How to Convince Bipolar Teen to Take Meds
February 12, 2020 7:01 AM   Subscribe

Let’s say you’re a parent to a teen who is recently diagnosed as bipolar 2 and won’t consider meds. How do you convince her? Is it impossible? Do you have to wait for a(nother) crisis to hit and hope then she sees just how they’re needed? How do you manage BPD without meds? Is that even an option?
posted by anonymous to Health & Fitness (13 answers total) 1 user marked this as a favorite
What are the reasons for not taking them? The approach would be wildly different if e.g. they just "don't want to" versus "they make me feel weird". Age of the teen would also be a huge factor!
posted by london explorer girl at 7:08 AM on February 12 [3 favorites]

How old is the teen?
posted by chesty_a_arthur at 7:34 AM on February 12

One of the things I've heard about for situations like this and similar situations with adults is a therapeutic model called motivational interviewing which is a technique to talk to people about their lives, their desires and goals, reflect on their current life to identify feelings about change. You do this to help people move through stages of change to implement postive action on their life. You see this method used alot in addiction but imho it applies to lots of things.

It's a useful model I think for parents of teens in that it ultimately is self directed, the person reflects on their life, and decides to make their own changes. It has great example questions. This method requires alot of non judgemental listening and sitting back and letting people make their own decisions which for obvious reasons is hard.

But, ultimately you aren't a therapist you are a parent and this is a hard question. You'll never will be a professional source of help for your kids, you will be a parent. Getting professionals involved and support for yourself is important.

Some people don't ever take medication regularly. Some find medication intolerable for thousands of reasons and some of them are very legitimate ones. Some people learn skills to deal with their mental health without medication even with serious mental illness. Some people decide after an event to take their medicine every single day no matter what. I don't know your kid, only you know your kid.

Do communicate with your child, and the treatment team and be a support for your child. Encourage them. Their mental illness is not in their control. It is hard to be a teenager. It is even harder to be a teenager with mental illness. There is alot going on. Ask your treatment team if there are skills that they can work on now, helping your teen have strong emotional support from family and friends is very important.

There are lots of different groups, skills and things people can be doing to improve their mental health. Identifying when a crisis is brewing is an important skill, to look for resources before things get to crisis levels. Try to ask what might be available for them that's a good option for where they are at right now.
posted by AlexiaSky at 7:36 AM on February 12 [15 favorites]

Peer support could be a really good option if that's something that's available. If the teen in question is feeling isolated/alone/different/weird in some way because of their diagnosis, it could be really helpful to have regular contact with other people in the same boat.

But yes, a lot depends on why. A philosophical opposition to meds is one thing and "these particular meds make me feel like shit" is something very different. Likewise "I'm not willing to engage in managing my bipolar symptoms at all" vs "I'm willing to do ABC but not XYZ." I'm guessing you're just frazzled and frustrated and didn't think to include those details, but if you actually don't know what the teen's concerns are, you're not listening enough and your current job is to listen, ask questions, and make sure the treatment team is in place and is doing the same.

It'll come up if this thread goes on long enough so I'll just go ahead now and say that I Am Not Sick, I Don't Need Help is the canonical recommendation that you're going to get in NAMI or other support groups. I read part of it many years ago and remembered feeling like it was a weird mix of 'stuff that was too common sense to need to read about' and 'weird characterization of people with mental illness.' But I may be mischaracterizing it, and also my resource needs as someone many years into providing support for an adult with bipolar disorder are probably pretty different from yours as a parent of a teen with a presumably-recent diagnosis. So it may be worth picking up for a look.
posted by Stacey at 7:52 AM on February 12 [1 favorite]

Just a note: "BPD" is usually used as an abbreviation for "Borderline Personality Disorder".
posted by Tell Me No Lies at 8:14 AM on February 12 [8 favorites]

If she's not taking the meds due to intolerable-to-her side effects, that is a legitimate choice and she needs to work with a psychiatrist to find meds whose side effects she CAN tolerate.
posted by Murderbot at 8:30 AM on February 12 [4 favorites]

Also: the graphic novel Marbles is about a woman with bipolar 2 and her journey with therapy and medication. It talks honestly about the side effects of meds and the fact that finding the right meds can take a while, and also talks honestly about the risk of NOT taking meds - each manic episode increases the risk of another manic episode.

