Why do bipolar people stop taking meds, especially when medication is one of the best ways to treat bipolar disorder? I’ve stopped taking my bipolar medication before, and it wasn’t always with my doctor’s approval. Around 40–50% of people with bipolar disorder stop taking their meds at some point.
To other people, this may be hard to understand. If the medication is helping, why would you want to stop taking it? But the reasons why we stop taking meds are a lot more complicated than people think.
If you have bipolar disorder, you may relate with some of these reasons. If you love someone with bipolar disorder, this post may help you to understand us better.
Here are 10 of the biggest reasons why people with bipolar disorder stop taking their meds.
1. The Side Effects Can Be Hard to Live With
Let’s start with the side effects because this is one of the biggest reasons why we stop taking our meds.
Bipolar medications can cause mild side effects like tummy issues and sleepiness. But some meds cause side effects that feel almost worse than the disorder itself.
Depending on the medication, side effects can include:
- Nausea, constipation, diarrhea, and other stomach problems
- Dizziness
- Frequent urination and increased thirst
- Hand tremors or muscle twitching
- Brain fog
- Headaches
- Sleepiness and fatigue
- Weight gain
- Sexual side effects
Some psychiatric medications cause significant weight gain, heavy sedation, or make you feel like your emotions or personality are dulled. Others can cause more serious side effects like akathisia and tardive dyskinesia
Akathisia causes this intense sense of inner restlessness that can be hard to describe. You may feel like you have to keep moving or like you can’t sit still. It can be maddening and make you feel like you’re crawling out of your skin.
Tardive dyskinesia can cause involuntary movements such as lip smacking, grimacing, tongue movements, or other repetitive movements. Some people will continue having tardive dyskinesia even after the medication is stopped.
Some side effects are tolerable, but if you’re dealing with some of the more serious ones, you might decide to stop taking them.
2. The Medication Works So Well You Think You Don’t Need It
Sometimes bipolar medications work so well that you start wondering whether you actually need them anymore. When you start taking medication, your moods get more stable. After a while, if you haven’t been manic or severely depressed, you may start thinking maybe I don’t really have bipolar disorder. Or maybe my bipolar disorder wasn’t actually that bad, so I don’t really need medication anymore.
The problem with this logic is that the medications may be exactly why you’re doing so well. Once you stop taking them, your symptoms usually return. When they do, you may not have the same clarity, so you might not even realize you are having symptoms again.
3. We Want to Feel “Normal”
There is still a huge stigma around mental illness. Taking medication every day can become a constant reminder that you have bipolar disorder. Even if nobody else is judging you for it, you may judge yourself.
Sometimes we just don’t want to have bipolar disorder. If we stop taking medication, we can pretend that we don’t have it.
Going off medication can even feel like reclaiming your identity. It can be a way for your to go back to being the person you were before your diagnosis, before the meds, and before bipolar disorder became part of how you feel about yourself.
Unfortunately, not taking medication doesn’t make your bipolar disorder disappear. You might convince yourself that you don’t have bipolar disorder anymore, but this may not last long.
4. We Miss Mania or Hypomania
This one can be especially frustrating for family members who know what you’re like during mania. But some people with bipolar disorder actually miss being manic or hypomanic.
Mania isn’t always a miserable experience for us, especially in the beginning. Hypomania can actually feel really good. We have more energy. We may feel more confident, productive, or creative. When we’re manic, we can feel capable of doing just about anything.
And if you’ve experienced long periods of bipolar depression, mania or hypomania can feel like an incredible relief. Without the hypomania, you may start to think your personality has disappeared, like you’re not the same person anymore.
You may worry that you’ve lost your creativity or that the medication has taken away part of what makes you you. I’ve experienced this myself. I’m a very creative person, and I’ve taken medications that made me feel completely dulled.
But taking meds doesn’t mean you have to choose between stability and having a personality. Sometimes your body just needs time to adjust to the meds.
If you’re feeling emotionally flat or like your meds have dulled you, that’s something you should talk about with your doctor.
5. Bipolar Medication Can Be Expensive
Cost may not be the main reason people stop taking bipolar medication, but it can definitely be a factor. Many older psychiatric medications are relatively inexpensive. Some newer medications can be extremely expensive, especially without good insurance coverage.
And medication isn’t the only expense. Depending on what you’re taking, you may also need regular doctor appointments, blood tests, or other monitoring.
Then there are insurance problems and prior authorizations, which can be a pain in the butt even when you’re doing everything you’re supposed to do.
If cost is making it difficult to stay on your medication, ask your doctor whether there is a less expensive alternative or whether you qualify for a patient assistance program.
6. We Want a Natural Treatment Instead
I have done this myself. Some people don’t like the idea of taking a medication that affects their brain. Others don’t trust pharmaceutical companies or would simply prefer to manage their condition naturally if possible.
