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ON MENTAL ILLNESS: Why Psychiatric Noncompliance is Such a Big Problem

Jack Bragen
Thursday February 21, 2019 - 05:06:00 PM

In 1982-83, I was a young adult, and I had newly been diagnosed with Schizophrenia, Paranoid-type. I didn't agree with the diagnosis, and I believed that I had created the illness on my own, through mishandling of my thinking. And I also believed there were additional reasons that I became ill. I didn't buy the assertion that something was wrong with my brain. I thought that I'd mal-programmed myself. 

Soon after being released from an inpatient psych ward, I obtained employment with a janitorial service, with part-time hours at first. 

My job was torture. I was making myself function in the job in the presence of severe depression and medication side-effects. It was difficult to do any kind of physical work, because the medication side-effects impaired my ability to work. 

I decided to go off medication. I concealed this at first. Then, I was found out. I went in to see my psychiatrist, and I told him, or he'd found out that I wasn't taking my medication. I asked him if he could still work with me to keep me monitored. His response was that if I wasn't going to cooperate with doctor's orders, he was unable to do anything for me. 

I continued to work, and I asked the company's co-owner if I could get more hours. I obtained full-time hours and I began to save up money. Several months later, I had about eighteen hundred dollars saved. In 1983, this was a decent amount. 

I moved from my parents' house into a share rental. I continued to work. I studied various kinds of meditation. I was utilizing meditation techniques while working. 

However, as months went by, my delusions began to increase. I'd been able to shut off some of the delusions, but not to a good enough extent. 

I became ill and nonfunctional in January of 1984. I was 5150'd at a gas station. 

People sometimes become noncompliant due to effects of the medication that make it more difficult to function at numerous things, including work. Medication also can cause depression and can also cause "Parkinsonian" side effects. Medication although it treats parts of the symptoms of schizophrenia, also introduces a lot of suffering, due to the side effects. 

Additionally, by taking medication, a person is acknowledging that he or she has a problem. For this reason, taking medication in many instances can be considered a courageous action. 

People may stop medications "AMA" (against medical advice) because they are unable to face the concept of having a mental illness that requires treatment. There is no limit to the number of alternative explanations as to why we became ill. I've met people who believed that it was merely because they took a street drug, and that she or he will be fine if they just don't take the street drugs any more. Others could continue to be delusional and could have delusions to explain what happened. 

In one hospitalization, a fellow patient piled objects on his bed under a blanket to make it look like he was asleep in bed. He'd escaped. 

In order to become "compliant" with medication, we must become clear in thinking enough to understand what happened to us and why. If we never make enough contact with what most people would consider reality, we may never reach the insight that is needed. 

There is a lot of stick and not a lot of carrot for the person who faces what could be a lifetime of being mentally ill. 

We may be unemployable. (But we aren't necessarily unemployable, and I encourage school, training and/or work attempts.) We may not be able to go out on a date with the person with whom we are enamored. (Yet, we could find a meaningful relationship at some point in our lives, and/or we may have to deal with that issue in therapy.) 

The points are: A, we may have to acknowledge we have an underlying brain condition that affects consciousness and that must be treated with medicine; B, we may have to tolerate the suffering of taking medication; C, we should not give up on making decent lives for ourselves. 

The outcome of accepting treatment for a mental illness diagnosis isn't most people's idea of a fabulous life. This is something that is very hard to accept. People in mainstream society and/or treatment practitioners do not give us enough credit or enough leeway, and just assume that we ought to take what is handed to us and not question it. Human beings don't function that way. Of course, if we've been told we are going to live as a mentally ill person, it is going to be very hard to take. 

The choice of voluntary compliance with taking psychiatric medication entails sacrifices. Physical comfort and emotional comfort are sacrificed. The capacity to perform at numerous jobs is sacrificed. The self-concept that we are "normal" is sacrificed. The prospect of being treated by others as a normal and/or competent person may be sacrificed, replaced with people assuming we are "depraved, threatening" mentally ill people. 

Society's provisions for people diagnosed with mental illness, with or without voluntary compliance, are measly and unsavory provisions. 

Thus, there are numerous reasons that a person diagnosed with mental illness and expected to take medication, and additionally expected to participate in outpatient institutionalization, would want to deny this role in life. Society can address this by making conditions better for people with mental illness, and by ceasing bigotry toward us, and accepting us as valid human beings. Doing that could make the pills a lot easier to swallow.