How can I convince my friend who has bipolar that it is essential that they take their medication? (They refuse to.)
First, I think it’s important to establish why your friend is not taking medication. Ask if there are side effects they doesn’t like. If that’s the case, they should be honest with their psychiatrist. Finding the right meds can often be trial and error. I was diagnosed with bipolar disorder thirteen years ago. I can honestly say that the right meds (combined with other things like therapy) have saved my life, but it took a year before we found the right medication.
Second, in cases where the person has been sick for years and still refuses to take meds (or frequently stops) even though they demonstrate symptoms and experience consequences, it may be something called anosognosia. THIS CONDITION MUST BE DIAGNOSED BY A DOCTOR! That said, this is the most common reason for medication non-compliance. Anosognosia is when an ill person is physiologically incapable of recognizing he or she has an illness, therefore, they see 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 backfire and are often met with anger which is why it can be more effective to start by asking the person what goals they have, rather than to forcing them to admit they have bipolar disorder. (For example, a person would tell themselves, and others, that they take meds so they can feel better and finish their degree, but not say it is because of bipolar disorder.) If this is the case, with a supportive attitude, it is possible to get someone with anosognosia to seek treatment and take medication. One method is called LEAP. You can learn more about the LEAP® model used to treat it by Dr. Xaviar Amador here. LEAP® stands for Listen-Empathize-Agree-Partner.
Once you find out why they are not taking their meds, you can then begin finding ways to encourage them to take their medication. You could give them specific examples of situations in which you enjoyed being with them because they had been taking their meds and give a similar situation you did not enjoy being with them because they had not been taking their meds and their behavior was different. For example, “Remember when we (insert example here). It was so much fun! But, the other time we (insert example here) it was not as much fun because (give them an example of a behavior that you didn’t like such as, “your anxiety was too high”) Suggest to them that perhaps taking their medication really was helping because your experience with them in the first example was so much better for both of you. By giving them real examples of how things were different, it may put things in a better perspective for your friend and they may begin viewing taking their medication in a more favorable light.
Sometimes, when you plant the seeds and the person decides to do the action on their own, it is more successful than getting into an argument about it or making them feel like they are being pressured to or forced to do something. I know that I personally get irritated and frustrated when someone who does not have bipolar, or similar illnesses, as I do tries to tell me what I need to do or what I shouldn’t do.
A lot can be resolved by just asking why they choose to not take their medications. Start with that, and hopefully some of these other suggestions can help as well. Good Luck