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Bipolar blogger Natasha Tracy offers exclusive insight into the world of bipolar disorder.

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Can Treatment Noncompliance be Good?

Explore both sides of the argument regarding following your doctor's orders to a T.

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Medication, or treatment, noncompliance is basically not doing what you’re supposed to do. So the classic example is spontaneously going off your medication. Doctors don’t like this, and for good reason—it’s dangerous. Being a noncompliant patient can put you at risk for all sorts of things, up to, and including, death.A man is confused about his bipolar treatment

However, sometime noncompliance actually makes sense because when it comes to knowing yourself, you are the expert and not your doctor.

Doctors are Wonderful. Doctors are Terrible.

In my position I hear a lot of stories about doctors, some of them wonderful, some of them less so. And sometimes I hear orders that doctors have given that are just plain terrible.

My favorite mistake that doctors make is taking patients off of medication cold turkey. And this seems to happen a lot. This mistake causes a lot of unnecessary pain. Sometimes I wonder if doctors forget that there’s a human at the end of that medication prescription.

Willful Noncompliance

So sometimes it makes sense not to take your doctor’s advice. When your mind is screaming that something is wrong, it very well may be and it pays to listen to that voice in your head.

An example: your doctor reduces your medication from 300 mg to 100 mg. This might be perfectly reasonable. You leave your doctor’s office, get up the next morning and reduce the medication as expected. After 3 days you find the withdrawal effects are so bad that you cannot take it.

Now, if I were talking to you, I would tell you to get an emergency appointment with your doctor and discuss it with him. However, this isn’t always possible. So you might resume the 300 mg dose until you next see your doctor and can discuss it.

In other words, you would be treatment noncompliant. But I would argue that in this case your noncompliance makes sense.

Avoiding Treatment Noncompliance

In the end, treatment noncompliance really isn’t good because it means you’re making medical decisions without all the information. You’re guessing as to what the next right step should be even though you don’t have a medical degree. This isn’t smart. Doctors went to school for over a decade for a reason—you didn’t.

So, how to avoid this situation? Two ways:

  1. Understand your doctor’s reasoning
  2. Make a plan B

First off, ask questions about why your doctor is making the treatment decisions he’s making.

For example, some medications can be gotten off of cold turkey (really) but they are the exception and not the rule. You might be on one though and if you ask your doctor about it, they can explain that to you.
If you’re feeling that something just isn’t right about the treatment recommendation, then ask! They are there to supply you with information.

In the end, you should always agree with the recommendation before you leave their office. If they can’t convince you it’s the right thing to do then you might want to consider a different plan.

Secondly, make a plan B. So if you’re increasing your medication by 100 mg but you’re worried about increased anxiety side effects, ask what you should do if that happens. Think about this ahead of time and not when you’re too frightened to use the phone. Should you remove the increase? Increase more slowly? Use a drug to handle the anxiety? Wait it out? What is the plan B if something else goes wrong? A predetermined plan B is much better than the default of simply getting an emergency appointment with your doctor.

In the End

In the end, you are the one doing the treatment and you are the one that has to live with the results. This means you should be more motivated than anyone to understand, plan and take action when necessary.

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About the Author

Natasha Tracy is an award-winning writer who specializes in writing about bipolar disorder.

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