Psychiatrists Assume Medication Noncompliance

memo book kept of mental illness

This post is another one of my Recollections posts where I am trying to catch up the story of my son’s schizoaffective disorder from summer 2007.

After my son, DS, got out of the hospital for the first time (June 2007) it became apparent pretty quickly that in many respects he was just as delusional as he was when he was in the hospital.

From my notes in my little red memo book (pictured), here is a sampling of what I was hearing from him all the time:

He suspects alcohol or drugs in the household water. He knows people who are not in his family are here in the house pulling pranks or putting alchohol in the water. He was washing his sheets everyday because someone is putting something in them, like drugs. He takes his sheets with him when we leave the house to go to therapy. He thinks someone shot a paintball at our window because there is a small speck of dirt there. One time when he took his medicine he said they dissolved instantly in his mouth, and he felt immediately worse. A gang is swapping his pills for poison. He left a note for the family that some cups are “dangerously laced – drink at risk to health and state of mind.” He said someone was playing pranks on him, contaminating the bathroom with some unnamed substance, as he cleaned some surfaces in the bathroom over and over, something he usually never did. (Too bad he never did a thorough job of it.) He announced that he was certain someone has been tampering with his income tax returns in his file drawer, although he had not looked at them yet.

That’s just a small sampling. I will write some more in some later posts.

I was very distressed, and on top of it all, he was often cranky with me and his five-year sister and two-year old brother. Sometimes I would call it downright verbally abusive.

I felt we needed help right away, and we could not wait for the intake appointment with Highland Rivers in Canton, Georgia, that was two weeks after his discharge. I thought I wanted to have DS’s follow-up care with them because the social worker at the hospital said they could offer therapy and possibly other help. We went there for an emergency appointment. When we got in a room with a therapist, after doing some preliminary paperwork, we were told their psychiatrists were too busy. It might take three days for one to get back to us. I did something I hate to do in front of strangers. I cried. The therapist suggested I needed a support group. That made me bristle. The real need here was help for my son.

I called the psychiatrist DS had before he went in the hospital, Dr. DB. He was more willing to help. He first assumed that DS might not be taking his medicine. Since I trusted DS to take his medicine, and he was always very good about taking it before, I did not take charge of it after he got out of the hospital… although I thought of it. This is a word to the wise. When there is a severely mentally ill person in the household, a non-mentally ill person should take charge of the medicine. Dr. DB wanted to wait a few days while we made sure DS was on his medication.

Explore posts in the same categories: Medications, Mental Illness, People Who Help, Recollections

6 Comments on “Psychiatrists Assume Medication Noncompliance”

  1. Alex Sicre Says:

    Mental Hero, that is a very troubling and scary story. It is always sad when someone you love suffers with such a disabling illness that can be treated with medication and therapy. Your son is not alone with his medication non-adherence. 50% of patients on medication do not take them properly. The non-adherent numbers go up for patients with a mental illness to 64% for schizophrenia and bipolar.

    As a caregiver, you might not always remember your son’s medications, and sometimes your own health can suffer as a result of your caregiving. Intelecare offers a medical reminder platform that helps patients and caregivers remember their daily medications, prescription refills, doctor’s appointments and vital sign monitoring. Our reminders are delivered via email, text and voice messaging, adapting to your lifestyle, whenever you need them. I encourage you to visit our website, http://www.intelecare.com, to sign up for our free reminders for you and your son. I wish you good luck with your medication adherence, and best to your family over the holidays.

  2. Hero Says:

    Sorry, Alex, you missed the point of my story. My son was NOT noncompliant. The psychiatrist only assumed so. I guess I really did not finish the story yet. I was able to count his pills, and the right number was missing. It became a question of whether he was being deceptive about taking his medication, especially when he was doubting its safety. Reminders alone are not particularly helpful in this case. I had to take possession of his medication and dole out the dosages to him at the appointed times, watching him swallow. I believe you are probably right about the 64% statistic for schizophrenics. Many doubt the need for medication because they do not believe they are ill at all. Some medication has unbearable side affects for the patient, and that makes it hard to be compliant.

    Perhaps your service will be helpful to some of my readers for whom it may apply.

  3. Jason Wilson Says:

    Hero,

    I know DS has been put on a few different medications for his psychotic symptoms and I’m only starting to read your blog so I don’t know what he’s on now but you may want to look into having his antipsychotic injected assuming there’s an injectable form of his particular medication. I myself take Risperdal Consta injections every two weeks and not only does it ensure that I comply with my medication regimen, but it also helps keep my levels of the medication at an even, consistent level thereby reducing the likelihood of symptoms reoccurring. One other benefit to the injections is that some of the side effects such as weight gain (something I’ve really struggled with) are reduced significantly.

