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Why I don’t want to take my meds
There are lots of reasons to consider skipping or stopping, but read this first.
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Nobody wants to take medications. But if you’re living with a mood disorder, they may be the key to controlling your symptoms and staying healthy.
If you skip doses or think about discontinuing them, you’re not alone. More than half of people with bipolar disorder don’t take their meds regularly. But going off them can cause recurrence of your illness and successive episodes can be more severe.
Your objections are understandable. There can be downsides to psychotropic drugs. Here are some of them and some helpful suggestions for coping with them from Daniel Wilson M.D. Ph.D., Professor & Chairman of Psychiatry at Creighton University, Omaha.
I don’t want to take my meds because:
“I don’t like thinking of myself as a sick person.”
If you have bipolar disorder, you may also be talented, creative and insightful. Well, there are Fords and there are Maseratis. “You can get around in a Ford,” says Dr. Wilson, “but a high-performance car requires specialized maintenance to operate at its best. You are not an average person. Your equipment needs a different kind of maintenance – including medications – to work at its best.”
“I don’t want to deal with the side effects.”
Some medications in some doses can cause side effects in some people. “If you’re experiencing them, you should talk to your doctor about adjusting the dose or trying a different medication,” says Dr. Wilson. “In some cases, your doctor may recommend an additional drug to treat your side effects. Weight gain, for example, can happen with drugs that affect both your appetite and your metabolism. If the drug is effectively treating your symptoms, adding a drug that reduces appetite or helps control blood sugar levels could help.”
“I don’t want to feel medicated.” or “I’m afraid it will stifle my creativity.”
“Work with your doctor to find the minimal effective dose,” he says, “which is more easily done with many of the newer drugs. It’s important that the patient recognize early signs, such as anxiety or changes in sleep patterns, that might indicate a need to increase the dosage.”
“I have trouble remembering to take them.”
Try to maintain a routine of taking your pills at the same time each day. Use a pill box divided by time of day and days of the week. Ask a family member to fill it for you, if that helps. “You may want to ask your doctor about longer-lasting drugs, monthly injections or a patch,” suggests Dr. Wilson.
“I can’t afford my medication.”
Psychotropic drugs can be expensive. Look for programs that can help you get free or reduced-cost medications. Ask your doctor if a cheaper drug or a generic could be substituted or if samples are available. “The costs of medications can be high,” says Dr. Wilson, “but they must be weighed against the cost to your job and relationships, or the risk of hospitalization, if you don’t treat your illness.”
“I don’t think they’re working.”
It’s hard to be patient when you’re suffering, but sometimes drugs for depression or bipolar disorder can take weeks or months to be fully effective. We don’t always recognize signs of improvement in ourselves, so ask those close to you what they’re noticing. Let your doctor know what’s going on. It’s also important to make sure you’re clear about how to take the drug.
“I’ve been feeling better and I don’t think I need them anymore.”
Unless you’ve been in substantial remission for six months or a year, it’s not a good idea to quit, he says, because the risk of relapse is very high. There may be a time after a sustained period of stability when you can take a lower dose of medications or stay off them for longer periods.
“I’m not really sick.”
This is the greatest obstacle of all. Dr. Wilson suggests that you examine life experiences that may have been related to symptoms of a mood disorder, such as job problems or relationship problems. If you’ve been manic, you may not be able to remember things that happened. An intervention by friends and family members coming together to talk about their experiences and observations with someone who may be in denial about their illness can make a difference.
Managing side effects
How to save on prescriptions
Daniel Wilson M.D. Ph.D, Professor & Chairman of Psychiatry, Professor of Anthropology
Creighton University, Omaha
Doctor Wilson is co-author of the book The Evolutionary Epidemiology of Mania and Depression: A Theoretical and Empirical Interpretation of Mood Disorders with Gerald A., Jr. Cory, and Farid Dalili ( 2008) Edwin Mellen Press.
Colom F, Vieta E, Martínez-Arán A, Reinares M, Benabarre A, Gastó C. Clinical factors associated with treatment noncompliance in euthymic bipolar patients. J Clin Psychiatry. 2000 Aug; 61(8):549-55.
updated November 1, 2010