The Emotional Challenges of Medication Compliance

I woke up medicated, in four-point restraints, in the quiet room of a private psychiatric hospital in 1995. 

At the moment I opened my eyes, I did not know that I had numerous pharmaceutical drugs flooding my system. I did know that I had just had a manic episode that lasted over two weeks. I did know that I had lost everything in my life that I loved. I did not even know I was in a hospital. 

I simply woke up on various medications, and my life was instantly tethered to my new pharmaceutical regimen. Dosages, blood levels, side effects: a new vernacular was introduced to my lived experience. 

I resented the medication. 

I resented the lack of choice. 

I did not understand what was happening or what was put inside me while I was knocked out in the restraints.

I did not want my diagnosis to be true, and being compliant to medications would be a full, visceral acceptance. 

As I started to cycle in and out of psychiatric facilities, my relationship with medication grew even more complicated. I was starting to lose more and more of my life, and the life I was returning to seemed hopeless. Painful. 

One day my therapist asked me why I was fighting my medications. 

 I asked her, “Why would I take these? Why suffer through the side effects for a life I do not want?” 

I felt like a half-man, being offered a half-life with half-dreams. How hard much would you sacrifice for a half-dream? 

But that conversation was a turning point. 

We discussed my emotional attachment to medication. How each swallow of a pill let me know I was different, broken, sick. That the pills tasted like the hospital.

My therapist and I began to work together. I was allowed the space to discuss my feelings. I was not threatened or cajoled but listened to and empathized with. 

After my last hospitalization caused by being non-compliant, I decided to look at medications on a day-to-day basis similar to my addiction recovery. I gave the medications time to work and educated myself on them. Slowly, year by year, my dosages were lowered and lowered as my treatment evolved. 

I have now been on a sub-clinical level for over five years. My team  and I have discussed going medication-free, and the idea terrifies me. I never knew it was an option, but, as my recovery evolves, we will work together to see what is possible and safe. 

My relationship with medication is intimate, volatile, freeing, and terrifying.  They have lived inside me like an internal lifejacket for a decade and a half. But the medications are no longer a punishment or visceral violation. They are part of my treatment but not all of it.

And it was in being encouraged by my treatment team to address my fears, angers, and biases against medication as I would address challenges in any other part of my life, that I was able to gain new insights and move forward.

For patients of yours who need medication at certain times in their treatment - how do you approach the introduction of medication? 

Do you have a specific discussion around the emotions attached to medication compliance?

Are the medications offered as a time-constrained intervention or are they offered as “forever”? 

Do you have examples of working together with your client to allow them some shared decision-making? 

With other diseases/disorders, people are encouraged to get second opinions; - is that something behavioral patients are allowed in your experience?

Eric Arauz, MLER, is an international behavior health consumer advocate, trainer, and inspirational keynote speaker. He is a faculty member at the Rutgers-Robert Wood Johnson Medical School Department of Psychiatry, the Vice-Chairman of the current New Jersey Task Force on Opiate Addiction in citizens 18 to 25 years old, and a person with the lived experience of bipolar I disorder, PTSD, addiction, and suicidality. He is the SAMHSA 2012 "Voice Award" Fellow and the author of An American's Resurrection: My Pilgrimage from Child Abuse and Mental Illness to Salvation. 

The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors.