To think the mentally ill have a personal responsibility to take their medication?

[ABD091G6]

For the umpteenth time a close relative has stopped taking their medication, a choice they made whilst medicated and stable, and now we're all dealing with the fallout from that and treading on egg shells waiting for the malicious phone calls and harassment to start

If somebody relies on antipsychotics and mood stabilizers to be stable and able to function, they have a personal responsibility to remain medicated.

AIBU to think that they are expected to take responsibility for themselves.

@ABD091G6

Mental ill health aside they are a highly intelligent person. They certainly don't lack capacity when medicated, only when in the thick of a relapse.

Excuse the pronouns I'm being vague to avoid being recognised as I have friends who use this forum.

You're just not getting it.

I have sympathy for you on an individual level OP. It's never easy or straightforward coping with the effects of someone who is in the grip of an episode.

Having said that, if your relative is not subject to a CTO, then there's no obligation for them to continue to take their meds. I encounter hundreds of psychiatrists in my line of work, and sadly 'past behaviour as an indicator of future behaviour' is a mantra far too many of them adhere to in an absolute sense.

What's not commonly understood is just how awful some psychiatric drugs can be for the individual. Many of them are toxic, cause unavoidable massive weight gain, result in lethargy, loss of libido, disassociation, can cause involuntary movements and spasms, so on and so on. It's hardly a wonder a lot of people are desperate to stop taking them, and enormously frustrating to come up against entrenched and unhelpful doctors. That's before we even get to the stigmatisation and self-stigmatisation a lifelong diagnosis and medication can cause.

I know people who have been parked on Chlorpromazine for decades. It causes so many side-effects that most people on it have to take a cocktail of other medications just to control them. It can make people completely and utterly dysfunctional to the point whereby they have no quality of life whatsoever. So they decide they'd like to wean themselves off it, perhaps try an alternative antipsychotic, but lo and behold, they're met with a wall of 'we know it stops you having episodes, it's hellish to come off, better just to stay on it' from the doctors charged with their care.

So again, while I have sympathy for you having to deal with the unfortunate consequences, I really can't blame anyone for deciding they want to be free of psychiatric drugs. For a lot of people a diagnosis is difficult enough to come to terms with because of the labelling, stigma, and being immersed into a system that is both intransigent yet almost impossible to extricate yourself from. Then you have someone telling you 'you are unwell, you are never going to be well again, therefore you must take this toxic substance that just substitutes one load of symptoms for another'.

You have to question for whose benefit the drugs are prescribed.

@toolazytothinkofausername

Oh do F off.

OP, I know this isn't your AIBU but I wanted to say that it is not unreasonable for you to no longer have contact with this person. While they are not under an obligation to take their medication, you are also not under an obligation to be there to pick up the pieces after they relapse. I know you say that your DM is heavily involved with them so I understand that NC may not be an option for you, but I just wanted to let you know that there are those of us who understand how difficult these sorts of situations are and how awfully it can affect one's own mental health. I sympathise greatly.

YANBU if they have capacity to understand their illness and the consequences of not taking their meds

But I do sympathise with people who hate the idea of being permanently medicated. I’ve been on ADs for most of my adult life and I’ve long since accepted that I always will be. But in my early twenties I did try stopping them and ended up unwell, though never a danger to myself or anyone else. I know it’s no different to people taking other long term medication but I think there’s still more social stigma around Medication for mental illness.

As someone who suffers from bipolar disorder I can only speak from my own personal experience.

I’ve stopped meds in the past when stable because my brain (and from my experience, others with bipolar tend to do similar) starts thinking to itself that I am cured or that I must have been pretending to be unwell (such is the stigma of mental health, being told it’s attention seeking, symptoms being minimised by others and mental health professionals included etc) so I don’t need the medication. Most antipsychotics have shit side effects, including massive weight gain which in itself is a trigger for some people’s mental health. I came off my meds a couple of summers ago even though my logical brain knew it was a bad idea but another part of me was sick of being so fat. So I stopped and promptly lost almost a stone without even trying, but in the 3/4 weeks I was off the meds, I didn’t sleep and my mood took a deep dive into depression so I had to go back on them. I’m also worried about the effects of this tablet as it can cause an irreversible type of brain damage.

