one of my friend is having this disorder but she stops medicines so frequently and becomes manic after few days she resumes and becomes normal within few days, and admits that she will never stop medicine. but with surprize of everybody she quits it again and again. How one can help her to continue her medicine… with medicine she behaves like normal person,
One of the biggest issues in mental health treatment has been non-compliance with medication. Many people with psychiatric disorders more often than not require medication to help manage their symptoms. So if this is the case why do some people stop taking their medication? Well before we can try and answer this question we need to know what non-compliance or non-adherence to medication actually entails. Typically non-compliance to medication includes things like, failing to get a prescription and/or getting it filled, failing to take the medication, taking the incorrect dose, and/or taking the medication at an incorrect time, or missing doses or taking the medication for a little while and then completely discontinuing it.
That being said, why would someone with a mental illness which requires medication to help control symptoms stop taking their medicine in the first place? Well there can be many reasons.
- Some people do not have a good understanding of their psychiatric disorder to begin with. As a result many people do not often see the importance the role medication plays in managing the symptoms of any given psychiatric disorder.
- Some people can also have difficulty accepting they have a mental illness and may be in denial about it. When in denial people do not acknowledge the problem and therefore do not seek treatment. Stigma about psychiatric disorders can also deter people from acknowledging that there is a problem and can also be a factor for not seeking medical treatment and/or not taking prescribed medications.
- Some people think having to take medicine is a symbol of a chronic illness, some may try taking the medication but discontinue it once they start to feel well, believing that they do not require it anymore.
- Some have trouble tolerating side effects which are often present, especially when beginning a new medication trial/s, (even though a lot of side effects disappear in time many people don’t wait long enough for the medication to take its maximum effect) so they discontinue them thinking the medication is not working or is not working soon enough.
- Some people just forget to take their medication.
- Some do not have health insurance and cannot afford the medication
- Some people have been attempting to self-medicate through drug and alcohol abuse and believe they are fine and do not need prescribed medication.
- Some people, especially those who have bipolar disorder/mood disorders, feel that medication controls and flattens their moods too much.
Non-compliance to medication can have devastating effects and is one of the most common contributing factors in relapse with regards to psychiatric disorders.
So when we take all of these things into account how do we motivate a person/s to begin medication and/or stay on medication when they do not think they need it? Well first off let me start by saying if a person is heavily in denial and cannot acknowledge that they have a mental illness you may not be able to convince them or motivate them to seek treatment. However for most people there is hope in that we can get them to see that starting or staying on medication can improve their quality of life on many levels. Generally speaking most people with mental illness do much better when on the appropriate medication. That is not to say that everyone with mental illness must be on medication. There are a few exceptions where some people can manage their symptoms relatively well with things such as diet, exercise, counselling and involvement with support groups. But for the most part people who are mentally ill will struggle continually if not medicated.
One way to help motivate people to take medication is to provide them with understanding and compassion, while helping them to see that they have an illness which can negatively impact their well-being if left untreated. If we can encourage them in a caring and supportive way often we can motivate them to stay on their medication and/or at the very least go to see their doctor for further treatment. If they are having trouble making a doctor’s appointment or following through with one often times they will go if you offer to go with them. If a person cannot afford medication you may want to suggest that they make their doctor aware of this or encourage them to go to a community mental health clinic. Often doctors and mental health clinic workers can figure out an alternative to help a person obtain medication. Attending a support group for mental illness can also help a person realize that they have an illness which needs treatment as they can see that there are others in the group who are dealing with the same kind of things.
For those people who already have a diagnosis and have been off and on medication it is often helpful to remind them how things were when not medicated, to give them a “reality check”. If we are to help them see how they were unstable and struggled when not medicated that can often motivate them to continue on with treatment. For instance if a person with bipolar disorder is to stop their medication without a doctor’s consent remind them that they can “crash” very badly from doing so. Reminding them if they have had previous hospitalizations, increases in mania, spiralling depression, suicide ideations/suicide attempts, psychosis, and physical withdrawals from stopping their medication can often help them see the importance of being on and/or staying on medication. That it is vital for their well-being. It may sound harsh to remind a person of these things but if we can prevent a person from crashing, committing suicide or being hospitalized isn’t that the better alternative? And although some side effects may occur from being on medication more often than not being medicated far outweighs not being treated. Like most things in life there are pros and cons to everything, but if you can help a mentally ill person see that they have a physical illness that needs treatment that can go a long ways.
For myself I have acknowledged and accepted that I have to be on medication in order for my bipolar II symptoms to be managed effectively. Without medication I know how much I will struggle, how life will be that much harder and that it is in my best interest to be on medicine. I often use “diabetes” as an example for helping people understand my bipolar disorder. For instance a person who has diabetes has a physical illness where the body has difficulty regulating blood sugar levels. And for them to be able to balance their blood sugar levels they need to take medication, monitor their blood levels, and watch their diet. The same can be said for illnesses such as bipolar as we have a “chemical imbalance” within the brain and we often need medication to help balance the chemicals in our brain.
Furthermore the more we can educate ourselves about any given mental illness the better our chances are of being able to help motivate others to get medical treatment and stay on their prescribed medication. Last but not least try to be patient in the process as it may take a little while for a person to acknowledge and accept that it is in their best interest to be on medication. If you can empathize with them and show them that you are genuinely concerned about their well-being chances are they will listen to what you have to say. Ultimately it is a person’s choice as to whether or not they will seek treatment but if you can help motivate them along the way all the better! Thank you for your question. If you have further questions for us please submit them to askabipolar.com