The most common emails I get are from concerned parents, upset that their recently diagnosed teen/young adult has stopped taking the medications that were clearly helping improve their situation (from an outsider’s perspective). When something has proved to seem helpful to someone in the past,
Why would [anyone] stop taking their medication?!?
I realize that for a lot of people, this is an extremely baffling situation -and it isn’t limited to the young, the newly diagnosed, or the “unruly” patient. As someone who has gone through the process of trying different medications, it can be difficult for me to understand why this notion seems so foreign to people.
So, I wanted to take some time today to address some of the main reasons people stop taking their medications. People might think this sort of behavior is completely spontaneous or unjustified, but you’d be surprised at how much logic actually goes into the process of “quitting” whatever medication, for a lot of people.
1. Side Effects - side effects are easily the number one reason people stop taking their medications. The side effects for psychiatric medications cover a huge spectrum of different areas (both psychological and physical), some of which can be quite unpleasant. If side effects are unpleasant enough for someone to consider stopping their medication, I would highly suggest speaking with the prescribing doctor as soon as possible. Stopping a medication abruptly due to side effects can potentially make matters worse if a high enough dosage is being taken to cause withdrawal effects, and trust me. You don’t want that to happen.
2. Fear of Dependance - a lot of people go through one (or several) period(s) where the idea of taking a medication for the rest of their lives sparks fear around the idea of dependance. What if I reach a point where I can’t afford them anymore? What if something catastrophic happens an I no longer have access to the medications I need? What if I want to travel? The idea of having something that is not only helpful, but now seemingly essential to your well-being can be terrifying, because what if it is suddenly taken away?
3. Fear of Losing the Self – this is another extremely common fear, especially for people who are just starting to take medications or are teens/young adults. Will psychiatric drugs alter or diminish my creativity? My intelligence? My personality? Most adolescents are just beginning to to discover who they are and in that time it can be terrifying to imagine discovering that person (let alone building a life for oneself) with these things dampened or altered. I began taking medications around age 16, and this was a really big fear for me. It is important to consider that the right medication(s) will not damage this “self”, but for many adolescents trying to wade through however many medications it takes to find the “right one”, this can seem like a waste of important, younger years.
4. Cost - it is also extremely common (unfortunately) for people to quit taking their medications because they simply can no longer afford them. There are things you can do to get the medications needed, for more information I would check out Best Kept Secrets For Getting Affordable Treatment for Mental Illness.
5. Not Feeling Included – I would say this is also fairly common for teens or young adults who are in the care of their parents. If someone is not included in the decision-making regarding their own care, I would definitely expect some backlash. Many parents give their child a pill and that is the extent of their involvement in the process, and I am constantly reminding parents that that pill alone will not solve everything. Try to take the time to talk openly with your child about what they are experiencing, try to include therapy or group therapy if you can. If your child is not included in their own medical care (and decisions regarding medications as well), can you ever expect them to continue care on their own after they’ve left the nest?
6. Mania Addiction - this is something I am planning on going more in-depth about a bit further down the road, but addiction to mania or hypomania is a very real problem for a lot of people. If you can imagine, let’s say your body suddenly produces a natural high that lasts for days (often for no apparent reason) for a week every month. Now, you’re given medication that keeps this high from happening. Sure, it may alleviate the bad symptoms you were having, but it also keeps you from feeling that natural high. Do you keep taking the medication? It is a lot easier said than done, and in a culture where addiction is already prevalent (cigarettes, for example) this is something that acts as a stumbling block for a lot of people.
7. A Sense of Shame - there are a lot of ignorant people out there (sorry to burst your bubble about that) that have no grasp whatsoever on the concept of mental illness. Some people face bullies that make them feel ashamed to be taking psychiatric medications, and these people can be peers, co-workers, bosses, family, even parents. Anyone who has sought help for anything in regard to mental health deserves to be praised for overcoming fear, but unfortunately feeling a sense of shame (ingrained by whomever) is quite common.
8. Misinformation/Misdiagnosis - now, more often than you think, people are given misinformation by their doctor or a misdiagnosis (or a series of them, if you’re particularly unlucky). Being told, for example, that an episode that someone experiences is singular is definitely more likely for someone to shrug off medications more quickly (yep, this happened to me). This can’t be skipped over as a real threat to people’s willingness to be treated, and a misstep by one doctor can lead to a mistrust of many down the road.
9. Fear Around Performance at Work - in regard to what I mentioned with mania addiction, there people who rely heavily on this “natural high” to produce a lot at work in small periods of time. There are industries that have come to expect this kind of output from their employees (and rely heavily on it), so there is certainly a genuine fear by a lot of people that taking medications will hinder their abilities to perform as intensely as they have in the past.
10. No Noticeable Improvement - finally, when people don’t actively see any benefit from a drug they are taking, the are much more likely to stop taking it. To come full circle, this is something that should be discussed with the prescribing doctor as they are probably more than willing to try something else instead.
If someone close to you has recently stopped taking their medication without a doctor’s authorization, try having a conversation with them about why. Chances are, there could be some very real physical discomfort they are feeling, or that they have been experiencing some very intense fear around the idea of committing to taking medications.
I just want to note that people have a choice in the matter, so whenever there is a choice, people will choose whatever route makes sense to them at the time. The best thing you can do is be open and willing to have a discussion about where those choices are coming from.