"Cartoonist Ellen Forney explores the relationship between "crazy" and "creative" in this graphic memoir of her bipolar disorder, woven with stories of famous bipolar artists and writers.

Shortly before her thirtieth birthday, Forney was diagnosed with bipolar disorder. Flagrantly manic and terrified that medications would cause her to lose creativity, she began a years-long struggle to find mental stability while retaining her passions and creativity.

Searching to make sense of the popular concept of the crazy artist, she finds inspiration from the lives and work of other artists and writers who suffered from mood disorders, including Vincent van Gogh, Georgia O'Keeffe, William Styron, and Sylvia Plath. She also researches the clinical aspects of bipolar disorder, including the strengths and limitations of various treatments and medications, and what studies tell us about the conundrum of attempting to "cure" an otherwise brilliant mind.

Darkly funny and intensely personal, Forney's memoir provides a visceral glimpse into the effects of a mood disorder on an artist's work, as she shares her own story through bold black-and-white images and evocative prose."
posted by Murderbot at 8:33 AM on February 12 [6 favorites]

The sequel to Marbles is Rock Steady and it’s about coping with bipolar as welll.
posted by bq at 9:06 AM on February 12 [1 favorite]

It's not clear when I became Bipolar II, but certainly Depression was an issue in my teens. I resolutely refused medication.

At the time I also refused recreational drugs, alcohol, caffeine -- basically anything I worried would affect my personality. I was just coming into myself and I wanted to live that without distortion. My peers were accumulating addictions major and minor -- I didn't want to be enslaved to the coffee maker first thing every morning -- and having my personality changed by drugs was a no go.

I remember thinking that if I ever went on anti-depressants I would be stuck, because coming off of them I would have sullied myself too much to live.

I had also fallen into the madness/genius trap that permeates our society. There is a serious confirmation bias in finding artists who were mentally ill -- the vast majority of artists were not and are not. But it's romantic and at that age you want romance.

So I had a fairly miserable teens and the twenties weren't so hot either. In retrospect I had developed Bipolar II by my early twenties, a fact that complicated things annoyingly -- Depression was now a misdiagnosis and thus a lot of things I tried of manage my mental health were pointless.

It wasn't until my late twenties that I had enough and dove into therapy with a view to sorting things out. I spent two years learning to manage my mental state and then, only after achieving stability on my own, did I say "Hey, this would be a lot easier with medication. Bring it on."

I don't know your teen but I suspect that last part will turn out to be important. Having experienced stability without the medication may let her take it.
posted by Tell Me No Lies at 9:16 AM on February 12 [3 favorites]

I was diagnosed (finally) with Bipolar 2 around age 16. I had had major episodes previous to that, but not the shit-hitting-the-fan one that got me the diagnosis.

I didn't want to take my meds because: 1) I was worried I would lose my creativity; 2) I was worried about stigma from peers; 3) some of them made me feel so sleepy I was like a zombie at school; and 4) Prozac made me unable to orgasm, which wasn't exactly taken seriously by ANYONE in my life as a good reason to not take it.

I then went off to college and stopped taking any psych meds.

It wasn't till rather recently (last 10 years) that I have gotten compliant and moved my life around and am really dealing with it.
posted by fiercecupcake at 11:24 AM on February 12 [1 favorite]

There can be a concern that taking meds takes away your “real” self. It helps me to think of it like wearing glasses. My “real” eyes don’t work so well. My glasses make my life better and I’m still really me. The meds help with my wonky brain chemistry and I’m still really me. Or diabetics taking insulin, same thing.
posted by kerf at 12:30 PM on February 12 [1 favorite]

Teen may have reasons that she is unable to articulate, or has not yet had the space to articulate.
posted by heatherlogan at 6:15 PM on February 12

"How do you manage BPD without meds? Is that even an option?" Daniel Siegel discusses this as part of a case study in his book 'Mindsight'. It's an early chapter so you would not have to read far. Robert Whitaker also looks at approaches to managing mental health without drugs in 'Anatomy of an Epidemic'. Whether you agree with the approaches or findings, it is worth reading them.
posted by Lilypod at 5:48 AM on February 13

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