When A Bipolar Loved One Quits A Med

By now you all must know I have a loved one (LO) who suffers from Bipolar Disorder type 1. I don’t name that person because stigma and fear dismantle job opportunities, friendships, romantic relationships and other structures that give life meaning.

From what I understand based on research, bipolar is a manageable illness but many patients’ symptoms resurface due to medication non-compliance. My shrink, other shrinks, books, documentaries, and the internet have all told me that almost without exception, bipolar people at some point or another experiment with their meds without a doctor’s blessing. I’ve always found the assertion suspect-there’s never one rule that applies to large, diverse groups and no experience in life is entirely uniform.

My loved one was put on a medication cocktail that included lithium and a low dose anti-psychotic after an emergency hospitalization. I’m a cynical, fearful person but I somehow never imagined my loved one would ditch a med.  I thought he’d been sufficiently scared by his last episode; I thought he trusted his psychiatrist; I thought he understood what was at stake.

I was wrong.

Perhaps I was projecting my own uncomplicated, cooperative relationship with medication onto him. Over the past 22 years I’ve tried many different anti-depressants, some of which I didn’t tolerate well. In those cases, I’d go back to the drawing board with my psychiatrist and we’d make a substitution. But there is a critical difference between my experience and the one I’ve heard some bipolar patients express. The medication I’ve taken has never made me feel especially different-not slowed down, agitated or foggy and certainly not like my personality had changed. Depressed I had no personality; the medication was there to help me find it.

When we found out at Thanksgiving that my LO stopped taking his low dose of an anti-psychotic 6 months ago without his psychiatrist’s knowledge, serious marked changes in his behavior had become apparent. I was seething with rage: we were back in the danger zone.

After some hideous knock down, drag out power struggling he’s back on the anti-psychotic, being observed while he takes the pill everyday. It’ll take weeks for them to start working.  

In retrospect I reflect on the error of my ways. There was no reason to think my LO was any different; no reason to think we’d be spared the medication gamble and its attendant chaos.

I’m prepared now for the likelihood that this will happen again. Maybe in 5 years, 10 years, whenever. This time we’re fortunate that nothing terrible happened except a ruined Thanksgiving holiday. Next time we might not be so lucky.

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