’t deserve medical attention.

She agreed the situation sounded weird, and she left a message for the doctor on my account. “She will call you tomorrow,” she promised. “Don’t stress too much about this. We will get it straightened out.”

With that verbal talisman tucked away in my mind, I left, feeling equally hopeful and angry -- angry at the doctor. Angry at myself. That is just like you and your asshole depression, I growled. Always finding new and improved ways to ruin your life. Well done, self. Now you don’t even get birth control.

Depression, of course, makes you feel bad about yourself. You blame yourself for your sadness, and you feel shitty about your inability to feel better, as if you were choosing it on purpose and fucking up your life just for fun. (I promise I’m not. It’s not fun.)

But what kind of doctor judges you for having a medical condition? Judges it so harshly that she turns you away? She didn’t even say I shouldn’t take the pill. She just told me to get it elsewhere.

There’s a sickening feeling of shame that results from confiding in a trusted professional, confessing one of your darkest secrets, and then being turned away for it. I confessed that I sometimes felt lonely and powerless. In response, this doctor made me feel tremendously alone and entirely helpless. She denied my requests until I fully understood my lack of power, my lack of recourse or guidance, and then she left.

The next day, the actual doctor called and immediately agreed to renew my prescription. She agreed that having depression doesn’t ban you from birth control, especially if you’re being treated for it and if the pill didn’t cause or worsen it. In fact, she noted, Yaz is particularly useful for my situation. (Yep.)

Nevertheless, the doctor defended the nurse practitioner, even though I explained how much she had upset hurt me.

“She was trying to help!” she declared, chipper and obtuse. “When you schedule your next appointment, you have to see her!”

I wish I could say I learned a grand lesson here. But mostly, the whole thing just makes me feel depressed. (Also, I’m finding a new doctor.)