What to do When Someone Refuses to Take Their Medication – Treatment Noncompliance

It is an unfortunate truth that many mental illness patients won’t take their medications at one time or another. This is known as treatment noncompliance or treatment nonadherence, if you want to be a bit more politically correct.

And also unfortunate is the fact that when a person with a mental illness refuses to take their medication they almost inexorably get sicker. People with bipolar disorder who won’t take their medication, for example, often become manic and then wind up hurting themselves or someone else and end up in the hospital. And watching this happen, as a loved one, is extremely painful.

So is there anything you can do when a person refuses to take their medication? Is there anything you can do about treatment noncompliance?

Why Does a Person Refuse to Take Their Medication?

I think the most important question to ask is why is the person refusing to take their medication. The answer to that really dictates what to do next.

There are really three reasons mental illness patients are noncompliant.

  1. The medication isn’t working and their illness convinces them to go off their medication.
  2. Their medication is working but the side effects are intolerable.
  3. Their medication is working, they’re experiencing wellness and so they think they no longer need their medication.

Refusing to Take Medication Because the Medication Isn’t Working

Refusing to take medication that doesn’t work is understandable. We’ve all been there and we’ve all seen the futility of taking some medications. But, the thing is, you have to get through the medication that doesn’t work to find the medication that does and going off of medication is not the way to do this. If the medication isn’t working, it’s time to work with a psychiatrist to find better medication that does work for the patient.

In this case a loved one might want to approach the case logically and say that without treatment, the mentally ill patient can’t get better. Stopping the treatment was understandable, but now it’s time to assert some control over treatment and find something that works.

Refusing Medication Because of Intolerable Side Effects

Medication NoncomplianceThis is understandable as well. Many of us have been in the situation where side effects destroyed parts of our lives. But again, just stopping medication is not the way to handle this problem. Working with the doctor to find better treatment is the answer.

In this case patients often feel like they have told their doctor about the side effects but the doctor hasn’t listened. This might be true. But that’s why it’s time to, again, assert more control over treatment choices and state to the doctor clearly that these side effects are intolerable and another treatment must be found. If laid out in this straightforward manner, most doctors will get the message and help. Just “complaining” about side effects doesn’t have this same effect.

Families can help by attending psychiatric appointments to help get treatment back on track in a way with which the patient agrees. And it’s important to remind the patient that better treatments are available and they don’t have to live with horrendous side effects. Treatment is in their control.

Refusing Medication Because They Believe They Don’t Need It

Unfortunately, this can be the hardest situation. Once a person is well, they see the medication as a hindrance, forgetting that it is the medication that made them well. This is a trick of the mind. No one wants to be on medication and this is a trick the mind plays to provide an excuse for refusing medication.

A loved one can approach this situation with logic such as, “remember before the medication, you did such-and-such, whereas on the medication, you’re able to such-and-such . . .” (And I should mention that just because a medication works once, it doesn’t mean that restarting it will make it work again in the same way. This is one of the major dangers of going off of working medication.)

However, the truth is that the patient may simply have to fall before they realize that it was the medication that was holding them up. For a loved one this is painful to watch but try to remember to be there if something like this happens and help out with returning to treatment.

Helping a Person Who Refuses Medication

No matter what camp the person falls into, it’s very hard, but try to look at the situation from their perspective – they likely have a real reason why they are treatment noncompliant. Try to speak to that reason with compassion and concrete reasons why they should work with their doctor to rectify that problem rather than try to handle it on their own.[push]Remember, the best medication is the medication a patient will take.[/push]

And as I’ve said above, remind them that real honesty with their doctor is the most important thing and that they are in control of their own treatment. And, if you can, try to support their wishes and act as their back-stop in psychiatric appointments. People dealing with psychiatrists often feel more comfortable being honest with this back-up which means they are more likely to get treatment that works for them.

There is actually much more to say about handling this problem, but, alas, I’ve gone long already. Hopefully a part two will make it’s way here at some point.

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  1. Dear Natasha,

    My name is Mohit age 28 yrs working in pvt bank in India. I live in noida India. My elder brother sachin age 32 showed first visible symptoms of psychosis in Apr 2015. He became violent and starting sermonising like a godmen. Acting as if he can see and speak with God. It was compounded by making facial expressions using tongue and shouting in aggressive manner.
    After much effort he was controlled by 5 indls and admitted to hospital. Where doctor diagnosed him with psychosis. Fwg drugs were administered to him
    Diva od
    Oleanz
    Larpose
    Folfit
    Sizodin for 9 months. We stopped his medication after we saw a marked change in his behaviour towards normalcy. 3 months passed without any medication incident free.

    Unfortunately on 22july16 he relapsed . He became more violent this time and hit all family members incl our mother and grand father. He was overpowered after 3 hours and admitted to hospital again on 22 July 16. Doctor is of the view that this relapse has occurred due to stopping medication. Presently he is being treated at neo hospital in noida India. Doctors have administered fwg drugs.:
    Clopixol acuphase 50
    Clopixol depot 200 mg
    Will start previously prescribed medicines again this time for 1 year complete.

    It is pertinent to mention that my brother sachin is of very intimate and shy nature. He mostly keeps to himself and rarely confides in anyone. He does not have any close friends or is not even socially active.
    Our father expired after elongated illness on 29 jul 2003. He evidently took that tragic event to his heart asks did not express open bereavement. He starting Working very early immediately after completing secondary school and quit job abruptly in 2012 after our sister got married without giving any explanation or reasons for the same.
    He does not concede to getting married or socialise.
    He do not admit that he is sick and need medicine. All medicine administered are mixed with his food. If he becomes slightly conscious He will not eat or drink anything.

    We are extremely worried about his medical condition. Pl Go through his case and give a frank opinion about his chances of full recovery and way ahead

