ON MENTAL ILLNESS: Noncompliance Revisited

Jack Bragen
Friday October 03, 2014 - 12:30:00 PM

Someone with mental illness may become noncompliant with treatment for numerous reasons. One possible reason is that you don't agree with your diagnosis. Another is that the side effects (for some people on some combinations of medications) are unbearable. Yet another reason for noncompliance is the loss of hope. 

If one's life isn't working while treatment compliant, it may seem like trying to get off medication is a way out of an impossible situation. This is not accurate. If one's situation seems impossible, something other than noncompliance should be tried. Or, perhaps a person has problems that they must just endure, or at least must muddle through in the hope that things will be better. 

If things weren't working for a consumer while cooperative with treatment, it may only compound one's problems to add noncompliance to the mix. If your car gets a flat tire, it doesn't fix things to also empty the gas tank. Thus, if there are problems while on medication, quitting medication will probably not do anything to solve them. 

Compliance has always worked better for me than noncompliance. 

I may have lost some brainpower due to the times I went noncompliant. A full relapse of psychosis due to going off medication may have bad effects on the brain, and these effects can last many years. 

Through deliberate effort, I have been writing for publication in the past thirteen or fourteen years. I began this about four to six years after my most recent relapse. However, I might have done much better at writing had I not earlier tried to go off medication. 

I do know that I owe my current level of liberty to the fact that I haven't been off medication since 1996, thus haven't relapsed, and therefore haven't caused anyone trouble. That is reason enough not to go non-compliant again. A repercussion to stopping medications and getting ill again (with the resulting chaotic or troubled behavior) may be that you could be incarcerated, or that at least you could be living under increased restrictions. 

When someone is on medication and is doing fairly well they may believe they don't need the medication any more. They may have forgotten what is was like to do without medication, as it may have been a few years since they became stabilized. 

There are a lot of problems that can be caused by going off of psychiatric medication AMA (Against medical advice). For one thing, you will be going through withdrawal. Withdrawal from psych medications may need to be done over a period of several years if it is to have any chance of being successful. During those years, it is necessary to remain closely monitored for a return of symptoms. If symptoms come back, the dosage must be raised once again, and one must give up on the idea of going off medication, for another few years at least. 

Withdrawal from psychiatric medications should be done only under the supervision of a psychiatrist. However, many psychiatrists will be hesitant to discontinue medications, since if you are doing well it may mean that the medication has helped you. If you are doing well, it may mean that something was done right, and it does not usually mean that it is time to stop medication. 

It may seem awful to think that you might never get off medication—but things could be worse. 

By continuing to cooperate with treatment, you are giving yourself the opportunity to possibly live in a somewhat normal, and maybe even enjoyable scenario. For one thing, people with whom you interact will likely be more cooperative with you, since you are cooperative with them. By being treatment compliant, you are demonstrating that you can live among people, and that you do not need to be put under various restrictions. Secondly, your mental health will be maintained. 

If you show cooperation with a psychiatrist, they will be more likely to comply with your wishes and requests. For example, if a medication isn't working or causes a lot of side effects, you could ask for a different medication. If a psychotherapist is obnoxious or is just not on your wavelength, you can ask to be switched to another one. 

You will likely live a lot longer if compliant, since the stresses of a psychotic, manic or depressive episode can be very hard on one's physical health, especially when you are getting older. 

Overall, for most persons with a mental health diagnosis, my advice is to be cooperative. This may help to salvage your life situation and your health, and this in turn will allow you to have a better future. 

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I can be reached with your comments at, but I can not dispense advice to individuals since I am not a mental health professional. I also have books for sale on Amazon, including a book that contains my first year of columns, titled: "Jack Bragen's Essays on Mental Illness," a self-help guide called, "Instructions for Dealing With Schizophrenia; A Self-Help Manual," and I have a short story collection you should try, called, "Revised Short Science Fiction Collection of Jack Bragen."