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Meds Compliance: Is Noncompliance an Option?

By John McManamy, Health Guide Friday, October 08, 2010
I never thought I would be writing this kind of piece, but one of my readers, Donna, put it right out there:My psychiatrist's opinion is if a certain med at a certain (high) dose is keeping me out of the hospital, then I should be content to take it and live with the unbearable side effects for the r...
Question of the Week: Minding Your Own Busy-ness
10/ 9/10 8:44am

meds are for symptoms and symptoms create meds

 

there are many pdocs out there, not all, who diagnose Bipolar and thus put all in one tight vaguely described box.  That box however, has a instruction sheet.. a universal generalized instruction sheet.

 

For Bipolar the patient must take.......

If patient does not take, patient will have relapse and thus.....

Patient must take ..............

The higher the dosage, the better management of the symptoms and the behavior that presents.............

Patient must take..................

Do not expose to sunlight or moonlight... patient must stay on couch or in bed near all day and do very little in the way of actual daily living skills.. they may develop a symptom while doing them

Do not expose patient to employment.. may de-stabilize them... label them disabled and enable their continued disability by having them take...... thus rendering them zombie, vegatated, overweight, unable to handle stress, unichs.

 

Does not really matter WHO the patient is or what symptoms the patient actually presents with or if the patient even exhibits such and such behaviors... patient who is diagnosed with Bipolar are prone to.... and must take ............

 

I've witnessed it in agencies I've worked in as an administrative person and I've experienced it first hand myself.  To be prescribed a medication because MAYBE a symptom will develop down the road and best to nip it now to prevent it from happening... when it's not even happened or ever has... just flips my brain stem.  Yet, it's done and it's been done to me and yes... I've gotten where I refuse to take the drugs... my choice and my decision.

 

If I have never had the symptom, not prone to having it, not currently having it, just because I have Bipolar does not mean somewhere down the road I may develop it... why add more chemicals to my system, that is known to cause damage to my organs, that can cause psychiatric symptoms of their very very own to manifest, when I'm not experiencing said symptom or ever ever have?

 

Oh yeah... I have Bipolar and I fit in that tight vague little box with that generalized universal instruction sheet.  I get it.

 

Oh and you know... I've taken the meds now for about 34 years... all types, flavors, sizes, and colors.  I still have a mental illness and I still have symptoms and even when I was on all the meds... I was still with a mental illness and oddly, I still had the symptoms and a few med producing ones to boot.

 

With antibiotics, chances are... the infection will clear (not if you don't take the full course by the way).  With blood thinners, the clot.. chances are... will not solidify or grow bigger or float.  With chemotherapy, chances are... you'll be sicker than a mad dog but eventually your cancer will remiss (hopes).  With heart meds, your blood pressure will drop and even out...

 

With psych meds... you are still mentally ill.  You'll still have symptoms.  You'll have to take the meds all your days because you'll always be mentally ill and you'll always have the symptoms (pros would like you to understand). 

 

If you don't you'll relapse and your symptoms will be worse (pros would like you to understand though they don't explain that in relapsing you are likely going through med withdrawal if happens immediately after you've stopped the med or meds.. they don't explain that).

 

There is no end to the mental illness... not really (pros would like you to understand).  So, they'll see you back in a few weeks or months.. if that med or meds don't work for you they'll try another.  Your diagnosis will change from clinician to clinician most likely or change over a course of a decade but drugs you will continue to be prescribed.

10/ 9/10 10:21am

As an individual in most any situation, we GET to choose, as long as it's within the boundaries of the law.

 

Non-compliance with meds is always an option.

 

It really depends on how well a person TRULY knows themselves and how to tweak what they take or do to stay optimally healthy regardless of what a doc says.

 

I do believe at the beginning of discovery a professional's direction is necessary. Or when in an acute stage of mania or depression or rapid cycling where a person is NOT themselves and/or can't think rationally for themselves, then intervention is necessary and something done for that person.

 

I'm fairly new to the diagnosis of bipolar (1 year)...so I don't have the longevity as some of the posters on this board.

 

These are just my opinions.

 

God Bless,

Shelly

10/10/10 8:22am

As someone who works in the counseling field and has family members with mental health and medication needs here is what I have seen. Like in any profession thier are those who are great at knowing what the books say and so prescribe meds as they have been taught by the book. This works for many clients and is helpful. But I have also had the wonderful priveiage of knowinng some pychiatrists who know the book knowldge but have the gift of persoanliity and expereince to discern subtle changes in brian chemcistry and side effects and listen deeply to the clients expereince. This allows them to go beyond the book knowldege and adjust meds more individually and in my thinking they are the true artists in this field. To be fair to both client and cousnelor sides. Med compliance is the only way for the client and doctor to know just what is and is not working. When someone is not med compliant most will just recommend same med and complaince as they don't know what is causing the expereinces for the cleint the mental health and brain chemistry issues or inconsitent med compliance. The norm for many is it takes some trial and error and ups and downs in finding the right client doctor connection that works for you.

10/12/10 1:39pm

I feel like I am entertainment for my pdoc. He puts me in the hospital at the drop of a hat to try some new or different drug. It's all poison! Nothing helps me and my pdoc that diagnosed me said I am one of the very few that no med works on. I can't find a "cocktail" that helps. The ones that have seemed to help hurt other parts of my body like my heart!! For God's sake!!! Why do we pay them for the "take this. Increase the amt each week until u feel better. If u have any problems call my office." The whole time pdoc sits there writing scripts and looking at his watch. I am having a very bad day and I have bottles of pills out the wazooo and none help me.  I need sleep! I need to be able to concentrate. Does the pdoc hear me? No way!

Anonymous
BPD Mom
10/13/10 7:15pm

I have a 19 year old daughter who was diagnosed with Bipolar II about 7 months ago, after 5 years or horrendous struggles socially and academically with some very serious impacts.  I was absolutely convinced that she would be dead within a year when she was finally diagnosed.  The psychiatrist we went to is wonderful - sensitive, extremely knowledgeable and his course of medications has been spot-on for my daughter.  He is great about monitoring her and always looking for combinations with the fewest side-effects and is quite cost sensitive too.  I wish I could say that it was easy to find him, but it wasn't and I think even the recommendation we got for him was a fluke - her psychlogist therapist recommended him after someone else because he was "kind" (which is is, but that certainly isn't the main qualification).  I dread the day when he stops practicing or my daughter moves away and can't see him anymore.  All this is a long way of saying after reading the above posts the issue behind the compliance/non-compliance really seems to me to be the quality of the treatment under the meds prescriber, not the actual taking of medication. I am always stunned at how difficult it is to find a really good psychotherapist to deal with mental health issues that affect so many people.  These are not 'cookbook' conditions yet it seems like an awful lot of the practitioners out there are trying to follow one.

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By John McManamy, Health Guide— Last Modified: 11/16/10, First Published: 10/08/10