Thoughtful Insight, Not Lack of It, Drives Some Patients to Quit Psychiatric Medications

Rob Wipond
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Rather than a “lack of insight,” it is actually a thoughtful weighing of complex risks and benefits that ultimately drives some people diagnosed with bipolar disorder to eschew psychiatric medications, according to a qualitative study in the Journal of Affective Disorders. And these people often develop sophisticated strategies in their efforts to manage without medications.

Three UK-based researchers conducted in-depth interviews of ten people diagnosed with bipolar disorder who were not taking psychiatric medications and were satisfied with their decisions, and then analyzed their responses using grounded theory.

“When asked about their reasons for stopping medication, all participants cited side effects as a major concern, describing distress resulting from problems including weight gain, tremors, loss of libido and lithium toxicity,” reported medwireNews. “Participants also frequently described side effects changing their view of themselves in ways they found undesirable.”

The participants “were generally very aware of their moods,” sought feedback from friends, and continually evaluated their condition and decisions. They also “used a wide range of strategies to manage their moods, including nutrition, self-discipline and channelling their energy into something positive,” reported medwireNews. Other strategies included using essential oils, cognitive techniques, exercise and creative pursuits.

The researchers described their study as the first systematic assessment of reasons for medication non-adherence in people diagnosed with bipolar disorder, and indicated that their findings were a fundamental challenge to a common belief that medication non-adherence is driven by “a lack of insight.”

“The complexity of the processes described by participants suggests that traditional models of explaining non-adherence may over-simplify some individuals’ experiences,” concluded the researchers. “Future research could focus on identifying factors predictive of successful attempts to manage moods without medication. Professionals should place more emphasis on non-medication approaches in order to increase engagement with people who do not use medication. This may involve focussing on individual׳s longer-term goals rather than on modifying moods in shorter-term.”

Non-use of bipolar medication typically follows careful ‘risk–benefit’ evaluation (medwireNews, December 11, 2014)

(Abstract) Managing bipolar moods without medication: A qualitative investigation (Cappleman, Reed et al. Published Online ahead of print December 05, 2014. DOI: http://dx.doi.org/10.1016/j.jad.2014.11.055)

14 COMMENTS

  1. Amazing to see something like this in a professional journal. I myself, because I was locked up so long ago, just missed being drugged, which would have meant I would not be alive now. But I have been tremendously impressed by the people I have met who have been able to get off psych drugs. It takes real strength of character to do that.

    And much of the time, people like that get little or no help in doing it. I think our movement should be demanding that that help be provided. We owe that to our brothers and sisters who have to go through the agonizing process of drug withdrawal.

  2. “Lack of insight” – that would be an affliction of most of the psychiatric profession.

    35 drugs, 25 rounds of forced ECT – all within 8 months. Why? An adverse reaction to a benzodiazepine taken at a time of great stress. A prescribing cascade followed and a diagnosis of dementia. 7 psychiatrists refused to see me. Tapered off on my own. It was hell. Ten years later obviously still alive and not taking pharmaceuticals, not in an institution, not receiving weekly maintenance ECT – as was prescribed and predicted for me. “Lack of insight’ indeed.

    We can demand help for drug withdrawal – but who’s going to provide it?

  3. I have known and met a great number of people who have recovered from “mental illness”. Every single one was “non-compliant” with psychiatric medications. I have never meet anyone who once had a serious diagnosis and who then attained a complete, drug-free recovery through compliance with psychiatric drug treatment.

    • “‘Lack of insight’ – that would be an affliction of most of the psychiatric profession,” I agree with you, amnesia.

      Subvet416,

      Nice to meet you, I was misdiagnosed as “bipolar,” but was actually a “compliant” patient, who was eventually (twice) weaned off drugs by psychiatrists.

      I must confess, however, I learned quickly to stop telling the 1st psychiatrist how sick his drugs were making me, and instead encouraged him (“if you think it’d be a good idea”) to wean me off the meds. But the bipolar drugs do cause super sensitivity manic psychosis, even when weaned off “properly.”

      By the time I dealt with the 2nd psychiatrist who “properly” weaned me off meds, I’d already been handed over some, picked up more, and read most my family’s medical records. That psychiatrist weaned me off the meds out of embarrassment, after I told him my oral surgeon had confessed to me that “antipsychotics don’t cure concerns of child abuse,” and I had evidence of such in my child’s medical records, plus medical evidence I’d been initially misdiagnosed based upon lies from the alleged child molesters.