It is a person’s responsibility to take their medication and comply with treatment but there is also complexities in it. It’s not just as simple as taking them and if you don’t suffer from mental illness then it’s not really up to you to comment. It’s hard to deal with someone who is ill but unless you’ve been there yourself, you can’t know how it feels or what the persons brain is telling them.

It’s hard to think that you’ll need to be on such horrible pills for the rest of your life, I would love to be med free but at the moment my brain knows I need it to function but it might not always see it this way.

I’m also a mental health support worker and I support people who know they need to take their meds (because I tell them to) but since they are ill, sometimes they don’t comply. Some hear voices telling them it’s poison, some enjoy the mania missing a dose causes because they’re sick of being so sad all the time, others don’t believe they’re ill at all and are being forced to do something they don’t agree with. It’s much more nuanced than just it’s “their responsibility”.

It's very common in those with a sever and enduring MH diagnosis to stop taking antipsychotics whilst well. Unfortunately, whilst well they may still lack insight into the diagnosis, believe the diagnosis is wrong or a mis-diagnosis, thus stop the meds. You can call the crisis team expressing your concerns, the team can make arrangements for a home visit and encourage compliance with meds. Also, if the team has concerns regarding a deterioration in the person's mental state, they can visit/telephone daily and refer for a MH Act assessment if necessary.

Unfortunately, the person you are talking about seems to lack the ability to take that personal responsibility, if that's what you think it is. Whether that's their fault or not is moot. But what would the alternative be? Or what sanction should there be?

Whether it's a moral failing or part of the illness makes no difference in the end. It's incredibly frustrating, I understand, but all you can do is be responsible for your own actions.

YABVU.

It's totally up to a person if they take meds regardless on how it affects others. We can't mould people into what we view as being an 'acceptable' person.

Totally understand that it is difficult for you, but if they choose to not take meds you also have the choice to not have them around or in your life if they are too much for you, although this is harsh!

@ABD091G6

For the umpteenth time a close relative has stopped taking their medication, a choice they made whilst medicated and stable, and now we're all dealing with the fallout from that and treading on egg shells waiting for the malicious phone calls and harassment to start

If somebody relies on antipsychotics and mood stabilizers to be stable and able to function, they have a personal responsibility to remain medicated.

AIBU to think that they are expected to take responsibility for themselves.

Are you talking about "mentally ill people" or your relative in particular?

To be honest, it doesn't matter, because in either case your view is unreasonable. Psychiatric patients are some of the most derogated and neglected members of society and we should also remember that they almost always a) live with significant suffering and b) have experienced profound trauma. We (society at large) interpret their difficulties as global traits (a "mental illness" that they unambiguously "have") rather than reactions to life experiences and circumstances, and by framing their problems as defects in the genes or brain architecture or brain chemistry we deminish our own (societal) responsibility to have care and compassion for people who are vulnerable, and instead we are able to delegate responsibility for managing/controlling those people to a) medication; b) the law; c) the psychiatric institution; d) "the mentally ill". This assumes these four areas are effective and very often they are not.

This construction , despite being faulty, allows us to maintain the notion that people suffering with mental health problems, or experiencing mental health symptoms that make them behave strangely, have enough individual agency and responsibility to manage themselves /while at the same time/ we use other mechanisms (the law, psychiatry, medication in combination: community treatment orders; confinement to prison; forced medication; sectioning) to control them, too.

Try being a bit kinder. Even for your relative, where the situation is obviously going to be a bit more close to home/raw/personal, you know they're probably not being this way because they're having fun, right? Like, if they had the option wouldn't they choose to have a life without the kinds of suffering and scary/concerning/difficult experiences they have? Put yourself in their shoes. You can set boundaries, but I don't see why you're choosing to be so denigrating towards people who are having an OBVIOUSLY difficult time.

Yes, everyone should take responsibility for their health, as far as they are able to, especially when a failure to do so impacts other people.

Not sure how that helps though if they don't.

I guess it's the old advice to understand what you can and can't control. You can't make your relative take responsibility and take their medication.

You can probably set some boundaries about how far you will allow that to impact you. And the same for your mother.

@XDownwiththissortofthingX

What you have written (much more articulately than I have) is completely spot on. I’ve been under the CMHT for well over a decade and I’ve never been offered any talking therapies, counselling or alternative treatments, just always different pills or cocktails of pills. And I’ve been misdiagnosed on purpose in the past, to try to discharge me from the service as they are so overwhelmed. I know my stuff though and was able to advocate for myself but there are many people who can’t and just fall through the cracks.

