Bipolar Disorder and Discontinuing Medications: Is It Common?

Reader’s Question

I’ve been diagnosed as Bipolar, Major Depressive and Seasonal Affective Disorder by different doctors and therapists over the past 12 years of my life. I’m probably bipolar, as that is the most common diagnosis I receive. I have made a serious suicide attempt and I have been hospitalised seperately for suicidal depression. I have gone on a wild shopping spree in which I bought useless items I thought I wanted and because it was fun, and was left with a negative checking account balance, no money for rent and an eviction notice on the door a short time later. I am a cutter, though with therapy I now go months without self-harming. When I am off my medication my normally great work ethic fails, I tend to get in trouble for not working and I know I spend more time thinking about non-work related things or playing on the computer than getting actual work done.

I am supposed to be on a cocktail of 2 antidepressants, a mood stabiliser, and a antipsychotic drug, but for the life of me I can never stay on them for long. Times like now, I feel bad — like I am disappointing my family, friends and most importantly, my therapist and psychiatrist. I hate taking medication, always have — even antibiotics. And maybe I’m lazy. I like how I feel off medication (at least at first when I’m feeling good). I have more energy and feel more creative. I never have a good reason to stop the medications and I know how dangerous it is for me to do so cold turkey, but I cannot seem to take them properly. The only times I’ve ever really been good at it is during a stay in the hospital or immediately after.

Friends I have who suffer from anxiety or depression are always shocked that I’d take myself off my medication — they would never do that. They don’t understand why I do it any more than I do. Is it common for people to take themselves off medication? How do I force myself to take them properly when I really don’t want to? I hate how I become after a month or so without the medication and swear up and down that THIS TIME I’ll take the pills as I’m supposed to. But once I’m on them, it doesn’t seem to take long for the decision to stop sets in no matter how good my intentions.

Psychologist’s Reply

I’m told that medication noncompliance is about 45% — in all areas of medicine. People don’t want to take their medications as prescribed, side effects bother them, they don’t take them on the right schedule, they quit taking them early, etc. Bipolar Disorder presents special problems, such as:

  1. Medications dampen the manic aspects of the disorder in an attempt to control the hyperactivity, hypersexuality, spending sprees, etc. One client with Bipolar Disorder told me “With medicine, it’s like watching the world on a black and white television”.
  2. The elation, energy, and grandiosity of a Manic Episode is very tempting — so much so that some people manipulate their medications in an effort to experience a little bit of the manic episode.
  3. While Mania is the most talked about side of a Bipolar Disorder, in reality, individuals with Bipolar Disorder spend the majority of their time depressed, wishing for an elevation in their mood.
  4. Once you reduce your medications and a small feeling of mania surfaces, that small amount of mania contains just enough grandiosity that you feel you can control the disorder and the medications. From that point, you’re headed toward discontinuing the medications and an eventual manic episode or possible hospitalization.

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When tempted to discontinue or reduce your medications, you might want to use a method often used in alcohol treatment. People with alcoholism don’t refrain from drinking by thinking of the “good times” on alcohol — they think of the “bad times”. If you think about manic episodes — a portion of that memory will be very tempting because it will contain an “Emotional Memory” or memorized feeling of that time. When we think about a joyful experience, we feel the joy…that kind of thing. When you find yourself considering no medication — remember the job losses, financial ruin, forced hospitalizations, etc. You are prescribed medications for your protection. When you are tempted to stop your medications, talk to your therapist/counselor or other supportive individual.

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