Wanting a natural approach doesn’t automatically mean someone is anti-medication. I’ve followed the ketogenic diet for years. For the first several years following the ketogenic diet, I didn’t really need psychiatric medication to manage my bipolar disorder.
But I eventually went back on lithium because the keto diet wasn’t enough to control my symptoms. I currently take medication along with following the ketogenic diet, and that combination has worked best for me.
Whatever approach you choose, stopping psychiatric medication suddenly can be dangerous. Many medications need to be gradually reduced or tapered, and stopping suddenly can cause a rebound effect that sometimes makes your symptoms worse.
If you’re considering going off a bipolar medication, it’s much safer to talk to your doctor about how you feel. I have tapered off my meds before. There are doctors who will listen to your concerns and help you.
7. Weight Gain Can Be a Huge Problem
This is a big, fat reason people stop taking bipolar meds. Weight gain from psychiatric medication is a big deal for many of us. It shouldn’t be brushed aside just because your mania is under control.
I’ve personally gained a significant amount of weight from some of the antipsychotic medications I’ve taken. Certain medications can increase your appetite or slow down your metabolism. Sedation and fatigue can also make it harder to stay active. And gaining a large amount of weight can affect your physical health, how you feel about yourself, and your quality of life.
If you’ve gained weight because of a medication, talk to your doctor before simply stopping it. There may be another medication that has less effect on weight or other ways to address the metabolic side effects.
8. The Medication Makes Us Feel Like a Zombie
There’s a difference between feeling emotionally stable and feeling like you’re a zombie inside. Some medications can make people extremely sleepy or emotionally flat.
I’ve taken medications that made me sleep around 13 hours. I’d still wake up feeling completely zonked out. Sure, your moods might be more stable, but you might feel like you’re barely existing. Some meds can make you feel numb, slowed down, or disconnected.
Nobody wants to live like that, so it isn’t surprising that people start thinking about stopping the medication. There are other options, so talk to your doctor about how your meds make you feel.
Sometimes the Medication Doesn’t Work
This reason doesn’t get talked about enough. Sometimes people stop taking bipolar medication because the medication simply isn’t working for them.
Finding the right treatment for bipolar disorder can involve a lot of trial and error. One medication may help mania but do very little for depression. Another may cause side effects you can’t tolerate. Some people go through multiple medications without finding one that really controls their symptoms.
This was one of the reasons I became interested in the ketogenic diet. At one point, I was rapid cycling while taking multiple psychiatric medications. I was desperate to find something that worked better for me.
My treatment has changed over the years, but starting the ketogenic diet was one of the best things I have done for managing my disorder. I currently take lithium along with following a ketogenic diet. That combination has worked best for me.
So if someone tells you, “My meds don’t work,” they aren’t always making up excuses or being non-compliant. Sometimes their medications need to be reevaluated.
10. Partners or Family Members Pressure Us to Stop
People often assume that when someone with bipolar disorder stops taking medication, everyone around them is desperately trying to convince them to stay on it. That’s not always true. Sometimes partners, relatives, or friends are the ones encouraging someone to stop.
They may believe the person doesn’t really have bipolar disorder. They may think natural treatments are better. They may dislike how the medication affects the person’s personality. They may even miss the manic or hypomanic version of that person.
Sometimes family members don’t want someone they love to have a psychiatric diagnosis at all. If they don’t accept the diagnosis, they may also question why that person needs medication.
That’s why decisions about bipolar treatment should ultimately be made between you and the mental health professionals treating you and not based on pressure from other people.
So, Why Do Bipolar People Stop Taking Meds?
There isn’t one simple answer. People with bipolar disorder may stop taking medication because of side effects, weight gain, emotional blunting, cost, stigma, a desire for natural treatments, pressure from other people, or because the medication doesn’t seem to be working.
Sometimes we stop because we’re feeling so good that we convince ourselves we don’t need treatment anymore. And sometimes we simply miss parts of ourselves that we associate with mania or hypomania.
Medication has helped me. But it took me years to accept that I had bipolar disorder and needed medication to manage it. The side effects we experience are real, and I think we can acknowledge those problems while also understanding that we need medications to be stable.
If you’re struggling with your medication, you don’t have to tolerate a treatment that makes you miserable. Talk to your doctor about what you’re experiencing and how you feel.
If you’re thinking about stopping a bipolar medication, make sure you involve your doctor in that decision. I know it can be uncomfortable to talk about, but stopping a medication suddenly can cause a relapse. If this is what you truly want, your doctor may help you taper off your meds more safely.
I am not pushy about medication, but for me, it’s made an enormous difference in my stability and my life. The goal is to find a treatment that works for you and helps you create the life you actually want to live.
So if you have bipolar disorder, have you ever stopped taking your meds?
