I often have read many bipolar patients choose to not take prescribed medications. What might be the reason for electing to not take their meds? Is it weight gain? Does it make some people sick or feel “uncomfortable”? Or, is it the disease itself that might cause or contribute to a patient not taking their meds?
Some people stop taking meds because of side effects (fatigue, for example)—it usually takes multiple tries for the patient and doctor to find the right medicine at the right dosage. Some patients stop because of weight gain; my weight has gone up and down on various meds (which is why I started a website for sick people called Fashionably Ill). In the end, I decided that my health was more important than being skinny—having family members remind me of that (“Do you want to be a size zero or do you want to be alive?”) has helped keep things in perspective.
However, in cases where the person has been sick for years and still refuses to take meds (or frequently stops taking meds) despite demonstrating the textbook symptoms and experiencing the consequences (like losing a job, failing grades, or broken relationships), it may be anosognosia. This is the most common reason for non-compliance. Anosognosia is when an ill person is physiologically incapable of recognizing he or she has an illness. If a person has anosognosia, he/she sees no point in taking medicine or going to therapy. The person is not in denial but rather has malfunctioning frontal lobes. Efforts to get people with anosognosia to admit they have an illness are often met with anger. It’s more effective to start by asking the person what goals he/she has than to force him/her to admit to having bipolar disorder. Amazingly, with a supportive attitude, it is actually possible to get someone with anosognosia to seek treatment and take medication. (For more information, here is an article on anosognosia with bipolar disorder.)
***Note: this is not intended to be taken as medical advice. If you feel that anosognosia may be at issue, it is best to seek medical treatment. We are not doctors here, just people who have bipolar disorder (among other illnesses) and can suggest possibilities, but in no way can we diagnose. ~Christi~