    My entire family shall be obliged

    A dutiful son and loving brother
    Mohit

  2. I believe there is perhaps a 4th reason someone bipolar decides to not take meds. I am 42, divorced ten years ago with 3 kids. I was misdiagnosed when I was trying to save my marriage and went as far as doing biofeedback for ADHD as they were convinced that was causing my anxiety, leading to my stress, which in turn led to moments of explosion which thankfully was confined to just yelling or I would probably be writing this from a cell. It has gotten worse through the stressors of losing everything I thought meant something to me, hence my family. I also self medicate with weed or alcohol as that was the only way I could stop my crazy, and I’m calling myself crazy for all of you that offended by the word (in other words, calm down, I can be as politically incorrect about myself as I want to be, my choice….and as a person with bipolar, if you don’t like it well….) but that was my solution. I have never really had a job, but I have always provided, when I was married, I successfully ran a business and worked my ass off to a fault as my hours I put in impacted my marriage. Since being divorced, the first couple years I didn’t do much, I was suicidal, drank way too much, I actually thought I would drink myself to death, which must take more effort then I gave as I didn’t pull it off. In the last ten years, I had a couple of different gigs, always paid the bills I wanted to, worked when I chose, although some days, I really can’t even function. I have had two substantial relationships, one was abusive, the other was perfect yet I convinced myself something would go wrong, or she was going to leave me, and guess what, with my voice in my head, I ruined it. Now I think, she didn’t deserve my nonsense, she was very caring and actually read up on bipolar and cared, I cast her out, like I do everyone. Now that I’ve rambled, back to my original point. I took seroquil, which did seem to help, but there was a horrible grogginess involved and I went to my mom’s condo and somehow in the middle of the night had a dream and woke up in a neighbors house at 5 AM, thankfully I finally came to before I woke anyone up and got out. Now I work when I can, I survive, or do enough to survive on my own, but without medical insurance I do things like go to a new place, yeah they’ll help me out……they’lll work with me, then I get a bill for a thousand bucks, and I don’t like latuda…..SO now I owe them a grand, it didn’t work, so now what? My answer is going back to my old fallbacks, or having that,and it is a crazy thought , well, if shit hits the fan, I just want to be done anyhow so let it happen and I’ve pushed everyone out with the exception of my kids. Point is, to experiment with meds, and having bipolar to the point you really have no one in your life for support, no insurance as your not one to get a “normal” job, nor could you ever pull it off, becomes complicated. Somedays, I feel good that I mailed off my child support check and think, yeah I got something accomplished, beyond that, I just beat myself up more as I know I can do more, but it’s hard….

  3. The article talks about not taking the medication once you think that you are fine. But what do you do if the person refuses to take the medications even before starting.

    My mother has been diagnosed with Psychosis more than Bipolar disorder. She simply refuses to believe that she has Psychosis and doesn’t take medications. This is also due to a prior experience with doctors. I don’t know the details but her mother died at the hospital when she was in her 12th grade. Ever since, she has had a stigma against doctors and medicines. She also read the side effects of the medicines and got further worried.

    How do I make her realise that she might be harming herself by not taking the medications? I was suggested hypnotherapy as an alternate but consistent procedure that can help her. How to convince her? I am able to talk to her about taking them but that all goes in vain when it actually comes to taking the medicine.

    Any suggestions.

  4. My daughter was diagnosed with bi-polar at 21, she is now 45. When she was first diagnosed it took the doctor’s a few months to get her on medications that worked. Over the years these medications changed as circumstances changed, different doctors, hospital stays, etc, Lithium is one medication that she has always been on, but she needs a typical anti psychotic also. It’s the typical anti psychotic which sometimes changed. There are only a few that work with her. She is in a mania stage at this time. Recently she went into the hospital for five to seven days, when she left the hospital the hospital doctor changed her anti-psychotic medicine, which is not controlling her mania. The medication seems to make her feel good, but does not control her problem. She will not go back on the medication that worked for her. It’s very upsetting when a hospital doctor changes her medication without talking with the family or her regular psychiatrist. Although she takes lithium and this medication, her mania stage if really bad. We also got a court order to have her evaluated, telling the judge some things that she was doing, which was dangerous. The hospital keep her less than 24 hours and left her go.
    It’s just hell knowing that there is little you can do when you know there is another medication that will really help her but she refuses to take it, and the hospital doctor should never have changed it. It’s seems ridiculous that a doctor would ask a really mentally sick patient what she feels will work instead of asking her regular psychiatrist and her family what we feel will work, now she refuses to go back on the other medication. Once she does get better, and she will if she lives through this, she will regret most of the things she has done while she is sick, in the mania stage. It takes people that understand, and be there for them when they are sick, yet being there for them is hard when they do so many things that they normally would not do. I take my daughter’s medication to her each night and watch her take it, yet I know she is not taking what she really needs to take. It’s sad when hospitals and doctors change medications like they have done with her. I could go on and on, although she does well for months, something happens, stress, seasons, and other things that just take over her way of thinking and we just go through the cycle all over again. She too thinks she works for the CIA, the police, the FBI, she thinks people are always breaking into her apartment and taking things, she thinks people try to poison her, are following her, stealing her money, her clothes, and she thinks people put cameras in her house and are always watching her when she is in her mania stage. It’s not easy, not at all having someone close to you with this disorder. Try to stay sane yourself and take care of yourself, hopefully there will be more better times than bad times.

  5. What if we’ve already made the mistakes already? My 23 year-old daughter had an episode 2 weeks ago after never having exhibited anything more than occational anxiety or depression. She became confused and and was saying nothing but metaphors without any context. I panicked after a day of it and took her to the emergency room. at that point she was cooperating, even though she didn’t think it necessary. The hospital was just supposed to get her stable so we could continue her care on an out-patient basis, but a paperwork mistake—we were told—resulted in her being transferred to a recovery center. The staff at the center told us a court hold had been placed on her and they refused us access except for a 20 minute visit and a few phone calls over an entire week. The doctor was an arrogant jerk who refused to talk to us. Terrible things happened while she was trapped there and she was forced to take a cocktail of drugs that made her sick. She spent the week trying to convince them to let her go and wondering if we might have abandoned her. It took a judge to get her out. Now she is so traumatized she suspects anyone who suggests she take ANY medicine that she wasn’t already taking before the episode. Now a week has passed and she is starting to slip back into speech and behaviors that are incomprehensible to anyone but herself. Any suggestion that she might need medicine is met with refusal. About the only treatment she doesn’t oppose is a councillor who saw her once before when she was having relationship problems, and she has agreed to see a psychiatrist as long as we find a female doctor. My fear is that by the time I can find the doctor she wants and get her an appointment she will be completely lost again.

  6. Tomorrow I have to go to court to ask the court to force my 45 year old daughter to take drugs that she vehemently does not want to take. She has been off her medication for a good while and has auditory hallucinations that involve the FBI, CIA and famous people. ( too many movies?) They are threatening voices and she is sure that a chip was implanted during a visit to the dentist or when she had a colonoscopy or some other time when she was in the hospital. She believes she is intercepting important information and wants to call the police or sheriffs department for their help. She wants an MRI to remove the chip. She has no place to live. Receives a small SSI payment but not enough to provide a decent place to live. She has heard these voices for years now. I thought for a long time that she was using street drugs or alcohol and had no idea that she had this problem out right, with out any ” help” from other mind altering substances.
    I love my daughter. I have seen her maybe an hour all added together over the past 10 years. No one will help her. Most people are afraid of her. She calls and leaves me messages where she is in danger or homeless or living with someone new. She never stays long wherever she goes. She is getting older now. She isn’t as pretty as she used to be. Life is getting harder for her. Do people get over being bi/polar? I don’t think so. How does menopause affect them? What will happen to my daughter? She has lived a hard life. Isolated from people who love her. I’m so conflicted on what right action would be. She sees me as her worst nightmare as I generally say no to whatever she wants and am forced to be the one who asks for help for her. Help that she does not want. Regardless of what I do tomorrow I will get harsh words from her. Regardless of what I do I will feel guilty that I did the wrong thing.

  7. Plz suggest me, if someone refuses to take medicine after becoming normal, and if we try to convince her that what she did before taking medicine, then she refuses to accept that she did all these things. it is actully about my mother, plz help if u can, i want her to be normal.

