Mental Chains – Vrays + Kevlar = Vraylar

Ok, that’s not really what Vraylar is, but that helps me remember the name of my new blasted medication. Welcome to “Reason #12480 for Why Troy Hasn’t Written a Longform Blog In Weeks,” the game that me, myself, and I just love to play with everyone!


Anyway, things have been… less than stable these past four or five months. When I started working at my most recent job, I did so with the confidence that I had overcome my mental handicaps and could officially hold employment like never before. To be fair, I was right. But to be honest, I was only slightly right, because while I only lasted about three months, it was two months longer than I had successfully withstood the daily brutal punishments of my own emotional weaknesses in the last year or so.

And yes, come to find out, that’s exactly what they were, and they weren’t something I had easy control over. The condition itself isn’t yet a medical diagnosis that is recognized in the DSM-5 (the book that all psychologists follow to diagnose mental disorders). It’s called Rejection Sensitive Dysphoria, or RSD. Basically, whenever anyone attempts to correct me or provide constructive feedback, my brain auto-corrects that to mean that the person correcting me hates me and my work and everything I stand for. I know it isn’t true, but the dysphoria is just that: I am fully aware of how insane I am when I take people at their most illogical extreme, but I can’t help but do so anyway.

Fortunately, I’m now working with a doctor that has also recognized the issue.

RSD isn’t an individual and diagnosable condition, but the condition that is nearest to it on the mental spectrum certainly is: ADHD. Yeah. Turns out I have a form of Attention-Deficit Hyperactivity Disorder, except it’s minus the “hyperactivity” and with emphasis on the “attention.” Not the deficit, mind you; that part of ADHD is (in my opinion) the most misunderstood part of the disorder. Most ADHD people (if not all) tend to have the opposite problem: they hyper-focus on the things they are passionate about and completely ignore everything they consider too boring or mundane.

In my mind, I don’t suffer from an attention-deficit disorder. I suffer from an attention-redirection disorder.

Simply put: I have an extreme inability to filter emotional stimuli, be it good or bad. I have difficulty accepting criticism from others, whether I like it or not. It isn’t that I don’t understand that most people just want to help me improve. It isn’t that I don’t appreciate the intense adrenal reaction when people actually try to insult or hurt me (which has saved me a few times). It isn’t even that I’m utterly helpless against people giving me compliments, of all things!

It’s the fact that I know I can’t help it.

I don’t watch movies or TV shows. Why? Because even the dumbest C-tier plot will fixate in my brain and force it to ruminate on plot, character, and theme for two to three days afterwards. Even if the movie is incredible, I won’t stop singing its praises because I can’t help it.

I have trouble listening to new music. Why? Because I hyperfixate on lyrics and beat, especially if it’s brand-new music that is chaotic in nature. Unless the song is very repetitive in tone (like a lot of electronica these days, or classical music), it’s like wearing an auditory blinder and I won’t be able to focus on anything else.

I am easily insulted and appear to have a thin skin, even when I don’t mean to. Why? Because my brain automatically assumes the worst in people, even if I don’t appear to. I perceive that I have been “burned” by people so often, my brain automatically assumes that’s what you’re doing whenever you criticize something about me. It’s the dysphoria that freakin’ sucks the most because I know it isn’t true. But knowing it isn’t real doesn’t help curb my body’s violent emotional outbursts. That’s where all the sadness and pain and anger is coming from: I have very little control over my internal emotions, and I spent an obscene amount of time and effort trying to bury them so I don’t hurt everyone around me.

And I can’t even begin to tell you how awful it is to know what I’m capable of.

There’s a character in Fallout: New Vegas in the Old World Blues DLC named Muggy. Here he is:

Ain’t he a doll? I always knew I liked this character, but I never really knew why until these last few months. Muggy and I have something in common, you see. We are both keenly aware of our own faults and how crazy we sound when trying to communicate how we think. He is the punchline to a joke that one of the doctors working at Big Mountain, Nevada started telling back before the war (almost 210 years prior to the events in the game). Doctor 0 created Muggy just to get back at his hated rival, RobCo Industries… and Muggy does not appreciate that.

His one line: “Of course I’m obsessed! They made me this way! You think I don’t know how crazy I sound?! Of course I do! They programmed me to know that, too!”

That’s what it comes down to, really: I almost wish I didn’t know what was going on with my attention-redirection and poor filtering. I almost wish I was as delusional as my brain makes me act. I almost wish I could completely rationalize my behavior away so that I don’t believe it isn’t completely my fault, that I’ve effectively ruined my own life for the last fifteen years simply because I didn’t know I had ADHD.

Come to find out that doctors aren’t interested in diagnosing adults with ADHD unless you clearly had a history of it as a child. At the same time, they are aware that some kids get really good at hiding their problems, especially before ADHD became “the norm” for clinical diagnoses.

Yeah, no kidding? You mean to tell me we put millions of children around the world on Ritalin (and especially on young boys) for acting like children, and in the meanwhile we ignore when adults are clearly suffering from inattention and emotional irregularity? And then we like to just diagnose it as “depression,” send ’em off with a couple Zoloft, and call it a day? Or worse, call it “bipolar disorder” when the Zoloft doesn’t work? That’s our acceptable modern medical practice?

I’ve spent about a decade under a single bipolar type-II diagnosis… just to find out that it’s probably not what’s actually happening. I am now working with a different doctor under much fewer assumptions about my mental issues. And so far, my prescription of Vraylar is helping me curb the worst of the depression and manic reactions to the stimuli of life.

Now, if my insurance would just start helping me pay for the damn medication… It’s $900 for a thiry-day supply, there is no generic. And get this: I was informed by my insurance that because I am still diagnosed as only bipolar type-II, they won’t cover it because I haven’t failed enough of their recommended medications.

Excuse me? Seriously?

In order to pay for Vraylar, a medication that is approved for treatment of bipolar type-I in the United States… although I have failed two other antipsychotic medications trying to treat bipolar type-II (one of which was present when I tried to kill myself in 2021), they want me to fail just one more medication to consider changing my diagnosis.

What in the actual hell.

Um, how about no? I’m not trying Clozaril or Abilify just to reject it! And I’m certainly not putting myself in that kind of harm’s way just to prove a point!

It gets better, though. The brand name for Lurasidone is Latuda (you might have seen their advertisements on television), and it just became generic last year. It was $1500 for a thirty-day supply. My insurance was more than happy to pay out the nose for a non-generic medication, but they won’t consider that its effect on me provides a great deal of evidence that contradicts my previous diagnosis. I have since fallen out with the psychiatrists and psychologist at my previous office, and I’m positively terrified of asking them for further information. My doctor has all of my medical records, however, so I don’t believe I need to worry about them anymore (the fact that I can’t help but worry notwithstanding). I’ve sent in an appeal to get the insurance to take a closer look at my ADHD diagnosis, and I hope the cost situation gets resolved soon.


Here’s hoping I can actually find some relief. I am so sick and tired of half-measures. Of telling my doctor: “Well, I’m not sure if it’s working or not, I just feel terrible in this other, completely and previously unrelated way. Can we try something else?” I just want something that will improve my damn life. You know, overall, in a net positive direction.

Otherwise, what is medicine even for?