“Why won’t you just take your medication? I take pills for my cholesterol every night and its no big deal?”
“Every psychiatrist we’ve seen has said you have a mental illness. Why won’t you accept it? Why would the doctors tell you that you’re sick, if it weren’t true?”
“Let’s look at when you were doing well and when you got into trouble. What was the difference? Medication. It was the difference. When you were on your meds, you were fine. And when you weren’t, you got into trouble. Can’t you see that?”
These quotes may sound familiar to you if you are a parent and have a a son or daughter with a severe mental illness. I’ve said everyone of them to my son, Mike.
It often is frustrating for us – parents — to understand why our children will not take anti-psychotic medication or take it only until they get better and then stop. The remedy seems so clear-cut to us, so simple - and watching them experience the mania, depression, and delusions that happen when they become psychotic is heartbreaking and horrific.
Early on, I tried every trick out there to get Mike to take his pills. Those of you who have read my book know that during one of his first breakdowns, I crushed his pills and mixed them into his breakfast cereal only to be caught by him. I snuck into his room and counted his pills too one day and when I discovered that he had stopped taking them, I followed the advice of a therapist who had told me that I needed to practice “tough love.” I told Mike that if he didn’t take his medication, he had to move out of my house. He did – that very same day.
Another time, I offered to pay him to take his medication — a $1 per pill.
It was my friend, Xavier Amador, author of the book, “I’m Not Sick, I Don’t Need Help” who finally convinced me to back off. “I can promise you, Pete,” he said, “your son knows exactly how you feel about medication. You don’t need to ever mention it to him again.”
And since that day, I haven’t. Not a word.
So why do persons with mental illnesses refuse to take their medication or stop taking them as soon as they become stable?
I am asked that question more than any other after I give a speech.
Let’s skip the obvious reasons –that some anti-psychotic medications can dull a person, make them feel physically lousy, kill their sex drive, cause them to gain weight or send them to bed exhausted even though they are already sleeping for 16 hours a day. Let’s ignore the fact that no one really knows the long term health impact that medication can cause on a person’s body.
Instead, let’s dig deeper.
One day, I asked Mike to explain to me in writing why he had struggled so much when it came to taking his medication.
Denial was a strong factor in my understanding and even when evidence of my own madness would be presented, my mind would find a way to weave out of the circumstance and an obtuse reasoning would somehow form that would keep my own pride intact. Always two steps ahead of the truth, my brain would tapdance its way into a room where I was not at fault, where it was everybody else versus me, where I was some sort of prophet or special medium who was undergoing visions, not hallucinations, and I was important, not a victim.
It is very hard to understand that one’s own credibility is broken. There is a lot of personal shame one undergoes when they realize that they are no longer in line with society’s understanding of sane. It makes one doubt one’s own instincts and second guess the movements and decisions that one makes. Suddenly, the veil of confidence and ability has been lifted and one is a wreck, struggling to piece together the remnants of what are left of one’s self image.
I learn a lot from my son. One lesson he has taught me is that taking anti-psychotic medication is much more complicated than being told by your doctor that you have high cholesterol.