  8. The thing is with taking medication,It might help one thing but destroy something else like your liver and kidney is part of the reason I stopped taking mine, I do have PTSD But I also know in QLD Australia if you have PTSD as a person you are not treated well and you are an out cast

  9. They tried to put me on Paxil because of low serotonin and anxiety this was never tested or analyzed btw just assumed.Paxil was handed to me the day before I found at I have h pylori I also have PTSD .When I couldn’t afford a doctor, this was at a free clinic I wouldn’t go through with suicide but these pills on day three had me all over. I’d rather be emotionally unstable then dead. I feel so alone now I truly understand true pain not being in control of your brain barely I’m starting to truly feel mental more than ever. It’s so sad to feel this way completely not in control closest to death I’ve ever felt. It’s comforting to read others experiences thank you . Blessings

  10. My 36 year old son has been diagnosed bi-polar for 18 years. He has had a terrible 2015-took off for a month to California and yes he refuses to take the meds. Fast forward, he’s back living with us…he knows the rules…you have to take your meds or you can’t stay here. I just found out from my niece that he’s been spitting the pills out even though I watch him take the meds. HELP. He is hypo-manic and I am afraid that he will hurt himself. He takes a lot out on me as I am his mother. Does anyone have any ideas to get a grown man to take his meds so he can be normal?” He just blew another union job…he’s all over the place and too dangerous to work.

    • Not everyone is meant to work like a slave in this life. The meds won’t “cure” anything, but could destroy other bodily functions. Everyone is different. See if you can work with your son in getting him closer to health instead of force medicating him leaving him closer to death. These psychotropic drugs are dangerous.

      • I don’t know what kind of personal experience led you to talk in such absolutes, but “everyone is different” holds true. The severity of BP d/o and other MIs differ too. That’s why psychotropic drugs are a life saver for many – yet other ppl. think them a scourge. And yes, psych meds can be dangerous, but manic psychosis is extremely dangerous too. Lithium saved my life – yes, I’ve had side effects…but that med saved my life.

        If the Mom you were responding to has been handling her BP son for 18 years already, I would trust her judgement in knowing that her son needs to take his meds – how to get him to take them is her real problem right now.

      • You are right these meds are poisonous. My therapist said to me after only 3 sessions that if I don’t go on seroquil, she won’t see me anymore! Isn’t that illegal? What, are meds friggin mandatory?? geeze. I’m a health nut and exercise but I’m also biploar. Never wanted to hurt myself or others, never in the mental hospital or jail. Ya I get depressed bc it’s hard out there to live and focus on myself. Does this constitute making me take seorquil? I’m confused and hurt by her threat.

  11. My psychiatrist that made me sick off of lamictal I can’t do very much to hem I can’t sew and I can have his medical license taken from him because the FDA doesn’t require Dr to tell patients about the side effects which makes it virtually impossible to sew a doctor for them ruining your life the bad thing is I’ve asked my doctor 5 times about the drug he was given me making me sick and he out out lied told me no and the bad thing is its been like this for 3 years and it got really really bad for the last 6 months I actually got to the point where I thought I was going to die the very bad thing is this idiot psychiatrist which should be in jail should at least when I was asking if its hurting me could have told me we could change your medicine in it yes its a possibility it now when my family doctor started figuring out what was going on he was like I never want you to take this drug ever again psychiatrist alone do not care about their patients all they care about is how much money they’re getting from these drug companies it’s more important to put a toxic drug into somebody’s body and let them pay I was on my hands and knees begging not to die I called all the attorneys in my area trying to sue this idiot doctor they couldn’t even apologize for causing this the FDA doesn’t require the doctors to tell anything about the side effects at all in reality there’s over 220 side effects and now I can’t do much I can’t walk or stand more than an hour that drug aggressively attacks and it gives you the symptoms of massive grave an autoimmune disease that attacks the muscles I was quiet I was so sick I actually thought I was going to die and I thought I was going to die very soon this is got to be the worst thing that a doctor could have ever done and they thought it was better just to shut up and take the drugs I am NOT a guinea pig

  12. I can’t stand psychiatrist it’s all a fraud they are manipulators and they purposely lie to their patients they all physically try to lie unless you’re suicidal you shouldn’t be taking these hardcore drugs I’ve tried a lot of drugs to a point where I got sick from the drugs and I never get rid of the stupid disease that they claim to that I had bipolar disorder 16 schizoaffective disorder it’s all a lie if you tell a psychiatrist you believe in God they think you’re crazy I hate all psychiatrist and they should live in their patients shoes my psychiatrist should be behind criminal bars I’m in kidney failure because of that bastard

  13. Hello,

    This is truly a great website and appreciate the content addressing the mental illness issue.

    Right now I am writing as a troubled brother as my elder sister is in the state of mental illness that has relapsed after two years. She has been suffering from this problem since 2007. It originated due to acute depression that came from family conflicts (as the doctor told). She is married and has a kid.

    This is the fourth instance that her mental problem has relapsed. It is because whenever she gets over this, she stops taking medicines. The gives reason that she will be become obese, she gets headache etc. During the bouts of depression, she becomes violent when we insist her to take medicines. We are not finding any way out despite trying all the avenues including giving proper reasoning and made her talk to the doctor. Still the problem persists.

    Can you please help? If she does not take medicine, her mental disorder will relapse again. It’s been constant struggle for us. Please HELP!

  14. Hello,

    I am trying to figure out what to do. My husband has Bi-Polar and high blood pressure and hasnt taken any meds since late April 2015. He is a verteran and likes to tell me he is taking his meds. But I just looked today and hardly to no pills are gone. He gets very angry and when I make a joke about anything he hits me so hard o the shoulder that sometimes there is a red mark. I have been telling him to stop, but he wont. I know he needs help but he refuses.

  15. Pingback: Do Medications For Mental Health Issues Work? |

  16. Hi, I’m wondering if you could advise my friends and I with a situation. Our dear friend has two daughters in their late twenties who have. BPD. We see our friend go through so many heart wrenching struggles over and over again. There are many visits to the ER as they stop taking their meds, they are in trouble with the law for stealing, cars are damaged, drug od’s etc. Our friend is the most caring, loving and devoted mother. We worry about her as the daughters take advantage of her and take her money and feel entitled to her never ending support. This is starting to take a toll on our friend. Each of us as parents know that it must be so difficult to say no to our children and we want to protect them but, when do you say enough ? They check themselves in and out of hospitals. When will they take responsibility for their own lives? Do the daughters need to hit their own bottom as in addiction? I myself have an addiction and I had to want to get out. We are supportive of our friend and want the best for her daughters but it pains us to see her life controlled by the girls. She deserves some peace and happiness too? How do we brooch the subject? Or do we not and just be there for her when she needs a shoulder? We don’t want to step on any toes….we just love her dearly and feel helpless. Any thoughts?

  17. i am so grateful for all the practical advice you gave me. I can understand his suffering but we suffer too not being able to do anything. Thanks again. You gave me a different perspective and a will to give it a second chance.

