When you have bipolar disorder, you need to stick with your treatment plan to feel your best. Yours may include talk therapy, lifestyle changes, and most importantly, medications.
It’s that last piece that you may find the most challenging. In fact, it’s estimated that more than half of people with bipolar disorder don’t take their medication as prescribed. That’s called medication “nonadherence” and can cause relapses, affect your day-to day functioning, and take the joy out of living. Untreated bipolar disorder can even be dangerous.
People with bipolar disorder have ups and downs in their moods. Mania is the high. You may feel very energetic and perhaps invincible. You may feel good or be very irritable and get into arguments. You may spend too much money and even get into trouble with the law.
When people feel symptoms, 75% of the time it’s the lows of bipolar depression. You may feel sad, sluggish, or have trouble eating and sleeping. You may even think about death or suicide.
If you have thoughts of suicide, get help right away. Call the suicide lifeline at 988 in the United States to be connected to a local crisis counselor.
Why People Skip Medications
It can be hard to accept that you’re on a psychiatric medication. People often avoid it because they believe it’s admitting they have bipolar disorder and the stigma that often goes with it. That can be a huge mental roadblock. It can feel like defeat. When you feel that way, it can sometimes just seem easier to just not take the medication.
Recent research based on surveys and interviews with more than 30,000 patients and health care professionals pinpoints the top reasons people don’t take their medication as prescribed:
Troubling side effects. People with bipolar usually take a combination of antidepressants, mood stabilizers, and antipsychotic drugs. But many of these drugs have side effects like weight gain, dry mouth, constipation, or sexual side effects.
Lack of understanding. Bipolar disorder can be somewhat mysterious even to those with the condition. Understanding the condition can help you see why consistent medication is so important.
Forgetting to take them. Sometimes, people have many drugs for bipolar or other health conditions to take at different times of the day. This can make scheduling complicated and lead to missed doses.
Fear of getting hooked. Some people believe they will become addicted to medication or fear long-term effects. Research reveals people are afraid the drugs might change their personality or make them “feel like a zombie.”
Lack of support from family, friends, and even health care professionals and a desire for alternative treatments are stumbling blocks to medication adherence, too.
How to Help Yourself Stay on Track
You may have one or more of these common problems or some other more personal ones that are keeping you from sticking with your treatment plan. A patient-centered treatment plan based on your lifestyle, preferences, and values has a better chance of success than one that focuses on treating the symptoms of the disease.
Educate yourself. If you learn the nature of bipolar disorder, you’re more likely to understand why consistent medication is so important. Ask your doctor for an explanation or resources to turn to for education. It’s easy to believe that once your depression lifts, you don’t need medication anymore. Or if you’re in the middle of depression, you may not have the drive to take it. On the flip side, if you’re in a manic phase, you may believe you’re bulletproof. So why take medicine? What you want is to stay on an even keel so you can avoid these super highs and crashing lows. Consistent medication can help you do that.
Be flexible. It takes some time for medications to work, and you might have some side effects before you see benefits. That can be frustrating. But if side effects are keeping you from taking your medicine, talk to your doctor. A simple change in dosage, taking it at a different time of day, or a new drug or combination of medications may work better for you.
It’s also possible that your body processes, or metabolizes, medications more quickly or slowly than the average person. That means that a standard dose may not work for you. If you metabolize a drug quickly, you’ll need a higher dose to see results. If you process it too slowly, you may be more sensitive to side effects.
Pharmacogenetic testing may help you figure it out. This is a painless DNA test that examines how your genes may affect the way your body processes and reacts to certain medications. Ask your doctor if pharmacogenetic testing may help you. Check with your insurance provider to see if it’s covered by your plan.
Do simple things. If you can’t remember to take your medicine, hang sticky notes where you will see them, set phone reminders, or use a pill organizer. Ask your family to help you stay on track. Make sure you get enough sleep, eat well, and exercise. Try a relaxation technique like meditation or deep breathing to ease stress.
Talk it out. If you don’t already have a counselor or psychologist, consider seeing one. Adding talk therapy can be an important part of treatment. It can help you overcome fears, define your wellness goals, and more.
Seek support. Some groups are led by mental health professionals, and others provide peer support. That means people with bipolar disorder or depression guide the conversation. Support groups can be very helpful because they bring together people with similar concerns and can help you feel less alone.
Show Sources
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SOURCES:
Depression and Bipolar Support Alliance: “Medications for Mood Disorders,”“Supporting Treatment,” “Therapy.”
Journal of the American Medical Association: “Diagnosis and Treatment of Bipolar Disorder: A Review.”
National Institute of Mental Health: “Bipolar Disorder.”
988 National Suicide and Crisis Lifeline: “The Lifeline and 988.”
Psychiatry and Behavioral Health Learning Network: “Six Key Factors Affect Medication Adherence in Patients With Bipolar Disorder.”
Psychological Medicine: “Mapping modifiable determinants of medication adherence in bipolar disorder (BD) to the theoretical domains framework (TDF): a systematic review.”
Informed Health.org: “Depression: Experiences with antidepressants.”
Caregiver Action Network: “Supporting Your Loved One With Their Medication Plan.”
American Psychiatric Association: “Stigma, Prejudice and Discrimination Against People with Mental Illness.”