I feel unless you have personal experience of either being mentally unwell or coming into contact with mental health professionals then you really have no business commenting on such things. I’m struggling today with articulating what I want to say in a clear manner as I can’t think of the right words. This is another lovely side effect of my medication. And it’s not very helpful when I have 4 assignments to do for my degree at the moment in time 🙈

my cousin had schizophrenia was on meds always got better then thought i dont need these anymore and stopped taking them

which led to psychotic dangeous episodes -her parents got her sectioned in the end she thanked them afterwards

would you mum consider that at all if they got bad

Try being a bit kinder.

I think that could work towards the OP as well. Put yourself in the OP's shoes. Nobody looks forward to malicious phone calls or harassment, but it's perfectly possible to feel sympathy and kindness for the person doing it while wishing to hell it would stop.

Our society puts a lot of importance ( and rightly so) on personal control over what goes into our bodies ( informed consent to medical procedures, abortion rights and taken to the full extent this includes rape laws). I hope you get support and protection for those who need it. It must be very difficult I can fully understand it must be so scary, frustrating, worrying.

Just to add, while not minimising the difficulties faced by the person with the illness, I don't think the OP is unreasonable to want her relative to take action to prevent a situation where OPs mother barricades herself in her room in fear.

It is not unreasonable to expect her mother to be free from fear in her own home, and OP believes the medication would enable that.

It really isn't as simple as that OP. Some people don't know or feel that they're mentally unwell.

But having been on the receiving end of a relative who could 'hear family voices whispering about him' day and night' resulting in him banging on our doors effing and blinding whilst armed with a hammer (terrifying for us, and neighbours too), I get where you're coming from.

It is hard work caring for someone who puts your loved one at risk. Having a lot of experience of this on mine and DHs family it has been one of the things that has always driven me to engage in my own mental health treatment. I haven't been perfect, I've missed appointments, not replenished prescriptions etc, but when I didn't get it right I was letting my husband down as he ended up picking up the pieces. It was my responsibility to do the things I needed to do to stay well.

I don’t think you sound ignorant, I think you sound at the end of your tether and I totally get it. I’m in a similar position.

I have a close family member who has done this repeatedly for years and it’s exhausting having to deal with the fallout. People who aren’t in this situation just don’t understand it and think we’re being cold and uncaring when we talk about it and how much it disrupts our lives. My family member stopped taking medication and said they forgot to take it so was put on a depo monthly injection. They won’t do anything to help themselves and everyone has had enough. They’ve been given so many opportunities to help themselves and got a flat fully furnished, decorated but they stopped going for their monthly injection and back to square one. Lost the flat, sectioned and now living in care for years waiting to be given another flat. Social workers, support workers, mental health services are reaching the end of their resources.

Last time my family member stopped going for their medication they ended up attacking me in front of my 6 year old, tried to abduct my 6 year old and it took 4 police officers to control them. And all this could have been avoided had they just carried on taking their medication.

I can empathise on how hard it is to struggle with mental health but there’s only so much we can do if they’re not willing to help themselves.

I agree. But I also wouldn't under estimate how unbearable the side effects are.

Someone may appear stable from the outside, but be in the early stage of a mental health decline, at the point they stop taking their meds - you can't know completely their mental stability from the outside.

As well, I think you have to see that this is such a common pattern for many people who mental health needs, that it should be seen as part of the condition, rather than a personal failing on the part of the individual.

I realise this doesn't make it easier for and your relatives having to cope with your relative's actions, but seeing it as that person being irresponsible or wrong or bad, doesn't help you deal with it any better, doesn't help them and won't prevent it happening in the future.

I do think you're within your rights to withdraw from relationship with someone who is not taking their meds and aware it will leave you vulnerable to abuse.

As PPs have said, it's not that easy. I'm stable and 'better' on my medication, but I still have an illness that sometimes leads me to make stupid decisions or neglect myself, including stopping taking it. It's just lucky that the only person that suffers when I do that is me, unlike your relative.

Some of the side-effects of these medications are so terrible, including weight-gain. I know as well having had friends suffering with Schizophrenia, they had religious/conspiracy/persecution complex issues, which can prevent people taking medication.