2) Medication Adherence

I work at a group home for young adults with a history of mental illness. One client keeps going off his medication. He says he “is tired of doctors telling him what to do” and “he hates being controlled and living on a schedule”. He is diagnosed with bipolar disorder and I don’t understand why he just won’t keep taking his medication! I don’t understand why he quits; he needs it so he doesn’t get sick.

This is a very good question that the medical profession has explored. There are several reasons why people stop taking their medication. A number of studies suggest factors such as age, gender, time of illness onset, and substance abuse may play a role (Baldessarini, Perry and Pike, 2007). Other reasons may include intolerable side effects, social stigma [[1]]or just feeling better and thinking they don’t need the medication anymore. A helpful book that covers non-adherence factors is Bipolar Disorder For Dummies [[2]].

It can be difficult to understand why people do not comply with taking their medication when it is believed to help them achieve more productive and healthy lives. Sometimes it can be as simple as the way the person perceives the illness and the impact it has on their life. Although I can not directly speak to your situation, it is not uncommon for people on a treatment plan to feel like they are “controlled” and “submitting” to a life dictated by others. Just like any other person taking medication, once they are feeling better, they may feel they no longer need it. Is your friend involved in counselling as part of his treatment plan? Counselling can help people gain a better understanding of the nature and treatment of bipolar disorder. As always, it would be best if your friend could find a mental health professional that can help to explore ways to stay well.

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