Anosognosia, a clinical lack of insight, affects up to 50% of people with bipolar disorder, leaving them unable to recognize their illness. This symptom can devastate not only those with bipolar disorder but also their loved ones. Discover why this happens, how it impacts treatment, and what you can do to help someone who doesn’t believe they’re unwell.
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Recently I was asked what to do when you don’t want to take your bipolar medication. What do you do when you’re battling medication noncompliance (also known as nonadherence) within yourself? I thought this was a good question as it’s something that many of us battle with. We know we need to take the medication, but some part of us doesn’t want to take the medication. I guess it’s a need vs. want scenario. This scenario is trickier than many people think, as not wanting to take medication is common and a very understandable impulse. So here’s what to do when you don’t want to take your bipolar medication.
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Bipolar Burble blog welcomes Lynn Nanos, a mobile emergency psychiatric social worker from Massachusetts. She writes about one patient’s experience with psychosis and the need for treatment without consent and assisted outpatient treatment (AOT).
I evaluate many patients with serious mental illness who lack awareness of being ill. Those who don’t understand they are ill, those who don’t have insight, are unlikely to initiate outpatient treatment. Here’s a story of one man who needed treatment without consent for his own safety.
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People with mental illness frequently stop taking their medication. This is known as medication non-adherence or medication noncompliance. No matter what doctors choose to call it, however, it’s a problem. By and large, when the mentally ill stop taking their medication bad things happen to them. But if this is the case, then why do people with mental illness stop taking their medication?
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Last week, the Food and Drug Administration (FDA) approved the use of a computer chip inside of aripiprazole (Abilify) pills. This computer chip is designed to indicate whether the person has taken his or her medication or not. The theory (and marketing push) is that this computer chip will improve treatment adherence (compliance). It will “ensure” people are taking their medications as prescribed. But will a computer chip inside of an antipsychotic really improve medication adherence?
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I take psychiatric medications daily and what I want to know is, why do people refuse to try psychiatric medication for serious mental illnesses? Why do people think they don’t need it? Why do people think they should ignore their highly-trained doctor’s advice? Why do people feel that taking psychiatric medication makes them less of a person? Why is it okay to take heart medication but not psychiatric medication? Why do people think that psychiatric medication doesn’t work? Why do people think that I know of some secret alternative? Why do people refuse to even try psychiatric medication?
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As people who read this bipolar blog know, I’m on medication, lots of it, actually. Nevertheless, many people (philosophically, even me) wish to be medication-free. I’m the first one to say this usually isn’t possible; however, today I’m talking with CEO and Medical Director Dr. Kim Dennis from Timberline Knolls (a sponsor) about bipolar disorder without medication.
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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?
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