  18. What if the tables were turned on you Irene, and some monster starting saying you were mentally ill, and had the capacity to lock you away for a long time? One has to judge their monsters, and it appears that you can confront him on his childish behavior of taking custody, which if he is legally able to, fine. It would probably be best to just drop the guy, and maybe a few years from now he can visit. Let him behave as he wants as you wouldn’t want anybody to tell you what to do, but don’t say things like he is threatening custody unless he really is trying to hurt because those types of things escalate things. I would simply say that you chose not to have him around for whatever reason and that you cannot cross that boundary, as those are obviously your children.

  19. Well, you seem to be right James. There was a reason. He thought that his meds would ‘interfere’ and would not allow him to give his best in the presentation of his PhDs. He thought he could control it. Anyway, I now think there is nothing else for me to do. Thanks for the tip anyway.

    • Irene,

      From what I remember, it’s writing the PhD which is the difficult part. Usually the defense (I think that is what you mean by “presentation”) is a foregone conclusion. If he wasn’t going to be passed, they wouldn’t convene his committee. What he needs to do to get the degree is simply to appear competent. He might think that on his medication he will not be as brilliant and exciting, but he has already established his talent by being in a PhD program. The only thing which could go wrong is that he might say something strange during the defense that would concern his committee.

      So, you might be able to convince him that getting back on his medication is a good plan for the time it takes to defend his thesis. If he does that, he’ll hopefully be in a better position to reflect on what happened with some insight. If he’s successful in passing the defense, that will give him some success to moderate the depression which is going to almost inevitably follow the manic period.

      That’s several “ifs”. But, that is a least a strategy you could take. My opinion is that you can’t oppose a manic person – you can’t tell them they’re wrong. During mania a person has an absolute faith in their perspective and anyone who opposes it is either stupid or suspect. The more successful strategy is to divert their momentum. Essentially, you propose the medication as a short-term tactic. The plan isn’t to make him into “not-him” permanently any more than drinking coffee in the morning makes a person “not-them”. It’s just a tool to temper his energy level.

      It’s the absolute truth that he always has the choice to go off medication later. It’s a choice he makes on a daily basis.

      Unfortunately, you should accept that he will probably end up screwing things up pretty badly. Because a manic person has unshakable faith in their perspective, they cut off or ignore feedback from people that disagree with it. If they can’t get away from those people, they will quickly develop a persecution complex. If he had agreed previously to some policy, say: “I will accept I’m manic and have lost perspective if 3 people on this list tell me so. In that case, I will let them tell me what to do for a period of 1 month.” then you would have a handle. He would have accepted that trust-control relationship and would tend to be consistent. Manic people value consistency quite highly, so it’s possible to divert that away from self-destruction.

      But, after the fact, it’s almost impossible. He will interpret a bunch of people telling him the same thing as a conspiracy behind his back trying to persecute him for who he is, not a group of concerned people he negotiated a sound policy with. It becomes a done-to vs. done-with thing.

      This is simply a personal opinion: you institutionalize people who you strongly believe are a threat to their own lives or to the safety of other people. If he is suicidal, do your best to have him hospitalized. If he’s physically abusing your family or threatening them, you pretty much have the choice of allowing him to beat you up (no) having him arrested (not good for him) or having him committed (the least bad option). But, if his mania is resulting in him being self-destructive and not a threat to his own life, he will not interpret hospitalization as helpful or caring. He will focus on the negative aspects of the experience, and it will distance him from psychiatric help in general. In general, being institutionalized is a pretty traumatic experience under the best of circumstances. You choose it when it’s the better of two bad options.

      In the end, killing yourself and being violent towards other people require restraint. Everything else is up to him to fix. That is true for everyone, it’s just harder for him.

  20. Hello everyone. This is an amazingly helpful website and recently I’ve been visiting it very often as my husband stopped taking his meds and he has now a full blown episode for almost three months. During this he has been fired from his job, he has moved to his parents house and generally he has been transformed into a monster. We have tried to talk him into taking his pills but in vain. The same applies for his doctor.. Nothing. Now he is just destroying his life nd it really pains me to see this as despite my anger for his foolish decision, I think he will have to start from scratch when he gets over it. How long should I wait until I do something? Isn’t his doctor the one who can take the decision of putting him into hospital or should we take it? And is it a sane decision? As far as I’ve read everybody says it is very traumatic. Are there other ways of approaching him? Bear in mind that now he is at the peak of his mania being paranoid and abusive. Another thing is that I am afraid about my kids. Now he doesn’t live with us anymore but he has been obsessed about taking custody of the kids as he says I am an unfit mother. Should I take measures? Please help! I am about to start paperwork about putting him into hospital. His dad thinks we should wait for him to go down. What should I do?

    • Irene,

      Did your husband give an explanation for why he became non-compliant? What do you think the reason was? In my experience, helping people get back to a program and stay there depends on figuring out why they got off. Sometimes it’s really hard to help a bipolar person, especially when manic, see that their decisions are causing very bad outcomes. When I’m manic, I believe that what I’m thinking is more important than anything, and that I’m going to be able to “sort it all out” later. I miss or ignore reasonable advice and cautions.

      So, it’s been more helpful for people to figure out what the cause was and try to figure out how to fulfill that need in a less destructive way.

  21. people don’t like what we say because we have no filter (bullshit screen) and we tell the truth. people don’t like the truth. i can’t abide being around other people who are unsympathetic and have NO compassion for people who are different. so not being in the company of cold hard brutal folks is not a bad thing. do i want to suffer from this mental problem or suffer from this problem AND the liver failure and diabetes ect. brought on from the drugs? i will take only the mental issues

    • Amanda,

      I have felt exactly the same way. I do think it’s important to look at things from the outside for a second and consider that there might be a connection between “other people who are unsympathetic and have NO compassion for people who are different” and “we have no filter…we tell the truth”. Everyone has a “truth” inside. It’s not just people with BPD who feel frustrated dealing with the social crap, being “nice”, and so on. I experience what I think is an additional burden of energy, attention, irritability, and so on.

      But, it isn’t that I don’t want to be considerate, “nice”, and get along socially in polite company. It’s just really hard sometimes. It becomes my turn to participate and what is in my mind isn’t consistent with the conversation, maybe in content, maybe in tone. So I need to drag my mind over. But the result is sometimes I make these really long pauses, or I need to restart a sentence a couple of times, or I just kind of nod and say something very slight. If I’m not paying attention I’ll say something very articulate, but also very disconcerting to people.

      What I say is the truth. It’s often insightful. But, it’s also often uncomfortable. It’s often not best to tell the truth. Just because I live in a kind of existential alienation from things, that doesn’t mean it’s a good thing to make other people live there. Very often, it’s most considerate to just say I’m fine, things are fine, whatever is in the news is interesting, and so on. And, eventually, if you small-talk people enough, you start to talk about things which are more serious. But you’ve got to build those relationships from the ground up. That is why it’s considerate to small-talk people. It shows you’re interested in being what other people want, and they do the same.

