What should I do if my loved one is bipolar and won't take his medication?

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
This is a difficult question and one that many concerned relatives all over the world are probably asking. Your case is particularly challenging from both angles in the sense that bipolar disorder is something that affects an individual’s mental abilities. You may feel that your loved one doesn’t have the capacity to make the decision to skip his meds. On his side, he may be more difficult to reason with when he’s not on his meds. It may be helpful for you to ask him to explain how the medication makes him feel. Very commonly with medication for mental illnesses patients will feel sedate, less creative or as if they’re in a ‘fog’. Sometimes patients may also suffer from side effects or the fear that side effects may develop, which can also create some resistance. Other times it is simply a matter of denial--your loved one may not want to admit that he has a problem or a weakness. Patients feel that the medication makes them into a different person and they don’t want to admit that there is anything wrong with who they are to begin with. It can be a disconcerting thought when you try to place yourself in your loved one's position.

Your loved one is going through a very difficult time, as are you. Remember your own mental health and well being. Make sure that you have a support system--people you can trust and activities that help clear your mind. This is not going to be easy but it will benefit everyone in the end.

It's essential to understand that his motivations for not taking medication are complex and important. It may be that his medications have side effects that are uncomfortable. Possibly the medication he takes alters his sense of self and he doesn't like the new self that he lives with. It may also be that his daily dose of medicine is a painful reminder of his bipolar condition and he'd rather not face that reality. All of these are common reasons why medication compliance is inconsistent.
It's also important that you find some empathic connection with him around his choice to not take medication. If he feels you understand his experience of medication, he's more likely to be willing to talk with you about the issues and through that process, possibly find some flexibility. Conversely, if he feels that his medication compliance represents a capitulation to your needs and wants, then you're likely to encounter more resistance.
Taking medication for many with bipolar disorder is a mixed bag. It can often take a fair amount of time (often several years) for the bipolar individual to value mood stability with sufficient strength to offset the reasons underlying treatment resistance.
For the partner, spouse, friend or family member who has to stand on the sidelines and watch the bipolar individual suffer multiple relapses due to medication non-compliance, the experience is painful and frustrating. The key to managing bipolar disorder within relationships is open and honest communication where the issues can be discussed with a sense of mutual cooperation and respect.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.