How to Respond When a Loved One Stops Taking Their Bipolar Disorder Medication

Why people stop taking bipolar disorder medication

Medication adherence is a common issue when it comes to bipolar disorder. There are several reasons why someone with bipolar disorder may stop their medication.

Some of the most common reasons include:

• Unpleasant side effects: Some people find the side effects of their medication difficult to tolerate.
• Feeling better: When a person starts to feel stable, they might believe they no longer need the medication.
• Desire for independence: Long-term symptom management, which is generally the medical recommendation for bipolar disorder, can feel limiting for some, leading them to stop in an effort to regain control.
• Hypomanic or manic episode feelings: Some people miss the elevated mood and energy that come with hypomanic or manic states.
• Financial constraints: The cost of medication can be a significant barrier, especially if insurance coverage is limited or absent.

Potential consequences of stopping medication

Discontinuing medication can have several negative consequences, including:

• Return or worsening of symptoms: Without medication, severe mood changes, manic episodes, or depressive states may return or intensify.
• Increased risk of mood episodes: Bipolar disorder is characterized by cycles of mood changes, and stopping medication can increase the frequency and severity of these episodes.
• Disruption to daily functioning: Mood instability can affect work, relationships, and daily responsibilities.
• Strain on relationships: Loved ones may feel frustrated or concerned, leading to tensions in relationships.

Effective approaches and practical support strategies

Here are some of the most effective ways to navigate a loved one abruptly discontinuing their medication.

Communicate with empathy and respect

Approach the situation with care, remaining mindful of your tone and language. Instead of focusing on the diagnosis, speak to the person and their individual experience.

Try to avoid using labels like “bipolar” to define them. Instead, refer to specific behaviors or concerns, such as changes in mood or energy levels.

Keep the conversation grounded in respect, acknowledging their feelings and concerns without judgment or stigmatizing language. This ensures the discussion remains supportive and non-confrontational.

Listen and validate their feelings

Allow your loved one to express their concerns about medication and acknowledge their challenges — whether related to side effects, the idea of long-term treatment, or a desire for independence.

Validating their feelings helps them feel understood, even if you don’t necessarily agree with their decision.

Encourage professional consultation and offer support

Instead of pushing them to start taking medication again, suggest that they consult a healthcare professional. A doctor can help address side effects or consider adjustments to their treatment plan.

Offering to accompany them to appointments or assisting with appointment scheduling can provide valuable support and make them feel less alone in the process.

Encourage a comprehensive treatment plan

Bipolar disorder is often most effectively managed with a combination of treatments. Suggest that they explore therapy or counseling, maintain a healthy lifestyle, and connect with support groups or peers.

Offer practical help with managing medication schedules or tracking mood changes, as this can make the treatment plan feel more manageable.

Develop a wellness plan together

Collaborate on identifying early warning signs of mood episodes and establish when to seek professional help. Create a shared understanding of the steps to take if they’re having trouble, and set boundaries to ensure both of you feel supported and protected.

Approaches to avoid

While it’s understandable to feel overwhelmed and stressed, some of the following approaches can end up making the situation worse.

Don’t: Use fear-inducing language

Language that instills fear or creates a sense of urgency can be counterproductive. It’s best to:

• Avoid fear-based terms: Using language that makes the situation sound worse than it is can make your loved one feel overwhelmed. For example, when describing symptoms or potential outcomes, avoid phrases like “warning signs” or “catastrophic consequences,” which can create unnecessary fear.
• Use neutral terms: Instead of using words that sound alarming, like “crisis” or “dangerous,” try to stick with neutral terms like “symptoms” or “challenges.” This keeps the conversation focused on understanding and managing the situation.
• Stay calm and supportive: Instead of making predictions about worst-case scenarios, like “if you don’t take your medication, things will get much worse,” remain calm and offer supportive language, focusing on how you can work together to address the issue.

Don’t: Blame or shame

Blaming or shaming can make a person feel isolated and misunderstood. Try to avoid:

• labeling their decision as “noncompliance” or a “failure”
• using stigmatizing words like “irrational” or “attention-seeking”
• equating their decision to stop medication with personal weakness or irresponsibility

Don’t: Make assumptions

Every person’s experience with bipolar disorder is unique. Try to avoid:

• assuming you understand their reasons for discontinuing medication
• generalizing about what works for everyone with bipolar disorder
• presuming they haven’t thought through the potential consequences

Don’t: Take full responsibility

While it’s natural to want to help, it’s important to recognize the following:

• You cannot control their decision to stop medication, nor can you force them to resume it.
• It’s unhelpful to take on the role of “medication police” or become overly involved in their decisions.
• Their treatment choices are ultimately theirs to make.

When to seek emergency help

In some cases, it may be necessary to seek emergency help. Consider reaching out for immediate assistance if your loved one:

• expresses suicidal thoughts or engages in self-harm
• exhibits dangerous behaviors during manic episodes
• becomes unable to care for their basic needs or experiences a significant mental health crisis

Taking care of yourself

Supporting a loved one through challenges with their medication requires balance. Here are a few tips to prioritize your own well-being:

• Set reasonable boundaries and make sure to take time for yourself when needed.
• Seek your own support from friends, therapists, or support groups.
• Recognize that you cannot control your loved one’s choices, and allow yourself to take breaks when necessary.

Takeaway

When a loved one with bipolar disorder stops taking their medication, it’s crucial to approach the situation with empathy, understanding, and a focus on collaboration.

You can navigate this challenge together by offering support, encouraging professional consultation, and fostering a conversation rooted in respect.

Remember that their treatment decisions are ultimately theirs to make, and while you can offer help, taking care of your own mental health is equally important.