      Or, you can make a choice to be all “just trying to keep it real.” That is also a good way to live. But, if you don’t start by demonstrating the self-control and selflessness essential to creating the simple foundations of a relationship, people are going to be “unsympathetic and have NO compassion”. My opinion is that you’ve got those things reversed. It’s maybe true that people were unsympathetic to you, and to me, when we were younger. When you’re a kid, you don’t know how to be anything but what you are. If people exclude you for that, it hurts, and it changes the way you think – and often not for the better.

      But, if you are an adult, you always have the choice. You can act “normal”, or at least show the sincere desire to try. Or, you can stay in the stubborn isolated tower of iron will. That tower preserved me during the times in my life when people were intolerant and abusive. But, eventually, the siege is over. You leave people that you don’t like behind. You have choices about where you live and work, and who you associate with. At that point it’s hard to readjust, because part of it is admitting that things you think are essential to your personality – to who you are – are really just strategies developed to survive, and they aren’t the best strategies for today.

      Sometimes “keeping it real” isn’t consistent with your present reality. Look around. It might be that claiming to have no “bullshit screen” is really just a bullshit excuse to keep people at a distance. I don’t know what your life is like. But, what you said reminds me of how I thought, and how I thought wasn’t serving me well.

  22. The most mind boggling excuse I hear is “I don’t like the way the meds make me feel”. “They make me feel flat”.

    That is easily remedied by talking to a doctor. Feeling flat does not always mean that you are missing something. Feeling flat is better than being manic, and feeling invincible, impulsive, or hyper sexual. Flat is better than suicidal.

    Flat for me, means I’d rather be happier. I’d rather feel more engaged in what I’m doing. It’s not a precursor to draining my bank account and maxing out credit cards, taking unnecessary risks, like speeding, poor choices in sexual partners or gambling. Flat means it’s time to tweak my meds, not drop them without having a back up plan.

  23. For me, there is another reason…pregnancy. I got off the pills with both of my pregnancies. With my youngest, I was off pills for almost 18 months as I was breastfeeding. I have bipolar 2 so the mania is not too severe. The doctors agreed with my decision to do whats best for the baby.

    Unfortunately, my cousin who was bipolar 1 committed suicide about 3 weeks ago, after several failed attempts. She went off her meds and just had been in a downward spiral for about 8 months. She told others she was off the meds so that she could drink alcohol.

    • Hi Samantha,

      Personally, I wouldn’t call a conscious decision to go off of your meds because you wanted to become pregnant medication noncompliance – particularly if you were doing it under the care of a physician. That’s more like an informed choice.

      I’m sorry about your cousin. That must be very hard. I always hurt when we lose someone to suicide.

      – Natasha Tracy

  24. my sister was diagnosed with bipolar some years back. they had her on a low dose med that was working great for her. No more manic episodes, she seemed to be her normal self for a long time, but it took being arrested and hospitalized to get her on meds. Once she started feeling better though she dumped her meds. It sounds to me like ALL bipolar people do the same. This time is really bad. She is manic out there some where in sub zero weather and no one knows what to do. I live so far away Im not much help except to pray. Im so afraid that she is going to hurt herself as she is threatening to do, or hurt some else in the process. Every family member has tried to help her, but when she is going through her episodes she always threatens violence, so everybody is pretty scared of her at this point. I just found out recently that she has had these bipolar bouts for more than 20 years. How’s we miss it. I don’t know what to do. I want to help her, but from what I am reading there really is no helping a bipolar person…..they have to comply themselves, and it doesn’t sound to me like many of them do. So what? the loved ones simply hang back and wait for something to happen? Somebody help me….help me help her.

    • Hi Carol,

      I am deeply sorry for your sisiter and I just wanted you to know you are not alone.Indeed I have a sister with BP too and I do know what is the meaning to hang back and wait for something to happen. I did it myself many times but …for all my worries and sleepless nights I received nothing from her. My sister is someone else in mania/hypomania and you have to accept that. She is manipulaive, she lies all of us, often she is delusional, she doesn’t say where she is and on top of it she gets nervous and irritable form the fact that you ask.
      My sister doesn’t believe she is BP although she took medication for sometime and was diagnosed from 3 different doctors.
      As for me- I tried to be there for the last 6 years of my life, I can no longer offer her my support/home and love because of her untreated condition. Yet she doesn’t stop calling me whenever she decides to tell me how much she loves me. She makes me feel scared, confused, guilty, panic and worried. I keep fight me dark thoughts about her. I pray for a miracle because none of my family believes she is really sick. It is no surprise as I live in Bulgaria and the topic of mental illnesses is somehow tabu for the society.
      In addition you cannot help someone who doesn’t want help. You can try to reach your sister when she is ‘down” from her moods. Or you can try the law and start a law process against her.

  25. When I’m off my meds, I’m very irritatable. One time I just went cold turkey and about a week later I was in the car with my mind m. She kept pestering and pestering it felt so unbearable I screamed hysterically took off my seat belt and was about to jump out of the movjg car(which was going 50 via speed limit). I destroyed my home as well. Im shocked I haven’t/never been hospitalized, i hate those and i refuse to go. But I hate the medicine. so I’m going off agian. If I commit suicide this time, oh well…it’s better than living with this god awful illness so this is a chance I’m going to have to take.

    I’m not sure if I,have BP1 OR 2.

    I think I just need to get through the withdrawal part and I’ll be good. I’m so sick of the medicine, I’m sick of being bipolar, I’m sick of being sick. And I’m sure most people if not all who have this illness is sick of being sick. I’ve been patient I was diagnosed at the age of 21 and I’m 24 now. This has to end. So no more meds, I am going to attempt to live my life as normal as possible.

  26. First of all, all of you Anti Psychiatry people here are evil. You believe in subjecting individuals with mental illness and their family and people they interact with, to uncontrolled outbursts. I am an advocate for involuntary medication, not only for those who are homicidal and suicidal, but for all diagnosed mentally ill people who refuse to take their medication. Evil monsters such as those who say “Schizophrenics and bipolars and others should be free to have episodes” are enemies of mankind and destroy society.

    I have personally seen the “before and after” of people who need to take mood stabilizers, psyche meds, and the rest, and I have seen the positive improvements. We need to have compassion and understanding for people and what they go through, and that includes them taking their medication. The meds do not cure the bad memories and illness but they calm the people down and stabilize them outwardly and somewhat inwardly so they do not have manic ups and depressive downs.

    Herbal remedies do not work for these things like pharma meds do. God bless the pharma corps.

    • Hope to God you are trolling.

      So those whose respect HUMAN RIGHTS and understand the wondrous (not) pharma pills don’t work for anybody are evil and destroy humanity…. while you wanting to ram pills down people throat’s, stripping their dignity and humanity in the process (that’s what involuntary treatment does to many)

      Just because we respects one’s approach to treatment does not make us “evil monsters”.

      You care only about the outwardly. So the person is no longer bothering you and being shame to some “dignified family”, because they are dwelling in horrendous fog of medically induced numbness. And you would induce that on everybody, just because of some diagnostic label. Don’t you dare to call others “evil monsters”.

