Compliance. 

The days are flying by. It’s a good sign. My mood has been good. I’ve had a few days where I felt browned off but nothing serious. It didn’t last. It’s important to be able to distinguish between normal changes in mood from the pathological. It’s only when the changes persist that it becomes problematic. 

So things are good. I’ve had a long stretch of feeling well. Paradoxically, it can be a dangerous time. Doubt sets in. Do I have bipolar disorder anymore? Do I need to take my medication at all?

These may seem like ridiculous questions but the mind can play funny tricks on you when you’re feeling good. These doubts also arise in the early stages of hypomania when I feel energetic and full of adrenaline. It’s an addictive state. I don’t want it to end. But there is always a crash after a few weeks and the elation never lasts. The aftermath is never worth it. 

I have never stopped taking my medication. I accept that bipolar disorder is for life. Sometimes that is a bitter pill to swallow. But nonetheless, it is better to make peace with the fact that bipolar disorder is forever rather than fool myself that it will somehow resolve. 

I have seen the results of non-compliance over the years. On every admission to hospital I have met at least one patient who has become unstable and deteriorated because they stopped taking their tablets. They have the unenviable task of starting again from the beginning in an effort to regain stability. It seems like such a waste of time and unnecessary pain. 

I understand why some people do it. I can understand the appeal. Feeling good can be seductive. It’s easy to hope it will never end. But experience has taught me that another mood swing is just around the corner. But I know that medication will reduce the frequency and severity of these events. 

When I have prolonged periods of balanced mood, my psychiatrist will slightly reduce some of my medication but never do I stop completely. Usually, they will just be increased again next time I become unstable. My treatment is tailored to my needs but it is never ceased. 

Taking tablets is part of my daily life. Occasionally I resent it but mostly I recognise the improvements they have brought me. It’s not easy to be compliant all the time. Some of the drugs I take have side effects. Some side effects are obvious while others remain unseen. 

For example, I take Lithium. It gives me a tremor in my hands. It’s not very obvious but I’m conscious of it and it bothers me. Because I have Diabetes Insipidus, I need to pee hourly. It can be a pain on long journeys. And every three to six months I have blood tests to check on damage to my kidneys especially but also my thyroid gland. And that’s just one of the medication I take. 

But for all it’s disadvantages, Lithium has changed my life. I don’t think I would be here writing this blog without it. In short, the benefits far outweigh the side effects. 

So if you’re reading this and you suffer with mental illness, think twice before you stop your medication. Talk to your doctor about it and be sure that it is the right move for you. 

One of the things I have to do to keep well is to take a few pills. It’s easy and I’m going to keep doing it.