Medication is the first-line treatment for bipolar disorder. While there are some people who do not respond well or at all to medication, it is still the treatment that can best prevent relapse. Despite this, there are many people who refuse to take medication they are prescribed or do not take it as prescribed. There are several factors that influence this behavior. Recent research has found three factors that may lead to patients being more adherent to their treatment, mostly surrounding having social support.
Around 60% of people with bipolar disorder do not take their medications as prescribed. This number includes a range of adherence from people who don’t take their medication at all to people who just frequently forget to take it.
There are several factors that lead to non-adherence including:
- Poor insight into the state of their illness
- Concurrent substance use disorder
- Negative attitudes toward medication
- Medication side effects
- Lack of funds to pay for medication
New research from Mahmut Onur Karaytug of Islahiye State Hospital, Gaziantep, Turkey and their team looked at 85 people with bipolar disorder to find out what factors may influence them to take their medication as prescribed.
Following the interviews, they found that 70.6% of the participants were moderately or poorly adherent to their medication. Only 29.4% of participants had what was considered good adherence while 34.1% were moderately adherent and 36.5% were poorly adherent. They did not define specifically what these terms meant.
They found three factors that seemed to influence medication adherence in a positive way.
1 Social support
Social support is an important factor in the treatment of bipolar disorder. People who lack social support tend to have longer and more frequent episodes. The people in the study who had more social support were more likely to adhere to their medication regimen.
2 Being married
This is likely connected to the finding on social support. People who are married may have a built-in support system that educates themselves on the disorder and encourages the person with bipolar disorder to seek help, keep appointments and adhere to treatment.
3 Previous suicide attempt
This was a surprise finding for the researchers. They concluded that there may be multiple reasons people who had previously attempted suicide were more adherent to their medication. Reasons included being more aware of the severity of their disorder, being more closely monitored by clinicians and, again, having more social support.
Building social support with bipolar disorder can be difficult. You have to choose to inform friends, family and perhaps coworkers that you need support. When depressed it can be difficult to reach out to people and let them know you need support, so you’re relying on them to notice the signs and symptoms. Then you have to rely on people responding positively to the situation and providing the support needed.
If you know someone with bipolar disorder and are looking for ways to be more helpful and supportive, here are a few ways to help:
- Educate yourself on the disorder so you know what the person is going through.
- Be understanding of what the person is going through and encourage them.
- Be patient knowing coping with bipolar disorder is difficult. Episodes can last a long time and treatment can be slow to work.
- Encourage the person to seek help if they are not already seeing a psychiatrist and/or therapist.
Image credit: Brandon Lim