  27. Typical NAMI statement, it is painful to watch a family member in pain. They support the family and turn their heads to the individual with the DX, many live with the pain 24/7. The individual is non-compliant or are they being proactive in their recovery. Maybe the medical professional do not know what to do, so they shove drug after drug down the individual throat. I wish NAMI would advocate for the individuals and not just for the family wanting more Gov’t money paying for their children and collect transfer payments. I Have ask NAMI several times to help advocate for me. At last NAMI walk I held a sign asking for help, and not one NAMI official came to my aid. I will spend my energy to help the individuals with DX and listen to their needs.

  28. Natasha my case is sad in that I now look back with 20/20 hindsight wishing that I had confronted my spouse with an ultimatum to seek treatment 16 years ago. If I had done so then when my daughter was just 11 years old perhaps my daughter would not have become a second generation depression victim.

    My wife was diagnosed with depression in 1998 following the deaths of my father and her mother. She would seek counseling and took meds for a brief while back in 2004, but all throughout my wife felt she was coping when in fact she was not. We argued virtually everyday about whatever as her moods were constantly dark. I would soon be blamed for all things wrong in her life. This volatile atmosphere became the norm for our family these past years. Sadly after seeking intermittent counseling as a couple my wife decides to sue me for divorce last October due to my inability to make her happy.

    All along I have been urging my wife to seek counseling for her depression but this was always met with opposition. “I’m not depressed” is the common answer. Unfortunately for me the only other person in my household that can vouch for me and my experiences is my mother who lives with us (at my wife’s personal invitation to live with us) who can vouch for the erratic moods swings and bouts with inappropriate anger.

    It saddens me to no end knowing that for years I was verbally abused by my wife and only when I decided to STOP taking the abuse from my wife and stand up to her did my marriage enter into the skids.

    Now my daughter who is now 21, suffers from depression exactly like that of her mom. Plus I get the added experience to be blamed by my daughter that it was MY FAULT that the family is broken. Most recently we had a falling out basically due to the fact that she cussed me out using the exact same cuss words and phrasing that she saw and heard her mom say to me many time before. I had no other choice but to ask her to move out. So now she is living with her mom (who recently moved out of our home due to the pending divorce).

    What I find especially frustrating is that my wife will not allow our daughter to live with her if my daughter doesn’t agree to stay on medication and seek counseling. Ironic isn’t it?

    So now I am coping with the fact that for over 16 years my wife had denied being a depression patient and the results of her denial has destroyed my marriage and made my daughter a clone of her depressed mother whom to date remains is a state of complete denial of her condition.

    We have a son who is 18 years old and my son’s experiences with his sister are a mirror image of my experiences with my wife. Depression has destroyed my family. If only I had acted more decisively 16 years ago perhaps our lives would have taken a different better course.

  29. You forgot to mention the fact that mental illness is a myth. Therefore the reason some people don’t take drugs is because they know better. Psychiatry is a total fraud.

    • Are you serious? What do you blame it on then? What is it then? I would love to actually read your answer to mental illness and what it is in your book if not mental illness.

  30. Thank you Natasha, as a former med nurse on many a lockdown unit, it is “door # 3” that I dealt with the most. They think they’re cured or better, so they stop taking their meds, they get worse … and worse … and worse every time, and sad to see their comprehensive abilities disappear, replaced by delusion. Yeppers, very tough patients to work with, takes a lot of time. Glad I retired early. :) Thank you for this blog.

  31. Pingback: Do Medications For Mental Health Issues Work? | Queensland Mental Health

  32. I think there is something you’re really not looking at here. Do you ever wonder WHY we need SO many medications? Americans make up 5% of the world population, yet we consume over 80% of the world’s painkillers, for example, over 70% of americans are on prescription drugs! Do we really need SO many of them? The pharmaceutical industry is a multi-billion dollar business here in this country at least, mostly for things that can (and should) be treated through other means. When you have high blood pressure, the answer is NOT blood pressure medication- the answer is exercise and eating salads with some plain, unmarinaded grilled chicken with some oil and vinegar dressing.

    Ever see that show, Sliders? It’s about alternate universes. One of which was an alternate Earth, even more drug ridden (and I REFUSE to call them “medicine” replace medicine with “drug” and it doesn’t sound so good “Take your drugs like a good little boy” In that episode, every time they had some kind of difficult emotion, they injected themselves with a drug to make them feel better. Seems like that’s what we’re heading towards!

    What if each of us had a pill dispenser for each difficult emotion we encounter, one labeled “fear” “anger” “sadness” “embarrassment” on our belt that we would need to carry around every day. Seems like that’s what my parents think, every time I get mad (like any other human being does) they attribute it to me not taking my “medicine” and the answer is more drugs. I’m human like anyone else. I do have episodes of these things. I think a more clear boundary needs to be established for people who need it and don’t. After everything else has failed (and they have put a GENUINE effort (unlike say obese people- diet and exercise usually don’t fail) into solving it without drugs.

    I’ve been on Paxil and Respirdal for over 10 years now, and it may have some kind of effect. It seems to stem the tide, perhaps it would be worse if I didn’t. But it’s never made be feel better than before a big bad event in my life. No,I wasn’t raped or beaten or tortured or anything, it was more about my philosophy of life that changed.

    One of the unfortunate side effects of taking Respiridal for so long, is now I am DEPENDANT on it. That’s right, it’s a drug designed to slow down racing thoughts, which also helps me sleep. Now my body expects a fresh infusion every night, that I must take in order to get decent sleep, on nights I’ve missed it, I couldn’t sleep, or get very bad sleep, so bad in fact, that I’ve had dreams in which I’m tired in my dream, wishing I could fall asleep- when I’m already asleep!

    I only take them because my parents would have a fit if I didn’t (and I’m an adult). A Psychiatrist, told them to make me take them, like it seems you are advocating. I wasn’t too fond of him.
    I’ve also been told “Not taking your medicine is like a diabetic not taking their insulin” Um, no, it isn’t.

    There was a time where I didn’t need Paxil or Respiridal, before an event in my life, which I mentioned (Which I will not go into detail about) changed things for me , it’s environmental, not chemical (unlike perhaps Bipolarism) A more accurate analogy would be taking Tylenol for hunger pains, it doesn’t solve the problem, it just masks it, while it gets worse.

    If you had a thorn in your side, would you take a painkiller and ignore it, or would you PULL IT OUT? If a child is being bullied at school, he should not be put on an anti-depressant, he should learn to defend himself and stand up to the bully, solve the problem not ignore it, which is exactly what most drugs do

    Now, don’t get wrong. I’m not saying drugs are pure insanity. I have nothing against an anti-biotics or vaccines (if you can call those drugs) say for a raging bacterial infection. Mental conditions get a little more obscure. It would be interesting to compare it to a time before medication was prescribed for everything under the sun, nowadays, what ever happened to good old fashioned, talking and reasoning through your problems?

    • Me79: If you want an alternative solution to all those medications, try looking at other cultures besides yours and how they conceive of and deal with mental illness. When researching or experiencing another culture, you see your own culture in more clarity and detail. You will see the whole picture of where medications fit into your own culture better. Also look up “Soteria” to see a philosophy whereby human companionship, support, and normalisation is used to treat mental illness.