    Just a suggestion. Good luck to both you and DS’ on his journey to recovery.

    Jason

  4. Hero Says:

    Thanks, Jason. One time DS was prescribed Risperdal Consta injections and I was beginning the struggle to get Medicaid to pay for it when the doctor made a change. Also DS has lost thirty pounds or so this year since he has been ill, so fortunately weight gain is not a concern at this time. His weight is normal now.

  5. Mental Hero » Blog Archive » Uncomfortable Memories of Dealing with Severe Mental Illness Says:

    […] Hero » Blog Archive » A Diagnosis By Any Other Name… on Onset of IllnessHero on Psychiatrists Assume Medication NoncomplianceJason Wilson on Psychiatrists Assume Medication […]

  6. Motu Says:

    Hey.I’m a 100% non synthetically-medicated psthcoyic kid. Diagnosed schizophrenic and have very serious positive symptoms and equally horrible negative symptoms. Here is what I do to keep on top of the depression that is one of my negative symptoms.1) Omega 3 Fish Oil. You may have to buy a brand manufactured for kids because adult brands don’t tend to be filtered for mercury and you DEFINITELY want a mercury-free product. 2) Multi-vitamins. Take something with a very high iron, vitamin D and magnesium.3) Exercise. If you’re overweight, a healthier bodyweight will help you out. If you’re not, exercise will still release endorphins. Personally when I’m at my worst I do yoga from flashcards, (this is when I cannot leave the house) boxing, and jumping jacks while a music channel (usually rock but I figure anything with a good beat that you like listening to when you’re happy will work) is on. I also go running, when I’m not as bad, usually in a forest on warm days or at a beach on cold days, somewhere where I’ll be alone with nature and my ipod. 4) Music. I mentioned the music channel & ipod above, but I also blare Queen, Bowling for Soup, Blink-182 and the All-American Rejects (aka nobody who sings about death, depression, suicide, sadness, or has a downbeat – less than 4/4 – track) and I HATE IT. It makes me MAD and MAD is better than depressed. It is more productive. ;]5) I force myself to do things I enjoy when I’m happy. I take a shower with the nice smelling soap and warm my towels on the radiator, I watch the funny episodes of Firefly and my favourite films and read magazines and This Book Will Save Your Life (A.M Homes – it’s my favourite book). And if that sucks, I do the laundry and hoover. For me what works is just keeping moving. Then even if my whole day sucks and I can’t bear it, the next day I can wake up to something good I’ve done and maybe feel better for it – or I have fond memories of my favourite movie etc.6) My favourite one – I read a book I’ve written. It’s a big old book that I bought ages ago and when I’m happy, I write things I like in the book. Stupid stuff like, Xander from Buffy, and the sound from line arrays, and Diamond 4’s, and sherbert lemons, and Harry Potter 1, and Gandhi quotes, things that have no consequence. If I’m only mildly down, it can get me back up.7) Meditation. Just sit quietly and concentrate on not concentrating on anything. If that makes sense. Don’t allow yourself to have thoughts. Let your only thought be the thought that stops you thinking about anything. It sounds complex but you probably get my meaning. I like to meditate either in the dark in my room but the sunlight is good for depression so I force myself to sit in the middle of the living room with all the shades open in the sunlight. Therapy. Not from a councillor – from a psychologist, in particular a psychologist who is a qualified Cognitive Behavioural Therapist – these people are like GOLDDUST. They will teach you how to get through your worst moments and help you tailor your recovery techniques to your own personality. Plus, they’re also usually really cool not-up-themselves people. Interview a few different psych’s if you can, and if they’re in an office and wearing a suit, don’t bother. Find someone who wears jeans and listens to the music you like and likes the TV shows you like, so you geniunely like their company and that way, you’ll get a lot more out of your time with them – it’ll be more friendly and less clinical. And that in itself will lift your mood.Please bear in mind that the most important thing to have to get over depression without meds is psychological resilience. You need to be the type of depressed person who says, this sucks, but I WILL GET THROUGH THIS. I WILL NOT GIVE UP.. I WILL FORCE MYSELF THROUGH THIS. If you’re prone to giving up (I am not saying this is something to be ashamed of, it’s just something to be honest about – I understand fully that being a can’t-be-f*cking-bothered/don’t-want-to-can’t-make-me depressive is horrific and not something the depressive can help) you may have to come to terms with the fact that you may need a low dosage of meds (Citalopram is good in low doses) to get you through, and you may have to rely more heavily on therapy. Either way, get a CBT and remember you are not alone, and you should never give up on yourself.’When all you’ve got to keep is strong, move along. And even when your hope is gone, move along.’Good luck. Was this answer helpful?

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