The single most significant reason why individuals with schizophrenia and bipolar disorder fail to take their medication is because of their lack of awareness of their illness (anosognosia). Other important reasons are concurrent alcohol or drug abuse; costs; and a poor relationship between psychiatrist and patient.
Other factors known to contribute to medication nonadherence in individuals with schizophrenia and bipolar disorder include cost of medication, lack of improvement in symptoms, confusion, depression, lack of access to medication because of being homeless or in jail, and (for individuals with bipolar disorder) ...
Fear of Stigma. It's estimated that half of all people in the United States with mental illness don't receive treatment. Part of the reason is that mental illness carries a stigma—and schizophrenia is no exception. Many people don't truly understand the illness, and they may react with fear or discrimination.
Lack of symptoms
Patients who don't feel any different when they start or stop their medicine might see no reason to take it. Additionally, once a patient's condition is controlled, they may think the problem has resolved and may discontinue using the medication.
People resist taking medication because:
The side effects can be upsetting and unpleasant. It may mean admitting that they have a mental illness. It may feel like they are being controlled by an outside force. It can trigger issues people have about loss of power and control in their lives.
Set clear expectations and discuss the possible outcomes of both accepting or not accepting treatment. Some mental health professionals believe a related condition, anosognosia, or a person's inability to recognize their own mental illness contributes to an unwillingness to take medication or participate in treatment.
For example, you can help them get a pill counter and download an app to help remind them to take their meds every day. Or you can help them do some research about mental health meds so they feel more comfortable with the idea of taking them. Solving the problem of side effects is more difficult.
The most common reason that people with bipolar disorder refuse treatment is that they don't believe they have a problem in the first place. This lack of awareness regarding their mental condition is known as anosognosia.
The short answer is “yes.” A person has a constitutional right to refuse medication and other forms of medical treatment, and that includes the right of parents to refuse to allow that their children be medicated.
As a trusted friend or family member, you have power, and they will be more inclined to listen. Explain and emphasize the consequences of being off medication and how it can affect functioning. Remind them of how bipolar has impacted them historically and of any significant consequences of their actions, Bressler says.
For example, point out the reasons to take medication. Say, "Your medicines help quiet the voices you hear," or "Your medicines help you study and keep your grades up." Link taking the medicines with things that the person enjoys. Give the person options about what to do if he or she wants to stop taking medicines.
Schizophrenia remains one of the more difficult psychiatric disorders to treat, largely because of the different symptoms attached to the disease, as well as the negative side effects like weight gain that come with the medications commonly used.
People often hesitate to take antidepressants because they're afraid of the side effects or of becoming dependent on the medication. But unlike many sleeping pills and sedatives, antidepressants don't lead to physical dependence or addiction.
Forced treatment–including forced hospitalization, forced medication, restraint and seclusion, and stripping–is only appropriate in the rare circumstance when there is a serious and immediate safety threat. In general, circumstances that give rise to the use of force are not spontaneous and do not occur in isolation.
It is not uncommon for those experiencing symptoms of mental health disorders to report that they initially tried to deal with their anxiety, mood disorder or psychosis by “self-medicating” with alcohol or drugs.
When Is It Time to Walk Away? In some cases, the decision to leave is obvious. If physical abuse is present to any degree, and especially if the individual fears for their own life or well-being or that of their children, it's important to leave as soon as possible. Safety is the number one priority.
Patients with severe mental illness, including schizophrenia, may be legally mandated to receive treatment.
Reach out to treatment centers in your area who have a structure for treating primary mental illness for possible help options, resources, and information.
If You Have Bipolar Disorder and Don't Take Medication
You may experience more severe symptoms: If you don't take medication for bipolar disorder, you may experience more severe symptoms. This can lead to a greater risk of hospitalization or suicide.
Using antidepressant medication alone to treat a depressive episode is not recommended in people with bipolar I disorder. The drugs may flip a person, particularly a person with bipolar I disorder, into a manic or hypomanic episode. Hypomania is a more subdued version of mania.
Myth 9: The Side Effects Are Worse Than the Original Symptoms. Some individuals believe that the side effects of psychiatric medication are worse than their original symptoms. This is not true. As mentioned above, these medications can provide the missing link to an individual's mental health struggles.