  33. I think everyone needs to be on some sort of medication. We are a pill popping nation, it’s our solution to every thing. I feel that until there is a better alternative, this is all we have. I’m extremely frustrated with my Vietnam veteran father. He just recently stopped taking his pills & it’s obvious. He finally admitted that he hasn’t been taking them & never plans to. He has no friends, hardly any family deals with him, I just don’t know what course of action to take, so I suppose I’ll start by contacting his psychiatrist at the VA hospital.

  34. Do you mind if I quote a couple of your articles as long as I
    provide credit and sources back to your website? My blog is
    in the very same niche as yours and my users would genuinely benefit from a lot of the information you present here.
    Please let me know if this ok with you. Cheers!

    • Hi Ortezy,

      Thanks for asking.

      I’m sorry, but I don’t allow reproduction of my articles online. What you can do, though, is quote _part_ of the article and link to the rest here. This allows you to quote things if you want to comment on them, and the like.

      – Natasha Tracy

  35. There is another concept beside ‘noncompliant” or “nonadherent”. The alternative concept is “medication interest level” on some scale. If my medication interest level in taking this anti-blood pressure pill is 3/10(10 being I am extremely interested), the question would be for what would it take for me to go to a 4 or maybe a 3.2? Also why not a 1 or 2 (I may not know the answer, but good question for me to reflect on).

  36. what if they are not taking their meds and they are on the loose? I am currently lookinng for the response to that. Do I call the police? He threatened to burn the university down today, and we had to warn campus police he was stalking someone. He was taking his meds, so I’mm guessing he had a plan all along. what do i do?

  37. I do have few problems with this article. It’s bit fear-mongering in “take your pills or you’ll DIE”. There are GOOD reasons not to take pills (and recently a pill-happy person actually pointed me to research that 10% of people with bipolar simply DON’T get better on meds).

    “The medication isn’t working and their illness convinces them to go off their medication.”

    I don’t like the “illness is lying to you” line. Especially when it’s used as power-thing. You are crazy, hence you need pills. Think you don’t need them? My, you are even more crazy then we thought…

    Many actually can do it on their own… and I think that reasonable support with this is GOOD. Help the person make their decision. Do not push them into the mainstream one… as it often simply doesn!t work all that well.
    Stopping abruptly, or wwhen in distress… yeah, that is stupid. But I think that is often rather lack of knowing better and despair then “illness lying to you”.

    same goes for “miss their highs”. It’s not like that stupid little crazy doesn’t want to take their wondrous drugs, because they “miss their highs”, oh-how-silly-of-them. It’s often one’s soul, personality, spirit one misses (and sadly, many pdocs seem to confuse boring for stable and normal… hence “travels to eastern europe” has been seen as symptom of my crazy).

  38. You have repeatedly stated that there’s better options for treatment if your current medication is unacceptable. That’s probably true for a lot of people, but I wanted to point out to the rest of your readership that it’s not always the case. However, it is important to exhaust your options before reaching this conclusion and to not give up prematurely.

  39. Affordability is a huge factor. With no insurance my psych appts were 90$ each visit and anti-psychotics are expensive- 300$/month st one point, which I could only sustain for so long. Programs are hard to come by and you can be low income but not low enough to qualify for Medicaid. We’re trying out older psych meds which are 35$/month. Letd hope they work.

    • Hi Cara,

      You are right, affordability is a huge factor for many people. However, if a person can’t get access to their meds, for whatever reason, I wouldn’t call them treatment noncompliant. But that’s me.

      – Natasha Tracy

  40. There’s one more reason.

    4. Because they miss the highs.

    I have a tendency to be partially non-compliant when my psychiatrist is upping my dose to bring me out of a high. Because I enjoy being high, and I lose just enough insight to not see what could possibly be bad about it. Hence why my psychiatrist has a list of the negative impact mania has on my work, my finances, my relationships etc.

    • Hi Ellen,

      Thanks so much for your comment – I can’t believe I didn’t mention that one! It’s an excellent point.

      This is a comment feeling and problem for many. The list you have is a smart idea.

      – Natasha Tracy

  41. As a consumer I agree that stigma is one reason I become “treatment non-compliant”, but there’s plenty of other ones too. :D But the reason I was drawn to comment is that my support team and I have found a great way to help me during these times that I decide to be “treatment non-compliant”. We have a list that I wrote of the reasons I do not want to take my medication, and “challenges” to those thoughts. These challenges include facts, past experiences, my support team’s thoughts. For ex:

    Reason for noncompliance: I believe I no longer need the meds
    Challenge: Information from my doctor about the statistics of relapse when you stop taking meds, my journals from the last time I stopped taking my meds, my husband’s observations from the last time I didn’t take my meds.

    My doctor suggested this after my last episode of “treatment noncompliance” and the re-reading this list has helped prevent anymore!

    • Hi Nicole,

      Thank-you so much for your comment – I think that is a great idea! I may quote your comment in an upcoming article so your suggestion can help others.

      – Natasha Tracy

  42. I am probably what you consider med non compliant. I’ve been following Natasha for a while now. She even wrote about one of my manic episodes. But I increasingly became more ashamed each day of having to take anti psychotics to function. Even my husband co tributes to me feeling this way. I finally started feeling better and went off cold turkey in march. Considering I moved twice, and two months ago moved to a new state and new job where I know no one, I think I’m doing pretty well. No dr in my new state. No tdoc either, who I actually do miss. I’m pretty sure I’m leaning strongly toward manic, mixed. Have bp1 and BPD. But am terrified of letting my new job in on my secret. So am working long hours and working my butt off to prove myself. Also, they did ask to list medications on my job application and new drivers license. I don’t want them to read my med list as “crazy person”. So yeah, I’m med non compliant. And the way I feel right now, it’d probably take another hospital stay to change that.

    • Hi Hannah,

      Of course, the choice is yours as to whether you take medication or not and if you feel well not taking it, then that is your business, but don’t you think you’re just treading water until you end up in the hospital again? Isn’t that what happened before? And this time the mania could be worse. You put your life and the life of others in danger, if I remember correctly, and you want to be in that position again?

      Like I said, it’s completely up to you, but from my perspective, you’re taking a pretty big risk because of “shame” that is completely illogical.

      I know you know this, but there is nothing to be ashamed of just because you take medication. Should I be ashamed? Would you shame me? Do you think I deserve that? Do you think I am lesser because I take medication to survive?

      I suspect you don’t. And it’s the same for you. That shame is called stigma. It’s wrong, it’s illogical, it’s harmful and it could kill you.

      Make the best call for you. Just don’t let shame be your motivator, let your health be.

      – Natasha Tracy

  43. i have no money, no insurance and therefore.. no psychiatrist and I’ve just NOW re-started with a psychologist who is only taking $20 from me a visit because she has “charity” care.

