When someone you love begins to recover from a mental health concern, it is such a relief to see their suffering ease and to watch them regain their stability. Unfortunately, the people we care about don’t always stick to their medication plans, and this can lead to relapses, hospitalization, and reduced quality of life. At The Pavilion, in Williamsburg, Virginia, we treat people who are struggling with serious mental health concerns, so we know this is a common issue.
Why People Generally Stop Medications
Even when the meds a person is taking are not psychiatric in nature, they may struggle to follow the directions provided by their doctor. There are several reasons why this occurs:
- Fear. People may worry about the risk of side effects, which they may or may not have experienced with this or a similar medication, or they may have witnessed a loved one enduring side effects they believe to have been caused by a medication similar to this one.
- Price. Sometimes patients don’t even fill a medication because they believe they cannot afford it. They may also ration their pills so that they last longer. They may not know that the doctor can prescribe them a medication that is covered by their insurance or cheaper for them to buy out of pocket, or they may be afraid to ask.
- Confusion. If the person doesn’t know why they need the med or that the medication will take time to work, they may quit taking it before it has a chance to help them.
- Overwhelming number of medications. For some people, having to stop what they are doing multiple times per day to take multiple pills, or scheduling their meals just right, so that they can take their pills on schedule, is really annoying. They may decide to just skip a med because they don’t want their day disrupted yet again.
- Being symptom-free. Some medications should be stopped once symptoms go away, and others should not. Patients don’t always understand this, so they will stop taking their meds once they feel better.
- Distrust of doctors. Many patients have heard stories about doctors being rewarded for prescribing certain medications to patients, so they question if their doctor is giving them a med because it’s the best option for them or just a good way to line their own pockets.
Nonadherence to Psych Meds Specifically
While many of the examples above apply to mental health and physical health, adherence can be even worse among people with psychiatric disorders. It is estimated that 56 percent of people with schizophrenia, 50 percent of people with major depression, and 44 percent of people with bipolar disorder don’t take their medications as prescribed. Some estimates are even higher. But why?
- Poor insight. The person does not understand their mental health disorder or rejects that they even have a mental health condition
- Substance misuse. Either the patient forgets to take their meds because they are under the influence, or they recognize that it could be dangerous to mix their prescription and their substance of choice, so they choose to refrain from taking their prescription.
- Negative views of medication. An individual may feel that there are options that would work better for resolving their concerns than taking meds, or they don’t like putting chemicals into their body.
- Memory issues. The person may just forget that they need to take their medications. Unfortunately, difficulty with memory and organization, which are integral to remembering to refill and take prescriptions, are very common mental health symptoms.
Signs a Person Has Stopped Their Meds
When someone with a mental health disorder stops taking their medications without telling anyone, you may notice some pretty significant changes:
- Trouble sleeping
- Loss of interest in activities they used to enjoy
- Routines go out the window
- Withdrawal symptoms such as headaches, anxiety, mania, crying, depression, or suicidal thoughts
How to Address Nonadherence
Most people don’t like being pushed around or having their concerns ignored. Patients with psychiatric conditions are no different. Some of the key things that can help to improve medication adherence include:
- Therapeutic alliance. Treating the patient with respect and earning their trust by listening to their fears, complaints, and concerns, so they recognize that they are on the same team with their doctors.
- Patient education about their disorders and their medications. Taking the time to talk to the patient about what meds are being given and why.
- Supportive family participation in treatment. If a patient trusts their friends and family are looking out for them, and those people trust a doctor, it may increase their trust in the doctor, too.
- Help the person set reminders. If a person is genuinely just forgetful, they may benefit from phone reminders, a pill box that keeps their medications organized and ready to take, or medication delivery.
- Find ways to reduce how many medications a person takes and how often. Some medications that were previously only available as pills that had to be taken once or more per day can now be administered as a monthly shot, reducing the volume of pills a person needs to ingest.
At The Pavilion, we offer evidence-based, trauma-informed services that are individualized to meet the unique needs of each patient we serve. We treat mental health and substance use disorders.
