ON MENTAL ILLNESS: Barriers to "Compliance"

Jack Bragen
Friday January 08, 2016 - 01:28:00 PM

It would be easier for doctors, family, mental health workers and society as a whole if persons with mental illness would just be cooperative with treatment, right? It seems that way.

This presupposes that we were correctly diagnosed, and that there is no clear and viable alternative to participating in conventional treatment. For many of us, this is true.

Let's use me as an example. Despite the fact that I am good at writing and can think independently when I am well, I must participate in conventional treatment. This entails medication and meetings with counselors.

It is primarily medication to which many mentally ill people object. We are being given a substance that affects mind and body, we are not being given a choice about it, and taking the stuff can be pretty darned uncomfortable, as well as having health risks. The fact that something like this is forced on us can be very upsetting.  

I don't have people busting my door down with hypodermic needles and accompanying thugs ready to pin me down and give me a shot of medication against my will. However, I am aware that I don't have a viable alternative to cooperation with treatment.  

I may have had a window of opportunity when much younger to stop medication, but probably not. I tried going off medication, and that didn't work out.  

One of the main reasons why persons with mental illness don't want to take medication is that it makes us feel physically abnormal, and creates a lot of physical and mental suffering. These substances hugely change the neurotransmitters in the brain.  

If medication made us feel good, no one would be rebelling against taking the stuff.  

Because of the way most people think, the fact of needing medication can adversely affect self-esteem. This is because most people are taught to believe we can't like ourselves if something is "wrong" or "defective" with us. This is a "software" issue, and people can learn to accept the fact of needing medication and can be okay with it on a self-esteem level.  

I do not have an emotional issue any more with the fact of needing medication. However, I have done a lot of cognitive exercises to get to this place. I approve of myself regardless of any physical or mental "defects" I may have. I feel that it is not so important what biology nature has given me; what really counts is what I do with it.  

Self-esteem issues are one motive for many people's noncompliance, and thus are a "barrier" to treatment.  

Concerning side effects, that is a harder issue to overcome, since you can't think them out of existence. There are medications that can help alleviate some side effects, such as "antiparkinsonians" like Cogentin. Yet, such substances in turn have their own uncomfortable side effects.  

Side effects of medication can not only be really uncomfortable, some are a risk to health. Obesity can come about from meds, and this can cause social rejection as well as shortening one's lifespan. Other side effects entail permanently becoming disfigured, for example, Tardive Dyskinesia.  

Is medication an acceptable risk if you consider the benefits? What is the alternative?  

The suffering of side effects are a motive for noncompliance of many psychiatric consumers, and this suffering is the biggest barrier to people accepting treatment. It would be nice if the drug companies would come up with medications that were not so unpleasant to take and didn't ruin many people's physical health.  

It is not fun to take psychiatric meds. However, many of us are fortunate that in the past seventy years or so, they were invented. Before psych medications were discovered, people were given lobotomies and a lot of shock, or perhaps were permanently incarcerated under unimaginable conditions. Many psychiatric consumers would be far worse off without the treatments that currently exist.