    I barely can afford my generic topiramate for my seizures.. can’t afford 4-6 psych meds on top of that. In addition, I’ve not found a single drug as of yet (and I’ve tried many… many many many over a course of near 35 years) that has done anything in the way of improvement for me – except, i tell a lie – Lithium. Lithium takes me out of the suicidal impulsivity… other than that, it does literally not one thing positive for me.

    It doesn’t “Lift the mood” overall, it doesn’t “settle” the mood and it doesn’t make me “feel better”. It takes me 1 step above the desire to kill myself and then leaves me laying.. on that 1 step. Don’t bother telling me to “increase your dosage” because once it gets above about 600mg per day – I get toxic, I mean SICK. So, never go above 600mg WHEN I take it.

    I’ve had convulsions, hives, eye swelling, limbs jerking and spazing, lips puckering, increased paranoia, muscle stiffness, hallucinations, heart racing, eyes dilating and remaining there for hours, feet shuffling, inability to urinate, etc… on so utter many meds and at such utter low dosages… and there is a small % of folks who are simply MED INTOLERANT… which makes docs view them as med non-compliant.

    I am on no “psych meds” and haven’t been for nearly 5 years now. Would I “feel” better or “be” better with something? maybe, maybe not… my history has shown, time and again, not.. not overall.

    I work full time, I pay my bills, I raise my daughter on my own… I do have episodes, I do have to miss work from time to time, and moods are so not pretty on many given days… yet, each day I awake and have to monitor and manage myself without the assistance of meds. It’s difficult, it’s a struggle, but I’ve managed for over 5 years…. thanks to years of CBT, DBT, and one on one therapy… years.

    Oh… and forget the “back up”. If I can’t get my family to come and support me at the neurologist office… i definitely can’t get them to go to the psychiatrist’s office. I could barely get them to take me, or bring me home, from my 5 psych inpatient hospitalizations.

    • You’re not the kind of person I think of when I think of “medication non-compliant.” I don’t think you’re who Natasha is talking about, either. Someone who is medication non-compliant has prescriptions but just stops taking them. They have a doc and access, but they just stop going.

      You’re a medication non-responder. That’s different. There’s a whole percentage of us whose condition is not responsive to medication and you’ve done exactly the recommended thing–you’ve used the non-medication treatments that have been shown to be clinically effective.

      A lot of times we say “medication non-compliant” when what we really mean is “treatment non-compliant.” Obviously you’ve been very treatment compliant—you’ve gone to great lengths to obtain and follow through on effective treatment to have pursued CBT and DBT.

      DBT is a major commitment of time and effort, and I applaud you for having the stamina to pursue it and follow through. It’s not always obvious how the skills relate to getting better. I did an abbreviated offshoot of DBT as treatment for some PTSD problems and it really helped me a lot.

      It’s great that the “talk” therapies have been able to help you. There are still some people out there who go the run of available therapies and don’t respond. We tend to forget that they exist because that’s a scary thought–“untreatable”–but they do. There are people who go through the whole run of existing treatments and still aren’t better. It’s a small percentage, but it exists. Mean old statistics–all the therapies have a failure rate, which means some unlucky souls get to fall through all the cracks of the *current* treatments (but they’re always getting new ones).

      I’m not judging you, and I don’t know how long it will take Natasha to post and I hate to put words in her mouth, but I doubt she means to judge you, either. You are treatment-compliant. You aren’t who she’s talking about.

    • Hi Tabby,

      I wouldn’t call you treatment noncompliant I’d say you are a person who has chosen a treatment path (therapy, in your case) that is not medication. That is different. If you feel like what you’re doing is right for you, and you can meet your obligations, then that’s what works for you. No one said you have to take medication, particularly if you don’t find it useful.

      – Natasha Tracy

  44. We can’t get medication compliance from people with mental illnesses until we reach and change the attitudes of the society we live in. Medication non-compliance comes from stigma.

    Stigma makes (some) doctors more likely to consider terrible side effects part of an acceptable result. Stigma makes (some) doctors less likely to listen to (some) of their patients (some) of the time.

    Stigma makes people with mental illnesses want to deny (to ourselves as well as others) that we have them. We want it to not be true. Our friends and families want it to not be true. We want it to not be true so badly we’ll grasp at any straws to believe. Or to believe that it’s okay or a good idea to “give our bodies a break” from this or that medication.

    Shame makes us not want friends or lovers to see us popping pills. Then there’s jail or all kinds of things that can separate us from our meds–like not being able to afford it, not being able to afford the doc, not being able to afford the prescription, not being able to leave the house.

    Not being able to leave the couch.

    When we take our pills, do we feel proud of ourselves for nurturing our bodies and minds, is it just something we do that’s neutral, or do we feel ashamed of ourselves for being broken and effed up?

    I’d bet a lot of people feel ashamed every time they swallow their dose.

    And until we can wake the “normals” up to the truth that they’re sick, too, it’s not going to get better.

    • Hi JulieC,

      You make a good point about medication and stigma. I’ve written about that exact thing, actually. Unfortunately, it’s up to each of us to rise above stigma because we certainly can’t sit around waiting for it to go away. We have to learn to put our well-being above the closed minds of others. It’s part of the process of accepting an illness. And that would be true of many illnesses. I think about what it takes to accept a diagnosis like HIV and I feel lucky sometimes.

      – Natasha Tracy

  45. I’m sure there will be more and more instances of a newer one unless we find some way to fight the pendulum swing. There will be patients who don’t take their medication because it triggers discrimination against them.

    When I lived in the state of Virginia, you had to list the medications you were taking on your application for a driver’s license. My psychiatric medications were on some state “list” that got me on a state “list.” The result was that every year I lived in that screwy place I had to get my doctor to fill out a form saying that no, I still didn’t have a seizure disorder and no, I wasn’t going to suddenly lose it on the highway and ram my car into other people.

    Every single damned year.

    Or they’d suspend my driver’s license.

    And the discrimination was triggered not by what my diagnosis was, but by what meds I was taking. And the only way I would have had to avoid the whole mess, if I had known about Virginia’s little “pothole” in the road in advance, would have been to just not mention the meds on my driver’s license form.

    But then I would *also* have to *stop taking them*—because if I got in a car wreck and a blood test showed those unreported psych meds in my body, a simple car accident could become vehicular homicide. Witch hunts and discrimination are a bitch–but if you’ve ever looked around, people don’t like us much. Whenever we’re around and something bad happens, you can see just how much they don’t like us.

    And, of course, if you’re a teenager and you think you might want to go in the military, if you start having troubles that might be mental health related, the last thing you want to do is knowingly get within ten miles of a shrink–much less take meds.

    Then there’s insurance. When I was looking for private insurance, to buy it as an individual, you know what the insurance companies asked me on the phone to determine whether they were willing to insure me or not? “How many meds are you taking?”

    There are so many people in the country that believe there is an epidemic of “misdiagnosis” that people can get away from a lot of stigma and discrimination–if they can “pass” (for a while)–by saying, “I was misdiagnosed. Stupid doctors just want your money. I do much better now that I don’t eat junk food.”

    Denial of illness–if you can pass, it’s a get out of stigma free card.