      I’ve been completely drug free for 7 years now. Does that count as “drug-free recovery through compliance with psychiatric drug treatment?” Irregardless, I’m quite certain is proves “lack of insight,” or criminal behavior, on the part of psychiatrists.

  4. It is pretty astounding to see this research in a professional journal. I will definitely be referring to it in the future, because this is what I’ve observed over and over again. People stop taking the drugs either because they don’t work or because the side effects are intolerable, or both. It also affects the way people think about themselves, and many feel they are better off finding a way without the drugs because these other approaches are sustainable and self-determined, rather than relying on an external force to alter their moods. Very few don’t feel they are suffering or believe there is no issue to be addressed. The “lack of insight” explanation needs to go on the trash heap of self-serving theories that don’t bear much if any relationship to reality.

    —- Steve

    • “Very few don’t feel they are suffering or believe there is no issue to be addressed. ”
      Then they are not sick. To be sick you have to be suffering or having a real medical problem not just being a pain in the ass for society. Psychiatry is social control not medicine.

  5. When I “became aware” of what psychiatric drugs were doing to me I went off them and the toxic side effects slowly went away. My behavior became more bizarre as the poly drugging intensified and my prescribing psychiatrist thought the craziness were all me, not the drugs.

    The benefits of being psych drug free are indescribably wonderful and so many people remarked about my clear thinking and calm demeanor. On psychiatric drugs I was UN-aware. Any”lack of insight” was due to poly drugging.

  6. Oh thank you so much for acknowledging the obvious. Now I’m waiting for an apology of your arrogant misinformed behaviour and human rights abuses (though I’m not holding my breath on that).

    Whenever I read about psychiatry discovering the most obvious thing on a planet as if they were having an Eureka moment I get a “bipolar disorder”: I want to cry and then laugh and end up hurting myself with a strong face-palm. And these people think they are smarter than anyone else…

  7. Hold on a minute here… how would psychiatrists know anything about what a “thoughtful insight” is? It is scientifically proven that psychiatry has never produced a “thoughtful insight” in all of it’s illustrious history of coercion, abuse and torture. And what on earth is the “Journal of Affective Disorders”? Is it not enough to have the devilish DSM-V? We need magazines and publications spinning off more falsehoods and lies? Slay the Dragon of Psychiatry.

  8. Fortunately, I was working with some remarkable men in weapons development when I was diagnosed with the then called “manic-depression”. An engineer saw me shaking one day and asked me what was going with me. I told him that I had a bio-chemical imbalance and was taking lithium, which made me shake. The engineer said that whoever prescribed me lithium had “his head up his ass” and that I should check the Toxic Substances Abstracts because any amount of lithium was toxic. This “heads up” from the engineer and the intolerable effects of lithium toxicity, motivated me to do my own”due diligence” about putting that element into my body.

    I learned that lithium is non-essential (no toxin is) and that is chemically similar to the essential element potassium, which is found in every cell of the body. Prior to lithium “therapy”, the psychiatrist’s drug of choice for those pesky symptoms now called bipolar disorder was potassium bromide. Potassium may be essential, but bromine is toxic and eventually all bromine-based medications, prescription and over-the-counter, were removed from the market by the FDA. Enter lithium carbonate. Lithium seemed to have the same mood-altering effects as potassium but without the toxicity of bromine. True, lithium itself is toxic but if “blood levels were carefully monitored, etc.” you know the rest.

    Something else I learned about from the remarkable nukes was tissue mineral analysis from a hair sample. Even back in the late 1970s, the National Labs were using hair analysis for security clearances and to detect toxic element poisoning in nuke industry workers. I had such a test performed on myself by Analytical Research Labs which had contracts with the National Labs and discovered that among several health issues, I had a severe potassium deficiency. In order to correct this deficiency, ARL prescribed me chelated potassium supplements as part of a comprehensive program . Chelated potassium contains the essential element bound up in a food protein, rather than compounded with toxic bromine.

    After following the orthomolecular program designed for me by ARL, I was able to successfully withdraw from all drugs prescribed by my psychiatrist and I have had no significant “mental health issues” while remaining drug-free since 1982.