ON MENTAL ILLNESS: Many Reasons for "Noncompliance"

Jack Bragen
Friday July 07, 2017 - 10:54:00 AM

Today's piece does not represent a professional opinion, and you should consult your doctor or treatment professional if you are in doubt as to what to do.

The medical/mental health establishment expects much from persons who are given a diagnosis of a psychiatric condition. They expect us to accept a life-ruining diagnosis, they expect us to take psych medications that often have horrible side effects--which can cause a great deal of physical and mental suffering--and they expect us to accept the idea that we will never be normal.

Anosognosia is the term given to those who purportedly lack the insight that they are mentally ill. If we do not go along with the plan of being medicated, being supervised, being restricted, and accepting that we are useless, then, according to mental health workers, the cause of it has to be "lack of insight."  

After all, if we were at least somewhat rational, we would agree with mental health workers, psychiatrists and psychotherapists, that we need medication, that we are sick, that we aren't normal, and that our only chance is to obey the edict that we be medicated. If we don't believe that, it is because we are too deluded to see their wisdom.  

Antipsychotic medication interferes with performing at a job. When we discover that holding a demanding job is next to impossible, because the medications do a number on the central nervous system, mental health professionals assume that our illness that makes us unable to work.  

(I have worked at jobs while medicated and it is doable some of the time. It may require more effort and it may require becoming acclimated to medication. However, if I didn't need medication, I think work would have come a lot more easily, and I might have done a lot better.)  

I'm on both sides of this fence, and this is difficult. In my column I advocate accepting treatment. However, once we are entrenched in the mental health treatment system, it can be very, very difficult to create a gratifying life situation.  

I'm not advocating going off medication against medical advice. If you're truly ill with one of these diseases, the earlier you get it under control, the better chance you have at preserving brain function, and thus at succeeding in your goals. However, it is always worthwhile to get a second opinion, or even a third.  

There are a lot of reasons why patients go off medication against medical advice, other than anosognosia. Being medicated and living out your life in the mental health treatment system forfeits one's chances at having a gratifying life. Doctors should try a bit harder to give young patients a chance at being off medication in a monitored situation, meanwhile teaching the individual some tools that will help them distinguish between delusions versus facts.  

At eighteen I went off medication against medical advice and asked my psychiatrist if I could still meet with him. He refused, saying that if I wasn't going to cooperate, there was no point in seeing him. I left. I worked for a year, polishing supermarket floors, and made ten thousand dollars in 1983, which back then wasn't bad for a nineteen year old. 

I became ill a few months following a terrifying, life-threatening situation at work, in which two armed robbers came out of hiding when I was the only other person in the store (that I was assigned to clean that night).  

Had that life threatening situation not happened, I might've been able to fend off the delusions, or might have had the presence of mind to get on a low dosage of medication--I don't know. I was starting to have delusions before the robbery incident took place. After the incident happened, it accelerated my deterioration.  

Up to the point where I was totally nonfunctional due to relapsing, I continued to work. If I had it to do over again, I would have immediately resigned after the robbery incident, and would have returned to treatment.  

My points are, if you need to be medicated to control a serious mental illness, then by all means, you need to cooperate with treatment. However, while you are doing that, in society as it currently is, there may be very few ways of living a gratifying existence. And those in charge of treating us need to realize this. If they do not, a segment of the human population goes to waste, and many of us have a lot of potential.  

Some hope of a better life needs to be provided for persons with psychiatric disabilities. In the absence of that, there is no way, in reality, that we can gain a good and lasting recovery. Hope is intertwined with the ability to coexist with these illnesses.